Episodes

Full Details Related to MPP 057 :: Insights from Dr Adilia Silva a Clinical Psychologist | Moulding Private Practice | KITRIN

In this episode, we discuss the intricacies of running a private practice as a clinical psychologist in South Africa with Dr Adilia Silva

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Link to Video Episode on Insights from Ashley Jones an Occupational Therapist

Show Notes on Insights from Dr Adilia Silva

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Contact Details for Dr Adilia Silva

Mobile Number :: 060 479 9823

Email Address :: adiliasilva@yahoo.com

Practice Address ::  32 Good Hope St, Kensington, Johannesburg, 2101

Website Address :: www.asfsilva.co.za

Full Details Related to MPP 020 :: Insights from Ashley Jones an Occupational Therapist | Moulding Private Practice | KITRIN

In this episode, we discuss the intricacies of running a private practice as an occupational therapist in South Africa with Ashley Jones

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Show Notes on Insights from Ashley Jones an Occupational Therapist

What does an Occupational Therapist do?

So an occupational therapist focuses on function. So be it for children, for adults or be it for the elderly we want to see function. And function ties into your occupation and that’s why we are occupational therapists in that occupation is anything that you should be doing in your day.

So it can be activities of daily living which are things like bathing, dressing or eating. It can also be instrumental activities of daily living which are preparing food or doing washing or cleaning. And then we get our work, education and play and all of that depending on what phase of life they are.

I actually did a post on our Facebook page, I wrote about function and what are the occupations and what are sometimes the hurdles that we face in these occupations. If it’s a client that’s had a stroke, they might not be able to bathe themselves anymore. And they almost need to relearn how to do it, or to find ways to compensate. And so it’s all about treating these hurdles that are affecting your occupation and what’s important to you. If you hate cooking and never want to cook again, we’re not going to teach you how to cook our rehab isn’t going to focus on that. It’s about helping you to be the best person that you want to be.

Did you always know you wanted to be an occupational therapist?

So for me, it evolved I was where the general public is at the moment and didn’t really know what it was. Even with having a brother that was in occupational therapy, I didn’t really know what it was.

But I’ve always had a passion for children. So that’s where my interest stemmed from and I sat and thought okay, what can I do with this. My first thought was to go into psychology and specifically be a child psychologist. And then I sort of stumbled on OT and just reading it and reading about the way OT does it and how they look at things, and what you focus on. On a person’s inherent job, on their own motivation on all of that, that was like “WOW” and I was sold and went on to study it. It’s an amazing career to be in.

Did you always know that you wanted to go into private practice?

Yes, I did know that I wanted to go into private practice and it almost strengthened throughout my studies. And going and working with other occupational therapists, made a phenomenal impact on my career and what I had chosen. So I did know I wanted to be in private practice, I just didn’t think it would come as quickly as it did. I thought I would be in that profession for 10 years and then I change over to running my own practice.

But the opportunity arose and I went with it. I was like, I’ve got this space, let’s go and it’s been an interesting road. It’s a very rewarding thing to have something that you can put your passion into. Your full passion and your interests and just reach a wider population, through doing talks and webinars and all of that. So that’s been a very exciting part for me, but it does come with numerous challenges. There are things that no one really tells you about. And then two months into the practice, you realize, Oh, hang on, I need to get this up to date or I need to comply with these regulations. So it’s a bumpy road, but I definitely think it’s worth its more ups than downs.

So when you say there were some ups and downs along the way could you tell us a bit more about that?

I think a lot has to do with that the more management parts, being an OT doing therapy almost comes naturally. And you love it, but then to actually sit down and think okay, where do I want to go to? Do I want to run a multidisciplinary practice and have a speech working alongside me? Or do I just want to be my own person and work on my own?

And I think I had a straight path that I’d set for myself, but that was one of the most difficult things to adapt to. For me, I mean, I play with children for a living it’s a very fun job but you sit down and try and do taxes which is really not my strong suit. And so a lot of that was quite difficult for me and luckily I signed up with a billing company smeMetrics from the start. So that almost took a load off me from word get-go. But there are all the other things like marketing, accounting, financial planning and all of that, that you sometimes let slip by the wayside?

Did you have a mentor or someone to show you the ropes?

