Texas Counselors Creating Badass Businesses

3. My Interview With Amanda Esquivel

October 19, 2022 Kate Walker Ph.D., LPC/LMFT Supervisor Season 1 Episode 3
Texas Counselors Creating Badass Businesses
3. My Interview With Amanda Esquivel
Show Notes Transcript

In this "Ask the Expert" session, I’m chatting with Amanda Esquivel LPC Supervisor. She’s been a colleague of mine for a long time, and she is actually one of the original members of Texas Counselors Creating Badass Businesses. Amanda's group practice Room for Change is booming right now, and she talks about hiring LPC Associates to help handling the growth and success of her practice. Often when we first start delegating tasks to free up time, we end up giving ourselves a new job as a micromanager. Amanda tells us how to become more comfortable letting others run with her ideas and things not turning out exactly how she envisioned them. As our businesses grow and change, we sometimes just need to get out of our own way. So listen in, get inspired, and take your business to the next level! Show notes and more at katewalkertraining.com.

Get your step by step guide to private practice. Because you are too important to lose to not knowing the rules, going broke, burning out, and giving up. #counselorsdontquit.

[00:00:00]

Kate Walker: Hey, it’s Dr. Kate Walker and I’m welcoming Amanda Esquivel with her practice, Room for Change, and she’s going to talk to us today about how she has incorporated clinical supervision into her multi-specialty, multi-location amazing practice that does wonderful things for her community. So welcome, Amanda, and thank you so much for being here with me today and answering my questions.

Amanda Esquivel: Yeah, absolutely. Thanks for having me.

Kate Walker: So tell me about this practice of yours, this wonderful thing that has grown. Just tell me all about it.

Amanda Esquivel: Yeah, so, I almost nine years ago became a mama, and I don’t know if it was a mix of hormones or what was going on, but I quit my job at the time – I was working in community mental health and started my practice. Way back when, it was just called Counselor Amanda because I was so low with no plans of expansion, had my little 113 square foot office, and yeah, became a supervisor a couple of years later. We’re now at four locations, 32 counselors across those locations, and those clinicians are a combination of Master’s students from a couple of universities here in the area that we have good working relationships with, associates under my supervision, and a new supervisor that I just brought on part time. So I’m sharing that role that’s brand new as of this month. And, independently licensed LPCs as well. So as you mentioned, multi-disciplinary. Luckily with 32 clinicians, we’re able to have tons of specialties. So when somebody calls in, as long as they’re looking for services for a person over the age of 12, we’re able to provide services in most cases.

Kate Walker: Wow. Okay, so supervision. Did supervision always play a role in your growth or did it just kind of happen organically and then it helped you build? Or how did supervision play a role in your growth?

Amanda Esquivel: Yeah, so just to take a step back for a moment, my role right before starting my practice, I was clinical director of a local community mental health center. And so when I went into private practice, it was quite lonely as you know it can be, and I really missed that role of clinical supervisor. So a couple of years in, as a solo practitioner, I was able to upgrade my license. I really sat on it – after I got the S credential, sat on it for a couple of months before somebody found me online and I guess the rest is history at this point. But he sought me out and about six months after meeting him and bringing him on, he wanted to just see clients in my practice part-time because he had another full-time gig, and then about six months after meeting him, I met another supervisee and then another. I think part of my ability to grow the practice has been through great retention of supervisees once they upgrade their license. So that very first supervisee still is employed by me now full-time.

Kate Walker: Wow, and we talk about that – or I talk about it because people ask me about hiring. The best way to hire is just to grow them from graduate students and it sounds like that’s what you’ve done.

Amanda Esquivel: Right. It’s definitely the long-game though, to invest in a supervisee, or at this stage, now I have former students that are upgrading their licenses to LPCs now – I almost feel like a grandma. But yeah, so it’s definitely a long-term game but I know what they’ve been exposed to, I know what to expect of them because I was the one that taught them at some time or another how to handle CPS cases, what professionalism in this field looks like, what treatment planning looks like. And so you may go into it blind – based off of a good interview, but you go into it blind when you hire somebody that hasn’t been under your supervision.

Kate Walker: So do you think then being the supervisor and growing your colleagues, along with hiring, that’s helped you grow and it’s been part of your plan?

