We restructured our practice model to create a space for professional people to support health, wellness, research, and educational pursuits.
Lessons Learned and Growing Pains A founding concept of the practice was to support both therapists and clients; we clearly had not reached that goal. The process of provider and recipient of therapy was multi-faceted and necessary to promote therapist wellness and reduce burnout. The progression included separating administrative work from clinical duties, and providing a high level of support for both administrative and clinical staff, all while creating sustainability. The organization secured funding to restructure compensation to a salary-based model, doubled the size of the clinic, doubled the number of clinicians, and brought on a full array of administrative staff. The amount of money needed was plan showing mathematical long-term viability was required, along with dogged persistence. Many unpaid hours of work were required of the owners to secure this type of funding; it is not for the faint of heart.
Building a corporation is a lot of work, and the primary reason why so many clinics operate on variations of the productivity compensation model is because the single largest overhead cost for most clinics is payroll. The previous model did not have this payroll concern because if the money wasn’t generated by the therapist, it did not have to be paid to the therapist. However, in a salaried model, the company must have months of salary in reserve to ensure sustainability. Using the salary model means the number of clients seen does not determine clinician stress. It also means the company is responsible for ensuring there are enough clients to provide a steady income flow. This necessitated contacting all the major insurance companies to establish a means for contracting and credentialing clinical staff, thereby allowing clients to between clinical and administrative staff duties, eliminating the burden therapy from the business of healthcare to allow for both the clinician and the client to focus on wellness.
Structuring Supervision and Professional Growth The need to create a supervisory support process for quality and cases. Restructuring the business to a salary-based system required a plan for consistent supervisory oversight, guaranteeing an ongoing caseload balance to make budgetary sense for clinic programs. Ownership carries the weight of liability; the decisions clinicians make directly correlate with the owner’s malpractice and liability plan. This model includes the provides professional growth and support but reduces individual autonomy due to the application of a consistent set of protocols.
Supervision is recognized as an essential component of clinician education and training, for play therapists included, and provides an Establishing peer consultation groups without regard to independent ideas to mingle with proven practices in the supervisory process. The clinic contacted local university programs and offered graduate student intern positions, fostering teaching and learning as foundational aspects of the company. Supervision and consultation are considered highly valued to many clinicians and should be available throughout a career, as evidenced by its mention in the ethical guidelines for different Association of Social Workers, 2018).
Compassion fatigue is a syndrome comprising a
combination of symptoms due to secondary traumatic stress and professional burnout...
The clinic also sought to support professional growth of all clinicians multiple days of paid time off for training within the calendar year, in addition to vacation or sick leave. This time is designed to support the staff’s educational endeavors without detracting from their time training by providing funding for workshops and conferences through a loan program where therapist time and expertise is given back to the community as repayment. The dollar amount invested into the employee to train or attend conferences is tied to an expectation of not paying out-of-pocket for potentially expensive training, and the also have support from the organization for initial play therapy setup, including toys, materials, furniture, and artwork; the agency provides consumable supplies. The goal of this business model is to support management of compensation expectations.
Promoting Clinician Wellness Newell and MacNeil (2010) described the risks of providing care for those who experience trauma. Compassion fatigue is a syndrome comprising a combination of symptoms due to secondary traumatic stress and professional burnout (Newell & MacNeil, 2010). Therefore, this clinic monitors compassion fatigue and burnout to provide sustained quality in the therapy space. Our clinicians and care coordinators believe trauma stewardship is not simply an idea. It is a
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