Live Consulting with Joe and Melissa Dohse Series 3 of 5 Five Fierce Females | PoP 280

Five fierce females

Have you ever wondered what consulting with Joe Sanok is like? Do you wonder whether or not it would be beneficial to your business? Are you feeling stuck in your phase of private practice?

In this episode, Joe Sanok speaks consults with Melissa Dohse live to give an example of what consulting with him is like.

Podcast Sponsor

We’ve created a lot of stuff, i.e.: opt ins, PDFs, e-books. At Practice of the Practice, we’re constantly developing things and making them accessible to you. But, sometimes, it’s hard to keep track of it all. So we’ve set up a landing page,, where we have put all of our free stuff. We have five free e-books there: the ‘Practice of the Practice’ e-book; the ‘HIPAA and Security’ e-book that I wrote with Roy Huggins; the ‘Adding Insurance to Your Practice’ e-book; the ‘How to Start a Group Practice’ e-book that Alison and I created; and the ‘How to Start a Practice That Thrives’ e-book.

Also, we’ve got checklists there galore! We’ve got your ‘Website’ checklist, your ‘Pinterest’ checklist, your ’28-Step Checklist for Starting a Practice’, and your ‘Group Practice’ checklist. Also, we’ve got some guides there: there’s ‘A Guide to Creating a Website’, ‘Comprehensive Guide to a Kick-Ass Content Strategy’, ‘A Guide to Start a Private Practice’, and tons more infographics, and worksheets. We have over 20 different, free resources there for you! It’s over at Go grab them before we start charging!

Meet Melissa Dohse

I received my Bachelors of Social Work from NAU and graduated with a Master’s of Social Work from the University of Denver.

I specialize with survivors of trauma, women in the postpartum period, and individuals parenting with PTSD.

I provide individual counseling in my office and walk-and-talk sessions in the community. New mothers are welcome to bring their infants.

Melissa Dohse’s Story

Melissa is an LCSW that has been out of Grad School for five years doing counseling work for non- profits and a consulting job on a native American reservation. She decided in January that she wanted to commit to starting a private practice, a dream she had for many years. Melissa took the next six months (January-June) to wrap up her previous employment and get all her ducks in a row. She listened to so many of Practice of the Practice’s podcasts, followed the 28-step checklist and read many of our blogs in the lead up to her launch. Melissa officially launched four weeks ago and she’s completely full already and has a waitlist. She only wanted to do the private practice part-time, as she has two young children.

In This Podcast


In this episode, Joe provides live consulting to Melissa Dohse. This is a prime example of what it’s like to consult with Joe, but also gives insight into Melissa’s stage of private practice; what she’s struggling with as well as a discussion on how to overcome these challenges. Joe looks at the low-hanging fruit and focuses on why Melissa wants a practice that thrives and how she can go about getting there!

Process of Consulting With Joe

Apply to consult with Joe

Have pre-consulting phone call:

  • Why did you decide to go into counseling?
  • How many clients are you currently seeing?
  • How much are you charging per session?
  • What are your expenses?
  • What is your office set-up like?
  • Are you interested in adding clinicians to your practice?
  • Why do you want a thriving practice?
  • What’s preventing you from attaining a thriving private practice?
  • What low-hanging fruit could you look at outsourcing?
  • How is your website set up?

Phase 1: optimizing practice

Phase 2: scaling practice

Useful Links:

Meet Joe Sanok

private practice consultantJoe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.






Thanks For Listening!

Feel free to leave a comment below or share this podcast on social media by clicking on one of the social media links below! Alternatively, leave a review on iTunes and subscribe!

Podcast Transcription

File: PoP 280 Live Consulting with Joe and Melissa Dohse
Duration: 0:44:23:03

[START] Joe Sanok: We’ve created a lot of stuff. I mean opt-ins, PDFs, e-books. At Practice of the Practice, we are constantly developing things and making them accessible to you. But sometimes it’s hard to keep track of it all. So we just set up the landing page, where we have put all of our free stuff. We have five free e-books there. The Practice of the Practice e-book, the HIPAA and security e-book that I wrote with Roy Huggins, the Adding Insurance to your Practice E-book, the How to Start a Group Practice E-book, the Alison and I created in the How to Start a Practice That Thrives E-book. Also we have got checklist there galore. We have got your website checklist, you Pinterest checklist, your 28-step checklist for starting a practice, and your group practice checklist. Also, we have got some guides there: “A Counselor’s Guide to Creating Websites,” “A comprehensive Guide to a Kick-Ass Content Strategy,” a guide to start a private practice, and tons more, info graphics, worksheets. We have over 20 different free resources there for you. So over at, go grab them before we start charging.


This is the Practice of the Practice Podcast with Joe Sanok, session #280.

