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Episode 122 | Getting Organized Behind the Scenes with Janaya Sadler


WITH Janaya Sadler

  • Episode 122 | Getting Organized Behind the Scenes with Janaya Sadler 00:00


Hi Group Practice Listeners! In this episode, I’m talking with Janaya Sadler all about getting organized behind the scenes in your practice.

In this episode we cover:

  • Identifying what needs “fixing” behind the scenes
  • Retention tracking
  • Communicating expectations
  • Marketing

This episode is sponsored by TherapyNotes. TherapyNotes is an EHR software that helps behavioral health professionals manage their practice with confidence and efficiency. I use TherapyNotes in my own group practice and love its amazing support team, billing features, and scheduling capabilities. It serves us well as a large group practice owner.

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Maureen Werrbach

Hey everyone, welcome back to another episode. I am excited. This episode is a coaching episode and I have Janaya Sadler on and I just want to say you’re a person that I feel like I’ve been following in the virtual world for a while now because you’re you’re really good at communicating things in your business and what’s going on. So I’m really excited that you’re on the show. So welcome.

Janaya Sadler

Thank you for having me. Morning. It’s a pleasure to be here today.

Maureen Werrbach

So we’re talking today about how to get organized behind the scenes. And I’m really intrigued by that statement, because that’s what you put on the coaching application. So I’m excited to see what it is behind the scenes that you’re wanting to organize and how I can possibly help a little bit.

Janaya Sadler

Yeah, you’ve been so helpful already. I enjoy all of the information and feedback that you provide on the site as well as in the group. It has been very valuable to my practice. So thank you for that. And I’m just so excited to talk to you one on one today.

So behind the scenes, I know that is very broad. So when I look at behind the scenes, I look at space. But of course with telehealth, I’m not going to talk a lot about that today. Unless if you’re going to give me some tips on how to keep my house clean! But then I think about tech and I think about G Suite managing email. I’m pretty good with that. And then I think about time management techniques and like productivity hacks, things like that.

But today I want to focus more about on how to organize what’s next. I feel like my practice is at a good place where I’m delegating. I’m semi following Clockwork. I’m doing less work. I’m only seeing about five people a week. But I’m still having problems on what to focus on next as like overall design work.

Maureen Werrbach

Ooh, that’s a good question. So tell me, where’s your business? I know you said you’re seeing around five clients, which is really good in terms of being able to focus the design work, right. Yeah. You said you’re following clockwork mostly. Where is there an area before we highlight the design part of it that you’re not fully focusing on? Or is it that you’re you feel like you’re doing good enough in it?

Janaya Sadler

I’m good enough for that.

Maureen Werrbach

Okay, yeah, so with design work obviously for those that are listening that’s part of Mike Michalowicz, his book, Clockwork. And he talks about the four D’s. And the design work is kind of the where you want to get to as a business owner, where you’re essentially doing that visionary work. So if you think of design, think of vision. So, back to you. Do you have a business plan?

Janaya Sadler

Yeah, I have a business plan, on what I need to work on focus on. Let me tell you a little bit about my practice Urban Healing located in Raleigh, North Carolina.

We have four clinicians which consists of a full time clinical director, two part time clinicians. And within those two part time, one is fully and two other ones are associate licensed. I recently hired an admin staff, which is VA and she does billing scheduling EMR. And I don’t know if you remember I just transitioned from notes to theranest. So that was like a huge big thing I should have did it years and years ago.

So those are kind of where I’m at in my private practice.

And so when I think about like design work, is like do I focus on clinical stuff? As far as like documentation training for my employees? Am I focusing on workplace culture? Do I do more systems and pay attention to dashboards and metrics? Am I supposed to do marketing next accounting? Am I supposed to cultivate my leadership skills right now? So I feel like I have a little bit more free time since I’ve hired this admin staff. But I’m still at what to do next behind the scenes.

Maureen Werrbach

Um, have you read Mike Michalowicz’s book Fix this Next?

Janaya Sadler

No, I haven’t.

