Feature

After Anahi Collado, PhD, completed her postdoc at Emory University in Atlanta, the university recruited her for an assistant professor's job there. But she turned it down when an unusual, but appealing, opportunity opened up: The ability to conduct research in-house at Alvord Baker & Associates, a group practice with two locations in Maryland.

Now, Collado spends 80 percent of her time providing therapy and 20 percent conducting outcomes research in the practice and in local public schools where she studies a resilience program. The practice also has a full-time research assistant and director of research to support the clinicians who are part of the research team, which collaborates with Catholic University.

"I have the scientist practitioner model that everyone aspires to have," she says. "Here, it's a reality."

Offering in-house research is also part of the allure at Portland Psychotherapy Clinic, Research and Training Center in Portland, Oregon. Founding partners Jenna LeJeune, PhD, and her husband, Jason Luoma, PhD, were both trained in the scientist-practitioner model and wanted to design a practice that lived up to that ideal. "Even for the clinicians on staff who don't have research time, they see it as a really valuable part about why they are here," says LeJeune, who, with Luoma, detailed their approach in Professional Psychology: Research and Practice in 2015.

Providing research opportunities is just one of the ways these successful group practices appeal to clinicians—others include offering flexible scheduling, community service and mentoring. The Monitor talked with LeJeune and others to find out how they have created group practices where clinicians feel valued and empowered and clients love to visit.

Encourage personal growth. Another popular feature at Alvord Baker is in-house continuing-education programs offered twice a month on such topics as ethics, telehealth and interjurisdictional practice—many of which are presented by clinicians on staff. "We are always learning and always presenting," says founding partner Mary Alvord, PhD, who has a part-time staff member devoted to organizing CE.

Professional development is also a priority at Portland Psychotherapy, which offers lunchtime learning talks. In addition, every six months each clinician meets with Luoma to discuss ways they can grow professionally. "It's really helpful because I don't think I would think as much about the big picture without that meeting," says staff psychologist Melissa Platt, PhD. "There is a lot of attention to professional development here even when we are not outright seeking it."

Clinicians at Southeast Psych—with locations in Charlotte, North Carolina, and Nashville, Tennessee—are encouraged to be bold: Recently, one of the practice's licensed professional counselors, Myque Harris, MS, who is also a certified yoga instructor, asked her partners about revamping her office space so she could combine her clinical work with yoga instruction—teaching children, teens and adults yoga poses and breathing strategies that could reduce their anxiety and depression.

"Something I saw as a far stretch, they saw as something great I could offer the community," she says.

Now she has an office with enough open space to instruct up to six clients at a time.

Provide a great space. LeJeune and Luoma renovated an 1889 Victorian home in downtown Portland to house their practice and gave each clinician his or her own room. Platt says the cozy surroundings boost her mood and make the experience of seeing a therapist more enjoyable for her clients.

"I have worked in places where the therapy rooms were sad with no windows," she says. "Clients comment all the time that our environment feels therapeutic."

Likewise, IntraSpectrum Counseling in Chicago, a group practice with psychologists and social workers specializing in serving the LGBTQIA community, creates a welcoming environment by having LGBTQIA magazines in the waiting room, gender neutral bathrooms and even brewing a local coffee brand that has LGBTQIA-affirmative policies for staff and clients. They keep the staff pantry stocked with cheese sticks, granola bars and La Croix sparkling water to keep people's energy levels up.

"Staff only have a few minutes between sessions and you often end up thinking about your growling stomach in the session," says Rena McDaniel, MEd, LCPC, IntraSpectrum's chief operating officer and a staff therapist. "It solves a big problem in a simple way."

Clinicians at Southeast Psych, a general group practice with more than 50 providers, say the fun, positive environment is among the reasons they find their work so rewarding. When clients and their parents come for an appointment, a hostess greets them and offers refreshments and a professional cosplayer wearing superhero or princess costumes entertains younger children before sessions, while older children can play X-box games. The practice also has a theatre in its Charlotte office to host speakers and films for clients or staff. Their philosophy? Break the mold on practice design.

"You don't have to have a water fountain," in your practice, says founding partner Frank Gaskill, PhD. "But if you do, make it really cool."

Make it fun. Several of the practices offer just-for-fun team-building experiences. The team at IntraSpectrum chooses a yearly activity such as bowling or a cooking class to attend together—and all wearing wigs for a festive twist. Staff at Southeast Psych carve out two hours on the last Wednesday of the month for play, such as having pizza and watching a movie or playing arcade games.

LeJeune and Luoma host board games and cocktails at their house once per month as a way for the whole practice to connect. "We try to get to know each other as human beings and meet each other's families and know what is going on in our lives," says LeJeune. "It has made it a totally different place to work."

Offer flexibility. For Harris, who came to Southeast after a stint in a Charlotte private school, getting to set her own hours allows her time to attend school events with her young daughter. "A lot of places talk work-life balance but aren't really living it," says Harris, who doesn't work Fridays and only works half days on Wednesdays. "We are definitely living it here."

Alvord also encourages her staff to set their own hours—and invested in high-quality videoconferencing technology so that staff who can't make it into the office on meeting days can connect from home. "Everyone can see each other even if we can't all physically be in the same office," she says.

Create a supportive environment. At IntraSpectrum, clinicians have weekly "consultation pods" where four or five clinicians with similar schedules meet to talk through difficult cases in depth. More informally, people make it a priority to carve out time during the day to talk through challenges. "People often say that it's a way to be independent in your work, but connected," says McDaniel.

At Portland, clinicians triage cases every other week and "check in on where we need support in our clinical work and our personal life," says LeJeune. Clinicians at Southeast Psych are assigned mentors during their first year with the practice; every new hire attends one lunch and one breakfast each month with his or her mentor to talk about his or her work with clients and how to build their practice.

Serve the community. Giving psychology away is an important common goal among the clinicians at Alvord Baker—many give free talks at local social service agencies and schools on such topics as cognitive-behavioral therapy and managing anxiety. They take turns facilitating monthly support group meetings of the local chapter of CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). In Charlotte, the clinicians at Southeast Psych do the same. Harris has given seven talks this year on such topics as how meditation can help children with ADHD and talking to children about sex. Southeast Psych also created "Psychology for All," a nonprofit arm of the practice that offers discounted services to local residents who can't afford psychological care.

As rewarding as these practices are, though, Gaskill says there is a downside to having a popular group practice: You often have to turn away great ­clinicians who want to work there. Southeast Psych gets at least two new resumes every week from prospective therapists.

At least one of those psychologists was inspired enough to create his own version. "He wrote to me eventually and said, ‘You guys rejected me, but I read your book, took it to heart, quit what I was doing and now I have my own group practice,'" says Gaskill. "Fifteen people now work for him; it is really cool to see that."

Further reading

How We Built Our Dream Practice: Innovative Ideas for Building Yours
Verhaagen, D., & Gaskill, F. 2014.

Resilience Builder Program: Practice and Research in a Private Clinical Setting
Alvord, M.K., & Rich, B.A.
Independent Practitioner, 2012.

The Integrated Scientist-Practitioner: A New Model for Combining Research and Clinical Practice in Fee-for-Service Settings
LeJeune, J.T., & Luoma, J.B.
Professional Psychology: Research and Practice
, 2015