We need new business models, new strategies to make a profit! NOW!
Do I have your attention? Good because we need to talk…..
I’m noticing a trend both here and on David Diana’s blog: Whenever I post a nice, safe article with helpful tips I get lots of traffic and comments. But when I post a “call to arms” article like, “You May Have the World’s Worst Business Model,” I get some comments (thanks to Rachel and Kathy), but it is much quieter around here.
Why is that? Maybe the idea that we need to do things differently feels uncomfortable?
I actually hope that is the case. I’m not sitting here writing these things on my own time to talk about safe stuff that you can read about on someone else’s marketing blog. Dudes (gender inclusive), things need to change. We are getting our butts kicked by Big Business. You know this, right? Managed care, big pharma, large conglomerates of hospitals and health care groups. They have lots of power, lots of money. You know this.
So what are we going to do about it?
The way I see it. We have four choices.
1. Feel helpless, complain, worry, do nothing and eventually reach a point where we can’t make a living in private practice. Unfortunately, I hear a lot of this and it makes me sad. We need to use our time more wisely.
2. Lobby your government representatives. Such a nice idea but…change takes so long, costs so much, frustrating as all get out. If you want this approach to solve the problem (and it won’t, but maybe you are more optimistic than I), join your professional association, donate money, time, make calls. Expect to wait for very little positive change. Big Business uses this approach well and they have way more money than you. I still think it is important to support out professional associations, but this strategy alone is not going to build (or save) your private practice.
3. Take a “If you can’t beat ‘em, join ‘em,” stance and go work for the big guys. Many actually don’t pay all that well, but there are benefits and it feels safer. (This is where you will end up when you’ve exhausted all your options with choice #1 above.)
4. Get creative, think hard, collaborate, learn about business basics and build new business models. Yay! Empowerment!
It will be no shock to you that I choose #4 and hope you do, too. With the new technologies available to us, there are so many ways you can make a VERY GOOD LIVING doing the work you love. (And not to brag, but I offer this as hope: I made close to 6 figures last year working 3 days a week and I’m no MBA…it can be done).
But here’s the deal….you cannot get stuck in option #1 above. I look at it this way: We only have so much time, energy and money. If we dedicate those resources to #1 we are choosing to waste our time and talents. Complaining gets you nowhere.
Option #2 is better, but how much progress can we make in a short period of time? And again, we pass off our power to an outside group to determine our worth. That doesn’t work for me.
Option #3 is a valid way to make a living. It’s where most of us start out. But why give over 50% of your hourly rate to a large organization, so they can pay you less than what you will make working for yourself, even after you calculate your overhead costs? Just to test this theory I recently applied to a large medical group for a per diem mental health position. They rolled out the red carpet, showed me all of their great benefits but wouldn’t talk salary. Why? Because it was waaaay lower than what I make working for myself. The math just didn’t work out. They get the same per session insurance reimbursement rate that I receive, but they take out all the overhead that allows me to have benefits, vacations, an office, phone, computer, etc. Why work for them in their cramped little, no window office when I can make MORE working for myself?? No thanks.
For me, #4 is the way to go. Not only are you completely in control of your career, you will make more money AND help more people. But for me, the most important, fun piece of #4 is you get to be creative! You can create new ways of helping, healing, changing the world. Want to do phone coaching? You can. Want to teach workshops? You can. Want to offer free reports to teach healthy habits? Go for it!
How do We Develop New Business Models?
First, realize you do not have to ask permission to try new things! Please, if you can be true to your ethical code, you can try new approaches. In fact, you must try new approaches to make your practice successful. Of course, this does mean you will need to learn about new ways of doing things. But we are all life-long learners, so this shouldn’t be an obstacle.
A new business model must include:
- multiple income streams
- variation in how services are provided (i.e. in office, by phone/Skype, social media, etc)
- minimal reliance on third party payers (you can accept some insurance, but it can’t be your only way to generate income.)
- collaboration with other professionals who serve the same or similar clients
- a content driven marketing plan
The good news is this: A different business model does not have to be ALL new and creative. Offering traditional approaches is important, but we need to think about what we can add. Or how can you give the traditional a new twist? Here’s an example: I work with kids and parents, but many parents can’t find time to get to my office, so I added phone coaching that I offer one evening a week. A new twist on a traditional approach!