Maureen Werrbach

You haven’t? It’s it is reminding me a lot about the question that you’re bringing up. Mm hmm. Because essentially, he talks about, you know, what you should be fixing next behind the scenes of your business. And I know, we’re bringing up, you know, the design work. And in his book Fix this Next, he talks about–it’s similar to Maslow’s hierarchy of needs–but this hierarchy of needs.

And essentially you start at the base, which is sales and there’s a few questions that you can ask or answer where you can find out if sales area is an issue that you should be focusing on. Next comes profit. There’s a couple profit related questions. And then there’s order which is like the organizational structuring piece. And that’s where some of the things you were mentioning, like should I be focusing on admin stuff or intake stuff will come in. And there’s impact and then there’s legacy. So impact is the impact on your community, is that an area that you should be focusing on? And then legacy is like, making the business go beyond you.

And so he talks about each of those stages and essentially what you do forever as long as you own a business is you as you go through and find out what your “next” thing behind the scenes is that you need to be focusing on.

When that thing gets fixed, you take that test again and see–because it’s not you don’t go up and then get to the top same with like Maslow’s hierarchy of needs, right? You might be you know, getting towards self actualization, but if your house catches on fire, you move back down to the base and have to find you know, a safe place to stay. And it’s similar for business and so my thought would be is that figuring out what to work on next in your business, using something like Fix this Next is a great tool to use to see where there is maybe a gap or a hole that you haven’t been focusing. And then the whole point of it is then to make sure that you’re spending all of your time behind the scenes focusing on that one piece until you fix it. Does that make sense?

Janaya Sadler

It does.

Maureen Werrbach

I mean, I guess let’s go through it a little bit.

So for sales, that’s the base and I just want you to let me know, “yes, this looks good to me.” And we’re doing this in a very quick version of it, just to see where you feel like you land. But when it comes to sales, do you feel like your clinicians are collecting on their income? Are clients for the most part paying for their sessions, or do you feel like there’s a gap in payments? Or are there what you would say is an unordinary amount of payments that aren’t being collected either by insurance or by clients?

Janaya Sadler

I feel like we’re good with that. But they’re not full. And the reason why they’re not full is is because I’m doing less marketing, because I’m scared that the behind the scenes things are not fixed.

Maureen Werrbach

I mean, we wouldn’t even have to go much further than that in the sales realm. Yeah. That’s not collecting on commitments, obviously. Sounds like you’re doing okay on that.

Janaya Sadler

Yeah. Great with that.

Maureen Werrbach

But are you having an issue with client conversions, like converting people into clients or is it getting people to call?

Janaya Sadler

Two things. So now that I’m having the time to pay attention to metrics is retention. I have two new, provisionally licensed employees, and I’m finding that retention is the issue. And then I’m not doing any marketing. My full time therapists is full. So yeah, so some of it is retention. And it’s because a lot, maybe more can come in the door. And I’m not because I’m scared that they’re not going to know what to do when do come in the door.

Maureen Werrbach

Okay, it’s sounding like two two things. One is administrative, right, in the marketing realm and getting to know that you exist and call.

But the second piece is more of a clinical issue. And that’s maybe towards relating to retention. And is this an issue that’s related to­–so this is something that we’ve been doing our own data on. Seeing because we track retention normally, but we’ve been tracking a shorter term retention, just two sessions to see if people return after their first session on telehealth and establishing rapport is a little bit different via telehealth than it is in person, right? So your retention, is it that your historic retention or is this like COVID time retention?

Janaya Sadler

I’m just beginning to track this and we should have been tracking it. Overall, I’m just looking at like, really three sessions are they come in back? And partly, a big issue I see is that this is private pay. So my provisionally license are at a an affordable private pay while I’m getting them you know credentialed.

Maureen Werrbach

So you’re basing your retention around three sessions and you’re finding the two provisional people are not retaining whatever percentage have clients that you use appropriately. Okay, so I would literally focus on that first one because it’s a quick behind the scenes fix.

