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 three years with toddler twins at home, and a big reason we grew fast without burning out was leadership. I don’t mean corporate leadership. I’m talking about positive leadership!
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!
What Is Positive Leadership?
Positive leadership is influence grounded in positive psychology.
It starts with the belief that people want to do good work. Your team wants to meet your standards, serve clients well, and help you reach the vision. If that is true (and I totally believe it is), our job is to remove barriers, build buy-in, and make it easy to do the right thing.
I borrow a lot from positive parenting here. Not because your team is made of children, but because the power dynamic is very, very real. Here’s a simple comparison: Old school leadership says, “Do what I say.” Positive leadership asks, “How do we reduce the power struggle so people choose the right thing on their own?”
Here are some quick reframes that you can start using immediately:
- See your team as partners, not subordinates
- Share power through choices and co-created plans
- Focus on intrinsic motivation instead of fear or punishment
- Use language that levels the field: “works with me,” not “for me”
Positive Leadership In Action
Let’s talk about positive leadership in a practical way, so you can envision it in action in your group practice.
Avoid the power struggle
Some personalities bump against rules by default. I totally have one of those at home! When I tried to force a park trip, we locked into a standoff. The moment I offered choices, we were out the door smiling. Your team is the same. Share power where you can:
- “Which consult script feels most natural to you? A or B?”
- “Would you like the Monday admin huddle at 9 or 9:30?”
- “Do you want to track consults in Jane or in the shared sheet?”
Offering a small choice creates ownership, and ownership creates follow-through!
Hot Tip: Speaking of Jane (my fav platform for booking, scheduling, billing, automations, and more!), you can try Jane App FREE for 2 months by clicking here!
Use language that levels power
Micro-moments seriously matter.
Here’s an example: Introduce people as “This is Jess, she works with me,” not “for me.”
It feels different in their body and yours. When you change the story of who you are to each other, your practice culture shifts in the right direction.
Coach with empathy
At the end of the day, you’re a therapist, so I know you can do this one well!
There is a line I love from negotiation research that says: people decide with emotion, then justify with logic. Empathy disarms defensiveness and opens the door to change. When people feel listened to, they are more open to listen. You should lead hard conversations with curiosity, for example:
- “What gets in the way of this policy in real time?”
- “What part of the process feels unclear or overwhelming?”
- “If we solved one friction point this week, which would move the needle most?”
Set shared goals and accountability
Here’s a simple three-step model that actually works.
- Find the why: Is it burnout, ADHD, confusion, lack of training, a newborn at home, too many back-to-back sessions? Diagnose before you prescribe.
- Co-create the plan: Make the goal clear, then let them design how to hit it. People follow plans they helped build. Examples: reduce daily clients from six to five for two weeks, add a five-minute reset block between sessions, admin checks rooms at shift change.
- Schedule the check-in: Book a date to review progress. Two weeks is perfect! Accountability is not punishment even though our brains make it feel like it sometimes. In reality, it is a promise to support the goal you set together.
Choose intrinsic motivation over punishment
Let me say this – Performance improvement plans have a place. I used them in the past for serious issues like discrimination, repeated disrespect, or safety concerns. But when it comes to everyday misses, punishment works only short term. Influence, on the other hand, lasts.
If you default to “write-ups,” you will create compliance, not commitment, and those therapists will leave.
Lead with radical responsibility
This one can sting a bit, and it is also freeing.
You need to take full ownership. You hired them, trained them, set the policy, and communicated expectations. If something breaks, ask, “What in my system needs to change?” Leaders who practice radical responsibility improve culture quickly because they fix the real levers!
Hot Tip: Click here to listen to my podcast episode where I tell you exactly where to find the best therapists when hiring for your group practice.
Building a Team Culture People Stay For
Let me make this super clear. Culture is not game nights and pizza.
Group practice culture is how you treat people daily. Invest in knowing your team as humans. When you understand their lives and strengths, you catch small cracks before they split the foundation. You will also find yourself less annoyed when something slips, because the relationship bank account is funded.
A quick pulse check for you to review:
Signs your culture is working
- People bring problems and solutions, not gossip
- Policies are followed without constant reminders
- New hires feel safe asking “basic” questions
- Your best clinicians refer their friends
Signs it might be time to part ways
- You have coached the same issue through the full cycle more than once
- Disrespect appears in tone or behavior
- They undermine colleagues or ignore client care standards
- Your gut keeps saying, “This is not a fit”
When it really comes down to it, you created this practice, so you get to be choosy. Bless and release with kindness, and keep your standards A-plus!
A Real-World Example of Positive Leadership
Here’s a real-world example of something that comes up constantly.
Two therapists share a room. One leaves chaos and the other is frustrated. You emailed, you met once, and it’s still messy. Now what? Try the positive leadership sequence:
- Meet again with empathy
“I know you want to do great work here. This keeps popping up, so I want to understand what is getting in the way.”
- Find the barrier
Overwhelm, stacked sessions, unclear end-of-shift checklist, or simply not seeing the mess because they are sprinting to daycare pick-up.
- Co-create a clear goal
“In two weeks, the room will match the end-of-shift photo on the checklist.”
- Remove friction
Add a five-minute reset block, print the checklist with photos, ask admin to do a quick walk-through at hand-off for two weeks.
- Book the follow-up
Put it on the calendar. Celebrate progress or adjust the plan!
The reality is that most people will self-correct with support and clarity. If they do not, you have your answer about whether or not they’re the right fit for your practice.
The Next Step on your Leadership Journey
Leadership is some seriously emotional work. It is also the highest-leverage work you do. When you lead with positive psychology, empathy, and shared power, people choose the right thing because it feels like theirs. That is how you build a self-operating company, one policy and one human conversation at a time.
If you want support turning this into repeatable systems, join my free training, How to Build a 7-Figure Group Practice. I will walk you through the five-step scaling method I used to grow to 55 therapists in three years. I would love to help you create a clinic people never want to leave!
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