Amanda Esquivel: Yeah, absolutely. It’s interesting because I’m very, very Type A, maybe to a fault, and so most things in my life are very, very planned out. This was not planned out. When I started my private practice, it was about six months or a year in before I realized, this is really lonely, I really miss that supervision piece, and then I thought, I’ll just supervise a couple of people. There was not this intention, or this thought on my end that I would expand this way. So it’s one part, very organic, although most every other part of my practice is very, very intentional.

Kate Walker: So ethical issues – what are the ethical issues in supervision, especially in a group practice with all of these people in different locations? What do you feel like they are?

Amanda Esquivel: Yeah, so I want Room for Change to always have a small mom and pop feel but that’s really hard to do once we expand. So, keeping a close eye on making sure paperwork is up to date, that when we’re seeing multiple family members, as we do – it’s really heartwarming to have a family come in and the teenager goes up the hall with one therapist and mom and pop go up the hallway with another therapist, or siblings. But we have to be very intentional with making sure that we have appropriate releases signed so those clinicians can collaborate on cases when appropriate. 

The primary thing is making sure that our supervision time is not eaten up by administrative questions and housekeeping. I do make sure that I schedule time with them routinely outside of supervision to make sure that we’re addressing those things and onboarding all of that is very separate from supervision. I think that’s probably the biggest error that a supervisor can make when bringing in supervisees, is meshing those two roles. But it’s also really had to be aware of when you’re stepping in and out of those two roles, so if possible, handing that over to somebody else would be ideal.

Kate Walker: I remember when I did the two roles, I would say out loud, okay, this is clinical supervision; okay, this is administrative. And if they tried to crossover and ask a clinical question during that administrative time, I would be like, “Nu-uh-uh, that’s clinical.” I had a small – it wasn’t even a medium-sized practice, it was really small, but I had to play those roles. Do you ever play those two – do you have to say out loud, “Nu-uh, that’s administrative”?

Amanda Esquivel: Yeah, so part of my supervison process is for each supervision hour, they have to turn in a supervision check-in sheet and that lists out the topics that they’d like to address that day. And so we can walk into the hour knowing, oh, okay, this is something that needs to be separated into our administrative time together. That really helps me manage it. And then other times, it will come up in an email or something like that. If it’s something that’s administrative that’s super easy to answer in an email, great. If it is something we need to dig into more clinically, I’ll say let’s move up your supervision time, or let’s address this in your next supervision hour.

Kate Walker: I love the idea of a check-in. Is that something you’d be willing to share?

Amanda Esquivel: Oh yeah, absolutely, absolutely.

Kate Walker: I would love to put that out there.

Amanda Esquivel: Yeah, so I modeled mine after paperwork that was given to me at supervisor training. I’ve edited it about once a year to keep up with what my current needs are but being able to know at the start of the hour what the supervisee’s needs are and to be able to manage that time, because if I leave it up to the supervisee, we’re looking at minute 58 and they’ve only talked about one case. Versus if I have this supervision sheet at the top of the hour, I can pace us and make sure that if you’ve got four things listed, we can’t spend 45 minutes of our time just on one of those topics. That was a big add-on for me. 

The other big add-on was having a supervisee complete their own supervision notes. For years, I was handwriting them and then typing them up and putting them into their file, spending all of this time, and then somebody at TASES a few years ago said, it’s not important what you take away from the supervision hour; it’s important what they take away from the supervision hour. If only we could apply that to clients, right? But now supervisees get to log into our health record system, they have a mock chart for supervision, and I have a template created in there so they’re able to add their notes from that time and then I’m able to go back in and say we did talk specifically about a rule – I can add that rule in there because they’re not always great about adding that type of thing in. But sharing that responsibility with them was a really big gamechanger.

Kate Walker: Well that’s huge. I mean, especially – you’re still in the supervisor role while you’re running this big practice. And so you have to be so efficient with your time and yet super clinical and ethical and all of those things. These are great solutions; I love that.

Amanda Esquivel: Yeah, thank you. Yeah, these things have definitely made it a gamechanger for me. Also having them do that supervision check-in sheet eliminates the “Well, I don’t know what I want to talk about today.” They’ve given some thought to that time and it’s just a much more rich experience when they have a little bit of time to think about it before the session.