So yes I definitely, at the practice I worked at before I opened my own practice. I was lucky they involved me in things such as billing, medical aid codes and everything. So already then, I had that skill passed on. And, you know, it all depends on who you’re working for. But the lady I worked for has still to this day, been an amazing mentor.

When I told her, I’m going into my own practice, she sat down with me. And said, just make sure you have this and this and this, and this in place. Which was amazing, and I often look back and think, how much how difficult this road would have been. If it wasn’t for her that sat down with me. I would have, had to figure that all out by myself and probably sometimes not in a good way, you know, a parent crashes into your gate, and you don’t have the right insurances, you’re gonna learn a very difficult lesson.

And so it definitely is very important to have a mentor. And, you know, if you’ve worked under them even better because you know them and, and they know you, and they know where your personality lies and what you might neglect as well.

What advise would you give someone who is thinking of going into private practice?

I think the most important thing that I’d say to someone is, “where does your passion lie”. Private practices are so diverse, and especially with occupational therapy, there are so many routes you can go. And I think the first one is to, find that passion of yours. What is your passion? Do you love working with older children or younger children or adults or mental health and just to go from there?

Because, the business side is hard, but you can get it right and there are resources out there. But you follow that passion and you slowly start seeing, what are your expectations? Are you aiming to work in a school or do you want to see the patients being pediatric OT. And then take it from there, slowly it’s almost like eating an elephant one bite at a time. Once you have that in place then take the next step further. And look at what therapy styles are you going to offer? Do you like sensory integration or DIRFloortime®? What I believe is what grows your business is your passion. And yes there are hurdles in the journey but as long as you have that passion and can follow I think it’s the most important to do that.

But research is really a very important thing as well. You need to have a look at where other occupational therapy practices are. Decide are you going to work at home, do you want the tax benefits from that? Or do you want to work from a school? Where is the closest practice to you? You can’t open up another practice three houses down and think you’re going to have a constant flow of clients because it may not work that way.

But I think the first thing is just to take the first step. As you start going through that and you get your expectations in a row you can cover the more abstract things. That we don’t necessarily think about. Things like your taxes and your insurance which is very important and probably should be first.

Is there anything from a practice management perspective that really surprised you?

So with my journey into the practice management side, I found that bookings play a big role. If you are in therapy all day, how do people book an appointment? That’s a big consideration, and you need to have things in place to deal with that scenario. I came to learn quite quickly that we also have to have that relationship with the parents from the start. They see your name from a Google search or from a friend or whatever and do take that step and phone you are actually a big thing. So you need to meet them there and you need to tell them what you do and how you can help.

Is it’s a case where you don’t see teenage children so the thing to be able to say I understand this, this is the base place you should go to see someone with that interest. So for me, the bookings has been a constant for me. It’s not, the receptionist taking your bookings and it’s you doing it and you establishing those relationships.

I think all round the financial things are the most difficult. But you do learn as you go and to have a support network around you with people that specialize is very important. I mean, I did the practice management course, to help start my own practice, just before I went into practice. At my age, I still got my little bookie, where I wrote down the notes. I go back, there and check, I have crossed all those things out? Have I met all those expectations, but it’s a constant thing you need to just keep up to date.

Working from home has that been what you expected? And is that something that you would recommend to someone as opposed to working at a center?

Working from home has worked very well, for me. When I decided that I wanted to open my practice I wanted lots of space and I needed lots of space. And that’s, what made the choice to work from home, with a center, you might not get that experience.

But with that, it does come come down to environment. If you going to someone’s home, and they keep up the maintenance it doesn’t always give the base image. So you have to stay very up to date, if you work from home with those type of things. And it’s sometimes things you don’t think about, if you have a friend visiting, what do you do in that situation. So I think luckily for your pediatric clients, it is a better thing.

But I do feel that a center also has a very good approach and you can knock on other people’s doors a lot quicker. And one thing I’ve battled with from working from home, is that it was quite a lonely experience. Coming from a practice where there was another two occupational therapists to suddenly being all on your own. No one was there to quickly, bounce ideas off of. That is difficult and and that’s something that I’m working towards it to actually turn the house that I’m working from into a multidisciplinary area. And that will take a while.

But you I think, for starters it’s actually more beneficial to be with a group of people. If that’s your personality,or you are not great at being alone.

