Hire Slow, Lead Well: Building a Clinical Team You Can Trust with Heather Bach

Welcome back to the Empowered to Lead podcast. I'm so glad that you're here and listening alongside us. This summer we are taking time to hear stories from real-life group practice owners, and just getting some of the pain points that I hear group practice owners talking about in Canada, and some of the things that can help you lead better, have better systems, just be a good business owner. And one of the things that comes up quite often is, how do we do hiring? I seem to bring people who are not a good fit or I thought they were, and not really having the systems behind that. And so I'm excited to have Heather Bach here. She is based in BC, and I'm going to let her share more about her group practice, but the focus of today will be primarily around the hiring. We'll see how our conversation meanders a little bit in there. But thank you for taking the time, Heather, to join me, and maybe share a little bit about you, where your practice is, and a little bit about your group practice.

Okay, thanks for having me as your guest today, Lisa. So our group practice has been well, it's been many years, like over 20 years as a group practice, and we have a team of, I believe we're about 14 now, that's outside of our admin staff. And we have two clinical supervisors, and myself, that makes three, and we also train interns for eight-month stints alongside the completion of their graduate degree and their preparation for licensing. So we see a variety of clients with a variety of issues, a variety of populations, ages, and such, and we do our best to properly match the clients and the clients needs and goals with the best fit counselor. But I'll probably talk a little bit more about that as our conversation continues.

Yeah, and you are based in North Vancouver, right?

North and West Vancouver.

Okay, yeah. Has it always been there? That's been for the 20 years, yes? Yes.

Well, I did have a practice on the down downtown and then on the West Side, and then eventually landed here on the North Shore about 25 years ago.

Okay, so you are well-established in there, hey, in the community. One of the questions that I try to ask everybody is, how would you describe yourself as a leader?

Okay, well, in asking that question, I think to myself, I wonder how my staff would describe me as a leader. So I'm going to say some of the positives, I think, cause that's easier. I think I am I am thoughtful, I am detail-oriented, I'm supportive, and I I really highly value the skill set that each counselor brings to the team, and I do my best to help accentuate their skill set and nurture their growth and their particular area of specialty. then have us share we have a quite a bit of well, we have a very positive team environment, so really helping the counselors

get to know each other as well, as they often will work collaboratively with families and couples. Okay. So, somebody might come to see one person and then their family members are seeing others on the team? Yes, yeah. Awesome. So, tell me a little bit about so you've got 14 people, you've been running for 20 years, you have had some experiences with hiring. What does your hiring process look like now? What would what would be your your steps to bring somebody on?

Okay. So, we're super picky. I'll just start there because well, I mean I mean ultimately, it is about the clients, and it is about their outcomes. And it for for us, it is about increasing the likelihood of our clients having positive outcomes, good treatment. And so, in order to do that, we need to have a strong clinical team. When we when we thinking about hiring counselors, we're thinking about that they have strong clinical judgment, some solid clinical evidence-based training, professionalism, a degree of maturity, and for sure, some self-awareness. I try to be careful about the questions I ask, but I want to know that the counselors have done their own personal work, because we know as a counselor that if we don't understand and have done you know, a significant amount of work on our internal landscape, and unfortunately, it can come out in the room with with the clients. We want to try to avoid avoid that, or at least increase our awareness of it so we can plan accordingly and have it minimally in any negative way impact the clinical work. Yeah. Oh, my. Where was your question? So, so we have with the applicants, we usually get about like say something like 20 applicants to one hire. It's probably more than that, maybe more like 30 or 40. But we there's a lot number of screenings that happen before they have an interview. So, they need three letters of reference, and we we send out a a a two-page questionnaire for the referee to fill out.

Okay, even before you interview.

Yeah, before we interview.

Okay.

And then we have them rate various things and add examples, and including their relationship to the applicant. So, we get to know like who is the person filling out this form, how do they know, how long have they known this person, and how would they rate them in various areas of their strengths and even their concerns, if they have any concerns? Yeah. So, there's that, and we also send out a case study. It's two cases, and they're actually based on some stories of previous clients, and then we try to add in a few things that are a bit maybe could be missed if someone isn't aware of perhaps safety issues and or specifically interpersonal violence. It's one of my Sounds like it's funny. It's one of my sweet spots. I'm very

Yeah, and warmth and connection and, yeah. Yeah, nicely done. Mm. And there's a part of, yeah, you might be nervous, but also we're watching your whole manners, and this which we're trained to do, and then what I want a client sitting across from you, too, based on that, hey?

