June 20, 2023

Episode 17:

How to Build a Private Practice with a BSW with Tia Bell

In this episode, Tia shares her experience as a private practitioner with a BSW. Tia shares everything from her private practice start-up journey to working within her scope of practice to managing imposter syndrome as a private practice owner.

Episode 17: How to Build a Private Practice with a BSW with Tia Bell

Show Notes

Kayla: Welcome back to The Designer Practice Podcast, and I’m your host, Kayla Das.

As social workers, we believe that the only way to be a private practice owner is with a Master’s in Social Work. However, that’s not always true. In fact, there are many social workers out there building businesses, non-for-profit organizations and private practices every single day. And that’s because social workers, regardless of their level of education, are driven to make changes and help others. And sometimes doing that within our own businesses makes it a lot easier to help those they want to help than trying to navigate the red tape that exists in some organizations that social workers work in.

Now, before we get into today’s episode, I do want to give a disclaimer that it’s always important to review and follow your specific standards of practice as each regulatory body and jurisdiction has its own set of standards regarding specific requirements for private practice start-up and compliance. And if you have any questions regarding your specific circumstance, please reach out to your regulatory body, licensing board or legal professional.

But I’m super excited because today I’m sitting down with Tia Bell who’s going to share with us how she started and grew her private practice with a Bachelor’s of Social Work. She’s going to share everything from her private practice start-up journey to working within her scope of practice to managing imposter syndrome as a private practice owner with a BSW.

Hi Tia. Welcome to the show.

Tia: Hello. Oh, I’m so excited. I can’t wait to dive into everything. As we were already talking about a whole bunch of stuff, I’m sure there’s lots to talk about.

I know. This is like such a great topic. And, you know, one of the reasons I started the Designer Practice Podcast was to really showcase the different ways that therapists and coaches can start their practice journey sooner than later. And start seeing the possibilities beyond just the typical way that we look at private practices. But much of the time it’s not knowing what the possibilities are. Of course, the imposter syndrome sets in. And even the stereotypes of what a private practice should look like versus what they can actually be.

Tia: Mm-hmm. I could have used you four years ago, when I was starting everything. That would’ve been really helpful and probably saved me a lot of self-doubt and headaches at certain points. But I mean, it brought me to the journey I am right now and I’ve learned a lot. So, I’m excited to share what I have and hopefully continue the conversation and learn from other BSW private practice and have them come out and chat about it as well.

Kayla: Fabulous. I’m so excited for you to share your story on the podcast and hopefully it will provide some inspiration and even build some confidence for any listener who may be holding themselves back from starting a private practice because they have a BSW.

Introduction

So, please tell us a little bit about yourself, where you’re from, and a little bit about your private practice and how it looks today.

Tia: Yeah, I always love the who are you question because I think what’s important before I share about all the fine little details, but it’s important to know that I am a relationships person. I base all of my decisions off of how it impacts my relationships with myself and with others. So, I have those core values that really guide me, which would be relationships and curiosity.

I, as a child, was always a why kid. So, I was told many times growing up that all I would say is why. And I just feel like it’s a way for me to figure out why do we keep doing things the way that they are if it’s not working the way that it is? And so, you’ll see how that comes into play a lot within my journey as well as like how I’ve built my private practice.

But then as the final little details are, so I married my high school sweetheart, so we’ve been together for, well, we’re going to be married for 10 years, but we’ve been together for a lot more than that. And we have a six-year-old daughter who is just so much fun, makes me laugh all the time. And gets us asking questions to a lot of the time as well. She’s very intuitive, really emotionally connected. Yeah, she’s just such a fun joy. And then we have a two-year-old COVID puppy. So she was, yeah, we got her during that time when we’re definitely realizing that we’re staying home a lot more. And so, she’s calm for the most part. She’s been sleeping in the sun all day. But then when I take her out to the dog park, she thinks that she’s the fastest dog of the dog park. And that just lights me up. That’s our little family and we have a lot of fun together.

I grew up in Calgary and surrounding area. So, I’ve always been in Alberta. I went down to University of Lethbridge for my social work degree. I thought I was going to go into psychology and be a psychologist. I think my parents wanted me to be a lawyer with a lot of the debating that I used to do. It made sense to go on to psychology because I was very much that person that was asking questions and supporting my friends. I was the go-to person, and really supportive in a way that wasn’t giving all the advice, but just sitting and listening and holding space. So, I think I learned that from a very young age.

And when I got into psychology at the U of L, it turns out it was a lot more neuroscience-based. And I like to say that I am a feelings person. I’m not a textbook person. So having to learn all over the brain very quickly became obvious that that wasn’t the route that I wanted to go. But of course, I went down to that university because that’s where my boyfriend, at the time, current husband. I say current husband as a joke, but my husband, that’s where he was going to school. So, yeah, I knew I needed to change course. So, then I went into sociology and that was too mega for me. And somehow, I don’t know how I wish I could remember, but somehow, I was directed towards the faculty of social work and I applied. Well, I took a year to figure out if I wanted to apply and I applied and sure enough, I got in and fell in love. I knew that was my space, those were my people. It was a program that it just started to become so easy because it was about asking questions and getting curious and sharing and hearing people’s stories. And really, again, those relationship pieces.

And from there, after I graduated, I worked for about six years in non-for-profit working with domestic abuse. So, I did everything from crisis counselling. I worked in the children’s program. Very quickly learned that I like figuring out the programming, but I was not very good at working with kids, which is okay. And then the last couple years had been really focused on outreach work and transitional support. So, working with people within their journeys and making big decisions.

