Should We Stop Badmouthing Evidence Based Practice? An interview with Jessica Tappana, LCSW
Curt and Katie interview Jessica Tappana, LCSW about evidence-based practices (EBPs). We talk about what EBPs actually are and how to implement them in clinically sound and ethical ways. We look at what therapists usually get wrong about EBPs and what they can do to improve their practice.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we talk about how Evidence Based Practices work in the real world
Jessica is a long-time listener of the show and a good friend of ours and has been talking with us about how we have spent too much time bad-mouthing EBPs. We decided it would be good to hash out the ideas around “manualized treatment” and how you can actually bring yourself as a clinician into the work, even when using these interventions that are backed by science.
What are Evidence-Based Practices?
· Using well-researched interventions
· Using the expertise of the clinician
· Understanding the needs of the clients
What should therapists know about evidence-based practice?
· There is room to implement EBP without full adherence
· Contrasting “eclectic” from “meeting a client where they are” and pulling from other evidence-based interventions
· The ways that EBPs are trained and studied (due to funding sources) lead to strict adherence
· How you teach or implement the EBP can be unique to the clinicians
· Contrasting fidelity of the model with adherence to model
· You can bring yourself as a therapist into the room AND provide evidence-based interventions
· Training and supervision is more challenging when you are not seeking strict adherence
· It’s important to have time to practice therapy outside of sessions with clients
What data or assessments should therapists use with Evidence Based Practices?
· Feedback informed care (e.g., FIT)
· Assessments of depression or anxiety consistently to see progress
· Screening tools and measurement to track progress
· It is important for clinicians to believe in and use the data collection
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Looking to streamline your practice check out therapy notes rated number one among mental health professionals therapy notes offers all the tools you need to thrive whether you're a solo clinician or part of a group practice try it free for two months with promo code modern therapists do you know if your clients are getting successfully reimbursed with the super bills you give them insurance can be confusing to navigate leading clients to quit therapy early join hundreds of therapists use thrizer as their go to resource for successful out of network reimbursements helping them get and keep clients in their practice visit join dot thrizer dot com forward slash modern therapists to learn more and get started you're listening to the modern therapist survival guide where therapists live breathe and practice as human beings to support you as a whole person and a therapist hear your hosts kurt whittom and katie vernoy welcome back modern therapists this is the modern therapist survival guide i'm kurt whittom katie vernoy and this is the podcast with therapists about the things that we do in our practices the way that we approach our work and one of the things that we may be guilty of around here is bad-mouthing evidence-based practices and and you know we talk about cog in the machine kind of things like workbook therapy where does the clinician come in i'm reluctantly admitting we may overestimate just how bad evidence-based practices are and here to help us with that conversation is our good friend group practice odour Jessica Tepana and she's here to help demystify and make it where it's like no there is room for all of the wonderful things that kurt and gatie talk about and doing evidence-based practice so thank you for joining us today thank you for letting me join i for like two years have been listening to you guys bad-mouthed evidence-based practice and then like you guys don't mean what you're saying we're so happy to have you here it's so wonderful to have good friends on the podcast and we've been wanting to get you on for a while we just finally made it you had to like travel the whole world and then come back before you had time to to come on the podcast but we're gonna ask you the question we ask everyone who comes onto the podcast who are you and what are you putting out into the world well yeah i am my name is Jessica Tepana i'm a licensed clinical social worker in the state of Missouri i'm a group practice owner i have a group practice in Columbia Missouri that focuses on offering evidence-based practice primarily for trauma and anxiety and have had that now for seven years and additionally i have a second business called simplified SEO consulting where we help other therapists get in front of their ideal clients and get matched with the clients that they work the best with so we can all do our best work by seeing the clients that we feel we can really help and we had Danica your is she chief operating after or something like some fanciness we had Danica on already so we'll link to the episode with Danica talking about SEO and AI and all the good stuff in our show notes over at mtsgpodcast.com as you know we start a lot of our podcasts with the question what do therapists get wrong about whatever the topic of the day is and this comes not from a place of shaming anybody but just to help clarify misconceptions tell people maybe not make the same mistakes so what do other therapists usually get wrong not us but others not us okay maybe maybe us too what do we get wrong about evidence-based practices to me what i hear people get wrong time and time and time again and it just is we just assume that what evidence-based practice means is taking the human element out of therapy and becoming a robot and i hear people talk about evidence-based practice as if what it means is just reading a book you know to a client and you know put a monkey there that can read and it's going to be able to do therapy to me it's about a lot more than that first my bias is my mom is a interventionist as a researcher and so i grew up with mother who was an MSW but worked in schools of medicine on these huge grants and i got to hear her frustration she would find these excellent interventions that would help alleviate stress um her air of expertise was hospice