[MUSIC] [INTRODUCTION] Joe Sanok: Well, welcome to the Practice of the Practice Podcast. I am Joe Sanok. You are live in the Radio Center Two Building in beautiful downtown Traverse City. I am so thrilled that you’re hanging out with me today. We are all about starting, growing, and scaling private practices in really innovative ways. On this podcast, we cover all sorts of things that I an curious about, and you know, it has been probably since 2012-2013, that I have been doing one-on-one consulting with people and in the last couple of years have launched some Mastermind groups and we also have our Next Level Practice which is for people just starting out at out supportive community over at But often if you haven’t had a chance to do one-on-one consulting with me or with anyone, you don’t necessarily know what it’s like. And so Melissa – today’s guest Melissa Dohse – she reached out to me and she has been a big listener. She has downloaded a bunch of stuff, follow the emails, really launched it, and said hey Joe, would you be off for doing a live consulting session to help me get to that next level of practice and I thought, you know, this would be a good chance to really kind of show what’s it’s like for someone that’s just at the beginning phases. Most of my consulting now is for people that are right there on the $100,000 ready to really scale up. And Alison Pidgeon is doing a bunch of one-on-one consulting and also running some Mastermind groups, and we are looking to maybe adding more consultants to Practice of the Practice so that we can really help everybody at every phase of practice.

But today on the show is super exciting for me because… we haven’t done much of this, where I have done the consulting on the podcast. So hopefully get some takeaways and Melissa has just rocked it out and grown so quickly and to learn from her, one of our five fierce females in February. She is rocking it out. So without any further ado, I give you Melissa Dohse.


Well, today on the Practice of the Practice Podcast, we have Melissa Dohse. She is an LCSW and and she is the owner and operator of Cultivate Counseling down in Flagstaff. Melissa has been in the social work for the last 10 years with a focus on Women on Trauma. Melissa, welcome to the Practice of the Practice Podcast.

Melissa Dohse: Thanks for having me. I am excited to be here.

[THE CONSULTING SESSION PODCAST – INITIAL DETAILS] Joe Sanok: Yeah, this is a unique kind of podcast for doing today. You dropped me an email, maybe a month or so ago, and tell the audience what you said in that email.

Melissa Dohse: Yeah, well, I don’t have in front of me, but I just kind of shared with Joe my story of coming into Private Practice. I decided about a year ago I want to move into it, but in January of this year I really started pursuing it. And I work… last year I worked out on the Hopi Reservation, and it’s about a two-hour drive from Flagstaff each way, and I worked out there two days a week. So on my drive two days a week, I would listen to all of Joe’s podcast to like really prepare. Get ready for my launch this summer of my private practice and I have heard tons of the podcast. I did the checklist. I really feel like I was a good student of Practice of the Practice, and my practice just like took off crazy and I really wasn’t expecting and I saw like a lot of that was due to just guidance and following a lot of the things you had suggested and I feel kind of stuck now like, well, what do I do. I am only like 9 weeks in and I already have a wait list, and I don’t necessarily want to take on more days. I have two small children and so I contacted Joe saying, hey, let’s do a live podcast where you show what are your consulting is like because I have listened to so many podcasts, but I have always wondered what’s the consulting process actually like. What you’re getting when you invest in that. So…

Joe Sanok: Yeah.

Melissa Dohse: …I, yeah, I thought that that would be fun to just give me and the listeners an idea of like what is that like with you and kind of what comes from that, so…

Joe Sanok: Yeah, so why don’t I sketch out – I [00:05:35.00] like this is like one of our first sessions. We haven’t talked about this before this moment. And so kind of the process of what it would be for people that are listening is they would usually go to I have got some testimonials and videos, kind of sketches that sketch out what consulting is. So someone would then kind of have in their mind they have at least a basic framework going into the application. And so they know that we are probably going to do two sessions a month for the first couple months and then we will move to once a month. We use Trello to keep track of kind of all that we are working on and that really is meant to help you create a plan for me to walk through when you get stuck during that time. And so if you had already kind of applied for consulting, then I have Emily my Director of Details. She goes through all of those applications and she reaches out usually within 24 hours, usually faster than that, and then says, hey Melissa. Looks like, you are a great fit for consulting. I just have a couple follow up questions for Joe to prepare him for your pre-consulting call. And so then she would look through what your goals are. Make sure they align with what you get out of consulting. And then we have a pre-consulting call, which is kind of like where you and I are going to start while also may be getting a little into as if there was consulting today. Does that sound, Melissa?

Melissa Dohse: Yeah, that sounds awesome.
[QUESTIONS LOOKED INTO AS PART OF CONSULTING PROCESS] [Why Did You Decide To Go into Counseling] Joe Sanok: Cool. So for consulting phone call, I love to kind of hear your back story of why you went into counseling. Tell me a little bit. You started listening while you are driving to the Hopi Reservation. What was going on that made you want to start a practice?

Melissa Dohse: Yeah, so, you know, I knew in high school I wanted to be in helping profession. It’s something that I kind of never questioned my path that I was supposed to be on and kind of started that immediately in High School, started going on in national trips and then immediately got my Bachelors in Social Work, was working in the domestic finance field and got my Masters in Denver, and I love the field. I love the work, I love helping people and I love trauma work specifically because I find so much hope in there and I find people getting better all the time and that’s just really exciting to me. But then I had kids as many people do, and it’s just not sustainable to do trauma work 40 hours a week and come home and…

Joe Sanok: How long it was that you had kids?

Melissa Dohse: Yeah, so I have a 3-1/2-year-old and then I have an almost 1-year-old.

Joe Sanok: That’s a busy age.