Would having an assistant would help, or do you just schedule certain times of the day to do things like admin phone, back client etc.

I personally feel like an assistant would be easier and would be to benefit me as a person. So that I can spend most of my time doing what I love, and that’s seeing the kiddies you and treating them. Unfortunately I think often when you start private practice, it’s not always in your, financial ability to have that.

But I think it is a very beneficial thing to look into. And to get that going right from the start so that you don’t let one clients slip through the cracks and never back to them. Because I wouldn’t like to phone a doctor, because I’m sick, and they never get back to me. It’s the same with an occupational therapist. But definitely would be an asset to any practice to have an assistant that can take on the things that aren’t your strong points, be it debt collection, or anything like that, that an assistant or system can take on as well.

If somebody was thinking of becoming an occupational therapist what advise would you give them?

If there’s anyone listening that thinks, this is the right route for me. My advise is to really do your research and follow that passion of yours. You can move mountains in your own practice, but you can also move mountains working for someone else, if it’s your job to do it, go for it, you know, flourish from there.

Contact Details for Ashley Jones

Email Address :: ashley.brighteyestherapy@gmail.com
Website Address :: https://bright-eyes-therapy.com

Full Details Related to MPP 019 :: Having No Limits in Your Private Practice | Moulding Private Practice | KITRIN

In this episode, we discuss the importance and strategy for having no limits in your private practice.

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Show Notes on Having No Limits in Your Private Practice

But if it did, if it just positively benefits someone that’s listening to it, and they make a positive difference in their lives and private practices, I think that would be a useful story. If we did get that story back, via a comment or an email, or something that would be amazing. But I’m not expecting that I’m just expecting that when we put out this content, it’s beneficial, it’s valuable. And someone that’s listening to it or watching it can take something of value, and run with it.

So on this idea of building, and again, using an academic approach to this, there’s a book that I want to reference. We spoke about this before, I’m not sure if you remember it some time ago, but it’s called No Limits Now. And it’s by John Maxwell. So everyone if you look looking at any motivational book. John C, Maxwell is the book that you want to be reading. And, one effect is on no limits. So in the book, I want to read the last paragraph because it kind of sets the tone for what we’re going to discuss.

And he says “if you’re aware of yourself and your ability to improve if you develop the abilities you already possess. And if you make the everyday choices that will help you improve, you will reach your capacity, your life did not have limits. As long as you are breathing, you can improve, you can make a greater difference. It’s all within your reach. All you have to do is seize it”. That’s a good way to put it, don’t you think?

Awareness of possibilities

I mean, it’s quite a complex one because he goes into all of these capacities that you have. I’m not going to go through every single one. But he just talks about being aware of the possibilities which we’ve already started speaking about. The fact that healthcare practitioners in private practice have all of these possibilities that they can harness that is not just time-based. That’s the biggest thing we wanted to get out of this is that it’s not just time-based. It’s not just about building a practice that’s doing R 70,000 per month.

It’s also an opportunity to build a practice. That’s just limited to the time on an everyday basis. So if you know what the possibility is, and you identify and develop the capabilities. That’s the other, parts of this, then I’m hoping this show will start fulfilling that gap. Most people don’t know what they don’t know. And unless you can identify that you do need to, go through and, look at, okay, the areas you don’t know too much about and then go find out.

And hopefully, the content that we’re putting out will kind of move our listeners in that direction. So that, yes, maybe they don’t get all 100 points from this from the show or from the episodes that we’re putting out. But at least they have the reference material that they can go and dig deeper and find that content if they need to. The book talks about making smart choices to allow you to reach your fullest potential, and become successful in developing these capabilities.

Example of being aware of possibilities.

I think when you start looking at it, introspectively and seeing okay, well, what can I control. And if I know what I can control, then I know what I can change. The best example of that, for me, would be three years ago, you wouldn’t have caught me dead in a gym. And then I looked at it and thought, but I can actually control my fitness level. I can take that step and see how do I do this. Just by changing that mindset of, but I control this, you start to see the benefits. And again, it’s just building it into that habit. But once you know where your limitations are, and what they are, you can find a way to get either around them or work through them. And from there succeed.

Energy Capacity.

I like that example of the gym, and getting caught dead in the gym. That kind of conundrum into terms of how that would work. But I like the idea.

