by
Joseph Peters
| May 04, 2023
Welcome to the Voice of Counseling from the American Counseling Association. I'm Christa Butler, and joining me today is drama therapist, Azizi Marshall, who is here to talk about creative ways that you can grow your private practice. Azizi Marshall is the founder and CEO of The Center for Creative Arts Therapy, an arts-based psychotherapy practice, and training center in Chicago. She also is the owner of Creative Clinical Consulting, LLC. She is a licensed clinical professional counselor, a board-certified trainer in creative arts therapy, and an accomplished author. Azizi holds graduate degrees in community mental health and theater. She has been featured in Oprah Magazine, CNN, NBC News, Thrive Global, Bustle, Reader's Digest, The Huffington Post, Chicago Tribune, and Glancer Magazine. Azizi, thank you so much for joining us on this important conversation on creative ways to grow your private practice. Can we start by discussing a little more about your experience in private practice? What made you decide to start yours? What are some highs and lows of things that you've experienced over the years in running your private practice?
Well, I can start from the very beginning, where both of my parents are therapists, so just growing up in that environment where they had studied psychodrama, so I even have a little cute picture up here by my desk of me standing with Zerka Moreno, because she used to stay at our house, that's how I grew up. When we had an issue or a challenge at home, we acted it out and that was my life. Instead of focusing on becoming a therapist, I actually moved to Chicago to become an actor. That's where my love of theater and of storytelling and of self-expression, especially working with youth in the inner city, because teenagers are my jam and will forever be my jam.
What I noticed is that theater had that beautiful effect of impacting them and showing them a different way that they could live their life and they had the lived experience of it to then take and use, and so I knew there was another way. I originally thought, oh, I created drama therapy, this is until I did my research, of course, you have to figure out is this a thing, and it was. I went through all of the training and jumped through all the hoops to become trained in drama therapy and then expressive arts therapy and then in counseling, and to be able to take all of that knowledge and put it into this beautiful practice and bring other creative arts therapists that had that shared vision of using the arts in a therapeutic way. That's where it stemmed from, it was from my upbringing, from my parents, me saying, "I'm never going to be a therapist," and then here we are.
Very cool. It sounds like it was just meant to be, it was instilled to you from the beginning. I'm curious, do you mind sharing more with our listeners about drama therapy, expressive therapy, and how do you use those approaches with when working with teenagers and working with clients, as well? What are some cool things that you enjoy most about drama therapy and expressive therapies?
I would love to tell you a story. It was actually doing drama therapy and more using psychodrama techniques to work with inner city youth in St. Louis with my dad. I was coming in as another teenager just trying to make the peace from all these different gangs. It was a gang peace talk, and that's what my father was brought in to do, using psychodramatic techniques. I remember one boy sharing that this is his turf and how he was planning to protect it and he was just going to kill this other person. My dad said, "Well, let's see what would happen," and so we reenacted, not the shooting, but the conversations he would have with his mother in jail and how that affected his mom, the apologies he had to make then to the younger sister of the boy that he killed and now where she has to live and is no longer with that family, because the brother was the one who was taking care of her.
Just seeing this kid just break down in tears because of the realization of this one moment is going to affect my life, but not only my life, but everyone around me, even people that I don't even know, and for him to take that back and go, "It's time for me to make a different decision." It wasn't just him experiencing that, it was everybody else in the room that saw that, hey, you make this choice, this is where it's going to take you, and people being able to step back and witness that and then take it and have it become part of their decision making process in their real-life experience. That's the power of theater right there.
Absolutely. I was just thinking how powerful that moment must have been for that client and how having that moment to narrate just the possibilities of what could happen really helped him and forming a decision for himself and problem solving through what his next steps could be, that's really amazing to hear. I'm sure there's lots of stories that you have about the work that you do and how powerful drama therapy, expressive therapies are in the impact that you see the approaches that you're using have on your clients, as well. Back to private practice, I'm curious if you could share with us what are three things you wish you knew when you first start your private practice that you think clinicians should know about before they start theirs?
Yes. I would say number one is have a strong support team. Sometimes people don't have that in their life, as far as family members or loved ones, then there are places you can go to form your own community of support. There's meetup groups you can do, there's networking events that you can do, there's joining the chamber of commerce and there's leads group within there, to have people that surround you, like your accountant, your attorney. They're considered your support team, too, and they're there to guide you to make the decisions that are going to help you with the health and wellness of your business.