And then I got burnt out, which we’ll go into I think in a little bit. But I experienced some pretty big burnout and I knew I needed to change from what I was doing. And the burnout was not from the client work, which surprised me. I thought burnout was going to be from lack of boundaries. So, I had such good boundaries. But it wasn’t from that, it was, I felt stuck. I didn’t have a direction to go. I felt like I wasn’t getting any further in my career. And so, I took a medical leave. And once I took the medical leave, I knew it wasn’t going back, and then I needed to make a decision of what I was going to do.

And that led me to figuring out maybe I could do private practice. There will be more things that I’ll share about, like how I got to that decision making. But yeah, so it’s been four years now of me in private practice and I could not go back. Like, I can’t change what I’m doing because I very much enjoy working in private practice and I get the challenge that I want and I get to be creative. It’s hard, but it’s also very, very rewarding for me.

So, I operate my private practice outside of Okotoks, which is just south of Calgary. And I connect with people within the counselling, definitely all over Alberta. But then I have a coaching aspect of it as well where I can connect with people in other provinces. So yeah, that’s where we’re at right now.

Kayla: That’s fabulous. And hearing your journey going into social work, it sounds like this is the place for you because not only are relationships something that you value and it’s a huge part of who you are. But that why factor, the curiosity.

Social Workers as Change Agents

And really, as social workers, we’re change agents, we advocate for change, and we look at systems and how they influence where we are and where we’re going. And that’s really what you’re doing today is you’re showing listeners another side of private practice that some people overlook or don’t know exists.

Tia: Mm-hmm. Yeah. I love that change agent. Yeah, it really is about the systems and being able to see maybe this isn’t working anymore. And there’s a big drive on what’s really kind of helped me to focus in on my private practice is noticing all of those gaps that we have in our mental health system and how much people suffer because of the way that things are set up and knowing that we can do things different.

And actually, a lot of us that are in the helping world or helping profession are a cause to the mental health stigma because things continue to stay the same in this system that is broken and not working. And so, my hope is driving that change and being able to say, “Hey, there’s other options out here.” And that we have really skilled professionals out there that have a beautiful code of ethics, standards of practice that we uphold and that we can do so much more to better people’s lives. And really support in that shift.

Journey as a Social Worker with a BSW in Private Practice

Kayla: Well, I’m glad that I am alongside you today to help you with that journey. So, I’m dying to know how was your private practice start-up journey. And tell us a little bit about it and how you got where you are today.

Tia: It was bumpy. It was very bumpy. It was interesting because it stems from different questions of why. Why and what do I want to do? So, I thought at first that maybe I would stop being a social worker. My last six months of my non-profit position, I was really like, I knew I was burnt out at that point. The first six months I was unaware that I was burnt out, but definitely experiencing it. And then the last six months I came into awareness and knew things needed to change.

So, during that time, I was able to take on a coaching course, and it was more the idea of going to this coaching course was so I could be prepared if a leadership role opened up and it would be that next step for me. When I took the coaching course, though, it was a very aha moment of, “Oh, this is what I do.” but it’s just in a language that is much more understandable, a lot less clinical, it was just approachable in the way that I do things anyways. And so, I really liked the way that it was set up. And so, I completed that coaching course and was able to use it at the same time of supporting a provisional social worker who asked me to supervise them outside of our non-profit, so that way they could, move around to different roles that they wanted to. And so, I got to be their supervisor, which was so rewarding.

So, as I was leaving my place of employment and trying to figure out, “Okay. Well, what am I going to do?” Not knowing at that time that I could provide counselling as a private practice. I thought I still needed my master’s at that point. So, I thought I was going to drop my social work and just go into coaching. And at that time there was this really great business community where I live, and we had this open forum essentially where a bunch of different business owners came together. It was a really collective thing. Again, people connecting relationships. And I put a question out there and I said, I’d really like to ask people more about their experiences of burnout, because I just went through it and I’m curious about it. And so, as I asked that question, I had a lot of people connect and share their stories with me. So, I created kind of an independent research, really my curiosity. But independent research of how does burnout affect people and what are they noticing? And then, what did they do to move out of burnout and how did they kind of resolve it?

And so those couple months of doing some research, I was noticing, “Okay, this is happening a lot.” But what was interesting was a lot of people were going to their doctors right away. So, I was thinking, “Oh, well, maybe that would be a place to connect.” And if I could get in where I work alongside of a doctor’s office, like within a clinic, that maybe they could bring somebody to me. If somebody’s coming in saying, this is what I’m experiencing. Because when I went to my doctor and I said, “Things aren’t great right now, I’m not doing good. I can tell it in my body. I’m snapping at home, at my kid. I’m not enjoying work. I’m feeling it.” And other medical things were coming up as well. My doctor just gave me a phone number to call to talk to a counsellor.

Even being in that professional world of knowing how valuable counseling was, it wasn’t the supportive handover that I think I needed at that time. But at the same time, I think a year or so before when I was experiencing really high blood pressure, my doctor was like, “Oh, here’s a nurse.” And walked me down a couple doors and took me to this nurse to start talking about my blood pressure. And that was so supportive that I started doing the work that I needed to for my health.

And so, it clicked six months later, a couple months later, that, “Oh, what I needed was my doctor to actually say, here’s the person I want you to talk to” not here’s a phone number. And that was the same thing that I was seeing with the results from my burnout study. And so, I went and approached a couple of new clinics at the time and asked, would you be open to me working here? I had to figure out what that cost would look like. And they were very open to it. They were very welcoming. They didn’t charge me for having a space. They just wanted like a slight percentage of anybody. I mean, there’s that gray area too, they can’t just give me clients because there’s the ethical pieces, right? I can’t solicit clients that way from them. But if there was anything that worked out, then I would give them a percentage back. I only got one client from them. It only worked at once.