So if I go back to the book, he talks about energy capacity. So touching on your gym idea, he talks about your ability to push on physically, I mean, that kind of makes sense. You know, if you’re sick or you not feeling well, there’s no way you’re going to be concentrating anything on developing yourself for your private practice, emotional capacity, your ability to manage your emotions. I think this year has been one of the years that everyone would remember. Definitely in our generation and in our lifetime. And I kind of see it now towards the end of the year, how people are getting quite drained because it’s a few more weeks, and then we are into the holiday season. And you can see the toll of like the emotions of this year in terms of the COVID 19 pandemic. In terms of how tired people are and sick some people are getting but it’s just the stress of that.

But again, if don’t have the capacity emotionally, there’s no way you’re going to be developing, building, or identifying anything. When it comes to my thinking capacity, my ability to think effectively. This is a term lots of people use and inspire critical thinking, and knowing this and our adventure to say this is probably one of the most difficult things to do. Because unless there’s there’s something or someone that’s pointing you in the right direction. It’s difficult, to know what to do.

I mean, you don’t know what you don’t know. And I’m hoping that some of those discussions will kind of spur on thinking.

People Capacity

Then you talk to my people capacity, your ability to build relationships. And I would say not just build relationships, but almost build capacity from an operational perspective. So what I mean by that is, for instance, with the Kitrin team, there is no way that I will be able to do what we need to do from a client point of view and a business point of view. Without having the team behind us to be able to do that it’s impossible. And just the fact that we’ve spent time on building the people capacity. Making it quite a conscious decision that we constantly building the skills of the team. That when something is going wrong, we spend the time on the training and thinking about it, not with the purpose that I know all the answers. But for the purpose of we are a team pointed in the same direction. And how do we use our common sense and intelligence to be able to come up with a solution for the thing that we’re struggling with right now?

So I think when healthcare practitioners think about this, this is probably one of the biggest things that I find doesn’t happen. Because the healthcare practitioner thinks that they, they can do almost everything, and it doesn’t quite work like that. So either you outsource those skills, or that capacity, as in, you get a company or you get a team that’s outsourced. And they can do this for you. Or you build a team that can do this. Both of those, options work.

Obviously, the first one, when you’re outsourcing it to something like the managed service that we offer, which is the Isoforge product, that’s a much more cost-effective manner to do it. But the best option is to build a team. Like we’ve been doing at Kirtin, that has a lot more in terms of monetary cost, as that obviously costs a lot more to do. But that’s a really good option. And there are many practitioners that have actually done this with good effect.

Creative Capacity

In talks about creative capacity, your ability to see options and find answers. I think this kind of ties in with the thinking one, but again, I would say it’s difficult to do this unless you actually have the ability to think creatively around the problems. And if you’re not as close to the issues, you do need someone that’s a lot more attached, that can provide that insight, whether that be a therapist, a coach, someone close to you that can point this out. But you do need someone to point you in that direction.

Production Capacity

Your ability to accomplish results, I will tie this a little bit to the people capacity, but it’s not quite the same, but it’s about getting stuff done. In private practice, the operational part, it’s getting your invoicing, your payment allocation, following up with the medical aides or the health insurance companies, it’s following up on overdue accounts. That’s kind of production or operational related. And you do need to know how you’re going to do that. Normally, that is either you’re doing it yourself, you’ve got a system to do it, you’ve got a team to do it, or you’ve got an outsource partner to do that.

Leadership Capacity

Leadership capacity is your ability to lead, to lift and lead others. Now, that’s quite important when it comes to a team. And it’s not as simple as just having a team and then everyone just does their stuff, like this just doesn’t work that way. Or else we wouldn’t have managers in the world we wouldn’t have CEOs, we wouldn’t have, all of these business development and operational managers. So there’s a certain art form, and there’s a certain skill set about how you manage people. And, again, if I had to venture healthcare practitioners never got trained on this, they might have amazing soft skills. But I think to become a leader or a manager is not just about having the soft skills, it’s about quite a few different aspects.

And one of them being, do you actually know how to do the work? And once you have those things in place, you can actually become the leader for the team that you need to be. I would say also, it’s not just the team, it’s about everyone that’s connected with your private practice. Whether it be an outsourced partner, a person that’s in your office, a referral source that you depend on. All of those become your ecosystem, and you need to know how to lead those relationships and build on that.

