When "Ask the Group" Isn't Enough: Expert Counsel for Your Practice

Camille McDaniel (00:03.95)
Welcome back for another episode. We’re going to be taking a look today at a topic that I know resonates with a lot of us. I’ve experienced it. I’m sure many of you all have experienced it or witnessed it. And essentially it’s about where do we go for advice when we’re facing a challenge in our private practice? You know, our first instinct oftentimes is to reach out to a trusted colleague, you know, pop up.

pop a question into maybe an online group that we’re a part of on Facebook, or if it’s another type of professional platform that we happen to be using, to just bounce an idea off of somebody, get an idea of what to do or what to say, how to handle it. And it’s important for me to just say right off the bat that I want to acknowledge that peer support is invaluable. So I know

how important it is for us to lean on each other. Essentially, that’s why I even created the Christ in Private Practice Facebook group. It went through different name transitions over the years, but it is the Christ in Private Practice Facebook group. And we do put things out there in the Facebook group to discuss, to think about. And so we need each other. We do need the camaraderie. We do need…

the professional knowledge that each person has to offer. But sometimes, sometimes, and this is what we’re going to talk about this episode, sometimes the questions that we have are not always for us to ask a colleague, because not all questions are created equal. Sometimes the questions that we have are very

nuanced maybe to our particular private practice or to our personal situations. And we may have a desire to throw it out there to our peers and to people that we trust just to get their expertise. But what we have to be careful about and we have to think about is the fact that certain questions do actually require specific expertise, a specific

Camille McDaniel (02:25.742)
kind of counsel, if you will. And we want to make sure that we think of the challenges that we are having kind of in the way of what might be the long-term outcome of me asking this person versus me getting someone more specialized in this particular issue. And we want to just make sure that we are using our discernment.

to just check in to see if this isn’t something that requires a little bit more deeper dive and more specialized professional in the area. So what we’re going to talk about today is when is a question appropriate for a chat with a colleague? When is it appropriate for us to actually get a professional consultation or specialized

service like supervision or whether we might need to do some personal reflection because it might be something that a colleague can’t really help us on because it is so personal to ourselves and our situations outside of work. So we’re going to let’s like kind of look at a few things that typically come up for us as business owners and as professionals in this field. And then we’re going to take a look at potential pitfalls if we ask

maybe questions in the wrong places and with the wrong individuals. So let’s kind of first just get out the way that in no way, or form, am I not advocating for peer support? Because like I said before, peer support is invaluable. We need to continue to lift each other up, to hold each other up.

to show up and hold space for each other, that is without question. We sometimes just only even need a listening ear real quick or to bounce something off of somebody real quick, right? You know, as we’re brainstorming as entrepreneurs. So I am not at all talking about that. I’m not talking about the biblical community that we also create as a body of mental health professionals who are also believers in Christ.

Camille McDaniel (04:48.13)
because we are called to bear one another’s burdens and to encourage each other in the faith. However, where we can sometimes stumble is when we take questions that have like significant ethical or legal or financial implications. And so we wanna treat those not so casual. We wanna make sure that we are careful.

of the dangers that present themselves. And sometimes the dangers are very real for us as private practice owners. And I know that that kind of can sound like, my goodness, Camille, what are you talking about? The dangers. But I wanna go over some things this episode and I want you to take note. Look at the show notes if you need to afterwards. Be very mindful because I’m going to try to be very detailed and I’m going to, like I said earlier,

try to give as much wisdom on how to proceed as possible. So just remembering that in mind, we’re going to kind of look at, first of all, what are some of the things that we have to be careful of? What are some of these dangers? I’ve already talked about the first one where I said, you know, there might be some legal, some financial, some clinical implications when we ask individuals.

who don’t have the right type of expertise. So as mental health professionals, we definitely have a certain level of expertise in the field of behavior, mental, emotional wellness. And then many of us have some specialization in a particular area. But that doesn’t necessarily mean that because we are in the mental health field and because we are business owners,

that we then are experts as it relates to employment law or all the nuances of HIPAA compliance or even all the tax codes that might go along with having a private practice, right? So we wanna just be careful that depending on the questions that we have, we are specifically checking in with people who are able to give us wise counsel in those areas.

Camille McDaniel (07:10.176)
Sometimes we have to be careful that when we are asking our colleagues, especially in open forums like social media, that we are not blurring the lines ethically. And I know that many people are very aware of this, but sometimes things come up in your sessions or in your business and it can be an emergency, not just feel like an emergency, it can be an actual emergency. And you may not know who to turn to.