But what it showed me was that yes, it was necessary, but it wasn’t the right space because there were other supportive networks that were in play that they could utilize within the medical system. It just wasn’t happening as quickly. And so, I knew, “Okay, this is still an area that needs to be supported, but it’s not the ideal way.” And so, what I did and what I altered was, “Okay. Well, maybe just facilitating a group might be helpful.” Maybe some of their patients could benefit from having some sort of group that would get them connected to themselves as well as their values and bringing on that awareness of how burnout impacts them. And so, I decided to put myself out there and do that. And that was successful. That was really successful.

And so, it kind of started a little bit there, but I knew that working within the clinic wasn’t going to continue. It just wasn’t going to work. And so, a few months later I still himmed-and-haw about combining counselling and coaching. And then somehow, I saw on either my insurance or someone’s insurance that they could submit their benefits for a social worker. And it wasn’t a Master’s of Social Work, it was a social worker. And that’s what started to change things where I’m like, “Oh. Well, if insurance will allow someone to use their benefits for working with somebody with a social work degree, then why can’t I start a full private practice that way?” So that was the curiosity question. What else can I do?

Kayla: You know, there’s actually a couple things going through my mind.

Tia: Mm-hmm.

Almost Choosing Coaching over Social Work

Kayla: First of all is the idea that you were going to drop your social work out of fear that you wouldn’t be able to do the work that you wanted to do. And here in Canada, coaching is an unregulated profession. So that’s why we see so many people doing coaching because there is no specific education requirement.

Tia: Especially adding on to that coaching piece, even though I went through and got a certificate for coaching, but you don’t have to. I met a few coaches over that first year that, because I wanted to, one, not create an area of competition, but also wanted to get to know who the other coaches were. But also wanted to learn from them. And some of them had certificates and went through particular programs and others, they just said, “Based off of my life experience, this is why I’m coaching in this area.” So that unregulated piece really shows that there can be such a range in the coaching aspect. So, it felt safe to go down that direction in some ways, but it also felt really scary because there’s no guidance around it of what I could or couldn’t do it. It’s nice to be able to get around some of those the red tape a little bit. But then also knowing that I have such a standard of practice and this is my programming that I’ve gone through, it felt also super unclear to just go through a coaching way.

Kayla: Yeah. And we need more social workers. We don’t need less, people leaving the profession so that they can do what they need to do and to help people. And I think that’s why this is such a great topic to talk about, that even though there is this idea out there, we have no idea where it comes from. We’re going to talk about scope of practice later in this episode, but I think that for any listener who’s listening that you with a Bachelor’s of Social Work is more education and more experience, because we even have two practicums in our BSW. And actually, in my BSW I did a counselling practicum. So many of us do have the experience and education for that.

So, I want to go into the fact that there’s listeners listening and they’re like, “Oh, I’m so intrigued. I really want to start my own private practice now.” Do you have any tips or guidance maybe from your own experience on how to move past some of the blocks that they might have had preventing them from going into private practice?

Tia: Yeah, definitely being able to talk to somebody would’ve been so helpful. It wasn’t probably about until it was six months after I was out on my own that I connected to somebody that was doing both. That was doing coaching and doing counselling as a private practice social worker. However, at the time, they were doing more coaching than counselling. So, I was like, okay, maybe I could talk about that. So having somebody just to bounce ideas off of. I mean, number one is probably the best place to start because you can go in so many different directions. I started with, and I know your website’s the same, where it’s just your first and your last name, dot com. I started the same way. I just had tiabell.com and I did that intentionally. I got the domain, I went with Squarespace because it was just easier for me to figure out, a little bit more costly, easier to figure out.

As a kind of background too, I had done like a hobby business. When my daughter was first born, it was a sewing business, and so I was sewing things for her, and then people wanted some items, and so I would start sewing for them. And so, I had a tad bit of experience of. Maybe some pieces of like how to start marketing and how to start getting yourself out there. By no means was I good at it, but it was there. So, I knew that okay, I wanted a place for people to go. If they heard about me, they could find me and where I can share my story about why I’m connecting with them. So, I did my Squarespace and tiabell.com so that way if I was still deciding do I keep the social work part or do I just go coaching or do I combine it? I wasn’t sure, but it, I didn’t have to commit either way. And yeah, I think that’s where like really, I started there.

You can though waste so much time updating your website or trying to find a logo or trying to find your branding. I wish I did more of that now versus spending the money that I did then because it was just a way to distract. And so, I would say that what was better for me and what helped me in the longer run was being able to network with people. And being able to connect individually. So, from going to local business groups, didn’t have to be counselling. Go outside your own scope, like go outside your own business because connecting with other people was helpful to see how they were running a business.

And then it also created opportunities where I could be a guest speaker. So, I was invited to do a bit of a workshop on burnout because that’s really what I was talking about at that time in my experience and things I had learned from my own independent study. So that was kind of where I had started. And I was invited to be able to speak at different things. So, taking those opportunities helped.

Getting on Insurance Panels

What I know now as well is I can get on a lot more insurance. Be a preferred practitioner through insurance, some of them have different names. I can’t remember what they’re fully called. What’s different with us as social workers through our registration versus like my massage therapist that I go to is that their association, once they’ve registered, will filter it through all the insurance providers and they’re set up with any insurance. So, they don’t have to go and call Green Shield or Alberta Blue Cross or any of the different ones to get their names on it.