Melissa Dohse: Yeah, crazy age. You know, two-super young ones. And so I got my LCSW right when my son was kind of finishing his first year [00:08:13.14] on my hours. And me and my husband knew we wanted to kind of transition back to Flagstaff where he was from. And so we took a sabbatical in Ecuador and we took three months and kind of re-thought about what we want to do with our life and I felt I really wanted to go into private practice. It just gives the flexibility and freedom for me to be a mom [00:08:34.13] only schedule clients when my kids are at school eventually, when they are in school. I think it was the ability to help the people I wanted to help, the people I felt good at helping. I think it’s a big part of it. I think when you are on a big agency, sometimes you don’t have as much say in what kinds of clients you see. And so knowing what my strengths are and really getting to do that in private practice was a big draw on this. – the freedom to not work as much so [CROSSTALK]…

Joe Sanok: It really sounds like flexibility, be able to be there for your kids, that’s what really drew you into starting your practice?

Melissa Dohse: Yeah, definitely. Flexibility and getting to like serve the clients that I really feel skilled at serving. So…

[How Many Clients Are You Currently Seeing] Joe Sanok: And then how would you frame out how your practice is right now in regards to numbers, in regrds to how happy you are with where you are at. I mean a few minutes ago, you said that you were surprised that you were so full after just 9 weeks… nine weeks, six weeks?

Melissa Dohse: Yeah, about nine weeks. It was like mid June. So I guess seven, eight… I don’t really know. So when I first launched, my plan was to do… I felt the buildup would be slow. So mid June I launched, and I had a day where I was like, oh, I have a full day that , that’s like six clients. I [00:09:54.24] take me a while to get six clients. And then in two weeks, I had six clients and I was “oh.” That was my plan. So then I added another half day and just like [00:10:06.06] things in place for my kids. In the last kind of two to three weeks, I have two full days now. Currently, I have 15 clients. My goal is to see 6 clients a day. It doesn’t always, you know, happen with cancellations and all that kind of stuff, but my goal is six clinical hour days with time for paperwork and other things. I have already turned away quite a few people because for a while that I had a wait list when I was transitioning to my second full day and I lost a lot of those people who had found other counselors. And then, actually I am getting an average of two new calls a week about people wanting to come in. So that’s where I am at. I am…

Joe Sanok: You have 15 clients. How many sessions a week do you think you are doing right now?

Melissa Dohse: I say, 10-12 sessions a week.

[How Much Are You Charging Per Session] Joe Sanok: And what you’re charging per session?

Melissa Dohse: So right now I am paneled with one insurance company and that is the payoff for about $80, but then I have about probably 4-5 private pay clients who pay $120.

Joe Sanok: All right. So if we’re at 4-5 times 120, so that’s about $600 a week and then if we have 7 times 80 or so, that’s $560 a week. All right. So you’re just around like $1100-$1200 a week. Is that about right?

Melissa Dohse: Yeah, yeah. I was averaging, I was kind of estimating around a $1000 plus depending on if I have any cancellations or anything like that come up.

[What are Your Expenses?] Joe Sanok: Okay, and tell me about your expenses what you’re spending money on.

Melissa Dohse: Yeah. So, my monthly fees are about – it’s super cheap actually – about $189 is what I am spending a month. On my office, it’s $83 a month…

Joe Sanok: What!

Melissa Dohse: …[LAUGH] because I am sharing, which you had recommended…

Joe Sanok: Who recommended that, that’s a great idea [LAUGH].

Melissa Dohse: [LAUGH] It’s only $83 a month. So that’s incredible…

Joe Sanok: Now with that is there any sort of limit as to like could you upgrade to three days a week or four days a week if you wanted to?

Melissa Dohse: Ahm, it’s kind of a conversations I shared with one other therapist, and he is not using it a ton. So we talked about it a few weeks ago, and he is like, yeah, you know, you could probably make it work for a while. There is three of us putting in and so that person looks like they are going to back out. So I think there would be an option to go to a third day. I would probably go up to like $120 a month or something [00:12:44.03]. But, yeah, so there is an option for a third day. Probably not a fourth day because of the other therapists that I am sharing it with.

[What is Your Office Set-Up Like?] Joe Sanok: Okay. And tell me about the building that you are in. Would there be an option, if you wanted to, eventually rent your own space if you wanted to scale and add people – like could you stay in that building? Just describe the space for me. [00:13:04.15]

Melissa Dohse: Yeah, so it’s just like a general office building in downtown Flagstaff, and there’s about probably seven other private practice counselors in there. So it has a really cool counseling feel, even though there is other businesses in there as well. There is like a real-estate and a chiropractor. But’s it’s mostly counselors actually. I am actually on… I am on a wait list to be the first person to see an opening in October that’s coming up in our building because there’s really low turnover in the building and so in October I will have the opportunity to see a space that’s about $400 a month. So it’s quite a bit more than I am paying now, but if I wanted that [00:13:44.18] [CROSSTALK]…

Joe Sanok: Mm-hmm. And how many offices? Would that just one office?

Melissa Dohse: You know, I don’t actually know. He just had sent me a message, but I think it’s probably one, maybe bigger office.

[Are You Interested in Adding Clinicians to Your Practice?] Joe Sanok: Okay. So, yeah. I think that’s something that when you’re at a point that you are starting to turn people away and you want to have that lifestyle, looking at, well, how do I continue to scale, how do I continue to grow – so looking at do you start raising your rates for private pay, do you start adding clinicians? When you think about scaling and growing since you have such a strong start, what are areas that you are like I definitely would like to do that versus I am not sure I want to do that versus I definitely don’t want to do that?