Yeah, and would I? How would you be in our because we have monthly team meetings, how will you be as a contributor when we do breakout rooms and we do case presentations and consultations? Yeah, so that so so there's the preliminary pre-interview, there's the interview, and then once someone's hired, we do SRS ratings, so for when people do the meet and greet and have their first appointment, we want to make sure the client feels that it was a good fit. And if it wasn't a good fit, then we re- We offer the client to rematch with somebody else or meet somebody else. But in the probationary period, if someone's scoring lower, then then that's a meeting and and you know, we try to see the level of insight the counselor has. Maybe they're able to flag something, or, you know, we're we're looking for people that are really growth-oriented because we're in a growth-oriented industry. So we want our our team to be really growth-oriented as well.

Yes. Mm. I am a huge proponent for hire slow and fire fast. And so that whole process sounds very deliberate, intentional, and even the way that you described it is like I'm thinking about the client. But not just the client, you're also considering the culture of your group practice. How are they going to fit in here? Where are the pieces that you consider like how does it how would it feel to lead this person? What what pieces in there help you lead? The question is not coming out properly, but you know what I mean. To suss that out, but that's not the word that I'm looking for. I

I yeah, I think, you know, is this person receptive?

Mm.

Are they So one of the questions in the questions is, What questions do you have for me? So you know, you learn a little bit about how receptive the applicant is. And then another question at the at the the first question is tell us tell me a little bit about your the professional background and or personal, anything you want to tell me, about what you think is going to help you be a strong or contributes to you being a strong counselor. What are your strengths? So you you know, people can over-disclose. Yeah. Definitely had some of those in interviews where it's like, uh-oh, you know, constant self-disclosure for the whole interview, that it's it's more much more about them. And so then it's like, well, if they're going to do that in an interview, that might be happening, and we have a pretty very conservative policy about self-disclosure Yes. In our protocol, so then I know that's not, or maybe it's the other way around, someone's really not open, not I don't want people to, you know, disclose, but well, well after as you probably know after 25 plus years in this profession you you learn how to read people. Yes. And that's maybe not in one of the questions, but it's something that you hopefully have gotten fairly good at doing.

Hm yeah. Yeah, as a therapist and then as a leader and owner, hey? Like a lot of times, and I think that's also part of the higher slow piece, is then you've got time to trust your gut too, and to slow down and pay attention to some of those things, whereas if if I've got this much of a runway and I'm going to hire somebody for next month kind of thing, I'm not. I'm in reactive mode or scarcity or fear or whatever is driving that, as opposed to I'm actually the one in the control of this process.

Yeah. Yeah, we have about an eight-week onboarding process.

Mm yeah.

With many many things in it, and so there's also there there actually was a time, just name about one particular one, where all everything checked the boxes, the interview, everything was great, but even that eight weeks, they they were having really struggling with this process, which people generally don't. And so and they were in distress about a lot of things, and

Mmm, yeah, okay.

Which saves the client, right?

Yes. Yeah. Yeah, I that is very interesting. Like I am a huge like also huge believer in like the onboarding process and that it takes longer than you think it does. I will have two or three meetings over six weeks just in that touch base period. Somebody else that I I interviewed for the podcast, she has a a month-long onboarding before they see clients, and so it's interesting to hear so two months before you're actually going to see clients. Let's make sure you're a good fit for everything. Do you ever have people say, No, that's too long, or do they appreciate that part of it?

I think most most counselors seem to appreciate it because they want to understand, like they're open and wanting to learn, so you know I think that that's a lot of counselors have actually commented about that after, how they felt very well supported and very well oriented before they started with the clients, and lots of room for questions and meetings and clarity, lots of clarity, so that there are no surprises, so that they can really focus on the specific work they're doing and less on all the other stuff. But like I say, there was the one time when someone was highly anxious and it just came out, and it was clearly not a good match for them or for us, and it was a relief to to have discovered that prior to them sitting with clients, and then needing to transition transition clients and interrupt their therapeutic process because it wasn't a right fit for us or counselor.counselor.counselor.