Whereas we have to go through a couple of different channels to be able to be on their list. Some of them just say, yeah, your first client will send you information. We’ll send us their information and they’ll check with you and then they’ll put you on there. Others, you can now register ahead of time. So that part was challenging and figuring out, but I would start with that too. Because you feel a lot more credible when you know that you’re on an insurance list, if that makes sense?

 Kayla: It does. And actually, it’s funny that you say that BSWs can be covered under some insurance because I didn’t even know that. But even MSWs aren’t covered under all insurances. And actually, when I meet with clients, I’ve never direct billed, and basically, I go through the spiel of saying,” That we’re covered under most insurances, but to double check to make sure.” Because there are some that we’re not. It’s some that’s just psychologists. So even as an MSW, it doesn’t mean you’re going to be covered under all of them. And I think that we’re getting a little bit better because even up until, I think it was last year, many of the providers didn’t even direct bill with social workers. Now you could do it without the direct billing, but you couldn’t direct bill. Now it has shifted a bit. So, I think social workers are getting included into more plans. But that is really great to hear that with a BSW you can be covered under some plans. And even as an MSW, you’re not going to be covered under all plans.

Tia: Yeah, and the big difference, so the one that’s really tough is, Alberta Blue Cross and what it comes down to. And I talk to them about it, what it comes down to is that it really depends on the employer and what plan that they choose. So, they might be choosing a plan that requires only a master’s level. And some employers will choose to do like an EAP program, so an employee assistance program. So, then they’re going to provide a little bit less through other counselling options through the benefit. So, Alberta Blue Cross is one that will have many different types.

I set myself up to direct bill so that way I can check if it’s going to work, but then I leave it up to my clients to actually do the invoicing themselves. I just send them an invoice. I don’t offer the direct billing because I’m a one woman show that a lot of work on my end to have to confirm all of the insurance beforehand. I know that as you progress within your practice, you can get things like Jane App that you support and offer that information around, which is beneficial because then they can put their insurance in it ahead of time. But until you feel like you are at a financial place to do that, then you’re working at the capacity that you’re at the time.

And actually even, it wasn’t until after COVID that Telus eClaim included social workers on their direct billing because they house so many insurance, different insurance companies under them. But we never could be one of them a provider, because they didn’t include social workers. And they do now, which is great. So, there’s a few more that are popping up. And I think they’re seeing it after what people are asking for from their companies, that they’re wanting more mental health choices and insurance amounts are increasing, which is good. I think we could do better, of course.

 I’m also really interested in the direction that our association, we just split our register and our association have split. So, I’m really curious as to what ways the association can help in supporting us a little bit more in the private practice realm. So that’s my hope, I’ll keep pushing that.

Roadblocks to Starting Private Practice with a BSW

Kayla: Amazing. Yeah, me too. So, it’s interesting, we were talking about the insurances and I actually thought that this would be probably an obstacle or a roadblock, but it actually sounds like it isn’t. So, my next question is, are there any obstacles, roadblocks, or even limitations that you’ve come across as you were starting your private practice or even now as you’re growing your private practice as a social worker with a BSW?

Tia: I would say that the biggest roadblock was myself, of course. Getting into my own head and, really dismissing my worth and my knowledge and my skillset, at the very beginning because then I was on my own. A big shift for me happened when I connected with another counsellor through one of the clinics that I was working with. And they had said something like, “If there’s anything I can help you and teach you.” And they were talking in regards to my scope of practice and really trying to say like, “Well, I can support you if you need it.” And I took a step back because I realized that the way I was presenting was that I didn’t know what I was doing in the world of social work, when really it was just in the world of business I didn’t know.

Difference Between Business and Social Work Skills

And so, I was able to come and figure out that it’s not that I’m new into the social work world, but I was new to owning a business. And those are two very separate things. There are times that I have to put my business owner hat on and figure out the marketing aspects, figure out the billing aspects, figure out all of those different things that would help my business grow. I’m still progressively learning over four years. But when it comes to me sitting one-on-one with a client who is experiencing their own self-doubt, who is experiencing stressful relationships or trying to figure out their boundaries working through some self-esteem, transitioning from one job to another or anything like that. I know how to support them. I have had those skills for a long time and I continue on a yearly basis within the different trainings I go to continue to support them so that I can do, and I’m confident within that. So, the biggest barrier definitely was in recognizing the differences between what I have as a skillset and then trying to be a business owner.

And then another piece I would say for myself is I have always wanted to work at a really reduced overhead. I didn’t want to have to invest more into my business than what I was making. So, I would make money and then invest into my business, and that was a conscious choice of where I was at financially, where our family was at, what we could do.

So, you could go and start a private practice by going through some supportive channels and getting loans and I think you could set up quite quickly and do quite well early on if that was the route that you wanted to go to or if you had your own big set of savings as well. But I wanted to keep my overhead low and work towards it. So that sometimes I think created a limitation because I wouldn’t do certain things that probably would’ve helped me a lot more. Like getting somebody that could really do a lot more supportive marketing or having a program like Jane App that would really make it easier for all of the aspects of intakes and things like that.

So, learning process for sure. I think it gave me some chances to learn a bit more about all the in-depth pieces of owning the business. But has made the progress slower just because I’m choosing to do it that way, and I’m choosing to make sure that I pay myself within that too. Because some people will choose to just invest in their business and won’t pay themselves for a few years. So, I wanted to make sure that I paid myself, which was important.