Melissa Dohse: Yeah. I’d love to start doing consultation like supervision for people getting their masters and getting licensure. But there is a process you have to go through in there, so they will need to be certified in that. So I would love to do, add that to my practice. I think I love like to add clinicians. It just feels like can you really do that, like two months in?? No, it feels like way too soon and I think that’s kind of what I felt stuck… as like one still kind of getting my feet on the ground and I think what happened was I grew so fast that I haven’t done so many of the things I have planned on doing. Like, I haven’t even optimized my website. I don’t have any social media presence. I, like, had been asked to do some presentations in the community that I haven’t done yet like there is so much more I could do to like grow my name in the community that I haven’t because I don’t want people to keep calling me because I don’t have… you know I don’t have space. So I think adding clinicians is definitely something I’m interested in. It’s just something that I don’t know a lot about and that feels like a big stuff. So…

Joe Sanok: Yeah, I think when I work with people I always look for the low hanging fruit, like what do we do right away that’s going to help bring in money, but use of a ton of your time and so, yes, you want to have an optimized website, you want good marketing, you want all of that, but you’ve got a great flow of people already coming in and you really don’t want to get the reputation that you are hard to get into that takes for ever, that you are not seeing clients because to undo that it takes a lot of time.

Melissa Dohse: Right.

Joe Sanok: So I am apt to keep running with the sprint, and if you are comfortable talking about how to add clinicians to your practice and kind of some those first steps and addressing some of that mindset, stuff around. Well, I might good enough. I just started. Like kind I really do this and some of that is genuinely, like yeah you should learn something. You need to learn how to be a manager. You need to learn how to organize people. Like, yes, maybe there are skills that we have built in you over kind of the long-term consulting whereas maybe there is other things that is like you are good enough. You launched a practice. You listen to hundreds of hours of podcast. You know a ton compared to other people and you probably are selling yourself short of the knowledge that you have. Because when you are around other high achievers or you are listening to people that I have interviewed or blogs you compare yourself to those people and feel like you always come up short. Whereas in reality, compared to the local counselors you are probably in the top one percent already in regards to mindset, in regards to knowledge, in regards to your ability to scale your practice.

Melissa Dohse: Mm-hmm.

[Why do You Want a Thriving Practice?] Joe Sanok: Well, I want to step back a little bit from kind of the advice side of your practice and here about your why’s – something I always do kind of on these consulting calls. Tell me why you want to have a thriving practice? I know part of that you said was your kids, but if you had a six figure or a multi six figure practice, how would your life be different?

Melissa Dohse: I think of this freedom to be with my family more. My husband works like 65 hours a week and we really want him to step away from that and it would be great if I could make enough in three days to support our family. So I think that’s been a conversation between us since like If I added a day and you quit this job where we don’t get to see you that much, like how could that change our family. So I think that is a huge piece of it.

Joe Sanok: And so have you looked at how much income would have to be replaced if you were to step back from that position or do a lateral move?

Melissa Dohse: Yeah, I mean I think we have looked at it and I think in three days I could easily replace and like make enough for us to be fine, like… so that’s kind of a…

Joe Sanok: So really you are two-thirds of the way there, just another day could potentially change your life in regards to seeing your husband more, being around your kids all that.

Melissa Dohse: Yeah and I think [00:18:37.28] just a huge need. There is… you know, I get calls every week I got a call… actually, I was in Traverse City a few weeks ago and I got a call. I was there and this client was like, “Nobody has openings on this time. Like, everybody is full.” She is like I have called therapists after therapists. And she said you are supposed to be the one with opening. Someone told me you just opened and I was like, “I know and I did like two weeks ago,” so like it’s just a need that I am hearing so often. In fact [00:19:09.01] there’s actually only one group practice in town.

Joe Sanok: Wow.

Melissa Dohse: So that’s just [00:19:14.12] [CROSSTALK]…

Joe Sanok: Right now, all these people who are listening and they are going to be like, “I need to move to Flagstaff.”

Melissa Dohse: [LAUGH] And so it’s a great city to live in. But, yeah…

[What is Preventing you From Attaining a Thriving Private Practice?] Joe Sanok: So what’s standing in the way of opening up a third day?

Melissa Dohse: Right now, it’s child care. I don’t really have the child care for the third day and I think I’m just trying to be mindful of how many different caregivers my kids have in a week, and some of the pre-schools that I would love to send my son to, my daughter can’t go to. So there’s all this, like logistical… I’m the main parent right now. So I think the main kind of caregiving parents. So I think that’s what standing in the way right now, is just the mental space to add a day while also my husband not being as available as he would need to be for me to do that. So…

Joe Sanok: Sure. So I wonder [00:20:05.12] if using something like… and I know that it sounds like it’s less financial and more like [00:20:10.29] consistent care givers which totally makes sense, but defined even a nanny for that day in the short run so that you can keep that momentum going while you are adding clinicians. Then you won’t be turning people away. I mean you probably in hour or two hours make enough to cover that nanny for the day or to even look at other things you could outsource just even in your personal life like grocery shopping or cleaning or things so that you have that like quality time with the kids rather than just kind of short of time. I think that’s something that often times we underestimate. You know if we spend a Saturday mowing the lawn and trimming the bushes and getting food like, that’s not a day that we genuinely have with our family and I am a big proponent of designing the lifestyle you want. And when you are cash strapped that’s harder, but if it’s like okay, if I work one more day or week, I can then pay for two full days for the family replacement [00:21:06.07] income and have more of a lifestyle and I don’t have to be doing all the stuff that maybe I have done in the past. Does that makes sense?