Kate Walker: I like that, it puts that on them.

Amanda Esquivel: Absolutely.

Kate Walker: Okay, so we were talking about barriers and problems, and I’m reading this because when I made this question, when I think about barriers or problems, lack of time, lack of space, lack of trust or a shared understanding to the purpose of the supervision, clinical versus administrative supervision, it sounds like that checklist mitigates a lot of that, the barrier to a good supervision. But what about time? Just being a big practice owner – and, again, one of trigger words is people telling me “I’m busy,” so I respect that you have this amazing practice and you have amazing systems in place. So how do you handle the time and the space for supervision?

Amanda Esquivel: So, yeah, as far as managing the time goes, I do two hours of individual, two hours of group a month. And the dates for group supervision are rolled out in October for the whole next year. So I touch it one time a year and then it’s set up and it’s already there. The dates are rolled out in October and then in December we all meet as a group and they get to build their own supervision topics for the coming year and what roles they want to play and what roles they want me to play in the group supervision. So I’ve shared on the page before that we’ve done it actually having a physical gingerbread house and so they’re building – the gingerbread house is group supervision and what to expect from each other as peers, as well as, like I said, what to expect from me. That really helps to share the sense of responsibility over group supervision. For individual supervision, I do outsource the scheduling of that to my administrative team, which is a game changer. It’s one of those small-time savers but a really big thing too. And we schedule those at least a month out, sometimes up to three months out. So again, the supervisee knows when they have supervision and I don’t really have to think about it, I just look at my schedule and make sure we’re at the pace of what they need for their licensure. 

More globally speaking, at this point in my career, I see very few clients directly myself. So as I’ve grown the business and taken on more supervisees, I see fewer clients. So at this stage, I only see four or maybe five clients a week; most of my time is split between supervision and the business development part. But I had to grieve not seeing clients directly as much. Now, I’m starting to grieve not having my hands on every supervisee that comes through because now I’m sharing the role with somebody that I hired to provide some supervision. These are specifically for students that completed their practicum and internship with us, and I really didn’t want to lose them, but I couldn’t take on more supervisees. I needed to have that reckoning, that I needed to cut it off somewhere, and so now I’m able to share that role with someone else that is coming on and providing individual supervision to those students that have now graduated.

Kate Walker: Okay, so that business plan of growing your students into your colleagues, you’re capturing these really, really great people with this second supervisor. And so how was it to hire a second supervisor?

Amanda Esquivel: I really went back and forth on this decision. The type of supervision that I provide is not the type of supervision that I know that other supervisors are providing out there. And so I needed to find somebody who I felt mirrored me pretty well. I’m not looking for my exact replica but I needed somebody that sees supervision in a similar way, that sees my business in a similar way, because if we’re at odds, the direction that we’re going to give to these supervisees is going to be quite confusing. Because I still – although I’m sharing supervision with her, I’m still their boss and I’m still the owner of Room for Change with a clear direction of where we’re going as a practice.

Kate Walker: So you guys have to align. It’s hard enough – and just speaking from myself, it’s hard enough when you know your supervisee has a second supervisor somewhere out there and you’ve got to communicate and make sure you’re not contradicting each other but when you hire them on, there’s a vetting process and now you’ve got this – like you said, I mean you have to know what everybody is on the same page with your strategic plan as well.

Amanda Esquivel: Exactly. And that highlights a couple of decisions I’ve made along the way. One, I don’t share supervisees anymore. And this is where what I think clinically and what I think for the business are at odds with one another – clinically, I believe having multiple supervisors can be a very rich experience and having multiple sites can be a very rich experience. I know that’s what my experience was when I was an intern back in the day. 

However, for the business, we want full-time clinicians. We want people who can really invest in their work at Room for Change and not be distracted by outside work. And so again, what I would want for them clinically as a supervisor, if I just have that hat on, diversify your experience, diversify your supervision. But what I want and am looking for as a business owner is I want you invested in this and not distracted by other things. And so along the way, I’ve made these decisions about I don’t offer off-site supervision anymore, I don’t share supervision with other people anymore with the exception of this one I just hired on, and I don’t supervise people that have off-site supervisors.