Virtual and Walk-And-Talk Models to Private Practice

Kayla: Yeah. And one of the things about the overhead that you were speaking about is now since the pandemic– Of course the pandemic had a lot of negative effects on a lot of people. But one of the positives for our profession was the fact that online therapy became available. And because of that, we can now access online therapy and be online therapists super easily so that helps decrease the overhead costs. Because some people won’t even have to rent out offices anymore, they could do it from the comfort of their own home. One of the things that stop therapists from starting private practice is the fact that now they have to rent an office.

Tia: Yeah. It worked out well that I had already started doing a lot of my support virtually before the pandemic, so it wasn’t a big transition for me. But yeah, I realized that the best ways for me to connect with my clients and how I supported people when I was working in the non-profit was making sure that movement was huge. When I was working in non-profit, the conversations that we had that were really supportive, that were counselling, that were best for the clients I was working with was when we were cooking in the kitchen together. Or maybe I was just standing there and they were cooking, they were doing what worked out well for them. Or we went for walks in the backyard. There was always movement involved rather than sitting one-on-one in an office and when I would very clearly have an agenda of what we were going to be discussing during that time. It didn’t connect very well, but when it was where they felt more comfortable in their space, or maybe it was after one of our workshops where they had just finished something with their hands and they could sit there and it was a lot more relaxed. And so, I wanted to bring that aspect into my counselling. And so, I do walk and talks and be able to get out into the community. There’s beautiful spaces to go. And I also recognize when we talk about scope of practice, that my clientele is not requiring a space that has four walls, like they can be out as if they’re talking to their best friend about what’s going on for them as they’re moving around. I do extra work in making sure that there’s still confidentiality involved, knowing if somebody’s walking too close to us for a while. Being able to redirect where we need to or even noticing when we need to sit for a little bit. So, I had already built that in. Of course, the walking therapy slowed down there for a bit because of COVID.

And then a lot of them actually didn’t want to do virtual, but they wanted to do phone. And I found that to be so easy and sometimes distracting for me cause I could hear them doing dishes in the background or I had one recently that was like watering their plants and so I could hear the squeegee the whole time. But the amount that they were able to work through was so much more than if we sat looking at each other the whole time. So that’s where I try to make some of those shifts of knowing we don’t always have to do it the same. I’m not the same as every other counsellor. There is a place for it. It is necessary. Some people really need those safe zones where they can drop it and leave, but others need their comfort zones where they can stay and talk.

Kayla: I love that you just highlighted that you’re not the same as every other therapist because no listener listening is the same as somebody else. And I think that that sometimes we think we have to be like everyone else, but the truth is we don’t have to be, and not being like somebody else is actually going to make us more marketable because if you are the same as everyone else, you’re one out of a thousand. Whereas if you are unique and if you show up differently, you’re one-of-one.

Tia: Yeah. And that has changed for me in how I view the gray zone when talking to our registration because it used to be so frustrating and like, “I just want very clear answers of what I can and cannot do.” But of course, it’s very gray, not clearly stating what I can or can’t do but still saying be within your scope of practice. What does that mean? Like, I would get so frustrated. And then over time, and especially now, I love that gray zone because that is where we can advocate for change, where we can show that things can be done slightly different. I know some people that are facilitating workshops and making beautiful macrame things while also delivering mental health counselling in a group setting. Or doing yoga and counselling. We can do some really unique things.

I have a contractor who started with me, so that’s kind of where I’ve grown now is I’m bringing on different contractors who are social workers that have other amazing skills. And so, my contractor goes into homes and supports in clutter management and being able to re-organize the stressful systems that are happening and being able to support people through that. If there’s leftover items from a loss that the person has gone through and they’ve now been given all of the items from this person. How do you go through all of that? Or being able to move. Or even somebody that’s in a really small space, but how do you still create it yourself and being able to say, “Hey, you don’t have to have your living room, a living room. It could be your dining room, it could be your just full playroom. You don’t need to have couches in here. We can do whatever.” So, she does an amazing job at combining that supportive counselling with also the working alongside you and supporting you in your space. And that’s, again, going through those gray areas. How do we figure that out? And I mean, we talk about safety and we figure out safety plans and go through all that. And yeah, I think it’s, we need more of that. I would love to see more of that.

Kayla: And like you, I also love the gray because– it’s not about being gray, sometimes even when we say that, it almost sounds like, “Ooh, gray.” That means we’re on the verge of doing something wrong. But no, it’s that we have the ability to make it our own without that oversight. And I think that’s the key here, is that your private practice, whether you do therapy, different passive incomes, coaching, even if you want to sell a product, you have the ability to create it yourself.

Defining Scope of Practice with a BSW

And I want us to talk a little bit about scope of practice, because we’ve talked about that a lot. So, from your experience, how do you differentiate your scope of practice when it comes to starting a private practice as someone with a BSW?

Tia: Yeah, so scope of practice is, in my opinion, what I see it as is really the education that you’ve received, and then also the areas of interest that you’ve started to specialize. So maybe you’ve spent, more time working with youth over working with adults or maybe you’ve spent– like, I did a lot of that transitional work and outreach support. But working in supporting people and making big decisions for themselves in a short amount of time. And what does that look like? You might have been in palliative care, you might have been in, oh my goodness, social workers can be everywhere, right? So really that scope of practice is going to be the education you’ve received, the practicums that you’ve done, the areas you’ve started to specialize, and then the areas you continue to work in and continue to get training in as well.