Will People Pay Me for My New Services?!
Yes. If you offer relevant services that your ideal clients want, they will pay for it. For example, since I take very few insurance plans, I now offer 30 minute sessions at a reduced rate. People pay for these without complaint.
The key here is you must have a clear service with a clear benefit. This brings us back to specialty (it always comes back here, doesn’t it? 
).
Once you define your services, you can market them in a way that allows people to see your offerings as a helpful solution to their pain. Once you make that connection people are very happy to pay you.
The Bottom Line
We need to become well versed in the world of business. It’s not a choice any more. Big Business will take advantage of us because they can. Health care is a business and we either participate in that or we stand aside and accept what is given us (but no complaining, please. You have a choice.). You are smart, well educated, have resources, are able to learn new skills. We have reached a tipping point and we all need to make some decisions. Neither path is easy. There is work involved. But always keep in mind you can use your time and energy in many ways. Worrying and complaining,waiting for a bail out are not productive ways to create a meaningful career. Let’s work together, learn, empower one another. We can be change agents!
If you found this post helpful, you may enjoy my free audio, The Way of the BizSavvy Therapist. Or if reading is more your thing, sign up for this blogs RSS feed (you can get the posts sent directly to your email).
Susan is a licensed psychologist, business consultant and marketer for health care professionals who want to diversify their income streams and utilize online tools to provide services and market their practices. She teaches providers how to leverage social media to educate about health care while growing profitable practices.
I think a good starting place for tackling this issue is for everyone to create a list of requirements for their working life. Some people want to work from home one day a week. Some want to get home before their kids get off the bus. Some want to teach part-time and practice part-time.
Next is to be confident in these requirements. Be confident in charging for your professional services and years of experience. Why on earth do insurance companies expect therapists to work for practically free? I do not accept that. “This is the price.” No one expects their doctor to work for free…why should we?
Great ideas, Rachael! This is absolutely the starting point…what does our ideal work life look like and what steps do we need to take to make it happen? Doctors struggle with the demands of managed care as well. We all need to adjust our business models.
I love this post! And this line: “First, realize you do not have to ask permission to try new things!” I run into the same thing when I do my coaching with attorneys. There is a lot of fear about doing something different, but the different things are what will lead you to success and a happier practice.
And even though we don’t have insurance companies to deal with, we do have people who are buying “Trust Kits” online from Suze for $49, or writing their own wills, or deciding to represent themselves in a divorce rather than pay a $10,000.00. The key isn’t to try to convince them to stop doing those things, it’s to figure out what they really want (online convenience, different payment arrangements, etc) and figure out how to design those for our practices in ways that work for us and the client.
Just complaining about (and blogging against) online legal service providers won’t help us. The same as just complaining about managed care won’t help therpists.
Well said! You actually get it. I sort of excited – for you, because I find so many who don’t, or won’t.
I agree wholeheartedly with you. What I’m most passionate about is providing a service to my clients that is supportive and helps them grow. However, without some basic understanding of the business world I would not be able to run sustainable practice that allows me to continue to assist those clients.
@Leanna Yes, the important part of new models is to figure out what our clients want/need and provide it for them in a way that is optimal. The world is changing, as is our culture. The old, “tried and true” ways of doing things is quickly becoming outdated. Those of us who are flexible, adapt and implement new models will thrive. Those who hang on to hope that the same old will eventually come back into vogue will be at risk of being left behind. This is what has happened to the newspaper and music industries, so it really CAN happen. Being proactive is the way to go.
@Paul We do need to understand business to provide optimal care for our clients. They count on us to provide relevant services that they can find, access and support their needs. Thanks so much for stopping by and your comment!
amen sister. I want to get out of the rut of indentured servitude to an agency. I have not started a private practice yet but am in the process of exploring possibilities.I think the helping profession is ripe for change, and luckily for those of us who are willing to stick our necks out, can shape our own future and hopefully lead by example.
Nancy, good for you to start to plan to take the lead in your own career! It’s so exciting to start out now because we can do so many cool, helpful things for our clients AND make good money. Let us know if you need any support!
Hi Susan – lots of great ideas….thanks again! Kathy
Hi again – I am now sitting on the phone with a managed care company who is doing a clinical review of one my clts, I have been on hold for 20 minutes. I need the review to get authorization for more sessions. Why does it take two ppl to to review 8 lousy sessions for one person? Ppl who choose to become coaches make more than licensed ppl…this is wrong. Sorry I am whining and complaining.
Kathy, use the time on hold to think up a new way to do the SAME work you do, maybe in a different way, maybe for a different amount of time, maybe at a different price point, so you can kick this particular managed care group to the curb. I don’t work with ANY MCO that disrespects me or my time and my practice does just fine. My clients understand why I don’t take many insurances so either they 1. switch ins, 2. do the leg work themselves, 3. pay me out of pocket. I also now offer 30 min sessions for a lower rate (but if two 30 min sessions go back to back, I make more than one 50 min session
) Works well for my clients and for me!
for the record, had i seen the post ‘worst biz model,’ i probably would’ve read and commented on it rather than this one…! i like a**-kicking!
just wanted to say thanks for reminding us that there are so many more ways to make money than traditional office visits. i love #4, b/c personally, i don’t have time to invest my limited energy into rallying the troops (#2)–i did that in grad school…
i like the idea of doing 30-minute phone consults for parents…is this a service for existing clients, or open to non-office visit clients? i was wondering about office policy, hippa docs, etc.
thanks susan!
Linda, this is the right place to come for a** kicking! I do phone coaching for parents all over the US. I don’t call it “therapy” (and it isn’t that), so I can sidestep the rules around practicing out of state, etc. We send documents in an attachment that are signed and faxed back. We bill month-to-month via an online shopping cart (switching to paypal soon). No insurance hassles! It’s a neat model. I don’t do therapy by phone. If you want more info on that I can recommend the OnlineTherapyInstitute.com
The world is changing rapidly and I fear many psychologists will fall.. in my neck of the woods they (psychologists) are often too obsessed with protecting their turf against clinical counselors, insisting qualifications rule…. seemingly unaware that the game plan is changing AND that there are more than enough clients to go around. They don’t teach psychologists business in university and only the astute seem to really “get it”.
You’re a breath of fresh air in saying what needs to be said.
Thanks, Kathy. Yes, as a generalization, psychologists seem to struggle more with these ideas. Though I am a psychologist, very few of my readers here are psychologists. Very telling. I don’t think one needs to be particularly “astute” to get what is going on. I mean how can you miss health care reform, social media and the overarching culture of change? The signs are EVERYWHERE — news, magazines, sports, arts — online, offline. Even NPR promotes their Twitter and Facebook accounts! I do think one needs to be open-minded and flexible, open to change. That is the criteria and anyone can choose to be open to possibilities.
And I do believe there are more than enough clients for everyone, regardless of training or degree. We are underserving our communities to the detriment of mental health care overall, and our financial bottom lines. We will be as successful as we are in collaborating with our fellow helping professionals. Turf wars are a waste of time, money, and energy that can be better spent generating new ways of developing successful interventions and businesses. [stepping off soapbox...]
thanks for the phone coaching tip, susan. i like your suggestions and think i may offer that as a service. btw, i like the new blog title–catchy and biz savvy!
I SO agree we need to do things differently. I get so frustrated and inspired to make a change when I hear therapists who keep doing the same thing expecting a different result!
I love the idea of chatting with you on how to grow my different “niche” business as a therapist. I can really hear that you have vision and are inspired!
I’d love to take you up on the phone consultation, Susan! I’d need a bit of time to develop my most salient questions. But if you can put me on the list of 20 — sign me up!
Thanks,
Carol
Hi Susan,
I love your honest perspective. I found my way to to #4 because I was an art therapist whose services were not eligible for reimbursement. What I thought was a”problem” turned out to be a great gift! I learned how to convey my value based upon the results I help my client’s achieve. I too have a thriving 6 figure practice, solely fee-for-service. When other therapists understand they have a choice and learn how to create programs that serve their client’s specialized needs, then they will re-claim their power and create thriving practices! I’m delighted to have you part of the therapist resource telesummit and I can’t wait to interview you!
Laura
Oops — wanted to edit my above comment, but wasn’t able to.
I’m interested in knowing where to start as fas as the best subjects to spend my time learning about — bookkeeping? Marketing? Networking? I especially would like to know more about developing and pricing other income streams besides insurance clients.
Thanks — and please do put me in the pot for the phone call drawing.
-Carol
i would love to have a free consultation…i really appreciate you offering this service.
thanks!