Melissa Dohse: Right… Mm-hmm. Yeah.

[What Low-Hanging Fruit Could You Look at Outsourcing?] Joe Sanok: What kind of low-hanging fruit would you say there is in regards to potentially moving towards outsourcing certain things in your life that you don’t like doing, that would give you more time with your kids or more time with your husband?

Melissa Dohse: Mm-hmm. And do [00:21:34.19] or shopping [LAUGH]…

Joe Sanok: Okay.

Melissa Dohse: [LAUGH] And cooking. I have looked into, like… we have done the [00:21:40.27] services….

Joe Sanok: Yeah, blue [00:21:42.28] or something….

Melissa Dohse: Yeah, I wasn’t like [00:21:44.24] about them.

Joe Sanok: And it gets kind of expensive. I mean, like for that [00:21:48.16] pretty much like go out to eat at a decent restaurant.

Melissa Dohse: Right. No, that’s true, and like, I would rather just get like Thai Food [00:21:54.06]…

Joe Sanok: Right. [LAUGH].

Melissa Dohse: Have to cook and do dishes after like…

Joe Sanok: Oh, Thai food…

Melissa Dohse: Yeah, so… I think, yeah, probably like food is not my thing, which is so [00:22:05.04] my husband is a restaurant manager and he loves cooking. Right… On his days off he likes to cook. So it’s like, all he does is cook, but… I end up doing most of the cooking. So I don’t really like cooking, and… I don’t mind cleaning and like [00:22:19.21]. So I don’t have much in my home to clean. But, yeah, I don’t know, it’s a hard question. The other piece is we just bought a house this summer. So there’s just a lot of like home projects to be done. So it would probably be more about stuff like hiring someone to put in our baseboards and hiring someone to, you know, like get our yard in place [00:22:39.13] it’s just a lot of house projects now that we’ve never had before.

Joe Sanok: And that’s such a mindset shift where you know when you think you’re going to be launching your practice it starts with, okay I got to bootstrap, I got to be the accountant, the attorney, the bookkeeper, everything. And then to have scale to over 1000 bucks a week. I mean you are ready, you are going to be at 50 to 60 grand a year gross. So you add from start to growth scale really fast. And that shift is going to be definitely kind of the phase that you are in. Phase I is that startup practice where you’re bootstrapping and moved through that in two months. That growth phase where you are up to about $60,000 or $70,000. That’s where you really start to say should I, Melissa, be doing this or should somebody else be doing this, where I found from the six and multi six figure practices that really thrive and can sustain is they do a number of kind of things different from the average clinician. But one of the biggest things is that they see time as one of their most valuable assets, and so people and tools and digital products that save them time and automate things they see not as an expense but instead as a multiplier. And so hiring somebody at 15 bucks an hour to answer your phones, do your scheduling, you know kind of handle some of the practice right now may feel like, “Well, that seems kind of excessive, but you are probably getting pretty close to that point of needing an assistant that can manage a lot of those just little teeny-tiny things so that that can be off of your energy, and your extra energy can go back into your kids, into your family, into your friends…

Melissa Dohse: Mm-hmm.

Joe Sanok: And so I would really want to, if we are working together, over the long haul, I would want to make sure that we really evaluate are there things that are on your plate, the things that have to be on your plate or are there tools or people that could take that off of your plate? Does that make sense?

Melissa Dohse: Right…. Mm-hmm.

Joe Sanok: Okay.

Melissa Dohse: Yeah, and my and I have talked about him kind of becoming that person, where he quits his job, like becoming kind of the assistant for me, you know, doing some of my dealing with… you know if I move into a good practice, doing some of the management piece, the billing piece, taxes, you know all that kind of stuff.

Joe Sanok: Now, would your husband take a job for 15 bucks an hour?

Melissa Dohse: Yeah, that’s about what he makes right now. So…

Joe Sanok: Okay, okay.

Melissa Dohse: It would actually be a lateral move for him… yeah.

Joe Sanok: So, it would be a lateral move for him… Okay. And that’s where I want to… For some people, it’s no. Absolutely not. For other people, it’s llike, yeah.

Melissa Dohse: Right.

Joe Sanok: Yeah. And so that can be… And that’s where it comes out kind of the couple side, like can you give him honest feedback? Are you still in charge of your practice or would that dynamic then get in the way of your marriage. And that’s the thing only you can really decide…

Melissa Dohse: Totally.