Also, learn how to delegate, which is really hard when it's like, "This is my baby." However, your baby's not going to survive if you don't have a good doctor, if you don't have a good nurse, if you don't have a chiropractor for yourself. Everybody needs to be taken care of, so making sure that you can delegate the things that you don't need that are the time suck, that are the bane of your existence, the things that suck the joy from you. For me, that's billing. The first time that I could find somebody that I could do billing for me, please know I hired somebody to do that. Also, anything accounting-wise, I hired an accountant as soon as I could, because doing all of that entry of the receipts and payables and that just, by the time I was done with that, I didn't have enough energy to fulfill and serve my clients the best that I could.
And then the third would be to, and again, this is something that therapists always say, "Take care of yourself," but I'm like, seriously, take care of yourself. Over the holidays, actually take time off and let your clients know, "Hey, you should do the same for yourself," and be able to mirror that, and make sure that you are connecting with people that fill you, too, because there's going to be a lot of naysayers that are going to say, "Why are you doing this? You shouldn't be, boo, boo, boo," and all these other things. Make sure that you have those people that are championing you to move forward, instead of the ones that are like, "I don't know if you should do this anymore."
That sounds important, all three of those things, so having a community, delegating, as well as taking care of yourself. A common theme that I'm hearing with each of those things is setting those boundaries, both personally and professionally, to help keep you going in your private practice is going to be crucial to things continuing to thrive for you. Is there anything that might make running a creative therapy-focused private practice different from those that aren't specialty focused on the creative arts or the expressive arts?
I would say the biggest difference is the materials that you need. In a typical talk therapy session, we're talking, you take some notes, you have some technology, hopefully, that you're using to keep everything streamlined. But as a creative arts therapist, we are using scarves, we are using parachutes sometimes, we are using tons of art materials. My art therapists, I think they have the highest budget as far as what we order for supplies. You're taking into account all those other additional items that you need to fill the space. Our space is laid out very differently, where we have two art studios and they're big art studios where people can come in and choose the things that they want to work with, we have two big movement spaces. We have a playroom that's a little bit smaller, because if you put a tiny kid in the big, big training room, it's a little overwhelming. It's also thinking about the space that you have and what's going to be supportive to the client.
Yes, those are really, really good points. Thinking about play therapy specifically, having different toys which pulls out different things for clients and then thinking about developmentally, what a younger client might gravitate towards versus an older client. I can totally imagine that as a drama therapist and expressive arts therapist that the need for having those additional items, toys, art mediums is ongoing. It sounds like having a budget to sustain those items is going to be really important, as well. What are some risks that you took in growing your private practice that's paid off for you?
Expansion. Expansion was the biggest risk every single time I've done it, and I've done it multiple times. The first one was when I had decided, "I'm going to start," and so I rented that little closet office from the shared community office spaces that we all know and love. And then I decided I need to expand into a larger space and that requires me to have a space that's big enough for a training room. That was a huge risk for me to go from this tiny, little closet office to then a place where I knew I couldn't afford the rent, so I was reaching out to friends like, "Hey, do you want to rent some space while I try to grow my business?" That worked out well, so that person, actually, the person who came on and rented space, ended up being our clinical director for a very long time within our company.
And then we expanded to the other side of the building and that was a huge risk, because again, I didn't know what was going to happen. I had thoughts and goals, but I didn't know if it was going to actually be a success. And then eventually, we decided, during COVID, that we were going to expand into a completely different building, into a much larger space, so we could fulfill all the things that we'd been wanting to do, but couldn't because of the current space that we were in. Every time, expanding new projects, expanding different branches of the business, each time, that was a risk, there was a plan for it and sometimes there wasn't, so it is, those are the scary times, of the expansion into where you want it to go.
I heard you mention expanding into having a training room, so it sounds like you've also diversified in terms of the services that you offer from seeing clients to... What are some of those things that you've done to incorporate in your private practice in addition to the client services?
Christa, you just got me really excited for that, because I love talking about diversifying your income streams for private practice because there there's only so much that we can do one-to-one and there's only one of us, so when you can diversify your income streams, that just brings in some other revenue so you can continue to be the best therapist that you possibly can. Actually, when the center opened, I wasn't doing therapy, I was training. The only reason why the counseling happened was because the students that I was training needed a place to do their internship, so that's why I rented that little closet office that we all shared in order to serve the needs of the community, and then the needs of the community said, "Hey, we need you to continue this service."