And so you may find yourself then sharing in the open forum. You want to just be mindful that this doesn’t appear like a casual discussion that may kind of, you know, kind of be like walking a little tightrope on the details that you provide. I know that many groups online have rules around how much information you’re sharing, making sure that this is not identifiable information.

And I am glad to say that I witness a lot of mental health professionals who now really don’t even share all the specifics. They will just say, I need a consultation from a professional who specializes in fill in the blank. Had a situation come up today, really need an urgent consultation session. Is there anybody available? And I absolutely agree with that format. I think that is the best way to handle those.

Another thing that we have to just be careful about is the fact that sometimes we are in groups of like-minded individuals that may not necessarily be able to step back and actually give you maybe an alternate view. For example, you you have colleagues that are sharing concerns that they have or questions that they have online. You don’t really know each other extremely well.

and you don’t maybe feel comfortable challenging them, even if your heart is in the right place with it, because you may see an area that they’re not looking at or maybe a bias that you notice might be coming out in whatever they’re explaining. But again, this is a professional setting. We’re not super, super familiar with each other, although many of us are trying to get to know each other. And so you might err on the side of caution.

Camille McDaniel (09:28.384)
and therefore kind of give an answer or a response that you think is going to be neutral or something that you think the person will like versus really giving them what they really need to hear. And sometimes because you all may be also aligned, you might notice that it becomes kind of like an echo chamber. So like everybody is just giving you the same answer that they think maybe you want to hear and they’re not as comfortable pushing back.

So you also wanna just be careful of what you are asking and making sure that the group you’re asking is going to feel comfortable giving you the response you really need versus the response that might keep the peace a little bit better. Wanting to be careful and you’ll see in some of the examples that we go over, be careful about getting misinformation because you know, we are well-meaning, we’re helpers, we want to help.

but sometimes the advice that is given, it’s just plain wrong. Sometimes it might be outdated. So that can kind of then lead you down a path that can be detrimental to you or your practice or your client, depending on what it is that you’re asking. And just also be mindful like in all of this that sometimes you might be carrying.

an invisible burden or a very recognizable burden that you then are coming to the wider group for. And again, because this is not necessarily a formal group with a specific confidentiality, checks and balances, and making sure that certain things just don’t happen within the group setting, that kind of leaves you maybe a little exposed.

And so you want to just be careful of your own confidentiality when sharing really personal things in the group. I am glad that I will say like in the Christ in Private Practice Facebook group, people have felt comfortable sharing some things that maybe left them feeling really vulnerable and they were taking a chance on the group, not really sure how the group was going to respond, but throwing it out there anyway. And people showed up in very warm and professional and kind.

Camille McDaniel (11:46.934)
ways giving very honest feedback. And you could tell it was the type of feedback that the person needed, but it was also presented in a way that was very, very kind, you know, from a place of genuine care. And that’s ideally what you would like to see in some of these forums where we were putting things out, but it’s not guaranteed, right? You know, in some spaces. So let’s break down, let’s break down some of the things that may take place.

that requires you to really get specialized advice versus just asking a colleague because you’re all in the same profession. So one of the first questions that sometimes can come up that is a pretty big question. A lot of these that I’m gonna go over are pretty big questions with pretty big implications, but.

Let’s start with this first one and that is asking advice about whether or not you should fire or let someone go from your practice. So for those of us who happen to be business owners, you obviously who have other mental health professionals working within your practice, you have different experiences with different individuals. Sometimes those experiences are not favorable.

And so you may find yourself in a position where you are having to evaluate whether or not this professional is a right fit for your practice environment and how long you are going to continue to work with somebody who is displaying certain behaviors or certain verbal expressions.

that’s not really going to be good for the way you would like your private practice to run, or it is not in alignment with the policies and procedures of your practice. And so you may be really overwhelmed and not really know what to do and find yourself turning to open online spaces to find out what to do. But let me tell you, this is a massive question, a question of whether or not

Camille McDaniel (14:07.584)
you should relieve somebody of their position in your practice. And while a lot of colleagues might want to help you and may even show up to help you if you were to ask, they can not give you legal, sound advice on termination. This is a legal area. This is a human resources area.