I don’t want to go into too many others. And I mean, typical, John Maxwell style, he’s very in-depth.

Abundance Capacity

But there are other ones like discipline, capacity and attitude capacity and abundance capacity. This is a good one, because it’s, the one from a values point of view, that I kind of resonate with. Because I always talk about abundance. And you know, we are not closed off enough that there’s only a certain finite amount of value that or things that we can get.

I think if we really think about it, it’s limitless, and which kind of goes with the No Limits concept. But that’s the idea is to have that abundance capacity. And that’s pretty much it. I definitely recommend that everyone goes and reads the book and sees how to apply this in their personal life and their private practice.

Full Details Related to MPP 018 :: Insights from Shelley Hall a Clinical Psychologist | Moulding Private Practice | KITRIN

In this episode, we discuss the intricacies of running a private practice as a clinical psychologist in South Africa with Shelly Hall

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Show Notes on Insights from Shelley Hall a Clinical Psychologist

What is a clinical psychologist?

It’s, a little bit of a difficult question to answer at the moment, there have been some disagreements around scopes of practice. And so it’s really based on competency, what you’ve done in your training, and what sort of supervision you’ve had.

But traditionally, in the way, I was trained, and most people of my age group, I believe, you as a clinical psychologist, you have to spend at least six months of your internship, where you’re working in a mental hospital. So our focus is mostly on actual mental illness, working in hospitals or working in private practices, with that focus on mental illnesses if that makes sense.

What made you decide to become a psychologist?

Pure fascination, I come from a family of teachers and I didn’t quite know what I wanted to do, but I knew I didn’t really want to be a teacher. So I went off to university started doing psychology in my undergrad, and I just wanted more. And then I was fortunate enough to be accepted into master’s program, and then into clinical psychology because, in those days, they took very few people into the clinical programs. So it was just yeah, a fascination that really, really grew. And it’s definitely a passion.

Were there any role models/ mentors that you had growing up that shaped you to be a clinical psychologist?

My life was quite impacted from a young age, I lost my father when I was about nine, just very, very suddenly, he had an aneurysm of the aorta so it was just a sudden death that knocked all of us. And I think I wouldn’t really say I’ve had any role models, I’ve always had to be quite independent from a young age. So I think that just sort of drew me to the profession, and just wanting to be able to support other people who go through major traumas in their life because it is it’s completely life-changing. So I think it did pretty much grow from that.

How long have you been in private practice

It’s a little bit of a story again because I actually finished my training and went into private practice for a year. Because, as clinical psychologists, we have to work for the government for a year for community service. So I did mine at Ngwelezana Hospital in KwaZulu-Natal, which is a local hospital.

And then I was in private practice with a colleague for I think, two years. My husband and I then decided we wanted out of South Africa and wanted a different worldview. So we actually went to Jamaica, based on his qualifications as a farmer. So we were over there for about almost 10 years. And then we moved back to South Africa. So we’ve been back for about six years now. So I had to start my practice over from scratch.

Were you still able to practice as a psychologist in Jamaica?

I had stamped my passport that I was not allowed to be employed, but what I did to keep myself current is I actually joined their board, because, at that stage, anybody could call themself a psychologist to work in the fields in Jamaica. You can imagine the horrors we were seeing.

So I joined the psychology board as their secretary for a few years and we managed just after I left, to get it through with the government that you had actually had to have specific qualifications to practice psychology. And then I did some voluntary work with mustard seed organizations, actually a Catholic organization. And I ended up teaching, I ended up teaching at a school as well, the thing I did not want to do as a child, but I’m glad it’s helped me a lot. When I’ve got to assess children and things like that, having a teacher’s perspective as well, has actually really helped, it’s been quite a journey.

Coming back to South Africa, after being in Jamaica, and having to rebuild again, were there any challenges that you faced having to literally start from ground up again?

Yes, it was quite difficult, you know, trying to get my head back around things like medical aids and ICD 10 codes. And just getting your name out again, was quite hard, I can remember I printed a bunch of business cards, and I went around to all the doctors, and very few referrals came in.

So it’s been very, very much realizing it’s actually word of mouth and having good collegial relationships, and just running a business, because that’s something that our training does not cover and essentially, you’re actually running a small business.

