Welcome therapists and group practice owners! I’m Nicole McCance, a psychologist turned business coach for therapists. I scaled my group practice to 55 therapists and multiple 7-figures in just three years with toddler twins at home, and I could not have done that without one thing – change. Real, sometimes uncomfortable, very necessary change.
In this article, I’m going to walk you through what to change first in your group practice, how to introduce those changes without breaking your existing culture, and how to get your team on board so everyone is rowing in the same direction!
P.S. Not a huge fan of reading blogs? (I’m more of a podcast girl myself) You can listen to my podcast episode all about this topic by clicking here or by watching my YouTube video below!
Why Growth in Your Group Practice Requires Change
I’m just going to say it plainly: growth is change!
You cannot keep doing exactly what you are doing now and expect to magically hit your next level (even though it feels much safer keeping things the same). Think about it this way – If your current systems and habits were enough to reach your big goals, you would already be there.
Most practice owners I work with inside Clinic Growth Map are super excited about change. Because you and I are the people who listen to business podcasts for fun and actually like talking about systems. That’s probably a big reason why we started a group practice in the first place. Your team, on the other hand, is often a different story.
Some therapists love the idea of structure and others hear “new system” and their nervous system spikes.
Here is what I want you to remember:
- Most people don’t complain about too much clarity. They complain about confusion and chaos.
- Systems equal safety. Think of it like kids with a bedtime routine, where everyone is calmer when there is a predictable flow. Your team is the same.
- Structure does NOT kill culture, disorganized leadership does. Clear systems actually create a safer, calmer culture in the workplace.
So, at the end of the day, our job is not just to implement change. Our job is to implement change in a way that feels safe, supportive, and clearly tied to a bigger vision!
What to Change First in Your Group Practice
One of the questions I literally get all the time is, “Nicole, I have your manuals, scripts, and systems. Do I roll them out all at once or in stages?”
And I always come back with this filter: Need to have vs. nice to have.
Nice to haves can wait, and need to haves are the changes that directly impact revenue, client flow, and team sanity.
Here is where I recommend you start.
1. Move to the right practice management software
If you are planning to switch to a platform like Jane, I recommend doing it early while your team is still smaller. It is much easier to train 3 people than 13 (or more!). Look for software that supports:
- Clean online booking and clear profiles
- Easy reporting and payouts
- Automation for waitlists, reminders, and receipts
Hot Tip: When you switch systems, ask the new platform what they can migrate for you and book a live onboarding training for your whole team. Record it, so you have your own custom tutorial to use with future hires!
Hotter Tip: I absolutely love using Jane App, and you can try it FREE for 2 months by clicking here!
2. Build your manuals and SOPs
Please promise me you won’t keep hiring without anything written down. That’s how you become the CQA: Chief Question Answerer.
Your manuals should cover:
- How intake, scheduling, and cancellations work
- How to use email and phone (who replies to what)
- How to chart, bill, and document
- Room resets, safety procedures, and daily checklists
You’re essentially building the “this is how we do things here” handbook, and this is what eventually lets you step into the CEO seat instead of re-explaining the same things every week.
3. Choose one communication platform
Choosing one communication platform will make your life SO much easier! No more texts, WhatsApps, Instagram DMs, random emails, and sticky notes on your desk.
Pick one platform for internal communication (I love Google Chat inside Google Workspace) and move everything there. This reduces:
- Lost messages
- Confusion about where to reach you
- The mental load of checking five places every day
Hot Tip: You can use this link to get 10% off your first year using Google Workspace, they will also give you a free 14 day trial so you can make sure it’s a good fit!
4. Implement regular team meetings
Even if your team is small, I recommend starting this now! Team meetings give you a predictable place to:
- Share changes and the “why” behind them
- Answer questions live
- Build culture and connection
If your therapists are employees, you can make these meetings mandatory. If they are contractors, you can incentivize attendance with clinical trainings in the second half of the meeting.
How to Roll Out Change Without Overwhelming Your Team
Ok friends, this is where change management seriously matters. You can have the best systems in the world, but if you drop them on your team like a surprise pop quiz, you will likely get resistance.
Here is the framework I recommend.
1. Start with the why and what is in it for them
Every change should be clearly tied to:
- Making their life easier
- Helping them grow a full, stable caseload
For example, instead of saying “We are implementing a new consult call script,” try saying something like “I want to make sure your consults feel easier and your caseload fills faster. This script has helped other practices increase conversions, so we are going to start using it together.”
2. Roll things out in stages
Don’t bring a giant list of ten changes to your next team meeting and say, “We’re doing all of this next month.” That is a fast track to shutdown. Instead:
- Present the bigger vision and high level roadmap
- Introduce one main change for this month (or a few very small ones)
- Let them know what is coming next, but focus training and accountability on the current step
Remember, you can always move agenda items to the next month if you notice overwhelm. Going slower but deeper is better than rushing and having nothing fully implemented, I promise.
3. Train, document, then hold accountable
For every change, I recommend following this sequence:
- Communicate live in a meeting where they see your face
- Document it in writing (manuals, SOPs, checklists)
- Train on it and allow time for questions
- Set a clear start date and follow-up check in
I find that most group practice owners skip steps 1 and 3. They send an email with a policy and expect perfect execution. But you need to remember your therapists are busy and they need you to teach, model, and repeat before you measure.
4. Handling resistance without a power struggle
You’re probably going to have at least one person who doesn’t like change, especially around scripts, documentation, or tech. Here’s a simple way to respond:
- The what is non-negotiable if it ties to ethics, client care, or business viability
- The when and how can be flexible
Here’s a quick example:
“We are going to use this consult script because it is going to help you fill your caseload. I am open to giving us five weeks to roll it out instead of three and we can adjust some of the wording so it feels natural in your voice.”
This gives them some power without sacrificing the standard.
However, if someone consistently resists all change, even after support and coaching, they may not be a culture fit for a growing group practice. That clarity is helpful data too.
The Next Step in Growing Your Group Practice
You don’t have to implement everything at once to become a stronger CEO, you just need to start. In fact, it’s better if you roll things out slowly. Here’s a simple next step you can take this month:
- Choose one “need to have” change
- Put it on the agenda for your next team meeting
- Tie it clearly to easier days and fuller caseloads
- Decide on a realistic rollout timeline and stick to it
And most importantly, remember that your future practice already exists in your mind! The systems you implement now are simply the bridge between where you are and where you are going, and you can get there without burning your team out in the process.
Want even more tips on growing your practice? Follow me on Instagram and listen to my podcast for all the best support for growing your therapy practice and attracting more clients!
Your Business Bestie,
Nicole