And so as I'm thinking about people listening here, a lot of times we are nervous to put in systems or protective things because it protects me, or it protects the business. But yeah, in that, you're protecting client, you're protecting therapist, you're protecting the business, and all of that, and it's okay to go at the pace that you need for that. And you know, a lot of times we feel like, well, if if we don't match what another group practice does or they could go down the road and have clients the next day, kind of thing, almost that freedom to say, Yeah, they could. And so if they want that and they don't appreciate this, then we're not the best fit, and that's that. There's freedom in that. And even in that screening part, like we in that in the screening, we used to do a you come in, and part of it is you're in another room with one of our therapists, and we're watching a mock session happening. And people got super nervous, and they would name that, but also the other side of it is you obviously care about how things are happening clinically in the room, and so I see value in that. And so if that's the kind of therapist I want on my team, then they're going to see the value as opposed to saying, Well, no, that's not for me. You get to weed that out and find it out sooner. Yeah. And

And why why would they not be open to that? Yeah. Right. That would bring up some questions.

Yes. Yeah. 20 Years of doing this. I'm you probably didn't start out doing that. And so even just to normalize that, like this is a process, and you come back and review you review your systems on a regular basis. What's working, what isn't working, Oh, I learned a lesson here. we've talked about a couple of specific scenarios that really helped you hone this process. Do you mind sharing a couple of those that helped shape your interview process?

Sure. Yeah, I I I also want to say that when counselors leave us for a variety of reasons, we do do an exit interview, and we have an exit we have a form that they fill, a survey. We really, really want to grow, and and we've over the I mean, it's been many, many years, like especially with our interns. Because because they're leaving on a regular basis as we through their eight month program, and so I really want to you know just express how that we've learned so much through that. So being open to learning, being open to feedback, is really what's got us to where we are here. Yeah, and then additionally, I will just say that I think that having experience in a variety of other settings before private practice really helps round you out when you're in private practice, and it helps you flag and perhaps pick up on things that you might not pick up on if you haven't had exposure to other populations or challenges in the public sector, for example. Yeah, I didn't answer your question exactly.

Yeah, no, and I like that's actually important to consider. Too. A lot of times we only think about how am I bringing them on, and I know when I first started, I was scared to tell them how they left because maybe that'll put it in their mind that they should leave. But there's also like, hey, this is what our process looks like. We want to value you as you're come on, as you're here, and as you leave, and so and also, if if we actually want to learn and be the best that we can, teach us and tell us what worked and what didn't work while you were here. That's awesome. Yeah, let's talk a little bit. There's a couple of stories that I think people would relate to of the challenges in the hiring process that really kind of fine tuned or added a piece to your interview process.

Yeah, we can think of a couple of examples. One where we had a staff who was seemed to have a blind spot around safety concerns, which was rather shocking because they did really well in the interview and they flagged they they did really well throughout and the preliminary process. They're a mature person in their 50s, profession, long professional career behind them, and but there were some safety issues with clients that they didn't adequately flag, or like I guess I would say is we have protocols when there's any kind of safety concerns, where whether it's interpersonal violence or suicide litigation, those things like clear assessment strategy, assessment tools, and next steps, and pretty clear to support the counselors that maybe have less experience or need more support, and also for those that already know and use these things, so that came to our attention, and it was surprising. So we addressed it directly with the counselor that they hadn't reported when they needed to report, even though they're aware of apparently aware of our of our code of ethics, then it happened a second time with them, and actually it was an intern, and I did need to the second time notify the university, and I'd let them know I need to talk to your university about this. And then we needed to transition them out because after two significant errors around safety concerns, we couldn't have them yeah, seeing our clients. So we specifically had them finish slowly, like no more new clients, and slowly transition them with the clients, transition the clients that were seeing them onto other better matched counselors. And then later, what was also complicating is they wanted a a letter of reference. Yeah. So,

Okay. Yeah.

So that's actually something we learned from that is in one of the documents that our interns sign, they sign that these are the these are the conditions to acquire letter of reference from from us. And if these conditions aren't met, the the letter of reference will not be coming forward. However, that had never happened for years, so it was quite shocking. Yeah. And I think the only thing that comes to my mind is that it it I'm guessing, I don't know for a fact, but I'm guessing it was some kind of a personal blind spot, given all the other factors that seem to be in line with this counselor, and just another reminder of how important it is for us to do our work, to understand our own landscape, and yeah, there's some countries that require that for licensing. We don't. So someone could go to school, read a lot, and be a counselor with, you know, all kinds of trauma and challenges, and not have looked at their own potential blind spots. And I I think that was this example.

Yeah.

But I don't know for sure.

Yeah. It surprised me that there's been a couple people, I think mostly in the student side of things, yeah, have never been to counseling. How do you know how this goes then, and what's going to come up in the room for you, hey? Yeah.