Joe Sanok: But usually as a rule of thumb, that isn’t recommended because it just adds extra stress to the couple than instead of just one of you thinking about your business all the time and having to learn to pull back on that. Now you both are. And so I would want to just make sure we looked at the pros and cons of that versus him finding a job that he can show up to, he can enjoy, he feels filled up with, and then he can come home and would be 100 percent there for you and you guys can kind of step back together. So I would want to make sure we evaluated that. So kind of the three big goals that I am hearing are first, to really just examine how your lifestyle fits in with your business and making sure that we’re outsourcing everything we can, that we are setting up systems that are sustainable for long-term multi-six-figure growth. Because to do this much in such a short period of time, I think it’s important that we really set up systems that aren’t just like this hotch-potch, but that they can take you up to 6k, but that they can also take you to a multi six figure practice without having to change and undo too much. I am also hearing that scaling it, there’s a lot of opportunity here. And so adding contractors to your practice and figuring out how to do that. And a really kind of clear way would be a big goal of our consulting. And then third, I am hearing kind of other streams of income such as supervision being a part of the equation as well. You know, there’s just some kind of logistical things in Flagstaff to get certifications to do supervision. But then how do you market yourself? How do you stand out to be a supervisor, and all of that? Do that sound like it captures kind of your three big goals for consulting?

Melissa Dohse: Yeah, definitely. I think that systems pieces, like, has been really hard for me because I expected to have the time to set up systems.

Joe Sanok: [LAUGH].

Melissa Dohse: And I haven’t. So that piece has been where I feel like I am really lacking.

Joe Sanok: Yeah. And so if we are working together over the next six months, the first month I would say we would spend the first two sessions really evaluating your systems – what’s working, what’s not working, what do you understand, what can your outsource. So even something as simple as “I know I should be blogging.” Well, should you be the one that’s blogging? Should we hire a copywriter that will write some blogs for you and then you kind of go and then add your essence to those blogs. So that you write 20 percent of them. Or if you’re more audio for you to just talk into something and have someone transcribe it while you are driving or while you are going for walk or something. So finding ways that we can kind of overlap parts of your life, so we can multiply your time. Because you are busy, you have kids, you have a practice that’s thriving already. So figuring out what really should you be doing, what shouldn’t you be doing. And then having even someone like an IT person that if your website breaks down they jump in there while you are in session rather than you doing it. Who do have your website through?

Melissa Dohse: Ah, Squarespace.

[How is Your Website Set Up?] [OPTIMIZING PRACTICE; SCALING PRACTICE] Joe Sanok: Squarespace. Okay. So good for SEO, but we may want to have somebody like Jaime Jay from Slapshot Studio at least go ahead and just make sure website is optimized for SEO and kind of outsource that to someone that knows what they are doing SEO wise. And the metaphor that I like is the idea of a ship. You know, I’m a sailor, and so we got to make sure that the hatches are battened down. We got to make sure that everything is kind of tight like it’s supposed to before we set the sail. Otherwise, we are going to take on water and if we add people to the boat that’s not going to help us optimize this. So making sure the practice is optimized, so I say that would be like phase I. And then phase II I would say would be, us really looking at how do we scale. And so what we would do is in Trello. We would create a board for you, where it has Melissa’s one thing, so the one thing that you need to do between now and her session. So that might be here’s the systems to evaluate. l want you to meet with these people and get quotes and see if that fits within your budget and then next let’s look at outsourcing as much of that as we can to free up your time and mental energy to work on bringing clinicians. Then we’ll have Melissa’s next things, which is another column. And so as we talked during consulting, I am talking notes in there, adding cards. I can drop videos and checklists and due dates into that. And so that could be what you need to do next step to your one thing. It could be something that’s six months or a year from now that I want to stay on your radar. Then next column would be questions for Joe. And so if between sessions you had questions or thoughts you wanted to work on, you drop those in there. Then in our next consulting session, we can be super organized and efficient rather than looking through emails and be like, “Didn’t you send me something you wanted to talk about or if kind of what that was?” Like, so it’s all just in that one spot.

Melissa Dohse: Mm-hmm.

Joe Sanok: Then the fourth column would be your KPIs, your key performance indicators. So we would say what are the key performance indicators of success in consulting with me. So that might be I want to be at $2000 a week, but I don’t want to work more than 25 hours a week. So we keep track of those very clear indicators, almost like a treatment plan where there are goals that are measurable outcomes, same sort of idea, but a fancy business term KPI. So we keep it really kind of structured within Trello, so that you know where you are at, I know where you are at. You don’t have this big list of 20 things to do and so you know this is the one next thing that I need to be working at. So then in regards to scaling and adding clinicians, tell me what you’ve thought about in regards to that already, so that we are not kind of repeating things you’ve already thought about.

[HOW TO KEEP COUNSELORS IN PRIVATE PRACTICE/ PROVIDING QUALITY SERVICES / MANAGING PRIVATE PRACTICE] Melissa Dohse: Ahm, I mean I think I have just thought like… I think my biggest hesitancy is like how do you do it well, so that there is an incentive to keep people around. I think the different people I have known in Denver and also have had good practices it seems like kind of revolving door of clinicians that come through. And so my biggest hesitancy is like how do you keep people incentivized to stay, how do you pay them enough and value them enough that they would rather work for you than go start their own things. So I think that’s probably the piece that’s been the biggest question for me. I think too just… yeah, like, how much do I have to check in with those people? How do I ensure they are providing quality services that would be, you know, prior to say yes they were critical to the counseling. Just some of that management piece. I think I have done a lot of supervision of clinicians in Denver, but I haven’t done a lot of managing. So I think looking at that piece. Yeah, those kind of… those are the big ones.