It started with training, then it went into counseling and serving the needs of our community, doing group work out in the community, not just in our space, and then we eventually branched out into workplace wellness, which has been so fulfilling, because we can go in and talk to rooms of 100-plus people about their mental health and then that leads into further conversations of, "I've been thinking about this, but when you said that thing, that's definitely how I'm feeling," it's like exactly, and if it's not, that I'm pairing them with one of our therapists at our practice, there's other therapists out there that can serve that client better, so I'm like, "You know what? There's so-and-so and I know they're taking your insurance and I know they're taking clients right now, so here's their information." It's being able to have many more ripples instead of just a couple tiny ones, and then seeing that spread out and know that we're affecting a larger community.
Very good point. That brings up two things that you mentioned earlier about having your community and delegating, because I heard you say that you aren't necessarily providing the wellness workshops and seeing those clients all yourself, depending on the client's needs, you have a network of referrals that it sounds like you are referring those clients out to, as well, which is really important, as well. Thank you for sharing that, really cool to hear. It sounds like you're doing some really amazing things in your private practice. You mentioned workplace wellness, that's a whole nother podcast, I wish that we could... We may want to have you back on for that one. For clinicians who might not be working in private practice, but would like to eventually transition into private practice and maybe even managing their own practice, what suggestions do you have on things they can do to prepare for when they're ready to take that leap?
Oh, don't do what I did. When I say that is I put a lot of debt on my credit card and it was our family credit card and probably just a year ago, we finally paid it all off, so don't do that. Make sure that you've saved up enough money to float you for at least six months, because you just don't know, if you could float yourself for a year, that's even better, so start saving now, because when you're financially stressed, you're going to make decisions that are not going to be the best for your business or for yourself. You want to come into your private practice with that kind of woosah mentality, like, "No matter what happens, we got this in savings and it's going to be all good."
Next is start to make connections, start networking now. Let people know about your intentions. Depending on where you work and if this fits for you, let the place you work know that that is eventually your intention, too, because you want them as a referral source to funnel in clients for you and you want that transition to be amicable on both sides. Those would be my two things, get your finances in order and make sure that you're networking and making connections, so then when you're ready, people know and they're like, "Oh, oh yeah, absolutely, I can send so-and-so to you," because there's a lot of mental health professionals right now in private practice that are at capacity and they're looking for places to send other clients because they want to fulfill the need. It's also you make them look good, because you are now somebody that they can rely on for services and for referrals, and then that client says, "Thank you so much," and they share that with their friends, and that helps both businesses.
That's another, you're making so many good points, is that financially, you want to prepare for that. Thinking about the overhead cost of running a private practice, if you have a actual brick and mortar, like actual shop, I don't want to say shop, but you know what I mean, an actual place, and just even the expenses of operating your platforms, if you have a Zoom account, if you have all these things that eventually add up, and so financially, I think that is really great advice, and then, of course, like you said, networking, making those connections, as well. What are your thoughts on, are there trainings that you might suggest? I know there's so many private practice 101 trainings that are out there.
Also, thinking about the business side of it, as well, because there's obviously the things that you have to do as a clinician and then, of course, there's the federal regulations, the no surprises, the confidentiality, and HIPAA and all of these other federal regulations that you have to adhere to, and have documentation of, and have built into each step of your intake process and all of that. Going back to what I was saying as far as trainings, there's just so much that folks need to know in operating a private practice and adhering to all of those state, local, and federal regulations, and so I'm curious, what are your thoughts and suggestions for clinicians on where they can start in terms of learning those additional pieces that they may have the help and support of at an agency that, in private practice, those are the things that clinicians are needing to do more independently, perhaps?
I would say to look at their local association. The Illinois Counseling Association, specifically the Mental Health Counseling branch of that, they have a regular training on how to open a private practice. That is the first thing that I took when I was like, "This needs to happen for myself and for my life and for my family." I took that class, it was a weekend workshop, I got a lot of wonderful information, and then it was, when I say a lot, it was a lot. One workshop is not going to prepare you for full business ownership. It will prepare you for crossing your t's and dotting your i's, but running a business is a whole other thing.
Another great training that I know of, and I absolutely adore this woman, is Laura Long, I believe it's Badass Practice or something like that, and she is phenomenal. It goes above and beyond just that weekend workshop, she does more of that walking alongside her participants and she coaches them through the more business aspect of running a private practice, along with here are the things that you need to cross your t's and dot your i's with. It depends on who you are and what type of support you need, so if you're a weekend workshop warrior and you're like, "I've got this, no problem," then do that. But if you know that you need somebody to hold you accountable for things, too, and you need additional support and guidance and you need just like a community to help you with it, knowing that you're not the only one going through this process, then a program like that I think would be really beneficial for anybody looking to go into private practice.
