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Remediation vs Progressive Discipline Plan. What’s the Difference?

Posted on by drk8d

My last Back to School Post is about keeping your practice ship-shape.

If you are a LPC or LMFT supervisor with supervisees who see clients in your practice or agency, then you are constantly navigating the boundary between clinical and administrative supervision. As the supervisor you must address both, but how? The licensure codes specify you must remediate your interns, but how do you discipline them? How do you fire them if you feel they are no longer capable of delivering effective services?

The answer is twofold: You must have an effective remediation strategy for clinical issues, and a progressive discipline plan for administrative issues.

Remediation Plan

LPC (as of this writing): 681.93 (e) (4) If a supervisor determines that the LPC Intern may not have the counseling skills or competence to practice professional counseling under a regular license, the supervisor shall develop and implement a written plan for remediation of the LPC Intern.

LMFT (as of this writing): 801.143 (f) (4) If a supervisor determines that the LMFT Associate may not have the therapeutic skills or competence to practice marriage and family therapy under a regular license, the supervisor shall develop and implement a written plan for remediation of the LMFT Associate.

A good remediation plan:

  1. Defines the problem in specific, observable, behaviors. You can’t remediate ‘attitude’ or ‘flaky,’ but you can remediate ‘has forgotten to bring case notes four times in the last two months,’ and ‘takes phone calls and answers texts during supervision.’
  2. Identifies specific, measurable, attainable, realistic, trackable goals (SMART goals) with accountability dates. Here are some examples of remediation tasks:
    1. Intern must research the LPC rules regarding intern and supervisor liability and write a one page paper – Due March 3, 2016
    2. Associate must attend supervision one extra hour each week (at the supervisee’s expense) for a total of eight hours for the month of March – Due March 31, 2016
    3. Intern/Associate must refrain from cell phone use completely during supervision – Due immediately
  3. May contain a ‘strike 2’ clause if the supervisee struggles to complete the assignments by the specified due dates.
  4. Contains a paragraph stating that failure to complete the initial and ‘strike 2’ remediation assigments will result in termination of the supervisee relationship.

It is important to mention here that there are two preemptive steps to remediation that I have convered in other blogs: a supervision contract and a process of regular evaluation.

Progressive Discipline Plan

When you have interns or associates who work in your practice or agency, whether they are volunteers, W-2 employees, or some other designation, then you must have a system in place to monitor administrative issues. At achievebalance.org we have a discipline system that offers team members opportunities to correct problems before punishing them. Every year we hold a team-wide meeting to go over our policy and procedures manual (this is another blog post) which includes our Progressive Discipline Plan. Our plan consists of two parts:

  1. Immediate Disciplinary Action

We believe that engaging in certain types of misconduct should subject a professional to immediate suspension or discharge, rather than allowing opportunity for correction of behavior through progressive discipline steps. The following is a list of examples of conduct for which immediate disciplinary action will be taken:

  • Unethical behavior
  • Illegal behavior
  • Endangering a client
  1. Disciplinary Steps

Should there be a problem regarding the professional’s adherence to our rules, the professional will be given three opportunities to change the unwanted behavior:

  • The professional will be given a verbal explanation of the errant behavior, including a reiteration of what our rules are regarding that behavior. In addition, the professional will be advised of the consequences of further infractions of the rule in question. If no further problems occur regarding the issue raised at the verbal warning stage, no further disciplinary action will be taken.
  • If the problem persists, the professional will be given a written explanation of the errant behavior, including a reiteration of what our rules are regarding that behavior. In addition, the professional will be advised that continuation of the problem will lead to suspension or termination. As before, the professional will be given an opportunity to change the unwanted behavior and, if the behavior does not recur, no further disciplinary action will be taken.
  • If verbal and written warnings fail to bring about a change in the undesired conduct, the professional will be suspended and will be informed that further occurrences of the conduct will lead to the professional’s immediate discharge, without additional warnings.
  • We reserve the right to bypass the disciplinary steps and base our disciplinary action on the severity, frequency or combination of infractions when circumstances warrant immediate action.
  • We will document a disciplinary process beginning with the first verbal warning. A report of the disciplinary action will be retained in the professional’s personnel file. Should a challenge arise regarding the disciplinary action in the report, the report may be used in the ensuing grievance proceeding or arbitration.

Would you like more information about remediation, effective progressive discipline plans, evaluation procedures, or policy and procedure manuals? Keep checking our website for great resources!

 

 

 

Back to School Special: Don’t Forget to Achieve Balance

Posted on by drk8d

Fall is almost here and your practice is about to start booming! It’s time to make sure you have strategies in place to maintain a healthy work-life balance. This blog is about a few tactics that have been especially helpful to me over the years. In 2007 I had just finished a Ph.D., my husband was back from a recent mobilization with the US Army, I’d completed my last reconstruction surgery following a double mastectomy, and I was starting a business. Oh, and I had three kids under the age of 15. Success wasn’t an option unless I could also achieve balance; so I began my search for strategies and ideas to help.