I have been following your blog for the past month. I am a trained clinician with 30 years experience, my prior private practice fell into my lap while working at a teaching hospital. Nurses, staff and psychiatric residents referred clients, I never needed to market.
NOW I’m in a new local and times have changed. Although I have ideas on how to market my business I’ve not followed through and it not for lack of desire my fear over whelmes me. Secondly, I see phone and internet therapy as the new model but I continue to have ethical and moral concerns. I’m not convinced people really benefit from the service. I don’t like the feeling I would just be doing it for the money and not believe it’s beneficial to the client.
i just returned from two months overseas on paternity leave and was willing to accept the fact that i would have to essentially start my practice over when I returned. i was blown away by how many clients took advantage of my offer to skype with them during my time away. Needless to say, on my return my practice was alive and well, as was i.
As i shift other areas of my life so that I may devote more time to my private practice I am intrigued by your ideas.
Thanks.
Just started reading your blog this weekend – so many great ideas, Susan! Thank you for sharing and helping us find “a better way” to go about this great work. I look forward to reading more..
I agree with advocacy. In fact I’m going to Capitol Hill tomorrow to lobby on behalf of psychologists.
I’m interested in talking with you.
Thank you so much Susan for such a great post.It is true, we therapist have to loose our own fear of trying different things and diversify our income. There are two parts that I find particularly difficult: one to define your niche because I am afraid that if I narrow it too much I won’t know how to target those clients and secondly, networking with other professionals in the area. I have tried to reach out more than once with no response, so I wonder how people develop those relationships. The idea of developing products, conducting workshops, and offering talks is very appealing to me but I wonder how to market them without a big budget.
I also hear many people recommending to try and not be part of insurances but really don’t know what route to take yet. Thank you again for your help.
@Miranda Yes, doing the same thing over and over, expecting different results…didn’t someone say that was the definition of insanity
Establishing a focused practice is the first step to making it work, so you are on the right track.
@ Carol The first thing to establish is your specialty, what do you offer to clients that they need, want and is helpful? How do you clearly define it. And the answer is not “therapy.” Once you have that piece defined, the next step is to get a web presence and figure out how to leverage that for marketing. Bookeeping is best outsourced. You need to focus your time and efforts on those tasks that only YOU can do.
@Alice The key to marketing is the consistency and we all have some fear of putting ourselves “out there.” And you don’t have to do phone/email counseling (though there is a nice body of research that says it can be just as beneficial as face-to-face therapy). But if you want to keep your practice all face-to-face you can use that model and still have a great business.
@Larry I am NOT surprised so many of your clients took you up on Skype as an option. Many of us do not realize how many people are “plugged in” and accept communication via technology as part of their everyday lives. Good for you for offering it and I’m glad it worked out well for your business as well. Win for your clients (who benefited from your work during your absence) and win for you who comes home to a thriving practice!
@Julie I am interested to hear how your trip to Capitol Hill went. Please give us an update when you can.
@Isabel The idea of niche can be hard at first, but when we start to think about all of the possible presenting problems in our communities and how many people could really benefit from support around that ONE problem, we can never really niche too tightly. People have developed really successful practices around supporting truck drivers, parents of kids with ADHD, women with chonic pain, people who need support to manage diabetes…the options are many. Marketing w/o a big budget can be done. You need to leverage online options and networking with referral sources.
Hi,
I have abstained from being on any insurance panels at all since I started my practice in 2002. I have been able to consistently average 30 clients contact hours per week using this method. I have used my website,google adwords,print media, yellow pages,etc. to generate new business. I have invested a lot of energy with client/customer service in order to achieve these results. I would like to take my business to the next step! I already do some phone/skype but I would like to expand that to at least 50% of my practice. I would like to reach a wider audience than I am able to reach here in the very small town in which I live. I would also like to further narrow my niche, and add to my credibility by writing a book. I would also like to start telecourses and cd’s to my menu of offerings. Currently, my menu of offerings is too small. Thank you for your generosity! Your blog is inspirational.