Awesome. Thank you for bringing that up. Of course, I want to second what you said about joining your state association. That is a great place to go for additional resources and support and trainings on private practice and many other topics impacting the counseling profession, so thank you again for bringing that up. What are some creative solutions that you've used to work through some of the challenges that you've experienced in private practice?
Creative solutions? I will say probably one of the biggest challenges that we've had is trolls. When I've worked with other coaches, they laugh, they're like, "Now you know you're showing up and you're making it in the world, because you have all the trolls," and so that is something that's like, okay, yay, and also, how do you manage that? Because not everybody is going to agree with your opinions on certain things when it comes to mental health. There will be people that will say, "Pray about it," and you're like, "Well, yes, there's one aspect of that, but we also need to look at these other pieces." There will be, especially when we start talking about using the arts and we've had many trolls pop onto our social media and go, "Hmm, is it really? Where's the research?"
We have to come back in the most loving and gentle way and say, "Here's the thousand of articles and you can look at them." That is the biggest challenge when you start to grow and you'll start to notice it, especially if you are active on your social media pages for your business, that managing trolls, showing up with love in your heart when you respond to them, and then also knowing that there are some trolls that there's no way that you're going to talk them into something or out of something and some of those, you just have to ignore or block.
There you go. Setting those boundaries.
Boundaries. I'm very strong on boundaries, Christa, very strong.
I am in support of blocking the trolls. What are some creative strategies that one may use to pivot in a different direction in private practice?
As a business owner, as an entrepreneur, our brains work in a different way. We see things in the macro level. I want you all as business owners to float up into that macro and see what is happening. Right now, we have meta that's coming out, that's trying to come out real strong, and I can already see virtual reality therapy sessions. If any of you out there are tech-savvy and want to jump into that, I encourage you now. I'm not doing it, but anybody out there who wants to, jump into that, because you can see it. Look globally and that way, you can start to see where those themes are, where those, oh, this thing just got invented and this thing just got invented, and how can you fill the gaps into the things that are starting to be created? There's so many possibilities, so it's really just encouraging people to start thinking not outside of the box, but that there is no box.
That is the biggest thing I tell any entrepreneur or any private practice owner, that there is none. When people go, "Well, I can't do that because I'm a therapist," I'm like, "Yes, you can. Yes, you absolutely can, within our ethical standards." It's being able to look in that macro level and understand that there's so many possibilities of what we can do because of our unique training and skillset and how we connect with people. I've worked with coaches that have wanted to know how to reach their people more and I've been able to work with them and they go, "Oh, there's a hole here, we don't know how to make those connections to people," or, "We don't know how to manage somebody who's been through trauma." I'm like, "Yeah, because you haven't had the training, so let's make sure that everybody stays safe." There's a hole right there, if somebody wants to train coaches on how to be trauma-informed, somebody please do that, coaches are asking for that. It's really just looking at that macro level, seeing where those holes are, and where you want to fill them.
Great advice. Azizi, this has been a great episode, there's been so many nuggets that you've dropped here. I'm curious if there's anything else you'd like to leave our listeners with as far as growing your private practice in creative ways and incorporating what you do, in terms of incorporating the use of expressive and creative and drama therapy into your approach as a therapist?
I would say for anybody, because, of course, I love drama therapy, I love expressive arts therapy, and I love hearing that therapists want to incorporate in that into their work because it also helps with burnout. Thinking about talking constantly all day every day with a client and that's all I do, I would not be in this profession anymore, I just wouldn't, so to do the training to learn how to incorporate the arts in a safe way, because there are some things that therapists can do that when they come back to me and they're consulting with me, and they say, "You definitely should not have done that, because this is why it went way south."
If you can, definitely get the training, there's so many workshops out there, there's beautiful conferences that are happening all the time, in-person, virtually now, with this kind of postpandemic experience. I just encourage anybody who's wanting to incorporate the arts or who's wanting to incorporate creativity into their practice to do the thing, not just reading the books, but having that experience and that training, so then they can learn how it affects them and how it could possibly affect their client. That way, they can bring it in in a more safe environment, in a more safe way, to help with the healing of their clients.
Absolutely, for our listeners who would like to get in touch with you, how can they find you?
I'd say the best way is my website, azizimarshall.com. A-Z-I-Z-I-M-A-R-S-H-A-L-L.com. And then you can find all the goodness on trainings, on retreats that I hold for therapists that want to start doing workplace wellness, and also trainings on creative arts therapies.
Awesome. Thank you so much, Azizi, for being here with us today and everything that you've shared on this episode. We appreciate all of the nuggets of wisdom that you love us with, so thank you so much.
Thank you for having me, Christa.
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