This week marks a very special milestone for me: the 10-year anniversary of the practice (or, as we now call it, our “Collectiversary”).
Recently, I was looking through some old emails and notes and came across a message I had completely forgotten about. It was an email to the attorney who originally helped me set up the business, asking him to make sure the practice was structured in a way that would allow it to eventually become a group practice.
Apparently, even at the very beginning, I knew I didn’t want to build something entirely on my own.
I wanted to create a community. I wanted to work alongside other clinicians I respected, learn from them, and build something that could have a larger impact than I ever could as one psychologist working independently.
Just as importantly, I wanted the people who joined the practice to be both excellent clinicians and genuinely good people to work with — thoughtful, personable, collaborative, and committed to learning. I believed then, and still believe today, that those qualities help create not only a better workplace, but better care for clients.
Over the years, we have interviewed a lot of clinicians. We certainly could have hired more people and grown faster. But growth at all costs has never been the goal.
Quality has always mattered more.
The clinical team at CBT Collective has been built very intentionally, and I am incredibly proud of the clinicians who make up the practice today. Together, our clinicians now provide evidence-based care to more than 1,500 clients each year.
And the impact of good therapy often extends well beyond the person sitting in the therapy room. When someone becomes less anxious, less depressed, more confident, more connected, or better able to navigate difficult relationships, the effects can ripple outward to families, workplaces, friendships, and communities.
Building a culture of clinical training
From the beginning, I was determined that the practice would provide high-quality treatment grounded in Cognitive Behavioral Therapy and other evidence-based approaches.
What I did not anticipate was how extensive our training program would eventually become.
Today, our clinicians have access to ongoing supervision, consultation, and training from experts with deep experience in CBT and related evidence-based treatments. Our trainers include authors, researchers, leaders in professional organizations, clinicians trained at major CBT institutions, and professionals who teach and train therapists internationally.
Their credentials are impressive, but what I value just as much is the way they teach.
They are warm, thoughtful, supportive, and able to create an environment where clinicians can talk openly about difficult cases, uncertainty, and areas for continued growth. That kind of environment is essential if you want clinicians to continue improving throughout their careers.
Our trainers regularly tell me how much they enjoy working with the clinicians at CBT Collective. And I think that says something important about the culture we have built.
Clinical excellence needs operational excellence
There is another lesson I have learned over the past 10 years: excellent clinical care alone is not enough to build an excellent practice.
A practice also needs strong systems, thoughtful operations, good communication, effective technology, responsive client support, and people constantly thinking about how to make things work better.
For a long time, I was essentially the entire business team.
I did my best. I would not necessarily recommend that model.
As CBT Collective grew, we were able to invest in a dedicated Business Team with people who bring expertise in operations, growth, technology, client experience, and practice management.
Their work often happens behind the scenes, but it affects almost every part of the experience for both clinicians and clients.
They have helped us develop better systems, improve how we match clients with therapists, build clinicians' caseloads more efficiently, open and operate new offices, improve our technology, and continually refine the hundreds of small processes required to run a growing mental health practice well.
The practice is dramatically stronger because of them.
Growing without outside investment
One part of the CBT Collective story is especially meaningful to me.
The practice has been entirely bootstrapped.
When I first opened the practice, I had no idea exactly what it would become. I certainly didn’t imagine that 10 years later we would have a team spread across four offices in the Tri-State Area, along with employees working remotely from as far away as California and Alaska.
I started it with only a few thousand dollars while living in my childhood bedroom. There were no outside investors, family loans, venture-capital firms, or private-equity owners funding the growth.
Instead, the practice grew by reinvesting what we earned back into the organization.
That has meant that growth itself has never had to be the ultimate objective.
The objective has been to build a strong, sustainable practice that can continue investing in better training, better systems, better facilities, stronger support for clinicians, better care for clients, and to serve more people.
Responsible growth gives us the ability to keep improving.
There are still plenty of things I want to improve (anyone who works with me knows that I am rarely short on ideas) but one of the exciting things about reaching this stage is that we increasingly have the people, infrastructure, and resources to turn more of those ideas into reality.
The next 10 years
Over the past decade, I have tried to make decisions based on what I believe is best for our clients, our team, and the long-term health of the practice.
That philosophy is not going to change.
As CBT Collective enters its next decade, I hope we continue to grow responsibly while making our clinical training stronger, our systems smarter, our facilities better, and the experience of receiving care from us easier and more effective.
But the most important goal remains the same one we started with:
To bring together talented, thoughtful clinicians and give them the training, support, and environment they need to provide exceptional evidence-based care.
Ten years later, I am incredibly proud of what this group of people has built.
And I am very excited to see what the next 10 years bring.