So, as you start your private practice, maybe you’re in an area where you’re like, “Oh, I think I can start here.” Yeah, you start where you’re at, and then you can start to begin to specialize in even further areas within the trainings that you choose to do. You know, we have to keep up a registration. We have to get those 40 credits a year. So, as you’re doing that, you are going to start choosing, this is what I want to learn more about. I want to do more trauma work within BSW private practice, I think there’s a way to do supportive trauma. I’m very trauma informed. That has been my training. And so, it comes into play as I’m supporting clients. But also comes into play when I say, this is an area that is beyond my scope of practice. Let’s find somebody that can support you from what we’ve uncovered now to continue for you to do the work that you’re looking to do.

And so, scope of practice doesn’t mean I can’t help anybody. It just means this is who I can help. And when I feel, which I had somebody recently, I felt like this is starting to shift more into a where you’re needing somebody that can really work within the crisis piece and then really work within the family systems. Because there was family systems work there. That hasn’t been my specialty. And I think you are going to be way more supported by going with this counsellor that I know. And then me and that counsellor, with permission did a conference call and was able to transfer things over and that was supportive for that person.

So yeah. The scope of practice is areas that you are feeling confident about. You know, when you’re working maybe in a non-profit, most likely non-profit already, you are probably getting to a point where you’re like, “Yeah, I know my job.” You’re starting to teach other people your job and you know it so well. That’s when you know this is your scope of practice. That’s when you know this is the area you’re good at and you can start to transfer that outside of the workplace. If you’re still unsure within the private practice sector, you’re then looking towards the mentorship. Who can I still touch base with if I’m having questions? If I’m needing support or guidance? Or where can I get some more training and continue that training? So, a lot of the work that I’ve done is within CBT, mindset, journaling and those sort of aspects. And how it works and that self-compassion piece. And you’ll always continue to learn. If you’re not learning, then I think it might be time to change careers, right? If you’re not interested in learning more, then maybe that’s the transition point for you.

Kayla: Yeah, and when you were speaking about referring out and knowing your scope of practice, I mean, that’s the same again, whether you have a BSW or an MSW. It’s about, where does my training, experience end? And there’s lots of times–

Tia: Yeah.

Kayla: –I had to refer people out as well with an MSW. And you know, sometimes when we think of scope of practice, it really does trip social workers up because there really isn’t a clear line between what is and what isn’t within ‘my’ scope of practice. And it’s because we all have different education and because we all have different experiences and because we’re just different people and we’re motivated and energized and do different things. Again, that’s that gray area. Not that it’s bad or good. But just gray in the sense that you’re unique and that is okay. And that’s marketable, right? Being unique is marketable.

Tia: Yeah.

Kayla: And of course, our scope of practice can change, profession to profession or jurisdiction to jurisdiction. Because of course every regulatory body has maybe its own definition or what it identifies as being scope of practice. However, I have found a really good definition of scope of practice from the Ontario College of Social Workers. And this is how they define scope of practice. So, and I quote, scope of practice “is a description of a profession’s activities, including the boundaries of these activities, especially in relation to other professions where similar activities may be performed.” (OCSWSSW, 2008)

And you know, as social workers, we know that there’s people with Masters of Counselling, Psychologists out there, we are all doing very similar type of roles. Of course, our theoretical basis are different and how we work with our clients is different. But from this definition I take that it’s kind of the boundaries of what we can and what we can’t perform, especially in relation to others. Like of course, we’re not doctors, so we are not going to perform doctor-related roles, right?

Tia: Yeah. Well, and at a BSW level, you’re not providing a diagnosis. So even if somebody is coming to you with anxiety– I mean, you can work with somebody that has anxiety and has mild depression. And we might recognize those signs and be able to know that’s what somebody’s experiencing, but we’re not going to diagnose it to the point where they’re getting a treatment plan and medication for it, right? That’s not our role.

It’s more about figuring out, okay, these are the symptoms that are impacting you right now, that you’re speaking to. It sounds similar to anxiety. I can recognize that as anxiety and I’m not going to diagnose them with having extreme anxiety or anything. But anxiety is the symptom that everybody has and they’re feeling it more. So, let’s talk about that and based off of the work that I know and what I can provide, this is how I can support you.

If it’s not working after a certain amount of time that it’s, maybe we’re revisiting things that are not supporting. Then okay, maybe it’s time to switch to a different provider. And that’s again, okay. That’s why we have choice. That’s why we have multiple people in different areas because I might uncover something that they have been experiencing and now they’re ready to talk to somebody else about it. That can go more in depth.

Understanding the Structural Limitations to Your Private Practice

Another thing to know about scope of practice within private practice is that knowing where your capabilities are given that you have limitations in being private practice. So, you may have a lot more experience of being able to support somebody like I did within crisis support when I was working non-profit. I am not set up to support somebody that is going through an active crisis because I am only me and I don’t have a space that they can safely be in. And I don’t have maybe another person that could come in at that time if maybe I needed to do some extra phone calls while we figure things out. I don’t have that sort of team around me because that’s where I’m at of my private practice. And so although I might have more of a scope of practice that I could be going to and could be using, it is being limited because of what I can do right now. What I feel capable of to safely support somebody through something. So yeah, I actively don’t work with people going through crisis because I’m not set up to support them in a crisis.

Kayla: That’s a really good point that you’re talking about, like the structural, not even about the education. Not even about the competency–

Tia: Yes.

Kayla: –But it’s about the structural setup. And I think that’s the same with say, online therapy. There are some clients it will not work doing online therapy. So, it’s important to acknowledge that when you work with certain people. Is it safe to work with this person online? Or do they need an in-person therapist? So, I think that’s really great as well.

I went down a little rabbit hole before our conversation today, just about scope of practice in case there’s any listeners worried about. “Okay, we’re talking about scope of practice, but what does it look like for me?” And of course, I’m not speaking on behalf of any regulatory body, but I just did my own little research and here in Alberta what defines social work, scope of practice is the Health Professions Act. And of course, the Alberta College of Social Workers, their standards of practice.