It is a little bit frightening. I can think of another example where it was a a mature person, a woman in I think her late 40s would be my guess, with a long career as a counselor, and she really five-starred, I'll just use that as a five-starred, she really had top references, three top references, she did exceptionally well in the case study, and she also did very well, very very well in the interview. And she had a good presence, and and there was three people for that position at that time, and I really wanted her for all the reasons I just explained. Yeah. But there was some hesitation I had, and I couldn't place it. Like, why am I having this hesitation? What is this? And it went on for about a week. I was like, Oh, I want to send that. You know, I want our admin team to send out the offer. But I kept delaying and delaying anyway. Long story short, we did some further research on her, and she had lost her license. I think about 10 years earlier for sexual abuse allegations in her role as a professional counselor, as a licensed counselor. Yeah. And so I'm not I don't I don't want to say that people shouldn't have second chances. That's not really how I operate in my world. However, when I look, you know when I'm when we're hiring, we're looking at who are we putting clients with. It's always clients first. Who are we putting clients with, and what level of confidence do we have that they are going to be offering high level, best practice, evidence based, trustable, of course trustable. So that was a pretty shocking one.

Did you have other people in the interview with you, or was it just you with her?

It was just me, and then we record our interviews as well, so

Okay.

Sometimes if I I'm not sure, sometimes I'll rewatch interviews.

Yeah. Yeah, cuz even in that, like if somebody else is in the room, Did you feel that too? or Have you got a hesitation? And so yeah, or rewatching it. One of the things too, like how do you trust your gut? And one of the ways to help you trust your gut is to go slow. So you even said like a week later, you're still sitting with that. It's not like, Hey, they sounded awesome! Let's, you know, make that offer right away. You can give yourself time before you pull that plug.

Yeah, we we've usually wait because there's a usually few people interviewing, but we usually wait at least two weeks.

Okay.

And we've lost people doing that, I'll say that, we have. But I still that's okay.

Yeah.

That's how I see it. You know, that's okay, these that they It wasn't That's all right.

Yeah.

It's better to stick with the the the you know, what you think, what you believe, and what you've designed to offer, ultimately, the clients the best you can.

And a lot of times when you miss that opportunity, a year or two later, that opportunity comes back too, right? Or somebody similar. And so, yeah, just being okay with this is our process and it's okay that it takes as long as it does. What's one thing, and it's probably a few things, but what's one thing you wish you had done differently as you look back? Maybe at the very beginning, or maybe there's something that stands out as a group practice owner.

One thing. Oh, that's a hard question.

One thing. Well, I'm pretty driven person, pretty driven person, let's say, and so, I think that it's interesting, I asked my daughter about this. I think that my, you know, my commitment to, providing quality work, you know, it cost me some of my family time. I'm not saying I was working 20-hour days or even 12-hour, or even 10-hour days. Not that that didn't happen sometimes, but, you know, I think that maybe, I would pull back a little bit on my gas pedal, which tends to be like that. But it's interesting. I said I asked my daughter. I'm like, Did you did you miss me? Did you ever think? She goes, Mom, I was at dance. I was busy. I'm like, Oh, okay. That's the right answer.

I kept you busy enough.

But my standards are are pretty high for myself. So, maybe I'm I'm thinking that, but I don't know. I haven't heard from my family that they suffered in any way. It was just the decision that I made to really put a lot of, a lot of energy into my career, because of my passion for it, and I think the difference that, that I understand, you know, and we witness that we can have in people's lives is pretty spectacular. It's a such a gift. So, maybe I would, maybe I would, maybe I wouldn't. I'm not sure.

Not sure. It's worked out well so far. Yeah. Yeah. Well, thank you so much for taking time out of your day, to join us, Heather. You've got a lot of pearls of wisdom. Is there sure we could talk for quite a while, about a few different things here. Well, let's do it again, Lisa. Yes, that would be awesome. Yeah, and so, and listeners, thank you so much for taking time to listen in. If they wanted to learn a bit more about BCG Counseling or, yeah, just your group and what that looks like, how would they find you?

Best thing to do would be to go to our website. Okay. www.bachcounseling, spelled the Canadian way,.com, or they could, email the office info@bachcounseling,. Info@bachcounseling.com. Yeah.

And we'll have it in the show notes, too, for people. So, yeah, thank you so much, and we will Yeah, I will likely have you come back on. And, yeah, for everybody listening, I hope you come back next week. We're sharing real stories, from group practice owners in, some of the things that we all tend to be facing and want to work through. Have a great day. Bye.