Marketing can be a quick fix, but it’s also more of a long term haul in some ways, right? This is about establishing know, like and trust factor. So there aren’t many ways to get just a blast of new people in by doing one thing. And so I like to start with things that can have like short, quick success.

I would initially focus on retention because you don’t need as many new clients coming in the door if clinicians retain their existing clients.

So the the issue of getting new clients in the door goes down a little bit. Obviously it’s a secondary thing to work on but it becomes less slightly less important when those that are coming in are keeping the clients that they have. Like a pool with a hole, if you can plug the hole, you’re not going to have to worry as much about filling new water and every time. So this essentially is a coaching issue. And so I would say does your team know your retention expectations that you have on your end?

Janaya Sadler

On my end, because it’s so new, like literally like within the last two to three weeks, I’ve been paying attention to it.

Maureen Werrbach

So yeah, I would use this as an opportunity to talk with them about retention, what it means to you and your business. Why it’s important. You know, for me what when we explained it, you know, I mentioned it’s not about like trying to make an arbitrary number that is really unattainable for you. It’s not about trying to find you doing something wrong or not being good enough at something. It’s not something for you to be competitive about. It’s really one way for us to ensure that client needs are being met.

And, you know, and that low retention isn’t necessarily meaning that you aren’t a good therapist, it can mean things outside of you specifically in your skills. That’s what you can dive into behind the scenes.

It could be that you need to grow in your skills. And that might be one reason for retention. But it could be a host of other things, and then just, you know, you’re in a great position because they don’t yet know how to really make this a positive thing.

A lot of owners talk about it when their staff have low retention. But you haven’t had this conversation, you can get fresh from the beginning to say this, what having good retention will do is not only help clients get the help that they need, so that they’re not leaving and potentially not finding another therapist. But it also helps with your own satisfaction, because you feel good, right? We as therapists feel good about We feel like we’re doing good work. Yeah, clients that are leaving after one or two sessions every single time or most of the time, it doesn’t, it’s not going to help that.

That therapist who has low retention, whether they say it out loud or not, is going to have some feelings about why clients aren’t staying right. And so it also increases client-clinician satisfaction, and staff satisfaction. I would bring that up, and then say, you know, what my goal will be is for you to know your retention, so that you feel like you have an objective grasp on your work.

Every job on the planet has this type of tracking behind the scenes.

And I think when we get into the feelings of kind of job like being a therapist, we like to take objectives and measurements away because it feels too non human and connecting. But I mean, in every job there is–m first job was at Hallmark Cards. Selling cards. And we had like, objectives on how many? Like how if we if we were doing our jobs? Well, there’s a handful of things, things like, you know, client or client, customer complaints or whatever. But um, how well, the cards were stocked, they had like some way of measuring every day, at the end of the day that cards were restocked the way they needed to be. And then also they have those like trinkets and stuff, you know, yeah. They had an expectation on how many trinkets like you had to just try it almost like try to upsell them and not just get a card, but like, buy these random flowers with balloons that are sitting on a shelf, like that kind of stuff. And so those that were selling those things, you know, obviously we’re getting, were doing their, air, quote, job well. And so every job has this and so it’s just getting to a place where they understand that this is one way for them to even self measure that things are going well.

And then I’d expand on that by saying, I want you to look at retention and–those that are listening don’t get to have my visuals right now. It helps to me move my hands around–does that retention is like the separate issue over here.

And then me and you are side by side right here. And we’re looking at retention as the as a potential problem. But you and me are over here. Retention doesn’t equal you, you are not the problem. Retention might become a problem. If it ever does. We’re going to look at retention over there in the corner at the at that problem. And you and me together, we’re going to exercise and see what could be contributing to it.

I would in the beginning, give examples so they can get a sense that it really isn’t always about them. Because it could be that the bio on the website isn’t clear enough and that the wrong type of clients are being attracted to you and scheduling. It could be that our intake person is doesn’t quite know your specialty like you like they should have and we need to maybe have you sit down and talk with them a little bit more about who your ideal clients are so that they’re not referring you the wrong type of clients. Again, maybe it is a clinical skill issue and you need need more supervision because they’re provisionally licensed.