This could be a legal minefield, like literally traps all over the place if you do not take the proper steps. So you really need to talk to either an employment attorney or an HR consultant. If you are not able to connect with either of those professionals, you can contact the Department of Labor for your state.

and find out what the rules, what the proper process is for releasing somebody from your practice. And one of the first things that you have to determine, well, you don’t have to determine it, but what you have to start with is, is this individual a W-2 employee or is this individual a 1099 contractor? Because there are different laws and rules that go with each status.

and how you are to release people based on your state laws. This is not generally something that your mental health professional colleagues, they’re not necessarily going to be able to help you. They can absolutely empathize with you and your situation. They may even tell you what they would do, you know, as far as the behaviors that you’re seeing or not seeing.

but you have to make sure that you are covering yourselves as it relate, you’re covering yourself as it relates to the laws for your state when it comes to hiring and terminating. Otherwise, you can leave yourself in a position of significant liability for your business and nobody wants that. So that would be one example where,

Camille McDaniel (16:31.458)
This is not going to be something you just bounce off of a colleague. This is something that is more specialized and you need to make sure that you get the proper person to talk to. The next one is going to have some other implications for your business that are financial. And this one is like asking questions regarding insurance. Like, how come the insurance keeps paying me a different rate or.

How am I supposed to bill for this particular service? And that I would say, if you’re going to ask that online, let it be specifically a billing group that is run by somebody who is an actual certified biller. Billing and coding is their thing, and you’re able to vet that out, so that you know for sure you are in a group where the individuals who are then

speaking to you can specifically give you a sound wise counsel on how to properly do that. And if you can’t vet that out, then I would encourage you to speak to the insurance company representatives directly. And I know that is a nightmare and a half because they really are trying to lessen the number of calls. So they oftentimes want you to go online. But if you do not ask,

the right individual about your insurance claims and why you are not able to get paid for this or some of the things that may go along with coding, you can end up messing yourself up financially and nobody wants that. The other…

You know, the other things that people can’t necessarily ask or excuse me, answer for you exactly unless you are talking to someone in a specific billing group where you have billing specialists are questions about whether or not your interns can see clients when clients are using insurance. You know, now there are some questions that I’ve even put out in groups regarding that same thing about

Camille McDaniel (18:47.434)
insurance ability to allow interns to use their insurance. And people have given me different feedback that got me started so that when I contacted the insurance company, I was able to refer to some of the information I had received. But ultimately, I am the one who has the contract with the insurance company, and I have to make sure that I am abiding by the contract that I signed. There are some

different things that happen when you live in different states from one another. The different insurance companies do not all require the same thing. Some insurance companies require a modifier when you file a claim. Some insurance companies do not. Some insurance companies might pay for certain extended visitation under emergency circumstances and certain insurance companies will not.

It just kind of depends on the insurance company and the contract that you have with them. So these are questions that are best left for a billing specialist or an expert in insurance credentialing or insurance coding, but not just to put out in a mental health group because all individuals, you know, we may be well-meaning, well-intentioned. We really want to help you.

we may not be giving you sound wisdom as it relates to your specific situation. And then that could cause you to have some challenges financially or with regards to the insurance company that you are contracted with. Another question that sometimes comes up that, again, for, I would say some kind of clear reasons, you wanna be careful who you ask.

And that’s asking people whether or not you should structure your practice in a specific way. Like, should I do an LLC? Should I do an S-corp? You know, should I be a sole proprietorship? And that, I cannot even begin to tell you how many implications for your taxes you’re talking about now. The best that people can do when you ask those kind of questions in a mental health setting or a-

Camille McDaniel (21:11.438)
a mental health counselor’s group, the best thing they can tell you is what their tax preparer told them. And sometimes those things change. mean, you really have to look at the structure of your business as in how much money you are bringing into your business and how are you filing taxes and what are some of the other things that are going on as far as your personal liability and how much liability can you take on?

what else, like your future growth goals. And there’s just a lot that goes into a question like that. So it would really be best if you were able to talk to a CPA, a certified public accountant, or a business attorney, somebody who understands all of the nuances about business formation and tax law. Again, the best that we can do for you as mental health professionals is just tell you what our tax preparers

said, and that could be absolutely wrong for your specific situation financially or with your business goals or even with your like tolerance for risk. And so again, we want to be there to support. We want to be there to kind of like validate the difficulties of the journey and all the decisions that have to be made. But that kind of question really isn’t something that we could help answer for you.