caregivers and so she would tell me you know we've spent literally millions of dollars proving how helpful this intervention is and then the minute the grant goes away people stop using it and i got to hear her frustration about that then i come and become and enter into the workforce myself and i'm hearing therapists on the other side talking about all the problems that we have with implementing evidence-based practice and particularly implementing these interventions in a way that's adherent to the methods and i'm sitting here like guys there there's a happy medium when you've heard the researchers and you've heard the clinicians i feel like often the points that we're making aren't contradict when i started providing for an ASW some trainings on evidence-based practice i went looking for the definition of evidence-based practice trying to find that happy medium and what i found is every field that talks about evidence-based practice talks about the same three elements they call it something different they use a little bit different wording but basically what they say is it's using well researched interventions so it is using something like dbt emdr gopman whatever it is and it's the combination of where that meets the expertise of the individual clinician and where the clients um needs are where they're where we're considering their culture their preferences all of that and i have not found any definitions of evidence-based practice someone's gonna listen to this correct me and send me a definition so i'm ready for it but i've not found any definitions to date in like really respectable journals really respectable um like the apa or you know those sorts of things or even the nursing association that doctors you know that did contradict that that we need all three of those elements if we're to deliver evidence-based practice and if i am just going to a client and saying every single one of you need me to read this cognitive processing therapy manual with not making anything to meet you where you are that's not evidence-based practice but that's what we often as clinicians think it is where do you think these ideas around evidence-based practices like this manualized you know give a monkey a book that if they can read it they can do this therapy and and i think at this point it's more like put it into an ai bot and it'll be able to do this therapy i think it's more accurate to what we're really worried about right now where do you think the ideas became so off-base so wrong from your perspective about what evidence-based practice is you know when i was in in school we talked a lot about taking in a collective approach when i it cracks me up all the time aspired counseling's website is all about evidence-based practice and i still get clinicians who will apply for a job and what what approach do you take? i take in a eclectic approach i draw a little bit from here and there and there and so we i think as a field prided ourselves on this idea that we can take a little bit from a bunch of different theories and create this artwork almost of a beautiful therapy session and we've seen so much magic in that we know from the research that the single biggest thing that we have any control whatsoever on is is the therapeutic relationship that just having a good therapeutic relationship is going to make a positive impact so therapists see all of these gains that they're making with clients and then they hear somebody say but you can make more gains if you're using dbt if you're using emdr if you're using you know the first evidence-based practice was cognitive behavior therapy we hear that and it almost feels like they're saying there's something wrong with what we were doing to start with and so of course we're like but there's magic in being eclectic i do get annoyed because some of the well researched interventions do make it sound like you have to be very exclusive and only hold to that but i think a lot of times evidence-based practice can still be i'm doing you know when i do cognitive processing therapy with my clients for trauma for instance i still also send the do some dbt skills because i was a dbt clinician first and so i don't think it's mutually exclusive and you're still and i'm still providing evidence based treatment but i'm meeting a client where they are that if they need this other thing i'm going to pull from over here that doesn't contradict the fact that my primary treatment modality is this well researched intervention it just means i'm doing good clinical work of meeting my client where they are the misconceptions or kind of the the mental shortcuts that we make about abp is that they're colds that they're just kind of very like matter of fact here do this here do this and what you're speaking to and even you know calling back to katie's like oh this isn't just a i kind of doing this is the warmth of the relationship that does that is part of how we're taught abp is responsible for this like there's a lot of just kind of like break down kind of the human element at first to learn these skills and then bring the human element back in that allows you to do what you just described with all right i'm doing cognitive processing but i'm also going to pull something from over here dbt because this also will help you is it because of the way that we're taught this that we're kind of left with this vowel taste i think it's the funding sources because when you're looking at research to validate a new treatment um they want to know that everybody's getting the same treatment and in reality and therapy it's really hard for us to give every the same treatment and so you know when we're if you've ever worked on a grant before which i know many of us have when you're working on a grant it is very scripted you have to do just this this this because that's what the funder expects us to do and i think that that then becomes how we think of that treatment when in fact and often the funding sort the grants or the not grants but the any research that we're doing also excludes a lot of the population and i and i've heard this at so many different trainings for different evps where they say okay like you're the results and then you look at all the exclusion criteria and you're like okay yeah you got great results but you excluded most humans and i'm doing therapy with humans folks like i'm not doing therapy with your