Joe Sanok: So I think the first question we would want to answer is how much control do you want over your staff? Do you want a lot of control, because you used words like “quality” and “making sure” and words like that or phrases like that? That sounds more like what’s called a W-2 employee. And so that’s where they would be hired. They would be either salaried or they could be a percentage-based employee versus what’s called a 1099 contractor. So a 1099 – that’s what I tend to favor. You want to view them more like someone that mows your lawn at your house. And so it’s somebody that you say here’s the job I need done counseling here, quality counseling. I can’t tell you that you can wear flip-flops. I can’t tell you, you can only work these days unless it’s more like a scheduling thing. I don’t provide tools for you such as a computer or business cards. It’s fairly hands-off where more kind of businesses that collaborate together under one branding. And so that’s kind of the first big decision to make. What I like about a 1099 versus a W-2 is that the management side is much less. We’re more like colleagues that I am doing the marketing, I am doing some branding, helping coach them a little bit, but also I am not having to tell what they are doing right or what they are doing wrong. I don’t want to be a manager in that way. I want to set the vision for the practice and have people understand how it helps their financial bottom line and also their impact on their community. And so things that are important to consider is you want to look in your state specifically how contractors are viewed. There are some states that are very anti 1099 and you can get a lot of trouble with the employment law in your State if you are doing 1099s when they really should be W-2s. And if you get told by the State or by the Fed’s, hey, you basically are treating these people like W-2s, but they are 1099s, you can owe years of back to taxes. And so that’s what is really important to make sure that you are clear in your contract what you are. I actually have each of my people file their own PLLCs or professional limited liability company, so that I pay their company and then their company pays them. And so…

Melissa Dohse: Aah.

Joe Sanok: … there is a very clear line where I write a check to each one of their companies because the company can’t be a W-2 employee. So my local attorney kind of advised me on [00:34:34.20] how do we best make sure that it’s super clear that they are 1099s. And then they can also write off all their business expenses. So they can work with their accountant on what can I write off these dinners where I’m talking about my practice? Can I write off these expenses? There’s a lot of things that they can then write off that really helps out. So I think that’s kind of decision number one. It’s W-2 versus 1099, and then if you decide to do a percentage-based model which I would say whether you are doing W-2 or 1099 working with an accountant and an attorney on how to do a percentage-based model. I much prefer that. And so that means that they get a certain percentage of what comes in. And so my structure is that when someone first joins Mental Wellness Counseling, they are in what’s called the onboarding phase. And the onboarding phase they are in until they have their first month they bring in $2500. And so they are considered onboarding until then. And so I take 50 percent and then they get 50 percent until they have their first month that they bring in $2500. I picked that number because you know to hit that you have to have some relatively consistent clients. You have to have made some traction, connected in the community and all that takes time for me and for them, because I’m marketing the practice. I am trying to make us look good to the community and also introduce them to the community while they are doing kind of the same. They are out there marketing themselves, shaking hands, meeting people, blogging. And so there’s a lot of extra time on the front end. And so that kind of pays for my time when they are in their onboarding phase. After that, it switches over to that they are full clinicians. And so they get 50 percent of the first $1000 that comes in, then after that they get 65 percent upto $2500 for the month, then after that they get 75 percent. And so that really incentivizes the higher achievers if they are bringing in 8 or 10 grand a month for them to say, well, you know, the first $2500 Joe gets between 35 percent and 50 percent, but I get 75 percent after that. When you really look at most overhead for if they were to go on their own, they can expect 20 percent to 30 percent going towards their overhead. And so their incentive to leave isn’t really there.

Melissa Dohse: Mm-hmm.

Joe Sanok: Also, I look for people that they want to show up into counseling and do really awesome counseling and they are probably not as interested in going out and starting their own practice. And so if somebody says, yeah, I would love to have a practice, well, you are probably not the best person for me because I am going to get you going, and then you’re going to leave, right, when things get going well.

Melissa Dohse: Mm-hmm, yeah.

Joe Sanok: So then, that’s kind of how the structure is and then in regards to sticking around, I think that’s more the soft skill of management or of connecting. You know, to emotionally connect with people, help people get growing, giving them opportunities that go beyond just the finances. And so getting them on local radio. Helping them kind of be famous in your community through the press releases that you develop. Those are all things that a lot of people don’t know how to do, so the more that you can know how to market people, the easier that’s going to be to launch them, but also have them stick around.

Melissa Dohse: Right. Okay.

Joe Sanok: Yeah. And one technique that if we were, kind of, further [00:37:40.09] consulting that I would walk through is I send a monthly e-mail to them, kind of, with all the things that I have done to grow the practice that month. And that shows them all that goes into a practice, but also the expenses. So it’s like, you know I dropped a $1000 on Facebook ads last month and they didn’t have to pay any of that, and so…

Melissa Dohse: Right.

Joe Sanok: … for them to say, wow, like Joe’s percentage is you know paying for Facebook ads, Joe’s percentage is paying for these extra things that then makes it easier to just say, could you keep scaling at the level that you are scaling if you went and start it over in a private practice. And I’m guessing that the answer is probably “no.”

Melissa Dohse: Okay.