Kate Walker: Great. I mean, that’s something – you’re in the same group I am, the recently rebranded Texas Supervisor Coalition, and that comes a lot, sharing and the problems that are inherent with that. So I hear you, I totally see how that would be a thing as a business owner. And so maybe ending on that, what are some comments you would give, or some advice you would give, someone thinking about becoming a supervisor and who also has dreams and aspirations of growing a practice?

Amanda Esquivel: Yeah, so lean heavily on your peers. The page is an excellent resource. I know I have local fellow supervisors that I lean on as well. Seek business consultation – I know there’s a handful of us that offer business consultation on how to navigate this on a technical level, but also processing through how to handle this on an emotional and relational level as well. I will say, I made a decision last year that I’m now kicking myself for. I did change – I used to charge for supervision and for my full-timers I added that as a benefit, that supervision is now free. I wish I had stayed with charging for it.

Kate Walker: Tell me more, because that’s one of the things I talk about. Tell me more about that.

Amanda Esquivel: Yeah, so for one, that was me walking away from about $35,000 a year because I do supervise so many associates. So that was a hit to the pocketbook that I wasn’t…it was close to the holidays when I made that decision so maybe I was overly generous around that time of year. But I also think that when people have financial skin in the game that they value the supervision a little bit more because they’re paying for it. I know that I feel a little bit more indebted to quality supervision when somebody is paying for it versus when I am giving it away for free. I think mindset wise, it actually works better for both parties to be paying for and receiving payment for supervision. I don’t know how I’ll un-do that at some point because to go from paid to free, that was a huge gift to them. That was equivalent of like a $3,000 pay increase. But to go from free to paid, I’m not exactly sure how I’ll do that. I’ll end up probably grandfathering some people in and maybe navigating it that way, but we’ll see how that pans out. That is a piece of advice that I would recommend, is really consider that from all angles before pursuing it.

Kate Walker: I love that you’re saying this because business owners, we change our minds. I mean, we try things out and sometimes it works and sometimes it doesn’t. You’re allowed to be flexible and pivot and all of those things. So yeah, good on you.

Amanda Esquivel: Yeah, and when I make those pivots, when I change my mind on what can be seen by other people as drastic ways, I can say how much I want to be transparent on that topic. So with my staff, I can choose how much of the decision-making I want to share with them and say, this is why I’m making this change. And it’s not necessarily to justify myself. I’m justified in whatever I choose for my business because I’m the owner. But more so to help them understand that this comes from a good place in me that I’m not trying to hurt anybody or set anybody back but that these decisions are all made in an effort to help insulate this business so it’s something I can hand down to my children if they choose to come into this field.

Kate Walker: I love that. So I’m going to put in my show notes contact information because you do offer consultation to business owners, correct?

Amanda Esquivel: Yeah, I especially love three areas of consultation with other business owners. Those that are going from solo practice into group practice because there’s a lot to consider, it’s not rinse-and-repeat when you bring on other staff, so I really love that. I really enjoy helping – it’s through a consultation lens but addressing emotionally the barriers to business ownership because what makes us great therapists does not make us good business owners. It can actually very much work against you. And then number three is how to create the physical space for counseling. Our offices are known as being very cozy and homelike, so it’s not a sterile place for people to go into. So I really love helping people create their space as well.

Kate Walker: Yeah, I remember when you rebranded Room for Change and you posted pictures of your offices and I know that was a big push for you, was that people felt at home in your office.

Amanda Esquivel: Yeah, super intentional with the lighting and the textures and what we choose to decorate with. I really enjoy helping others that maybe décor is not their strong suit and helping them design on a dime. So I enjoy that.

Kate Walker: Oh, that’s wonderful. Definitely going in the show notes. And if you want to make a t-shirt that says “I’m the boss,” I’m happy to wear it and publicize that for you. Anything else you want to add?

Amanda Esquivel: No, I’ve enjoyed our chat today and I love being able to weigh in on the two groups you have, they’re just valuable, valuable resources.

Kate Walker: Thank you so much, and I’m glad to have you in the group. You are a valuable member; I love seeing your comments and when you pop in there, I always know it’s going to be great information, so thank you.

Amanda Esquivel: Thank you.

Kate Walker: Alright, thank you for joining me today, Counselor Amanda with Room for Change, and I will see you in a second. Everyone else, thanks for watching.

Amanda Esquivel: Thank you, y’all take care.