And maybe it could be a rapport building thing behind the scenes.

So maybe their clinical skills are first, especially if people are living up to their one or two sessions. It might be like, how are you having that first session? You know, are you knocking? Are you doing like a very, I know, depending on where you’re coming from. Mm hmm. are very clinical in the beginning and like you checklist asking questions, like, Seidel? Have you been homeless? And like, you know, agency based? Yes. Right.

That’s how hard it was. And I remember it was a big shift to just like, talk, yeah, you’ll be able to get the important information, historical information that you need, but without it being so like, you know, doctor’s office checklist. So it could it could be that it could be that you know, a whole host host of other things, but as you can see, 90% of the things I mentioned has nothing to do the therapists themselves. It could also be, you know, what are they saying in that first session when it comes to returning? Are they saying, you know, let me know if you want to come back?

Janaya Sadler


Maureen Werrbach

Maybe they need to be more authoritative. And the way therapy works best with me is scheduled weekly, we’ll touch base every month and see how things are going. Yeah, they’re feeling like the therapist is being a little bit more directive, at least in that sense.

Janaya Sadler

Absolutely. I think that will help a lot with being directive. And because our clientele, this is the first time that they’re in treatment. So I always, you know, try to teach them how to do therapy. So I think that will be very helpful. So pay attention to retention and the numbers. Okay.

Maureen Werrbach

Yeah. And then I would set up some way to normalize looking at retention. So that they feel connected to it, and see it’s not this negative thing. And so once you have the discussion, I would just as a leader, make sure that you’re checking back in, when retention, let’s say, isn’t great. And you have that initial discussion and you action plan, like, okay, we’re going to go whenever you talk to the intake person so that she can give you better referrals, because it looks like a few of those.

And another way of seeing where retention might be a problem is going into theranest, looking at the notes of clients who are active and retain and saying, like, what do they have in common? What are some things you want in common? And then looking at the ones that were not retained, and having them and asking, you know, that clinician, what are some things that these people have in common? Were they all couples, were they all I don’t know, young children, like maybe there’s some data that shows like that there’s some trends that letting that person know and you know, hey, there’s something very specific about the type of clients that are coming back.

And that is good information that you either, you know, do training behind or maybe not have those be their ideal clients, right? So I would I would look at that person, then just make sure that you’re checking in on them because that’s where that’s where group owners stop is they have the conversation, they think, okay, check, now that person is going to fix their retention doesn’t happen.

There really has to be ongoing behind the scenes conversations, even when retention is good, because if we’re only talking about it when retention is bad, then it becomes punitive negative thing even when we say it’s not.

So even when retention is good to say how are you feeling about your case? It doesn’t always have to be about talking about retention but say, you know, it looks like your retention is really good. How do you feel about the clients that you have on your caseload right now does everyone feel aligned with your your specialty? Because it opens the door for them to give feedback on, you know, intake is giving them still because you might have some clinicians who are good at retaining clients, even though they might have clients that aren’t their ideal, right?

Once you do that you can then focus on especially because you’re smaller, you’re the one that’s doing all of this, I don’t want to put both the marketing aspect and the real effect on you at once out of focus, you know, hold what Mike says, fix this next one thing. And that’s something that can be fixed relatively quickly. And you can start seeing changes on within, you know, the next couple of new intakes that they get, right? Yeah, then you can focus on the second potential issue, which might not be as big of an issue that people are retaining. You might be getting enough clients for the amount

Janaya Sadler

Oh, no, yeah, we’re not getting the national.

Maureen Werrbach

You might be and it just might look not at all in retention. And so we have so many clients, but then you can focus on the getting acquiring new people. That’s where it’s a little bit of a longer game because you have people typically come because they learn to know like and trust your business. And my first behind the scenes starting point and I don’t want to give too much stuff because it’ll feel overwhelming. But I would start with because this will give you some feedback right now and you can do this actually, right now at the same time, is make sure your intake paperwork has a very clear, where were you referred from? Mine is every place that I’m marketing, like when I put a new newspaper flyer, a flyer newspaper, I actually put that as a referral source in. Do you have like a paper form or a digital form?