Joe Sanok: Cool. So if we were in a consulting session, at this point we will talk about kind of your next steps for our next consulting session. And so if I was to say what your one thing is, I would say your one thing kind of moving forward between now and our next consulting session would be to really look at kind of those nuts and bolts of your practice, see where you need to firm things up. And really if you want to be working three days a week, then I would say even if you can fill that, get in the habit of working three days a week so that you can be working on the practice. Get everything kind of set up so that if you are working on your website for day three, then you can slowly start to insert people into that day. And you have the child care kind of all set up for you.

Melissa Dohse: Mm-hmm, okay.

Joe Sanok: Awesome.

Melissa Dohse: I had a question, but I guess left me…

Joe Sanok: Oh no, fell off the conveyor belt. Yeah, and so then I usually end with where do you think you’re going to get stuck or what questions do you have?

[MANAGING WAIT LISTS] Melissa Dohse: Oh, yeah. So the question which is like you know I know you talk about never having a wait list. So what do you do if you… say I get to a third day and it’s like, “Oh, that day is filled up,” what do you say, okay, at the point you really got a push towards adding connections?

Joe Sanok: I would say you’re at the point of adding clinicians now.

Melissa Dohse: Yeah.

Joe Sanok: I want you to tighten things up with the practice and really start to add clinicians now. That’s going to run into a space issue, but I mean you’re pretty close to October and so if you can upgrade your space so that you have one or two offices, that’s going to make it lot easier to scale. And really I would be more apt to say if you and your family don’t need the money right away, I would see if you can try to get a two-office space so that you can really start to scale on the next year rather than just jump up to your own office to only jump up to a two-office suite. I mean if you have a clinician that joins you [00:40:11.04] want to spend more time kind of going into that. But I would say if you can find a two-office space that’s in that $400 to $500 range, you can always sublet it for six months to make ends meet. And then maybe, you know, as you add clinicians in. I would also be apt to probably raise your rates – I mean you’re $120 now. If you are able to get five people that easily, I would say it’s probably time to jump to $135 and maybe have your intake be $150. That’s going to eliminate some people. You may not get as many people, but you will be making more money in a less amount of time, and I hope so. I would [00:40:50.19] on your next couple phone calls and just say my private pay rate is $150 for an intake and $135 per session. And I would be surprised if you didn’t keep getting just as many people.

Melissa Dohse: Mm-hmm, okay.

[CONCLUSION] Joe Sanok: And yeah, in consulting, we record every single call. So people can go back and listen to them because it’s often a fire hose of information, and…

Melissa Dohse: [LAUGH] Well…

Joe Sanok: And that’s why I take notes in Trello, and I can say all right, here’s all the stuff you need to do.

Melissa Dohse: Yeah. I was like, oh, I should take notes. And then I was like, wait I can just listen [LAUGH]…

Joe Sanok: [00:41:21.12] [LAUGH] it was in the podcast.

Melissa Dohse: Yeah [LAUGH].

Joe Sanok: Awesome. Well, Melissa, thanks so much for reaching out to me and asking if you could have this live consulting session. If people want to connect with you, what’s the best way for them to connect with you?

Melissa Dohse: Aah, probably my website. It’s, and they can e-mail me on there. There’s a form they can fill out to connect with me.

Joe Sanok: Perfect. And if every counselor in the world were listening right now, what would you want them to know?

Melissa Dohse: Oh, I forgot about that question. Ah [LAUGH]…

Joe Sanok: [LAUGH].

Melissa Dohse: … I mean I think the thing I keep coming back to in the last few weeks is like if don’t care of myself, my practice is going to like crash and burn, you know, really quickly. So I think like the way we show up for ourselves is just as important as the way we show up for our clients. So…

Joe Sanok: Yeah, I totally agree. Yeah, that’s the thing I heard over and over at Slow Down School from the participants like [00:42:17.10], taking care of themselves, like that’s the thing that helps them scale. So… well, Melissa, thank you so much for being on the Practice of the Practice Podcast.

Melissa Dohse: Thanks Joe. It was so fun.

Joe Sanok: All right. Bye.


Joe Sanok: Isn’t that great to see how much Melissa has grown in such a short period of time. You know, you can absolutely do that and if you are just starting out and you want my 28-step checklist on how to start a practice, a 5-minute video to know how easy is to rank in your area and paced-out e-mails to walk you through that process of starting your practice, if you are anywhere under that $40,000 a year and you’re just getting going, head on over to And you know what, if you are growing and you want some extra help, we have tons of downloads over at That’s where we have books, we have walk-throughs and how to start a group practice, all of our different things that for you are totally free. We aren’t charging for these at all. We have created over 20 different resources and we would love you to head over there. So thanks for letting me into your ears and into your brain. Next week, we have Rachael Norman who has launched a really amazing app to help people get reimbursement from private pay or from their insurance, and it really automates a lot of it. And it’s fully free for you. You clients are… they pay a small percentage for that service and it’s super amazing, super helpful. So next week make sure you tune in, and I’ll see you next week for five fierce females in February. We’re twice a week this month. So tune in. Thanks for letting us into your ears and into your brain. Have an amazing day. See you.


This podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It’s given with the understanding that neither the host, the publisher or the guests are rendering any legal, accounting, clinical or other professional information. If you need a professional, you should find one.

[MUSIC] [END OF PODCAST] [00:44:22.06]

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