Some therapists dive headfirst into the risks and rewards of private practice right out of school and never look back. But not Kama Hiner, LCPC. For this energetic therapist, it was a long, slow burn over 5 years to evolve from full-time agency worker to full-fledged entrepreneur, both in mindset and in practice. As of the end of March 2016, Kama (pronounced KAY-ma) finally exited her 10-year agency job to devote herself entirely to her thriving practice. In this Spotlight, we talk mindset shifts, social media, and taking control over your own destiny.
Thanks for being here! Tell us a little bit about the focus of your practice and what makes your practice unique.
Thanks for having me! My focus is in stress management and stress-related disorders. I see in my clients how the stress in their worlds leads to anxiety and depression. So we look at how to manage that so it’s not impacting their overall quality of life.
How did you get into being a counselor who works with stress?
Well, I knew I wanted to be a counselor since I was about 12. I got sick a lot in my 20’s, going to school and working full time. I had to have my gallbladder out and I got Bell’s palsy. Everyone was telling me, “That’s stress.” But I was like, No way this is stress because at that point I didn’t know the physical implications of stress.
As I got older, my work became about my own personal experience of the importance of work/life balance. I’ve seen first hand how stress can take a toll, like being an entrepreneur while working at a job 40 hours a week. During many times, it’s even been a stress on my marriage because I’m going crazy with a million things to do and I don’t have time to do yoga or do self-care. Self-care is preached in school, but counselors are the worst!
Do as I say, not as I do, right?
(Laughing) My husband is in the construction field and he always talks about how landscapers have the worst yards, mechanics have the worst cars and then here we are, counselors with the worst self-care.
I do a lot of clinical supervision so I work with new counselors and I can see me in them. I always think to myself, “You’re me, 20 years ago! You have got to slow down.” Looking back, those were my most challenging years, even though I was excited about what I was doing. It’s always a good reminder for me to slow down and breathe, do yoga, and make sure I’m eating well. Otherwise, I notice that my immune system is suppressed and I start to go downhill again.
Tell me a little bit about how you made the transition to private practice while balancing agency life.
I think there are 2 groups of therapists – the cautious group or the all-in group. I don’t know how the latter group does it. That’s not me. I had to do it really slow and steady. I was worried about whether I’d have enough income. I had those questions – Will people want to come see me? Will I be able to fill my caseload?
I remember that a long time ago, I had told my boss at the agency when I started my private practice, “I have no desire to be an entrepreneur. I don’t want to own my own business. I’m perfectly happy working for someone else and always have been.”
I was sort of under the impression that counselors can’t make a decent income and I was ok with that! I love helping people, so I was like whatever, I don’t care. I’ll basically be a volunteer and if I make money, then, “Yay! New pair of shoes!” And if I haven’t collected anything on that client all year? “Oh well!”
So was there a lightbulb moment where you went from “I’ll just take it as it comes” to “I’m an entrepreneur and I can actually do something with this?”
The lightbulb didn’t REALLY go off until I transitioned from working 40 hours/6 days a week to deciding to work at the agency 3 days and in my private practice the other 3 days. I sat down and went through the numbers. I was probably seeing 10 clients privately at that time. It occurred to me that if I can bump it up to 15 clients a week at $100/hour, then oh my gosh, I can make more money working for myself than working for someone else in twice as much time!
And that would also mean I would have time to cook or have a hobby or do yoga or have a life again outside of all of that.
How did you decide to finally let go of the agency job?
I love my agency – it was nothing about them. I just got to the point where I wasn’t excited to go to work. I wasn’t inspired. I recognized I was spread too thin and I wasn’t able to give 100% anywhere in my life and that had to change.
I also just needed to feel safe in making the choice. I’m obsessed with the Insights section in SimplePractice and seeing how much money I’ve collected each month. It was really helpful in making the decision because you can visually see, “Ok, this is what I’ve done consistently month after month after month.” So after a year of a consistent bar graph in the insights section, it was obvious that there was no reason to be afraid and it was time to make the leap.