Ten years later, after countless trips through the Google jungle, I have a huge collection of ‘Top 10 Strategies,’ and ‘Easy Life Hacks That Will Help.’’  Since I’m a strategic family therapist and I like to focus on what I can do rather than what I must stop, I took some of the most practical advice and ‘re-framed:’

Original advice: Let go of perfectionism

Kate’s re-frame: Put out the first draft and let the audience co-create

I can think of VERY few successful things I have created, developed, presented, implemented, or sold, that I felt was completely 100% perfect. Seeing everything as a first draft allowed me to produce my art and see my audience as collaborators. The result? I have some pretty cool products and some very amazing fans.

Original advice: Limit time wasting activities and people

Kate’s re-frame: Do five, 20-minute job sets every day

This is a game I play with myself using my phone timer (it’s also called Parkinson’s law of productivity). I set a twenty-minute timer and race the clock to see how much I can get done. Then I set the timer again and again until I have done five ‘sets.’ I rarely finish all five but my productivity skyrockets when I self-impose these deadlines.

Original advice: Re-structure your life (what does that even mean??)

Kate’s re-frame: Buy back your life.

A few things I have hired out: house cleaning, grocery shopping, meal delivery, cat litter delivery, toilet paper (all kinds of personal paper) delivery, driver’s ed., driving my kids, cooking, social media posting, SEO optimization, bookkeeping, accounting, and legal defending just to name a few. I want to try hiring an Uber once each week just to see what I can get done on my commute (I bet it is worth the $6.00 fare).

Original advice: Manage your time

Kate’s re-frame: Clock out.

Literally set an end time for your work every day. If you need to purchase an actual time/card punch to set on your counter, go for it.

Original advice: Manage your calendar

Kate’s re-frame: Make some friends

Did you know there are some people who stay busy with work because they are bored? These folks may be shy, introverted, scared, or socially anxious. They choose to be out of balance because it is easier than facing their issues. Surrounding myself with amazing friends and being an amazing friend are two of my goals for 2017.

Want more tips for achieving balance? Check out our Private Practice University for more resources.

Back to School Special: Answer the Phone

Posted on by drk8d

Today’s blog will be short and to the point.

Answer the phone.

The Summer doldrums are coming to an end and your client load is going to build steadily through the holidays. Clients will usually choose a counselor based on the following (not necessarily, but probably) in this order:

  1. Recommendation
  2. Specialty
  3. Which one calls back first
  4. Who can get them in quickly

I’ve talked about building a referral team who is passionate about your services and can show potential clients how to connect with you quickly and easily (see my blog: Back to School Special: Networking). If you are doing this consistently then your phone will ring. The question then becomes; will you be available to answer it?

Making the leap to hire someone can be scary. Allowing calls to go to voicemail can be scarier. I love to talk with counselors in private practice about my biggest mistakes but hiring a professional to answer our phones did much more than just increase our client loads at achievebalance.org. She streamlined our practice, improved client care, created an amazing client experience, and helped eliminate the client-therapist-money triangle.

Here’s what our phone answering professional at achievebalance.org does for us daily:

  • Collects credit card information to secure the first session
  • Utilizes a script which has increased client conversion rates for every therapist in our offices (measured by the number of phone calls who complete a first session)
  • Calls clients the day before (or Friday before) their session to confirm
  • Fills empty slots with wait-listed clients and clients needing to get in quickly
  • Calls late-cancels and no-shows to inform them they will be charged the full amount of their session using the credit card information on file
  • Follows up with past clients to see how they are doing

Still not convinced?

Imagine you decide to hire a professional for $9/hour. And let’s say to start, you want this person to work two hours in the morning and two hours in the afternoon Monday – Friday. That is $36 per day for five days or about $180 per week. If you are a cash-only therapist, this is probably close to what you charge for one session. One and one-half sessions would pay for one week of part-time professional phone-answering.

If your goal is to average 60 sessions per month at $140 per session, wouldn’t it be worth donating six of those sessions to pay for a part-time professional to answer your phones and KEEP your client roster at 60 sessions per month?

Watch for future video blogs when I share the intake script our phone answering professionals use. You can see a demonstration of our script on our DVD set Private Practice University.

Back to School Special: Networking

Posted on by drk8d

New business owners sometimes have a tough time networking. I remember when I used to sweat making a presentation to a group or talking with a chamber of commerce member over coffee because I thought I was recruiting a client. Certainly that is one way to build a practice, but what if the goal of networking is really to build a referral team? I recommend that instead of recruiting a client, you look at networking as building a posse of passionate advocates who can’t stop/won’t stop talking about how awesome you are to everyone they know in the community.

It’s easier than you think.

Do you remember the shampoo commercial from the 80s? The one where it was such a fabulous product that “you’ll tell two friends, and they’ll tell two friends, and they’ll tell two friends, and so on, and so on…”

It’s just like that; but instead of two people, I want you to tell ten.

There are lots of places where small groups of people meet to interact and learn from one another. Some examples are:

  • Your local Chamber of Commerce. These can be larger groups but you can usually find smaller committees to attend.
  • Toast Masters
  • School PTO and PTA meetings
  • Business Networking International (BNI)
  • Social media local special interest groups that meet in person

12 Seconds of Information

Most of us can only handle about twelve seconds of information before we start to think about how we want to respond or get anxious about the content (think about the last time you went to the doctor and she was explaining your next procedure). As anxiety goes up, cognition goes down. Simply put: your audience can’t remember and store important info about you if you talk too much.

Here’s a simple formula:

  1. Tell them your name
  2. Tell them what you do
  3. Excite their emotions
  4. Tell them how to talk about/connect their friends with amazing you
  5. Tell them your name again and give them a call to action

Sometimes this is called an elevator speech and maybe, back in the age of slow elevators, you had thirty seconds to make your pitch. I don’t know about you but I’ve been in some pretty fast elevators so I stick to my original premise: twelve seconds and no longer.

If you don’t have a phone number or a website stop reading and go get one. You must have a website, phone number or (ideally) a scheduling app that your audience can see on their phone. This is kind of like passing out your card by the way, without all the stone-age communication and dead trees.

Before I start my 12 seconds, I make sure my listener has a phone handy or I tell everyone in the group I’m addressing to get their phones out. I have my own phone or IPad handy with my app pulled up and ready to go. Our practice software Full Slate allows potential clients to self-schedule a 10 minute consultation utilizing a big orange square button placed prominently on the achievebalance.org website.

I don’t want you to leave this blog guessing so the following is exactly what I say and how I say it:

  1. “Hi I’m Dr. Kate Walker and…
  2. …my marriage and family therapy practice is achievebalance.org located in Market Street in The Woodlands.
  3. Everyone in this room knows someone who needs help with a marriage, a child, or a loved one. You feel weird telling them to go to a therapist.
  4. The achievebalance.org Orange Button makes it easy for struggling friends and loved ones to ask tough questions and get answers today, for FREE [I show them my phone/IPad with my orange app prominently displayed].
  5. I’m Dr. Kate Walker with achievebalance.org. Tell someone you love to push the orange button today.

Remember; you are not recruiting clients, you are building a referral team who is passionate about you and has an easy way to tell people they love how to connect with you. Stay tuned to katewalkertraining.com for the video blog where I describe this in more detail.

Taxes Aaaaagghhh!!

Posted on by drk8d

Why am I writing about taxes in July? Because it’s always a good time to talk about why it is important to set aside money to pay your federal taxes. Really. I promise.

One of my favorite mistakes I made as a new therapist was not setting aside money for taxes. I became a school teacher when I graduated from college, and before that I worked in restaurants and orchestras. I had no idea when I started my private practice that there was no ‘cosmic central office’ magically making sure I was putting aside money for taxes and retirement. So, my first year was a BIG surprise. Luckily I didn’t make much profit so it was a mistake I could, and did, recover from. In this blog I’m going to show you the charts, teach you the math, then give you a shortcut so taxes don’t become your big mistake.

The takeaway? You must always set aside money.Profit chart

First, let’s define profit. When you take money from your clients for counseling services, that is your income. When you write a check for rent, that is a business expense. Ideally your income will be greater than your expenses.

Breakeven chart

When your business makes just enough income to pay expenses, we say that it is ‘breaking even.’ There is no profit and so, you may not have any taxes to pay.

When you make income that exceeds the amount you need to pay your expenses, then you have made a profit. This is the amount that will be considered when you are figuring out how much to pay in taxes.

Here’s how you find your tax bracket and federal tax payments:

  1. Determine your profit (you just learned how to do that)
  2. Google ‘IRS tax bracket ______(insert year).’ Lots of helpful websites will pop up including the IRS site. I found this site really helpful for figuring out my tax bracket:

http://blog.taxact.com/how-tax-brackets-work/?utm_source=TaxACT&utm_medium=Tax-Bracket-Calculator&utm_campaign=Learn-More

 

  1. Determine your filing status (single, married, etc.) and add your partner’s profit/income (or not)
  2. Now do the math!

 

The US government has seven tax brackets. Your profit will probably fall over more than one bracket. Here are three of those seven for a single person in 2016:

Bracket 3. $37651 – $91150 = 25%

Bracket 2. $9276 – $37650 = 15%

Bracket 1. $0 – $9275 = 10%

As you can see, If you are single and your profit was $9000 last year then your tax bracket will be 10% and you will pay $900 in taxes. Easy peasy.

If you are single and you made $19,000 then we need to a little bit of math.

 

According to our chart above, if you made $19000 in profit, some of your profit falls in the 15% tax bracket and some of it falls int the 10%.

Here’s how it works:

10% of your first $9275 = $927.50

Subtract $9275 from $19000 and you get $9725. This is the amount in the 15% tax bracket.

15% of $9725 = $1458.75

$1458.75 + $927.5 = $2386.25 is what you will pay in taxes

or

about 13% of your profit.

My shortcut? I always put aside about 15% – 20% of my income every month. So for every $100 my clients pay me, I put $20 in a regular savings account. When I figure out my profit later on (remember, this will be lower than my income due to business expenses), I will be able to draw out enough to pay my taxes AND put money into a SEP IRA retirement plan. This lowers my taxes even more!

Sounds like another blog post to me….

 

 

 

 

 

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