“I haven’t seen a salaried therapist in a group practice paid fairly yet. I would love to see it. I would love to see it in the wild and know that it can be done and be done well.”
A practical audit of culture, contracts, and compensation—with Alicia Murray (The Therapist HQ).
Self-assessment time. For group practice owners: Do your internal systems align with the company’s client-facing messaging? For group practice employees: Is fear (of failure, of retaliation) holding you back from calling out harmful behaviors or leaving altogether?
There are a lot of exciting reasons to exit group practice––relocating, exploring new career opportunities, becoming a solo practitioner. Unfortunately, many therapists leave because the group practice that touted care and community in public fosters a culture of caseload creep and low compensation in private.
Group practices shouldn’t operate under a string of red flags.
Alicia Murray, LMHCD, is the creator of Therapist HQ, a digital platform for therapists ready to transition into entrepreneurship. I invited Alicia to discuss how group practice employees can protect themselves against extractive policies and how group practice owners can revamp their misaligned structures.
“I love helping therapists quit their jobs,” laughs Alicia. When she’s not working in her own group practice, Alicia coaches therapists in community mental health and, increasingly, group practice who want to reclaim their career autonomy. Group practice owners, she observes, have so much power. “We are the decision-makers, [yet] we’re so far removed that we’re making these really poor decisions and poor structures that are causing therapists to feel like they’re too afraid to leave.”
On the flip side, many therapists aren’t in touch with their own personal power. They tend to shrink when confronting (or confronted by) an owner or authoritative figure.
Creating sustainable group practices that work for everyone is challenging. Instead of focusing on all-or-nothing gamesmanship, Alicia urges both sides to welcome the discomfort of reshaping company culture, together. She recommends starting with calling out, then addressing these red-flag behaviors:
- Intimidation at any level in your practice by peers or the practice owner
- Valuing caseload quantity over quality of care
- An unbalanced ratio between private pay receipts and therapist compensation
- Lack of conversation around equitable benefits (ie, if your practice can’t cover health insurance, can they cover CEUs?)
Even the most green-flag-laden group practices aren’t immune to the cyclical nature of therapist retention. That said, great company cultures start with authentic conversations.
MENTIONED IN THIS EPISODE
NARM – NeuroAffective Relational Model
GUEST CONTACT & BIO
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Alicia Murray, LMHCD, based out of Syracuse, NY, is a group practice owner and consultant for therapists going into private practice. In-between sessions, you can find her binging TLC shows, spending time with her husband and two young children, or hitting up her favorite coffee shops and ice cream stands. Free resources for therapists are available here.
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