Sometimes there are also questions that you might notice come up that have to do with like client risk, client safety, client boundaries. And again, that actually would be right up our alley because we could definitely as mental health professionals help you. But it is an online format, you know, a forum. And you may you may find that what you really need is to

actually talk to somebody so that you can lay out the full situation so that you can then get feedback from them so that you can document that you actually consulted with a colleague and what some of the discussion was about. And this is going to depend on what is actually going on in your situation. Like, is this a mandated reporting situation or is this like a

Camille McDaniel (23:35.756)
treatment plan question or are we talking about something else some other kind of ethical dilemma or dual relationship, know type of thing so You want to actually? Take a take a step back real quick I know sometimes things happen in practice and you’re like I need to I need to ask somebody but you want to be mindful of asking in open forums if you’re able to if you have some trusted individuals that you can go to

that you can maybe call, that you can shoot an email and ask if they could, you know, meet with you, then you’re going to want to do that. I have definitely done that. I have had that done with me. I want to just note that sometimes going back to something that I just shared a second ago, sometimes depending on what it is that a colleague may be going through.

you might be documented in their notes as the person they received consultation from. So that’s why we wanna really actually take some of this really quite seriously depending on what this person is going through because you might be the person that they notate if they are asked, did you seek any consultation whatsoever regarding how to move forward with this situation?

And the person can then say, yes, I did. I actually spoke to several colleagues about this situation. And if they’re like, and you know, can you provide that information? Your name might pop up. you, you know, when it comes to ethical dilemmas, you really are going to probably want to err on the side of caution and really do it the right way. Set up some time. You can put in a group and ask, does anybody have any time in order to speak with you? It’s an emergency.

and then let them know what’s going on. But you always want to respond to people as if this response could be documented for some type of case that might come up in the near future. Let’s see, I’m thinking right now about a situation that actually did occur. I think it was this year, matter of fact, where a colleague did ask me if I had the ability to…

Camille McDaniel (25:57.42)
to talk and they were court involved. So there were some things going on with their client and there was some court involvement and they did have some ethical dilemma. They also had some confidentiality and HIPAA questions. And so I was able to meet with them, but like they contacted me by phone and was like, hey, do you have a minute? I need to talk. This is what’s going on. So.

knowing that this person might need to actually document that they sought consultation, then I made sure that we had like a proper time and they made sure too, that we had proper time to actually talk and lay out some sound wisdom versus just kind of putting just a few little notes in like a chat box and putting it out on social media. I do understand though that other people’s ethical

challenges can be helpful for other people to see. But generally, we don’t have the ability to get fully in depth with a proper response unless the dilemma is very light. So I guess we have to just kind of be discerning about that one as we move forward. Sometimes, and I’ll go over like.

This next one too, because this one has to do with hiring. know earlier I was talking about like termination, but sometimes we are asking about how to bring on an associate or how to bring on an intern. You know, what did you do when you brought an associate or an intern on? Again, this one really it’s like a legal and ethical considerations. You have paperwork, you have agreements.

you actually aren’t going to get a solid answer just in like, you know, in asking online. And I share this because I don’t want for people to also think that maybe people aren’t wanting to help them. People aren’t wanting to respond to their question. But when you ask those types of questions that are related to licensure and they’re related to like maybe laws regarding

Camille McDaniel (28:15.982)
employment and being a 1099 contractor versus making someone a W-2 employee and liability and ethical responsibilities and all the different things that you have to consider in the paperwork, what you’re supposed to collect. It’s really not something people can answer in totality on or within a social media platform.

People might give a few nuggets, but really can’t go into detail. And you really wanna go ahead and then find a way to get an actual appointment with somebody who specializes in like private practice setup, or they do consultations about this. They’re highly knowledgeable about the requirements. Also in your state, if you’re talking about providing hours toward licensure for somebody.

You may even need an attorney depending on what your setup is and certain things that you want to do. So I would definitely say you want to look at it not from the point of view if you didn’t get a lot of responses when you asked online, not from the point of view that people don’t really want to help, but from the point of view that maybe what I’m asking is so in depth that there is really not, this is not the place for someone to give me a full in depth answer.

And I definitely, I offer consultations when it comes to private practice set up. Matter of fact, I’m going to be talking to somebody else this week who is asking about how they might be able to scale to a group practice. So if you need to ask somebody anything about that, please feel free to reach out to me as it relates to how considerations on how you might bring individuals on as interns or contractors or how you might scale up.

These are all things that we wanna just make sure that we are aware of. Again, these questions are asked. It’s great to ask questions, but are you asking the right person? The next question that sometimes is asked is about like subpoenas. So like, how do I handle a court subpoena? You know, for my client, do I give testimony? Do I charge? You know, what records do I have to give up? Again.

Camille McDaniel (30:41.422)
when you’re talking about subpoenas, we’re talking about the law, the courts, we’re talking legal documents, we’re talking about showing up in court possibly. You wanna make sure that you are connected with maybe even your liability insurance company sometimes will allow you to call and get some information about how to handle subpoenas. I’ve had experiences where

Some companies have said, we don’t really offer any consultation services unless you are actually called to court and have proof that you are called to testify in court. Some liability insurance companies might actually offer you consultation before you ever have to show up in court. And if not, you want to also look in your state to see if there are any attorneys who help mental health professionals.

