So, Now What?

11- From Scarcity to Creativity: Transform Your Private Practice When You Have Zero Clients

• angela tam

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In this episode of the 'So Now What Podcast,' we delve into the unique experiences and challenges faced by mental health therapists of color who are adult children of immigrants. The focus is on navigating the downward spiral when new client referrals dry up. We discuss practical steps such as creating budgets, exploring side incomes, and leveraging community support. The episode also explores the concept of viewing your business as a living entity with its own spirit and intelligence, encouraging therapists to embrace creativity, openness, and play during uncertain times. Join us as we redefine what it means to thrive and support mental health professionals in these complex spaces. Tune in and let's navigate this journey together!

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SPEAKER_00:

Hey, this is the So Now What podcast. And I'm so glad you're joining me in this another episode of this podcast series that I'm making for mental health therapists of color, specifically for those who identify as adult children of immigrants. And there are not many of us, which I feel so privileged to be one of them and to work with so many adult children of immigrant mental health therapists. And we provide a huge edge in the industry because we have lived experience of what it's like to care for not only ourselves, but our families. And we have been born sometimes from a collectivistic mindset, collectivistic family. And there are incredible heirlooms and gifts that come with that. Of course, there's a lot of trauma and a lot of issues, but I love working with mental health therapists who identify as second or third gen or even first-gen adult children of immigrants. And some of the things that I want to discuss in this series specifically relate to that population, but also can relate to anyone. The topic that I want to explore today is the topic of the downward spiral that happens when we have no new client referrals coming in. And in the northern hemisphere, it is no longer the summer. And that could be a huge relief to a lot of folks who are experiencing the summer slump, which I talked about in the last podcast around how there's literally no one knocking on your door, no new client referrals, no new consultations, and you're putting yourself out there. You're probably on all the directories, you're updating your website, you're networking with other therapists, and you're noticing I'm not getting any referrals. People usually hit me up and they're not hitting me up. So what is going on there? It's the fall. Maybe there's a sense of anticipation related to potential referrals coming in, but some things have changed in your practice. Maybe you left some kind of group practice co-op where you relied on them for referrals. Andor you used to rely on them for using their insurance umbrella, but now you're on your own. And maybe you're transitioning to another group practice umbrella where you can use their insurance, but you're only taking one insurance now, or you're taking no insurance and you're really fully cash pay and out of network, and you're not fully licensed yet. So you can't get paneled on your own, but you don't also want to go back to a group practice. That is a tricky situation. You could easily find yourself getting nervous, overwhelmed, and vacillate between apathy and panic, and noticing your checking account or your savings dwindle because maybe expenses are going out quicker than income is coming in. And maybe you'll hear yourself saying, Oh my gosh, maybe I did make a mistake. I shouldn't have left that group practice, even though I had to give them such a big cut of my procession fees, or maybe I have to give them such a big monthly payment every month to use their insurance coverage. Maybe I shouldn't be self-employed. Maybe I should be a W-2 employee. I regret being in a big group, leaving my big group practice, but I really didn't want to give them a huge chunk of my income. It's just so important to pause here and acknowledge that these feelings are real, that they are so valid, and it doesn't mean that you're failing. It means that you're human, that you want to move towards having more income, and that's okay. That doesn't make you greedy or selfish. It means that you're a person who has needs and you're wanting to move towards those needs. Naming and reflection, reflecting on all these emotions is the first step towards that transformation. Now, here is what I want to invite you to consider. What if this difficult season is actually a window or an opportunity to discover new parts of yourself, to play around, to be creative, to practice self-discovery. Yes, these times are so uncertain, but you carry creativity and courage that's helped you and your ancestors face the unknown with openness. It isn't rare in your ancestral lineage, because most of you are adult children of immigrants that have parents who emigrated from different continents, how they came over here maybe a few decades ago, maybe a few generations ago, with a lot of uncertainty. Our ancestors are really good with creating something out of nothing. In some ways, they are magicians, they've made something happen from sheer grit and will. That's not something you want to do. But maybe this is an opportunity to redefine what it means to use this time of uncertainty to play a little to see what can happen on the other side. In 2019, I opened an additional office adjacent to the office that I was in previously for a few years, and I had dumped a lot of money into the renovations, about$50,000. And they weren't there is money that was very precious to me, and I was having a lot of cold feet already because of my immigrant mentality around scarcity and gambling into and investing in myself. I just didn't want to understandably so lose out on income, right? So I really hustled and I made the renovations