So all of these things were kind of thrown at me and trying to figure out the best ways, the most cost-efficient ways of running things, and finding office space and all of that. But it’s actually it’s been really exciting. I’ve really enjoyed it.

Do you have an assistant helping you? Or did you get eventually get in an assistant when you started your practice?

Initially, I didn’t, I did everything myself, which I think is very valuable because you really learn and get to know your business from all aspects.

So last year, I had somebody join me just before lockdown, I took on a lovely young lady, who had no experience at all, and she’s had to learn all the ropes with me, and we slowly getting there. That’s been a big, big help because I do also have two young girls of my own. So it’s just not having to come at home in the evening and still have to do your billing and follow up with the business side of things. It’s so nice.

Also, we can’t answer our phone when we are with the clients and some people don’t seem to understand that and they get quite irate. So it’s lovely to have somebody who can do all of those things or if you’re in a zoom session, and somebody calls Get on to the session that your receptionist can assist you with that and help your client.

When would you kind of start suggesting that person maybe takes that first step to go and maybe I just need to have a chat to somebody?

Often people come when things are very, very broken, and it’s much harder to fix. You know, we’re not all happy all the time. That’s impossible. We do all go through moments of sadness. When a trauma, something happens, whether it’s a loss or something like a hijacking, you do expect a few nights of disturbed sleep, feeling unsafe, all of that is normal.

But when things start to persist, like if you’ve had a sad mood, or if you had a trauma, and those symptoms are increasing after say, two weeks, then it’s worthwhile just checking in. Even if it’s just for one session, just to find out, what can I expect? How should this progress? What are some things I can try to see if I can relieve these symptoms on my own? And it’s usually a good idea if you’ve been trying for two weeks, and things are just not getting any better?

And of course, the minute you start feeling, actually don’t want to be here anymore. I wouldn’t mind if tomorrow morning, I just didn’t wake up. That’s a massive red flag, then, you know, then it’s, I wouldn’t even wait the two weeks, then, you know, you need to really try and see somebody quite urgently.

If I start seeing a therapist, is it going to be years in therapy?

I think in most psychologists, we don’t want to keep our patients sick, trapped in therapy forever. We’re all very, very well aware of financial constraints. So most of us when you come for the first time, we’re going to sit there people always go, why must I go back into the history, but we must because we like to conceptualize, we like to see where you’ve come from where you are the moment get a really good concept of watching needs.

So we can say to you, it’s very hard to say where there’s gonna be two sessions or ten sessions because things can organically kind of come out in therapy. But generally, we want to keep you there get you well, again, as quickly as possible give you the skills, so you can get on with it. If we need to refer you to a psychiatrist, we’re not allowed to prescribe some medication, if we feel is a diagnosis and a reason or neurologist if we feel it could be an underlying condition causing something.

But our aim is to get you back out there. We don’t want to have you lying on the couch for years and years and years of possible.

I think we should also just qualify that, you know, if you had something like a bipolar disorder or a really, really severe depression, then it might be that you would be checking in more often. And then we do start spacing it out so that you are coming in like say once a month and then every three months and then every six months. And with those sorts of disorders you do kind of go backwards and forwards especially if you’re not well maintained on your medications, then you might need to come for a period of more intensive therapy again. But generally, that is the aim to try and get somebody stable to give them the skills. So they rely on us less and less.

Anything else that you would like to let people know from a clinical psychologists perspective?

I think just on their points, actually wrote an article on my LinkedIn profile a little while ago, is people tend to come when they are in crisis. And I find it quite interesting, you know, we want to exercise you want to do mindfulness, you want to do all of these things.

And then people will say, Oh, you know, I’m writing exams, or I’m so pressurized at the moment, I can’t come to the exercise class, so I can’t make my therapy this month. That’s really interesting. Why would you drop the healthy habits that are maintaining your physical and mental health, when you’re under more stress? Put down the running shoes to increase your stress time. Doesn’t make sense, but we all tend to do that. That is when we should actually increase those habits really not decrease them? And I think that’s something I’d really like everybody to think about.

Contact Details for Shelley Kim Hall

Mobile Number :: 0630552172
Practice Address :: 5 Addison St, Empangeni Central, Empangeni, 3880
Email :: shelleykimhall@icloud.com