And actually, the ACSW, so the Alberta College of Social Workers, has a document that addresses practicing outside of the scope of social work. And I’ll link all of the references that I’ll talk to about today in the show notes. So, if anyone wants to read more about these, feel free to scroll down to the show notes and click on the links.

But this is what the practicing outside the scope of social work document explains. And I quote, “social workers may practice outside the scope of social work practice provided that the activity performed is not a restricted activity and the social worker can safely and competently perform the activity.” (ACSW, 2020)

And it’s interesting because the word competently also trips us up. So, the word competently or competency, often leads us to feeling a sense of imposter syndrome. And when imposter syndrome sets in, many of us don’t feel competent. Or at least that was the case for me.

But what I realize is that sometimes we often mix up the word competent with confidence. So according to the Canadian Association of Social Workers, their definition of competency is, and I quote, ” individual competency is developed through education training, continuous professional development, supervision and self-reflective practice approach that bolsters learning from experience.” (CASW, 2020)

Competence Vs Confidence

However, when we think of confidence, that’s way different. Confidence is really trusting in our own abilities. And at this point we’re not feeling too trusting, right? When we’re experiencing imposter syndrome. And the thing about confidence is, confidence is built. When we think of self-doubt, that’s a type of fear. And when we experience fear, the way we build confidence is by taking actions towards that fear. And once we start taking those actions and recommitting to those actions, we start building that confidence in our ability and our fear subsides.

And this is why it’s important to niche a private practice, not just for the marketing side, although I do believe it from the marketing side as well. But again, from my own experience and from working with other therapists, niching your private practice helps you to decrease your imposter syndrome because you’re starting to build the confidence working with one type of client. Going back to scope of practice, usually clients you’ve worked with before. Or if you haven’t worked with them before, you are having very specialized training in that one area versus having to know it all.

And what I’ve noticed is that we almost do it backwards as therapists. We become generalists first, and then we narrow down. But what happens is, “Well in 30 years from now, I’ll start a private practice.” Yeah. If you want to be a generalist, it might even take you 60 years because there are so many areas that you could potentially be working with. But when you start narrowing it down and then you almost expand out, as you start growing your confidence, your training, that scope of practice, that’s when you start feeling both confident and competent.

Tia: Mm-hmm. Yeah. I think that you summarized that really well because, yeah, when I started, and I’m still going through it too, of figuring out exactly what my niche is. But I really was being a generalist because I’m like, “I want to work with everybody.” But what helped me was I started to figure out the list of people I didn’t want to work with, and that narrowed it down. I did not want to work with anybody under the age of 18. That was not an area of competency for me. And I’m not ready to explore that at the moment. And, I think there’s a lot of really great people out there that can support youth. And, okay. I knew I didn’t want to work under 18. I knew that there were certain sectors that I couldn’t support, and again, that was within actively being in crisis. I was not set up structurally for that. So that helped in creating my do-not-work-with-list. My I-want-to-work-with-list is still fairly long because I get curious and the relationships and I just love it because I learn so much from each session that I have with somebody. I’m learning something new and still trying different things too. And if I try different things, I will share that with my client too. So, if it comes up, then I will share that with my client of saying, “Okay, this is something I’d like to try. If you are willing, are you wanting to explore this? If not, I don’t have to try this. We can do what I know that I can do, but we could try something different.”

Managing Imposter Syndrome

Kayla: So, we kind of talked a little bit about imposter syndrome a little earlier. I know imposter syndrome shows up for pretty much all business owners, not even just private practice owners. So how did you navigate imposter syndrome when starting your private practice?

Tia: I navigate it all the time because it just pops up. It’s that piece of you that’s wondering when you’re entering something new. Am I capable of this? Could somebody else do it better or maybe having no direction? And so, I mean, the way that I navigate it is I do it anyways and see what comes from it. That’s my curiosity. I want to see what happened. I’m okay with failing at things. And I’ve come to that. I mean, one of my very first sessions that I offered online, I did a workshop I had 20 plus people registered for it. This was my first year. It was all about burnout. I had 20 plus people registered. I was so excited. And then when I came to offering it and we went live nobody showed up and I was like, “Oh no! Everybody registered, but nobody showed up.” And so, I switched it anyways in that moment of being able to just record it and then re-share it later on because it was the experience that I needed.

We connected recently because I shared a webinar, an info session that I was doing for out of curiosity because people were asking about private practice at BSW level. I had a couple of people in a Facebook group ask questions. And so then I said, “Yeah, I’m doing that. Ask me your questions.” And so, that person asked me questions and then more people asked me questions and I thought maybe let’s have a collective conversation about it. Because the more we know, the more we can learn together. And when people started saying yes and people started registering, oh, I had this huge wave come over me of being like, what if I missed something? Like, I know what I’ve been doing, I believe in what I’ve been doing but what if for some reason, you know, on page 32, on the standard of practice, it says MSW only. I reread it and it’s not there, but I had to go through that to make sure, okay. Am I still in the know? But I went with what I’ve experienced so far, and I leaned back on what I know so far. I don’t know everything and I’m learning so much from other people and having these conversations, which is great. I mean, I didn’t even know about MSWs not being able to fully be in all insurance. And that’s helpful to know because it makes me feel like, okay, it’s not just about the level of education. It’s just more advocating for social workers in general and the amazing things that we do.