ideal person that only ever went through one trauma they had a perfect life until they had one trauma their ace score was like zero and and by the way they're like just this very narrow age range and they're obviously white i mean like it no i'm doing i'm doing therapy with humans they have a whole bunch of other factors and had huge ace scores and have had gone through you know had complex trauma and then a single incident trauma and on top of the on top of all their childhood stuff to me i think that that's where it comes in is when they're doing the research and they're validating it and they're like you must do it exactly this way then it comes out and people think oh that's how you do evidence-based practice i guess the the question i have then is are we stopping the research too soon are we too narrow in the research and so we need to get more into this place of having the evidence-based support more of a i let's say a clactic also integrated approach or a meet the client where they are approach i mean how do we actually move beyond this such limited scope of research do you think first of all i think some of them are um i know when i've attended professional conferences in the last couple of years i am hearing more of the presenters say and here in our exclusion criteria was less or the good news is and so i i think that we're going to be moving that way you know we started as a field train so hard to prove ourselves that they had to be that rigid and i think that there is a movement more towards including but i think that the researchers are responsible quite frankly for making sure that they're doing that but then on the ground folks what we've got to do is we've got to explain okay so it is important when you're doing for instance dbt to use all four components right it's really important that you teach skills and that you're making sure that you're following certain formats that you're having a skills group that's long enough to get something out of but there needs to be a lot of guidance about how you teach that skill can vary greatly you you go look at five different dbt groups with different co-leaders and how they all teach it because they're going to draw from their own personality they're going to bring themselves and they're going to make it relevant to their clients i don't think any of those groups are not doing dbt so we need to be explaining what it means to do these evidence-based practice and where the human element is you can teach a dbt skill and not just pull the examples straight from the book but you also can you know use this great metaphor that you've thought of or this example you've seen and that's still dbt and that's okay and i think teaching that is really hard and giving that clarity especially when you're often implementing them in larger agencies where there's higher turnover and really new clinicians who who you're worried aren't going to do it to fidelity but there are ways to do it to fidelity it's providing good supervision and if anyone needs to know how to do that you guys have some excellent podcasts on providing good supervision therapy notes seamlessly integrates scheduling documentation and billing into one easy to use platform plus enjoy features like secure messaging e prescribe group telehealth and more with 24/7 live customer support you'll get answers to your questions anytime anywhere no matter your field or specialty therapy notes is dedicated to helping you care more and worry less so use the promo code modern today to try it free for two months well and what you're talking about is a couple of things number one is being able to more accurately describe not just what is therapy but what is therapy like with you then you're illustrating that really well because the dbt that we offer in our practice is probably going to look very different than the dbt that you offer and the second piece of this is something that i really work with on my staff is it's not just teaching the skills but it's also living the skills and being able to demonstrate that that brings that human component right back into having this as a basis for it exactly i used to describe to to people that if you call and you want to do i'll use the example of dbt since we've started down that route if you want to do dbt i have these two i had more than two but i would use two of my clinicians as an example you know you can go with this with this clinician or this clinician they're both going to do dbt or they're both going to do they both could do cognitive processing therapy they had some of the same modalities that they were using but if you're in this session over here you're going to have a whole lot of laughter i'm sorry we're just going to hear it's going to be such laughter that we can hear him laughing from the lobby you know and he's going to use a lot of humor and it's going to be infused in there and if you're over here this is a former high school teacher who's going to be mutt who's going to they all are going to expect you to keep a diary card but this one's going to basically approach it like a classroom setting almost and she's fantastic but their personalities were so opposite that sitting in an individual therapy session with them we always knew was going to be very different even though they were doing the same modality even though they sat on the same consultation team and with staff cases together how it would feel to sit in a session with the two of them was different and that was okay and wonderful and they were yeah but one of those clinicians has now moved on or i guess they technically both have to their own practices but they were my perfect example of two totally opposite personalities who both were doing dbt two fidelity both getting excellent results we could see from the data that their clients were getting better but they weren't just being a robot they were being they brought themselves to the session and so for assigning clients a huge like the amount of training we put into our client care team is huge because when they're assigning clients they need to not just say oh you have a lot of suicidality you're going with dbt or oh you have trauma you need to go with one of these but they need to also be able to describe who those therapists are and how they how they approach therapy how they show up in the therapy room it's interesting because as you're talking and