Janaya Sadler

Digital forms that we’re tracking.

Maureen Werrbach

Yeah, I would add and I wouldn’t be general I wouldn’t have like Google.

Janaya Sadler

Yeah, so more specific.

Maureen Werrbach

I have Facebook and I have Instagram because I do both. Now if you don’t do both–

Janaya Sadler

I do do both.

Maureen Werrbach

I would put them separately because you’ll find you know, even if you’re putting the same sort of information on there maybe your ideal clients are found more on Instagram. And so if you’re if you have a flyer at a doctor’s office putting putting fliers I mean really being clear about it, having a referred by a past client or refer by a family member friend is important, because it lets you know maybe word of mouth is what’s working. So I’d start with that so that you can get, you know, for next month, let’s say yeah, and where people are finding you. For me. I am an advocate of doing more of what works. So if you have a few places that your information is circulating, instead of adding to it and adding more ways to market it might be that you just focus more on the things that are working. And I know you mentioned that you’re not really marketing. But you did mention Facebook and Instagram. So you’re doing something?

Janaya Sadler

Yeah. Oh, yeah, we’re doing that, not anything paid. So we’re just on the directories right now. And doing like their bare minimum. And I know I guess how to market like I said, it’s just the fear of more clients coming in, but thank you for explaining like the sales and the hierarchy. So although I have the fear of them coming in, I mean, I have to come in order to make money you know, and that the other issues, although and are important, and this can be fixed, you know, secondary, because we do have some behind the scenes systems in place. Okay, that’s very helpful. So retention, and then as sales, so focus on marketing as well.

Maureen Werrbach

Yeah. And I would start like right now by just having as clear of a tracking system for where how people are finding you those that then you can see is there one method that you just are using that you can just spend more time on and highlight and maybe you find that it’s scattered across all of them?

And then you can be you know, kind of at square one with what you choose to market and it really depends on your kind of your business as a whole. If digital is something that you like, it might mean being in Facebook or Google ads.

If you are similar to me I’m more community based, like our largest referral source is word of mouth is like telling people so we get do one free presentation a month in the community, and right now they’re webinars.

But we go to like the local YMCA or you know, a local nonprofit or when our Chamber of Commerce has something we go and speak for free or a local farmers market. You know, like will will really get in the community and do once a month, something for free. And because we know that when we are in the community, we’re offering free information and opportunity for learning for people who maybe can’t afford to come in or need to really know that they can invest the money that they do have in it by hearing us and be like, okay, I really like what I heard. And I’m going to try I’m going to try it out.

So, you know, obviously there’s two branches, which is in person, community marketing, and then virtual digital marketing. But once you start to get a sense of where people are finding you most you might find that one of these two is something that you want to focus on more. Yeah. Another conversation on how to do it.

Janaya Sadler

Yeah, and especially in this environment. Yeah. So definitely going to go back to the how did you hear about us and have more tabs because it is very general. On a couple of directories, and then just like online or social media, so I can definitely do that and spend more time in those areas. And then the goal is also to do a little bit more paid, like ads. We don’t run any ads and then community marketing as well. That’s always been a dream of mine to do more of that and those opportunities that constantly you know, present itself. Okay, thank you.

Maureen Werrbach

Yeah. It was really good talking to you.

Janaya Sadler

Yeah, really good talking to you, too. I appreciate it.

Thanks For Listening

Thanks for listening to the group practice exchange podcast. Like what you heard? Give us five stars on whatever platform you’re listening from. Need extra suppor? Join The Exchange, a membership community just for group practice owners with monthly office hours, live webinars, and a library of trainings ready for you to dive into visit www dot members dot the group practice exchange dot com forward slash exchange. See you next week.


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Meet your host


Maureen Werrbach is a psychotherapist, group practice owner and group practice coach. Learn more about her coaching services here:


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