work, even though I was shaking my boots, because again, we as immigrants don't usually invest in ourselves without a lot of certainty. So I put a lot of money into the renovations, and then when I was done around Christmas time, COVID happened, and I wasn't able to fill my office for many months, if not years. So I was stuck holding the lease for the office for an indefinite period of time without anyone coming in. People were pulling out. I had a full office next door with a lot of renters, but they were all pulling out. They were like, nope, COVID is happening and I'm not meeting anyone in person. And my old office space and my new office space, which I dumped a lot of money into, was sitting empty and I was panicking. I was thinking, oh my gosh, I how am I gonna pay these bills? And thankfully, a lot of new clients were knocking at my door around 2020 because the BLM stuff was going on and they wanted to process racial trauma, which is a lot of my specialty right now in my private practice, but also back then. And the problem with that was I had decided to homeschool my kids. So I wanted to put my energy in homeschooling and not in growing my private practice. And so at that time, I actually refused a lot of my new clients coming in so that I could homeschool, but it came at the detriment of my bills. And I was scared. I was scared about what to do. And so I remember at that time panicking, but also in my moments where I wasn't panicking, I was trying really hard to meditate. I was trying really hard to daydream. I was trying really hard to just linger in this moment of uncertainty and tried to hold steadfast. And I did all my coping mechanisms. I moved my body, I took walks, I connected with friends, I deepened my connections with my partner. I putzed around. I just played a little bit, played with ideas. I signed up to be an Uber driver temporarily, but my paperwork didn't go through. And I knew I just needed to calmly move through the creative process of finding a new solution of how to use this office space when nobody was going for in-person appointments. So in my daydreaming, and maybe it was my night dreaming as well, I was laying in bed, and in a moment of silence, an idea came to me. It was, I remember so clearly around the time of day, it was like maybe in the morning time right before I woke up, or in the evening time, right before I went to bed. But either way, I woke up thinking, oh my gosh, an idea came to me. I can rent out my mailbox as a virtual address to folks who are working from home. And I could allow them to put it on their marketing, put it on their directory profiles, on their websites, business cards, and they could receive mail at my brick and mortar therapy office, and they could use the therapy office as a backup space. And the idea took off, and I had so many people sign up for this service, and that definitely was able to cover my rent for a season and help me to break even at least. And I was so grateful for that idea, and how I was able to sit with it and just allow it to come to me as an open vessel. So for me, that was really helpful financially, and it helped me to just stay with my clients and not add to my client load while not going into debt. And so for that time, it worked. For you, you might not be in my situation, you might not need office space or might not have another business where you can tap into to optimize your income. For you, you might just have your private practice and that's it. What can you do if that's the case and you're not able to have any people come in to add on to your private practice income? There's no clients coming in, there's no one that you could really tap into to optimize your income. I want to invite you to consider this first. Start with creating a budget that honors your needs. Explore short-term side income and look into community support resources. Why is that really important? It's because financial security is different from having your basic needs met. And when your basic needs are not met, our nervous systems spin out of control and don't allow us to go beyond survival if we are truly in survival. So our nervous system is not built to live and flirt with being increasingly in debt or to not have enough money to put food on the table. It it starts our nervous system, it starts to go wild when we don't have those basic things in place. So having those basic things in place might mean that you might need to be an Uber driver part-time, need to take on part-time nannying work, or asking your neighbors if you could be the housekeeper or household manager or dog walker, or taking a side hustle income during this time to make ends meet. Something that is pretty quick. They could sign up for pretty quickly and watch money come in. It might not be a lot of money, but it's enough to at least give your nervous system and you a sense of, okay, I'm not in survival mode. I can feed myself, I can pay rent, I can pay my mortgage, I can pay my car payments, and the minimum amount of educational loan repayment payments I need in order to make it through the season. So whenever you make a budget that honors your needs, including not getting into debt and paying back debt, you can then figure out the number monetarily that you need to get through the season on a basic level without adding new clients in. So let's say you have an expense that adds up to your car payments, your rents, your educational loan repayments, your utilities, and your cell phone bills included. Maybe that adds up to about, I don't know,$3,000 a month. That's modest. So I'm being super, super conservative here. And this might be not realistic for Seattle folks or New York City folks or San Francisco folks. Maybe it's a little bit more. Make sure your side income, let's say you do Uber driving or you work at Starbucks or whatever it is, Target, Trader Joe's, make sure that money covers that first. And allow yourself to be consistent with that for a few months. That might be scary and that might not be the advice that you