Interestingly enough, several years ago, I did have to consult with an attorney because of a records request that was coming through and some other things regarding that records request. But in our state, we had a gentleman who was like an attorney for mental health professionals. And I was able to talk with him right before he was retiring, thankfully.

And I believe since then there are other people who have shown up and offered that service. But I do remember that at one point in time before I remembered that attorney’s name, I actually was looking online and I could find a ton of attorneys that were to help people against mental health professionals. And I was having a hard time finding attorneys who specialize in consulting with mental health professionals.

So you may want to take a little time in order to get some of these resources for yourself just in case, or just in case maybe one of your colleagues needs it. But it is great to have the information before you need it versus needing the information and scrambling because you really don’t know where to go and who to talk to. So ideally this is giving you some, hopefully some

Camille McDaniel (33:02.976)
really good things to think about, questions that come up for us as we are, you know, professionals in practice who are business owners or who seek to be business owners. Because these are the things where you’re going to need specialized, you know, counsel for this. And you’re going to want to make sure that you know that ahead of time so that you’re not asking the wrong person or possibly receiving

wrong advice that then puts you in a really bad situation. then there are some things, like I said, that are just personal. know, sometimes people find themselves like burned out. know, you know, people will share and as mental health professionals, can definitely, we can empathize, we can validate feelings, but people will share that maybe they’re in a…

a toxic work environment, you know, and they’re just wondering if maybe they need to shift gears altogether and go into a different profession. And those are just like personal questions. That’s where you have to ask, you know, did the Lord really gift me with the talents to use in this field? I hear properly from the Father? And if I did, then what do I do? I will say that unfortunately, as far as toxic work environments,

Unfortunately, you can just find that in a whole host of career paths. And so don’t let that alone make you feel like mental health is probably not the path for you. But instead, you may be in a position where you have to evaluate whether or not that particular organization or practice is the right place for you to use your gifts and your talents.

But again, no one can necessarily answer that for you of whether or not you should leave the profession altogether. That’s going to be a very personal journey between you and the Lord and your family where you’re going to really need to be doing some introspective, you know, kind of like looks and a lot of prayer and then, you know, moving forward in discussion with those who are closest to you.

Camille McDaniel (35:22.55)
Although again, we as mental health professionals, we are here by our very nature. We are helpers, but there are some things that honestly, they’re just, they’re personal to you. It’s not necessarily something we can answer for you, but we can absolutely empathize, be there and let you know that you’re not alone. So that’s where we wanna kind of like take a look at which…

people we need to go to for the different things that might be coming up in our lives. Feeling burned out or like resenting being a practice owner, you know, what should you do? And again, as mental health professionals, we may throw that out to a group and the group definitely could give you some different tips or some different tools or even just say, hey, we’re here and we see you and we hear you.

And we’re so sorry that you’re going through this. But if you want more in depth, like I guess, feedback and support, that’s where I would say you want to then find, do I need to connect with somebody one-on-one? Whether that be like a pastor, whether that be a spouse, whether that be a friend or getting my own coaching or counseling, pastoral care.

What am I needing at this point in time in my life? That’s like a very that’s going to end up still being a very personal question, not necessarily one where you’re going out to, you know, to the group because the group can answer it for you. But the group can definitely hold space with you. And we can definitely be there to say, hey, it gets hard and you’re not alone. But at the end of the day, it will definitely still be where you’re going to want to connect.

with maybe some more support, a deeper level of support for yourself. Yeah. So, so many different things to think about when we are running practices and we are running families and we’re just trying to get through all of this successfully. So, hopefully this episode has helped you to kind of think about what wise counsel means in a different way.

Camille McDaniel (37:45.356)
You know, the Bible and Proverbs reminds us that, you know, without counsel, plans fail, but with many advisors, they succeed. And one of the things that we want to take a look at is that, you know, notice it’s not just any advisor, right? But we need the right advisor for the challenge that we are going through. And so my prayer is that you’ll be able to take from this episode

the information and really reflect on where you at in your journey. What are you needing at this particular time in your journey? Are you needing specialized counsel and advice? Are you needing something more personal to feed you internally, spiritually, mentally, emotionally, and starting to like cultivate these different resources so that you have them?

when you need them or when someone else needs them. So until next time, we’re moving forward in wisdom. We’re moving forward in support and love for the journey ahead. Bye-bye.