Roberta
Hi Susan,
As one of your psychologist followers, who has worked for an agency
for 16 years and now shifting into private practice with a
specialized focus, I greatly appreciate your insights and feedback
which provide issues to reflect upon for a broad range of tx.
providers. I was very comfortable in my career working in a safe
environment and now I’m pushing myself way beyond my comfort zone
to pursue a direction I’ve been passionate about for years….my
weak spot is self-promotion! Not a concept I had to be that familiar with in order to attract clients. I have worked hard over the past year to mentally adapt more & more to the reality that I am the best person to “sell my product” (me). Even though
I know this, your creative options are a springboard for ongoing
inner dialogue about pushing myself further!! I hope to have the
opportunity to speak with you live! Thanks!
I have gotten a lot of business from EMDR because my web site comes up close to the top for that in Los Angeles.
I read your article about refining your niche and I think I would target women with anxiety of abuse issues. I am not sure how to target that demographic or whether I should make it even smaller before trying to target it.
Also I need a product to sell on my web site.
My business model was working real well until the economy took a dive Now I have to modify my approach to find the clients who can afford my services and also offer some more services.
i am looking for help building my practice but i have a lot of trouble marketing myself because i feel shy to do so.
mirel
Susan,
You have lots of great information on here. I would like to end my relationship with insurance companies and build my bottom line. When I began my private practice about five years ago, I was supplementing income with teaching college courses. I have stopped teaching but do not fill my time during the middle of the day-except for a nap and/or insurance calls. I want to find a balance between working evenings/weekends and being home. Is there a balance? I like the 30 minutes sessions,but I am not sure I could se effective in that time. Any suggestions would be helpful.
Janet
I agree that trying to make a good living while depending on managed care is a difficult fit. I am not on any panels, and still find myself more involved with insurance companies than I would prefer (a number of clients need to make sure they will be reimbursed to be able to pay me).
Your options make sense, and I work as both a therapist and a coach (executive and personal). I will even be helping social workers to understand coaching and why they should be interested in it this Spring at the NJ NASW conference.
Hi Susan,
I took your practice building teleclass which I thought was great. I opened my private practice in 2005 and was fortunate enough to be supported by my husband that I was not pressured to make it grow quickly. Yes, I’m one of those therapists who does not enjoy marketing. I’ve been with BCBS since 2005. In January I was “accepted” by Tufts and my phone has been ringing off the hook since. But your suggesting people would actually pay me out-of-pocket even when they can get therapy paid for through their insurance? It’s rare that I have come across those clients. Even when they’ve called me because I have training/experience with a model they are interested in, if I don’t take their insurance, they go on to seek a therapist who does. As I write this, I’m wondering if it’s my lack of confidence in my worth and in communicating my worth. Work to be done, yes?
Thank you for all that you do!
great to see you motivating others to take creative initiative.
I think it’s great that as a community, therapists are getting more creative. I think we have been humble long enough. We have been trained to deliver quality and effective interventions to people who need it the most – we deserve to be reimbursed accordingly.
In an economy such as this, though, we have to get creative and flexible with our own expectations. The fact of the matter is that no matter how much we may deserve to be paid the big bucks, people simply aren’t in the position to dip into their pockets. I have had to turn away so many clients whose insurance I don’t take, that I am considering lowering my private pay fees. I can’t just dig my heels in about what I am worth when I turn away income every week. I know for sure that I am worth more than a failing business!!
We also have to explore other avenues outside of traditional therapy to generate income – we just need the confidence to sell those clinical skills!! We need to get real and step up!
I agree that thinking outside the box is the best way to improve and make thongs work better. I hope to win one of your free consultations because I am beginning a small private practice to supplement my other income soon.
Hi. I really appreciate your posting and hope to be entered in your drawing. I have been a therapist in private practice for almost 27 years. When managed care came along, I tried it. I really did try, but since case managers were telling me what to do and were not paying for my malpractice insurance, I gave up. I was doing fairly well until the economy tanked last year. For the past year, I downsized my office, sent out referral letters and I’ve moved letters, I have put my services on every listserv and organization that I can be a part of (except the really expensive ones) and I’m still struggling. I specialize in treating women with eating disorders and also teach other therapists in a certificate program. Here’s my problem. I have trained all these therapists and now, they’re my competition. I don’t take insurance and don’t want to. I would love the opportunity to dialogue with you about new ideas. After 27 years, I am not burned out but I would like to try something new. Thanks for your generous offer.
When I started my practice 2 years ago, I jumped on all the insurance panels. They fill my time with clients, but I’d like to learn how to branch out to private paying clients in a rural, low income setting. I find people canceling appts with just a $20 copay. I know those people are out there, but I’m not sure how to market to them.