thought I would give you, but sometimes that is important just to stay afloat and to not have your nervous system spinning because you don't want to go into debt in this season. Building a private practice and inviting private paid clients in takes time. And by having a side income, and maybe a main income that apart from your therapy practice puts less pressure on your business to provide for you and to pay for your bills. And the other thing is to not overdo it. Maintain some hours during the day where you can work towards marketing your private practice, you can work on giving yourself opportunities to get social contact and social time in to take care of yourself. This is a great time to invite folks that you trust to be transparent with them about your financial concerns. Hiding your financial concerns only adds to the weight of stress. And this is a really tough component for adult children of immigrants because our culture doesn't value vulnerability. Our family culture doesn't value financial vulnerability. It can bring up a lot of shame for people to say that they're struggling financially. And sharing with trusted friends can be a lifeline. It was a lifeline for me. I know that for me, being transparent with my friends about how I was struggling was huge. And I was met with a lot of compassion. And I knew my friends who I shared it with wouldn't give me unsolicited advice. And that was extremely relieving to me. And the second thing is streamlining your practice management and your client outreach. Maybe that means signing up for automated scheduling, updating your website, and reaching out to your referral networks, letting them know that you are accepting new clients. It's sometimes can be really disappointing to consider these options because this is not what you signed up for. You signed up to be a private practice therapist. You didn't sign up to work at Trader Joe's. You didn't sign up to put emails out there to tell people that you are taking referrals. You maybe expected or wanted to just have referrals come to you and have it be streamlined. When sometimes it really isn't. But this is where I feel like creativity and play can have an opportunity to take up space in your life. This is what I was talking about before, where this time of blankness, of maybe having a lot of extra free time, maybe not a lot of free energy, but a lot of free time is where the magic happens. The reality is that your private practice clients won't come to you solely based on being on directories or even networking with other therapists. And what I would call, this is not what I actually, I don't want to give credit to myself, but my business coach would call the spirit of your community, your spirit of your business. For me, hearing about how my coach has described the spirit of your business, spirit of my business has been extremely free. What is the spirit of our business spirit of our business is the idea that our business has their own intelligence, our business has their own aliveness. Our spirit is the spirit of our business is something to be regarded as their own entity that goes and comes as they wishes and has ideas and seeks to be working in our best interests. It seeks to look out for us, it seeks to allow us to partner with them for the betterment and the flourishing of the world. But it's not there to serve me. It's actually there to serve the world. And that feels extremely relieving to know that I'm not doing it alone, but also that my ancestors can partner with me in this and my spirit guides. For me, I am, I do consider myself a progressive Christian, I'm an ex-evangelical, and I do believe that my spirit guides partner with me in my business for the flourishment of this world. And in me partnering with my spirit of business, if I communicate with them, if I am open to them, if I am willing to spend time with it and love on them, not like a slot machine kind of relationship where I'm putting and investing resources, pulling the slot machine and then hoping that they'll pay my bills or hoping that they'll give me something, but actually approaching them like they are someone to be respected, that they don't exist to serve us or pay our bills, but they exist just because they love us, and when we cultivate them, they grow into their own maturity and one day maybe can end up giving us money. But that's not something that they're obliged to do, the spirit of business. But sometimes they might want to do, and that's not always a guarantee, and that's not something I continue to expect from them. Now some of you might be wondering, why would I not expect my business to give me money? That just feels extremely unintelligent. I opened up my business so that it could pay my bills, so that it could feed my children, so that it could give me a good quality of life. And the reality is that we can't force our business to do what we want it to do. That is the reality. We can't force anyone to do what we want to do, let alone our business. And you can do all the right things and still not get the outcome that you want. And if we do our things that we need to do for our business with a sense of urgency and with a sense of attachment to a certain outcome or agenda, and with the undercurrent of the fear of scarcity, our recipients will sniff it out and will not be drawn to you in your business. And not only that, you'll be so depleted and burned out. I wanted to introduce to you. And they look for vessels that these spirit of ideas look for vessels to plant themselves in and to perhaps grow and flourish in. And these vessels carry out the ideas that these spirits want to put out in the world. How does that relate to private practice therapists, owners, and our business? Sometimes the way that we market our business is a way to show community care and also a way to use our creativity, also a way to play. In our marketing for our businesses, we use a lot of writing, we use a lot of podcasting, maybe long and short-firm content making. And some of that comes from, I