i'm i'm the only i know dbt skills and that kind of stuff but i've never done adherent dbt so i'm the only one in the room not having done adherent dbt but what you're really describing is is actually distilling down a manual so to speak and saying these are the important principle this is what you're needing to hit this is what this is the information that needs to be shared and so adherent dbt is not the manual it's these principles and and skills that need to be taught and those types of things and i think that's that to me feels very very approachable as far as a clinician who has a lot of experience like if i can learn something and kind of infuse myself into it and understand it and just say okay i gotta hit these points but how i hit them is up to me that feels very doable but i think going back to what you've said Jessica is that's hard to teach and so do you have a sense of how when someone is learning or or teaching an evidence based practice how you can get to that distillation of this is this is the principle this is the core and this is this is how you can bring yourself in yeah in our practice our two most manualized treatments are probably we do both exposure and response prevention for OCD and we do cognitive processing therapy and so they're great ones to start our newer clinicians on our interns our provisionally licensed clinicians and Missouri interns means still in school but i know we all have different language for it but our less experienced clinicians do like starting with some of those i keep looking over the side because right next to me i have the manual for cognitive processing therapy and it's great because it is very here's what you do in session one session two session three but how we teach it at our practice is using a lot of open-ended questions asking our clinicians you know how would you describe this okay read this now close the book and describe it to me without looking and then the i'm looking i'm like well you hit these points but make it yours make it why do you believe it a lot of times we use scales and so we'll show when we're talking about evidence based practice i think that having that belief in it is really important and so we'll show the some of the data for our clients who have gone through that treatment help build that like sense of confidence in it and then ask them to describe that to how they would introduce a client to it it is more of an art and i think it's harder to supervise someone this way than it is to just be like okay you want to a training for for erp go deliver it and like we'll staff cases once a month specific to erp like that would be way easier but to do it right um we have for each of our primary evidence based practices and my group isn't huge for i think 12 clinicians at the moment maybe 13 but for each evidence based practice we have a google chat group going of everybody that does that particular evidence based practice so that you can hop in there and staff cases with our younger our newer clinicians they really need to be paying attention to that and going to the optional monthly consultations because it is more of an art than a than just reading a manual and they need to go beyond just one training they need to hear different examples here different ways of doing it and be able to staff okay this client doesn't quite meet the the picture perfect thing or this client has this request or this cultural thing that we need to consider how's that look it's we we tell them it's like you can grab one of us anytime you can grab three four of us we're constantly coming together and saying in in caseing these but it is harder and i think from a practical standpoint doing that in the larger your setting in some ways the more difficult it's going to be to figure out how to how to be able to have that sort of culture of lots of staffing the cases and lots of discussing how to individualize it because it's not easy what you're talking about is making people practice it in order to be able to do it like there's there's there's a whole evidence base around like if you practice things you're going to do better at doing them and it kind of brings the whole idea of what we do as a profession of like it's a therapy practice which means that we should practice it outside obsessions otherwise you're just doing therapy and subjecting clients to poorly practice therapy i guess absolutely we have to you you have to believe in it you have to live it you have to know how to use the skills i think you know the first couple years i was teaching mindfulness i still wasn't sure if i was doing mindfulness correctly myself because my brain needed it so bad i was like am i am i getting this right and so yeah i think having people live it having people do the treatments that are going to resonate with them or at least they can get to a point where it resonates you know when i'm doing emdr and talking about the container exercise i will literally show clients the container that my container is based off of because i have one i practice this and we'll not every client but when appropriate i'll do that you know when we're discussing it because i think that having the clinician buy in and having the clinicians not just buy in but like you said you know if i'm going to teach dbt skills i better know how to use deer man if i'm going to do this it i have to believe in it and understand how it works and and understand the pitfalls and the discomforts with it i think to do the very best work well super bills can be helpful for your private pay clients they don't help clients access therapy today when clients see you weekly or bi-weekly they may be out hundreds of dollars before they receive reimbursements four to six weeks later which can be financially straining on them the risers mission is to help clients access therapy today by working to get them instantly reimbursed for out-of-network sessions first you can help your prospects instantly verify their out-of-network benefits with thrizer providing them complete transparency on the cost of therapy ahead of their first session then just by charging your clients via thrizer's payment platform you can offer them courtesy claim submission and end-to-end claim management and even let your client just pay a co-insurance for sessions similar to in-network co-pays to skip the reimbursement wait entirely how thrizer covers the rest of your fees so you get paid and full up front and they wait for reimbursement on your client's behalf thrizer also has a super bill uploads feature which is completely free for therapists if you'd like to instead offer your clients a resource to manage their own super bills thrizer manages all claims end-to-end so you and your clients don't need to deal with any of the insurance stress visit join dot thrizer dot com forward slash modern therapist and use our promo code modern therapists to start your free trial and receive waived fees for your first twenty five hundred dollars in payments you've talked about the data and and being able to show especially newer clinicians who are learning kind of what has happened in your practice and we've talked about feedback and form treatment that kind of stuff so briefly if you can talk about kind of what is the data that you're gathering and and how does that fit into how you set up your evidence-based practices in your practice data makes people very nervous i like data a lot um talking about feedback and form care one of my favorite things that all my clients do is the arm five so i can see you know the impact of the therapeutic relationship and my favorite thing i tell new clinicians in my practice i'm like when it goes down just one point that's like the best thing because that's them being honest because they're not going to read us too little but they actually don't think we're as confident as we used to be and so knowing that we can go in and change so in our practice what it looks like though is because data does make clinicians nervous i have minimized my requirements around it other than you have to be measuring something associated with what you're working on with your client and at least once a month i need you using some major now some majors and some types of therapy we're going to use every week you know if i'm doing um certain trauma therapies my clients are taking the pcl five every single week so that i can see the progress that's part of doing it inherently and but i try to give my clinicians the control to see data as a tool and not as like some punitive thing i think that in some environments it's become like this punitive thing like if you don't get the right numbers that's somehow a problem or you've somehow failed when in fact it's not about that to me to me taking you know taking that those majors whether it's the pcl five or the gad seven or the ph q nine or the arm five is to be able to go back and tell my clients you know show my clients the data i we use a system where then i can share screen with clients or if they're sitting in the session with me i can turn it because they're like all they can see is here they've worked so hard and they still they still feel crummy and they see that and so then i'll show them the data and i'll be like look this is the progress this shows you make how does that feel to you do you feel that and a lot of times little that's when it'll start triggering oh yeah you know i i did used to be that depressed and i am less depressed now and so for us it is about thinking about what data is going to be most useful to that client and to the clinician more so than than me being super prescribed about it because i would love to tell all of my clinicians exact which tools to use for what but i think that my therapists are using the data more because i give them a lot of freedom and at this point when i first said you had to start using some sort of screening tools and measurement to be able to track client progress yeah i thought i was going to lose half my staff they were so sloppy they bought it hard and now all of them are like i couldn't practice without this and i'm like good that's great what do you find that helps because i think that there's a parallel between using things that work like ERPs and using things that work like eliciting client feedbacks through this stuff what do you think it is that really helps clinicians in those capacities to adopt it is it just as simple as like do it and finds that it actually works and get over yourself i i think it depends it depends we can all debate different ways to do this for me i try to get their buy-in but at the end of the day when i made the decision that they were all going to start using some sort of measurement tool that was that that i had to force on them i had to just say that's it i'm not going to require you what you do but like you're just doing it and i'll give you control where i can but i think that a lot of it too is we have this fear of being judged it's a fundamental human fear right we're worried that we're doing something wrong we're worried that we're going to be judged i think when we're talking about evidence about asking somebody to practice evidence-based practice they're afraid they're going to get wrong and if they go to consultation or you review a video and see they got wrong they're going to be in trouble and so i think it goes back to being able to create a culture of vulnerability and one where you know we're not we will have clients that don't make progress we will have times where you know we're in a session and we're not adherent and we're quite frankly super human and totally screwed up and that in being okay with that but it's hard because we just have that natural fear of doing it wrong we have that natural that natural tendency to be self-conscious and that fear of if we're going to get punished or force you at fired if we're not adherent or if we're not having clients show that they make progress but that very fear can cause the problems that lead to those things to happen how do you set up that that culture to me i'm hearing a lot of growth mindset and that kind of stuff but but what are the tools or the tricks or the the strategies that you use to try to set up that culture of allowing humanity into implementing evidence-based practices um from the time i interview i describe my view of i describe evidence-based practice as being not just um offering a well-researched intervention but also you bring yourself to the table and you meet clients where you are so from day one we're talking about that we're talking about the role of humility and therapy i actually actually ask in interviews about their greatest failures as a professional because i want to know they have the humility to tell me what that was and if they give me some