I would really love a consultation, as I am just starting out, and having a very hard time. Some support would be really great for me and help boost my self confidence. Please contact me, at mbtritel@gmail.com
PICK ME!! PICK ME!!
Thanks,
Beryl Tritel
Susan,
I am excited to read about expanding services, coming up with new ideas, etc. I am in private practice and am often trying to think of new ways to expand (both services and adding additonal professionals to my little clinic).
Jenny
I really appreciate that you’ve created this site devoted to re-examining how we do our work. I have found it frustrating how little attention is paid to this in our training and how it is often even frowned upon. I personally have more business ideas than I can possibly put into practice but I’m inspired by this blog to at least focus on one or two to get the juices flowing. Looking forward to upcoming posts!
Thanks for the supportive info Susan,
I wont take up your time with the generous offer of free phone consult (again!!) since I already have!! But suffice to say your suggestions about improved ways of marketing have been so helpful.
Thanks and all the best,
G. Katie Dashtban, Psy.D.
Medical Psychology Services
http://www.medicalpsychologyservices.com
Being relatively new to the business, I find myself unsure about focusing my marketing activities on either 1) referral sources; or 2) the target markets of my potential clients themselves. I know that “both” is likely the right answer, but I don’t have a sense of which is more fruitful in the long run. Thus far for me it’s been referral sources, but I’m not entirely convinced.
I really want to learn or develop a good business model the right way as I start my private practice. Unfortunately with the economy there is no room for error. I really miss being a part of people’s lives when they need help the most but do not know how to do it. I feel very much behind with all the new technology but very excited to learn! It is absolutely mindblowing all the positive energy out there and I want to be a part of it and hope to help my clients tap into that energy. I know I need to clarify my specialty and as you can see above…no website yet!! I don’t want to be left behind and I don’t want my double masters to have been a waste of money, time and effort!!!
I am struggling with integrating my artist-self with my therapist-self. It is not that I am shy, it is more that I like using the intuitive side of my brain or that it is the place that I am most comfortable. How does one submit to the linear nature of a business plan in that case?
I have just taken a year off from being a therapist and found that I really like my profession. Finding my place in it, and making it work for me, seems to be a great task. My history has been working in the public sector, but the state in which I was working went private, with a very complicated managed care requirement.
I need to make the transition to a model that supports who I am and my financial bottom line.
Susan -
Please enter me in the contests for a free 30 call!! Thanks.
I agree! I have had my doors open to my private practice for almost a year now, but I’ve been so busy trying to make sure that I have had income coming in to pay the bills, so the thing that has suffered has been my private practice. I’ve been busy building everyone else’s business while my own has suffered! Now I’ve taken the steps to ensure that my business will be my top priority, so I will have the time to actually work on developing business plans! I’m excited to start this part of the journey!
Hi Susan,
Thank you for the work you are doing and the service you are providing to help empower therapists to be more creative.
In January, I opened up a private practice in Boulder, CO. One of my specialties is helping individuals and couples see challenges in their relationship as opportunities for growth. Also, I really enjoy working with college students.
The business aspect of my practice has required a huge learning curve. I am enjoying the process, but I feel overwhelmed at times (especially about how to prioritize my time and resources).
While I strongly believe in the importance of having a creative business plan, I notice that I have been very hesitant about entering into the social media world fully. I do use fb (personally), twitter (occasionally), and, linkedin, etc.
I feel that I am ready to crack the ice in using an email marketing program (signed up from Mail Chimp), blogs/articles, professional fb and twitter, videos, and affiliate marketing programs. I’d like to develop a strong foundation to launch from, but am a little sure about how to go about establishing this.
Looking forward to a possible consultation,
Jessica Higgins, PhD, LPC
http://www.drjessicahiggins.com
I wish I had read this two years ago, but useless to look back. I have so many questions and so little time, yet I also lack such knowledge as you have.
Can you survive doing fee only if you are lPC? How much more is Insur. if you want to do home based therapy? how do you “incentivise” a program to the the legal community? How do you find an associate who wants to share space and also co lead programs? Taxes? lots I want to know, so looking forward to more! Thanks!
That was supposed to be LPC/I and in intern…even though older and 10 years in field.