One thing that really helped me when the association and the registration were still together, they had a private practice roster, through ACSW. And so, I was like, “Oh, I wonder if I can put my name on there.” And nothing on the documentation asked if I had a masters. It was just, what’s your information? Who do you support? How do you support? So, I put all that information there. And the one thing that set it says on there, which was really helpful, is that on the application, “it is an expectation that all private practice social workers will be in good standing with the ACSW and have the appropriate insurance coverage for liability and office.” That is all it said for a requirement. And so, I was like, okay, green light, go. Let’s keep trying this and exploring what it means for me. So that’s what I lean on and say, hey, if we have more people in this space, we can talk about it more. And then others can continue to get that support as well.

Kayla: And something we spoke about offline before we started recording today was that the fact that as BSWs, we are doing a lot of this work in agencies already. And I think this ties back to what you mentioned about business and private practice are two separate entities. You may not yet feel comfortable in business because a lot of social workers aren’t. We do not have any training even in the MSW. So any BSW listening, no business training in the MSW, or at least not the one that I had taken.

Tia: Mm-hmm.

Kayla: But in saying that we are working in agencies already doing a lot of these roles. So how come we can’t do it in a private practice model? And I think that’s important insight to reflect on today. And actually, that would be my homework for listeners is to reflect on that. Is the work that you are doing today, or maybe you have done previously, can that be transferred into a private practice model in some way shape or form?

Continuing Training as a Professional and Personal Goal

Tia: I would like to add as an aside that I’m not against getting a Master’s and that I want to be very transparent in saying that I still look towards getting my Masters, but it’s specialized differently. So, I’m not getting it to have a private practice, but I’m getting it to improve in the areas that I want to, because I want to be able to do a lot more leadership and policy changes. And I feel I’ll get the support in getting my master’s in that sense I don’t think it would impact my counselling, but it would impact my overall growth that I want to do in the realm of social work. And that’s the education furthering my competency in that sense. So, I think that’s important to know that. You can start at BSW but that doesn’t mean you have to stay there. You can go for your master’s or you can stay there if you want to. There’s some people that join the webinar that have been private practice for over 30 years at BSW, and that’s where they want to stay. You just do different sort of competencies. So yeah.

Kayla: I think what I hear you saying is reflecting back to the definitions I read out earlier is that you are growing your education because you want to grow your education. Not because the level of education you have limits you from doing something that you want to do. And I think that’s really important to highlight that regardless of what you do. Like very recently I did a strategic copywriting certificate has nothing to do with social work. But I wanted to do it because of course I’m teaching people how to market themselves. So, I did it because I want to learn.

So, I know that we’re getting close to the end of our episode, but I’m wondering if you have any advice or anything you want to share with our listeners to just motivate them or to get them moving forward?

Tia: Yeah. I think again, going back to if we want to see changes happening in our mental health system, we need to be advocates for that change. And that only happens if we step out of our own comforts and start making some adjustments to how things are done. That’s in the costs of counselling, the types of counselling, the way that it’s done.

So yeah, if things are just irking you and you’re like, we need to change this, I think you can be that support and you can start making those changes. Because as a social worker, you have so many amazing skills that are not shown in all professions. I mean, there’s a reason why we’re registered professionals versus in other areas that are unregistered and I think we do amazing things. And I would love to see some more social workers out there making change. It starts with us in many ways.

Conclusion

And yeah, and if you’re questioning or if you have questions, I’m always open for a conversation. If you’re local to Calgary area or south. I mean, I’m open for coffee even, but otherwise I can always have a phone call because it’s relationships-first and making changes that way.

Kayla: How can they reach you if they have any questions? Yeah, I mean, I’m really active on social media, so Instagram, I’m really active on Instagram, so connecting through @unscriptedco.ca I did change and fully take on a new name rather than just my name because I’m growing my practice to have other contractors.

And if you want to go online as well, just look up my website as unscriptedco.ca, so Instagram or website. Yeah, just message me and we’ll chat from there.

Kayla: Tia, I am so grateful that you took the time to be on the episode today. This was a fabulous episode, and I have a feeling a lot of listeners out there are thinking the same. So thank you so much for sharing your journey and of how you started your private practice and how you’re growing it with a BSW.

Tia: Yes. Thank you so much for having me. I loved it. We could talk for hours. This is amazing. Thank you so much.

Kayla: We so could. And who knows, maybe we’ll have you on the podcast again in the future.

Tia: Perfect. I’m there.

Kayla: Thank you everyone for tuning into today’s episode, and I hope you join me again soon on The Designer Practice Podcast.

Until next time, bye for now.

Podcast Links

Free Boosting Business Community: facebook.com/groups/exclusiveprivatepracticecommunity

Online Legal Essentials Legal Templates: kayladas.com/onlinelegalessentials

Use coupon code EVASPARE10 to receive 10% off any legal template pack.

Open Path Psychotherapy Collective: kayladas.com/openpath

Designer Practice Digital Template Shop: designerpractice.etsy.com

Credits & Disclaimers

Music by ItsWatR from Pixabay

The Designer Practice Podcast and Evaspare Inc. has an affiliate and/or sponsorship relationship for advertisements in our podcast episodes. We receive commission or monetary compensation, at no extra cost to you, when you use our promotional codes and/or check out advertisement links.

References:

Alberta College of Social Workers. (2020) Practicing Outside the Scope of Social Work. Retrieved from this link.

Canadian Association of Social Workers. (2020). CASW Code of Ethics and Scope of Practice. Retrieved from​ this link.

Ontario College of Social Workers and Social Service Workers. (2008). Position Paper on Scopes of Practice. Retrieved from this link.

Pin It on Pinterest

Share This