believe, magical spirits that travel to and from people with ideas. They're not just ideas related to marketing, although that's what I'm specifically talking about right now, but they could be ideas related to your business in general. So maybe you had an idea around your private practice and you thought, oh, I want to do my private practice this way. I want to serve this population, I want to do my marketing in this way. This is how I want to earn money. These are the ways that I expect my private business, my private practice business to run. Well, what if the spirit of ideas has a different idea about how you they want you to run your private practice? Maybe they want you to do an all-virtual private practice. And funny enough, before the pandemic happened, I had a daydream that I really wanted to do just virtual sessions and not do in-person work. And I was following these people at that time in 2018 and 17 when they were doing this, they were all doing virtual therapy. It was so not a thing. And people thought it was weird to do just virtual therapy. And now that's the default, right? Because of the pandemic, and because of how people have moved away from in-person work to virtual therapy. And so at that time it was nut so thinking to do all virtual work. But I had that idea before the pandemic happened. And when the pandemic happened, it was such a relief to my nervous system to do all virtual work as an ADHDer. And now I am toying with many ideas that seem ridiculous. I really want to branch out and to do more consultation work and coaching work. I want to run groups in the future for therapists who are in this, who's in the space of not having any clients come in or who are in like a stagnation period in their private practice. And I have other ideas too, I have many ideas because I have ADHD and many ideas come and go. But what if we just sat with possible new spirits that might bring ideas on how they might shape our private practice? And some of them might be out of this world, some of them might be really hard to entertain, some of them might be ideas that are seemingly impossible or don't make any financial sense. Those things might be true. And a lot of us thought that kids should die before the age of five, before vaccines were invented. And when vaccines were invented, it blew everyone's mind because a lot of people thought it was God's will that kids died before age five, and that no longer was something that is a norm now. And people stopped believing that it was perhaps God's will, and maybe it's just a matter of people dreaming big dreams and stepping into impossibilities that result in these seemingly normal. Things that we take for granted now, but before were only ideas and seemingly impossible, magical thinking. But I want to invite you to that. I want to invite you to not be afraid of periods of uncertainty, periods of extreme instability, and periods of scarcity because our immigrant forefathers and parents and ancestors, four mothers lived in the space of uncertainty and also thrived. Some of them did not thrive, and that's okay. But we have different options that they don't have. This is all devil talk. Fine. That's totally fine. Just disregard everything I'm saying. ADHDers, let me tell you, we are gifted and we're very creative. And what we do have is just a million and one ideas. And some things that ADHDers do tend to do is be flooded with ideas and we don't really follow through with any of them. But what we're good at is being really open to ideas and being curious about ideas and just entertaining ideas. And some might argue, like my partner, that I entertain too many ideas and that I can't focus on one thing. That might be true, but that's not what I'm talking about. I think there's something here about just sitting and playing and finding safety in our daydreaming. When we nurture our business, when we talk to our business, when we love our business, when we respect our business, when we don't expect our business to pay our bills, then our business then just sees us as someone that's not using them, but sees someone that wants to partner with them and allows us to then be open to making magic happen and just seeing what happens on the other end with no attachment to an outcome. And maybe we dedicate ourselves to an idea that brings us aliveness. And when we move towards our aliveness, I think that's when we can really contribute to social flourishment. When we are most alive and we use our aliveness to serve the universe, to serve humanity, it really does bring a lot of flourishing to the world. How do we do this in the day-to-day? This sounds really abstract, Angela, is what some of you might be saying. How do we do this in the day-to-day? And some things that I want to start you off with is to notice how you feel towards your business. Is there a sense of openness? Is there a sense of courageousness? Is there a sense of compassion? Is there a sense of curiosity? Or do you feel stressed, overwhelmed, discouraged, unhappy, unworthy, confused? Maybe you feel confused and curious. Maybe you feel stressed and open. That's okay. But just notice if there's access to curiosity and compassion and openness as you allow your stressful feelings, overwhelmed, discouraged, unhappy, unworthy, confused feelings to step back a little bit. And this is where we can approach your business with some self-energy. And that self-energy and access to curiosity and compassion will allow you to start building a relationship with your business. This energy will help you access your inner steadfast serene strength. This grounded resolve. And the state of being that this is called is steadfastness. It's this grounded determination that conveys a sense of balance of mind even under stress. It's holding steady in the storm with grounded confidence. How do you cultivate that when you don't have it? How do you do it when there's nothing but distress and scarcity fears and a sense of panic? First of all, get that job that will pay your expenses. Work at Trader Drows. There's nothing too humble that we can't do. Elizabeth Gilbert talks about in her book how she in The Big Magic, how she weighted tables at a bar for years before she wrote her any anything that made her any money. And that's the case with a lot of writers and artists and actors and actresses. They work menial jobs before they get their big breaks. And some of them never get their big breaks. But part of that means you probably need a place to work where you can pay your bills. That's number one. Number two is being community with a trusted mentor and trusted peers that allow you to unmask fully and unravel. That is a huge asset in this period where you are going through so many changes and really want more support, more certain, more love, more validation. But that goes against everything that we've been taught as adult children of immigrants, which is we just need to keep that support tight and not tell anyone that we're having a hard time. And when it's all said and done, then we can tell people that we did have a hard time, but let's not tell people right now because you don't want to burden them. I would invite you to work with that hyper-independence that has been programmed in you with a mentor, with a trusted mentor. And that's something that I do with therapists all the time. And I feel like what's really important is that therapists that understand other therapists, especially therapists who are second gen or adult children of immigrants, that we you work with someone that really gets you in these burdens that you've inherited collectively, cultural burdens and legacy burdens. And cultivating steadfastness doesn't just involve mindful breathing, breathing, body scans, five-minute walks, journaling, listening to podcasts, all that stuff. But once you find a routine that involves some of those elements and you do it on a regular basis, they will make a difference. The stacking of that really does make a difference. And the truth of the matter is that scarcity feels heavier in isolation. And that's where community comes in and resilience multiplies. Connect yourself with other therapists that get it, other therapists that get why you are doing what you're doing and share your values around maybe seeing insurance and accepting EIPs, not as a failure, but as a means to an end, as a means to getting some stability and security before you ultimately have your end goal, which is to have a cash pay private practice. And maybe that isn't even your end goal. Maybe you want to do course creation. Maybe you want to write a book. Maybe you want to be a speaker, maybe you want to be the executive director of a nonprofit that specializes in mental health. Whatever it is, surround yourself with therapists that get it and community that gets it. Meet with folks who do not give you unsolicited advice, but will be able to send you a lot of compassion and allow you to process freely with a sense of deep understanding that you are in a tough and vulnerable place. And then work with yourself, have conversations with yourself, and maybe with a trusted mentor like me, where you can map out a marketing plan. Because the reality is that if you want a private practice where clients are coming in to find you consistently that are really well aligned, you do need to be findable. You need to be highly visible and not just on directories, but where they could build a sense of trust with you, where they could binge watch your material, binge read your material long and short form content-wise, and really see who you are before they hire you. A lot of people don't hire other therapists or coaches for over a year and a half before they've observed them from a distance. And when you do your marketing, that is an outlet for people to observe you from a distance, for people to pre-vet you before they actually hire you. And that means that there needs to be some strategies with marketing that come from an internal alignment. And so part of that means getting on therapist directories, being findable, networking in person and virtually with other therapists. And maybe the next phase out includes some creativities for working with people who are adjacent to the therapy fields, other health practitioners, or even going third level out, which is working and networking with non-adjacent fields, like the legal field or the tech field, or the hospitality field to do your marketing. Or this could be skipped entirely, and your marketing could be done virtually through social media like TikTok, Instagram, Twitter, Substack, podcasting, long and short form content creation. And this is where we would work together to really hone in on what is ultimately fun for you. Remember, marketing and cultivating your private practice relating to your spirit or business is really meant to be fun. It's really meant to be a creative process where you harness your inner artistry and you play around. You throw some colors on the paintboard and you make something that expresses your inner values, that expresses your intentions, that invites people in to a journey of healing. And I put that in quotes because we're not allowed to like really give therapy publicly, but there are some ways where you can showcase your skills for others virtually before people hire you so they could see you. It's a way to practice mutual aid and it's a way to contribute towards the flourishing of others and to make the world, to leave the world a little better than you came through your marketing efforts. And a bonus would be perhaps that you would get clients out of it. So I would love to hear what you think of this podcast session, especially from those who are in a rut right now with their client caseload and they're not getting a lot of clients. And let me know what you think. I would love to receive your DMs, and there's a link to share your thoughts with me. Or you could leave a review in wherever you subscribe to your podcast. And I look forward to talking to you next time. I'm so grateful you tuned in. Bye.