like write-off answer i'm like really that's all you've ever done like lucky you because i think that um i want to set up from day one that we're going to all be human and we're all going to be learning and that evidence-based practice isn't going to be neat and tidy and easy to implement but it is going to be messy and and then and then as far as the culture aspect once they come on it's it's giving the support it's talking about it it's people demonstrating that vulnerability once you have a few people bought in it's a lot easier to get everybody else bought in because they see that somebody else admits that they were wrong and nobody gained in trouble for it where you know i'll show where i went wrong on on a regular basis i'll be like yeah look at this data from my client look it went down there it was great it was the best thing that ever happened when that data went down because we changed you know we changed up what we were doing this way or i found out this about the client and i encouraged the other people in you in formal or informal leadership positions within our practice to do the same by the time that you're interviewing people they've presumably been through their internships or practcums whatever it's called in listener's jurisdictions here it seems like this is a novel thing that many interviewees are experiencing with group practice owners like yourself like mine some of the other group practice owners that we interview where it's like there's coming out of brad school that it's kind of like oh evidence-based practice means that if i don't do cbt with 95 percent accuracy and results then it's a failure of myself as a human being and it seems like such a novel thing in interview processes like yours where it's like no like we can do everything right are we failing students in like presenting this in ways of like here's how how you do this stuff is this kind of more of a systemic problem that we're facing and you've just kind of cracked the code into having a successful group practice by reintroducing humanity into therapy i think that would be a great question for all of those that do teach in universities because i think that there are reasons you know i personally have never wanted had never had any desire to go teach at the university level and i think a lot of it does come down to the problems that i see with the way people are being educated um but i love but that's one of the reasons that i love actually you know we do bring people on when they're in the that final internship in school and our practice and um so far a hundred percent of the students that we've brought on have then been hired after graduation um but i love getting in there while they're still in school and being like here's our approach go talk about it in class and in your thing and come back and tell me if they have anything they can say to contradict me because i i have yet for them to come back and say and and any of the students that we've worked with come back and say no my teacher said that there is no way that you should you know do that with whatever and um and so i i would love to see the schools bring more more into humanity i think that our institutions our universities have such a difficult job of getting enough information in there and staying stuffy enough as the term i would use to to have validity in the eyes of society but also having that humanity piece in there i wouldn't want to create university curriculum i think i'd be horrible at it but you're you're kind of a rabble rouser like you're you're saying like hey interns come over to this uh this little practicum over here and i'm going to teach you all this stuff and you're going to go and infect your your university with all of my rabble rousing ways yeah yeah that's my role is to be the outside instigator alternate rebellion living those dbt skills i loved it i had an intern last year who was um or a practicum student last year who was splitting their time between us and another site and they did the same treatment they did cognitive processing therapy as both and i loved hearing about the other one and how it was much more manualized and then being likened here here it is manualized there is there are literal like scripts it's very it but have you thought about doing this and i loved reviewing the video and giving the feedback of well where's you where are you in this you're a human you have all of these really cool intersecting identities that make you who you are this particular clinician was working with clients that needed to see themselves in therapists and i was like where do you show up how are you reaching your clients and i just loved that they were getting both approaches that they were getting the same exact treatment in two different locations and being able to come back to me and say here's how it compares and can i take this over to you know one time they wanted to borrow a book to take with them to their other site i'm like yeah absolutely take that you know go go spread good good treatment everywhere you go where can people find out more about you and your practice and your business absolutely so my private practice website is um aspired counseling mo mo mo dot com and then my seo business is simplified seo consulting dot com will include links to Jessica stuff in our show notes over at mtsgpodcast.com follow us on our social media join our facebook group the modern therapist group to continue on the conversation and until next time i'm Kurt Withel with katie vernois and Jessica tepana a final thanks again to our partner therapy notes the highest rated practice management solution for behavioral health don't forget that you can use promo code modern for two free months when you sign up super bills and reimbursement weights are not a reliable solution for out-of-network clients with just a click of the button you can offer courtesy claim submission and end-to-end claim management support and even allow them to skip the reimbursement weights all together with thrizer visit join dot thrizer dot com forward slash modern therapist and use our code modern therapists to start your free trial today thank you for listening to the modern therapist survival guide learn more about who we are and what we do at mtsgpodcast.com you can also join us on facebook and twitter and please don't forget to subscribe so you don't miss any of our episodes