Sample Insights Page
When I was initially using a billing company, I had no idea how much money I was making, and what clients were paying or not paying. I’d get this Quickbooks report and throw it aside and think “meh”. For a long time, it was a hobby instead of a business, until I learned to really take control over my business beginning to work. And the better my business works, the better practitioner I am and the more my business grows.
Why do you think that it takes therapists so long to get to that point as seeing themselves as business owners/entrepreneurs?
I think therapists – and not to be stereotypical – but a lot of us are women. I see us like moms. Moms are the worst group of clients I talk to about self-care because self-care means that you’re selfish.
Therapists have that same mentality. They think that if they make a profit off clients, then they’re being selfish, maybe even unethical, and something’s probably askew. They don’t see that it’s a business and you can provide good quality services that people either have the money to pay for or you can take insurance if you want to do that.
Here’s how I think many therapists see it:
“Worrying about my business is stressful and takes time, so I’ll just focus on my clients, or go to work at my agency job, do my notes, and go home.”
But really, there are things to make it easier so you’re not spending hours and hours trying to figure out bookkeeping and taxes and this whole other side of things on top of trying to figure out how to take care of clients.
How did you get over that hump?
For me, it’s been all about having a good team. My accountant and SimplePractice makes up the majority of that team. I have a really good accountant that answers questions and keeps me in check. It’s invaluable to have this in-between person to run things by and get good feedback on what I need to do.
I initially worked with billing companies, but I was still giving all the control to them and I still wasn’t getting paid. So I decided, “I’ve really gotta streamline all of this”, including online scheduling. It was a hard jump, because if I was going to do all my own billing, then the responsibility was on me. And I could very well mess it all up and not get paid.
But I took the risk and jumped into SimplePractice and it’s been really great. I love having an online scheduling system that I can do everything through. I don’t want to call clients. It’s the biggest time sucker. SimplePractice has eliminated both a scheduling person and a billing company.
What’s next for you now that you’re done with your “day job”?
I think I work best at 20-25 clients per week, so I’ll continue to do that. Some of my partners and I are looking at building other businesses that are a spin-off from the counseling field. In order to work with my group of clients to keep it affordable rates, but to also make the kind of income I want, building passive income streams is really important.
One of my concerns is what happens if I get sick at one point or I can’t work? Whatever happened, what does that mean for my income? With direct hour to hour I can only bill a certain amount, so you’re really limited. I can’t just rely on my cute little face sitting in a chair all day. I love it and I want to do it, but I’m definitely interested in figuring out some other stuff.
Tell me a little bit about your use of social media. What recommendations do you have for therapists who are shy about using social media?
I find that therapists are aversive to social media and technology and all of that. I’m super focused on the ethical piece and how I’m portraying myself out there and careful about client interactions. It does add an extra layer that most people don’t face so I get the fear of it. I have a very clear-cut policy about social media in my informed consent.
Social media is helpful for referral networks. I’m not targeting clients, but I’m putting out things that state my message. The idea behind social media is that you should be building trust with whomever it is you want to build trust with. So on Twitter, I’m targeting local doctors, chiropractors, naturopathic doctors and I aim to tweet at and interact with versus just sending out random messages out into the world. However, I do think that the random messages also create a backlog of knowledge to give you some credibility in that sense. You’re not just an empty page with nothing there.
If someone goes through my page, they can see the history in terms of what is important to me and why I’m doing what I’m doing. I also think social media helps people to see you as human too. So the balance is that I want people to know I’m real, but I also don’t want them to know everything about my personal life.
Tell us about your name.
Well as you can imagine no one ever gets my name right. It’s pronounced “Kay-ma” and it means “loved” in Sanskrit. My parents are total hippies.
Ok, let’s end this with your best stress management tip for therapists.
For most people, including therapists, the best thing is just take a few long deep breaths. Take a moment and just be present and in your body. It’s so simple, so powerful, but also so difficult. And remember what’s important! Like WHY are you even doing this in the first place? You want to have a good life and you want to help others have a good life. So if you’re miserable and you’re stressed out, then you’re not meeting your goal. Start by just breathing.
You can find Kama at: