WP152 | Turnover & Trust: 5 Considerations for Group Practice Owners When Therapists Leave - Podcast Takeover with Amy Dover
Hello friends, and welcome back to the Wise Practice Podcast! This week looks a little different because my friend Amy Dover is taking over the mic for a special four-part series. Amy is a licensed marriage and family therapist, a group practice owner in Lower Alabama, and a Wise Practice Consultant. She’s been in the trenches of group practice ownership and has powerful insights to share.
In today’s episode, Amy tackles a tough question that nearly every group practice owner will face: What do you do when multiple therapists leave your practice in the same year?
Amy knows this firsthand—2024 was her hardest year yet, with nine therapists leaving her practice. Instead of shying away from the pain of that season, she shares the lessons, the leadership growth, and the ways God was at work even in the pruning.
Let’s walk through her five key considerations.
1. Start with Perspective Instead of Panic
When you get that resignation email, it’s easy for fear to take over. Your mind races: What’s wrong with me? Will clients leave? Is this the end of my practice?
But Amy reminds us that as Christian leaders, we’re called to start with perspective. Before scrambling to “fix” things, pause and pray. Ask God: What are You showing me through this?
Sometimes turnover is pruning, making space for the right people. Other times it’s redirection, shifting the practice toward a new vision. John 15 reminds us that pruning is never comfortable—but it’s always purposeful.
2. Honestly Investigate Why People Left
Turnover doesn’t mean you failed as a leader, but it is an opportunity to learn. Amy encourages owners to seek the “why” with humility.
That might mean holding exit interviews—not to defend yourself, but to genuinely listen. Therapists leave for different reasons: moving out of state, family needs, seeking solo practice, or feeling misaligned with leadership or culture.
In Amy’s case, most departures were tied to her transition from 1099 contractors to W2 employees. Some therapists simply didn’t want to give up their LLCs. Others had personal circumstances that pulled them away. While hard to hear, understanding the real reasons helped her see patterns and make better decisions for the future.
And don’t isolate during this process. Lean on mentors, colleagues, consultants, or your Wise Practice community. You don’t have to navigate this season alone.
3. Reflect on Your Leadership with Humility
The mirror is a hard place to look, but it’s essential. Amy reminds us this isn’t about self-blame—it’s about self-awareness.
Ask yourself:
Am I casting a vision that excites my team?
Do I address conflict quickly and biblically?
What leadership habits do I need to refine?
Amy shared a story about delaying a difficult conversation with a therapist who was struggling. When she finally addressed it, the conversation opened the door for accountability and grace. But she realized she should have acted sooner. God often uses these moments to refine us as leaders and teach us to step into hard conversations with courage.
4. Protect the Health of Your Practice
Even in seasons of transition, client care must remain the top priority. That means having systems in place to ensure smooth therapist and client transfers.
Amy learned to refine her contracts, policies, billing systems, and even her mission and vision statements during this season. In fact, she used the turnover as an opportunity to fully align her practice with Christian values.
She also emphasizes the importance of always recruiting. Like a sports team, keep a “bench” of potential hires in mind so you’re not starting from zero when turnover happens.
5. Move Forward in Hope
Turnover can leave both you and your team discouraged. Remaining staff might wonder, Am I next? Is the practice stable?
This is your chance to shepherd your team. Gather them, pray with them, and remind them of the mission. Share how God is at work and where you see the practice headed.
Amy leaned on Isaiah 43:19 during her hardest year:
“Behold, I’m doing a new thing; now it springs forth, do you not perceive it?”
Even in loss, God is doing something new. Today, Amy’s practice is thriving again—she’s hired new therapists, rediscovered her “why,” and found joy in leading a practice that’s fully aligned with her values.
Final Encouragement
If you’re in a season of turnover, remember:
Start with perspective, not panic
Seek the real reasons behind departures
Reflect honestly on your leadership
Protect your systems and your clients
And most importantly, move forward in hope
God is not surprised by your turnover. He’s using it to prune, refine, and prepare your practice for new growth.
Links and Resources
Email Amy directly at amy@wisepracticeconsulting.com
Looking for support and connection: Join the Wise Practice Community
Learn More about Wise Practice Consulting
Connect with Wise Practice on Instagram
-
Hello friends. Welcome back to the Wise Practice Podcast. My name is Amy Dover and I'm a licensed marriage and family therapist, a group practice owner down in Lower Alabama, and a wise practice consultant. Whitney has graciously allowed me to again, sit in her seat, and this is the beginning of a four-part podcast takeover.
I'm so glad you're here with me. So today's topic, it's not exactly the most fun one, but it's one that almost every group practice owner will face at some point. What do you do when multiple therapists leave your group practice in the same year? I faced it last year when I had nine therapists leave my practice in that year, 2024 was the hardest year I've had as a practice owner.
Let me set the scene for you. You open your email and there it is, another resignation letter. That's the third one. This year your stomach drops, your mind races, and you start wondering, Lord, what is happening to my team? What is gonna happen to my practice? If that's you right now, I wanna help you see this moment through a kingdom lens.
If you've been in this position, you know, it can feel like someone just pulled the rug out from under you. You might be wondering, what is wrong with me? What will my clients think? Do people not wanna work with me anymore? Is this the beginning of the end of my practice? I wanna start with a reminder from Proverbs 19, verse 21.
Many are the plans in a person's heart, but it is the Lord's purpose that prevails. That verse always reminds me that even when things feel like they're falling apart, God is still in control, and that brings me such peace. So today we're gonna walk through five things to consider if you're in a season like this.
Number one, how to start with perspective instead of panic. Number two, how to honestly investigate why people left. Three, how to reflect on your leadership with humility. Four. How to protect the health of your practice. Five. How to move forward in hope. All right, let's get to it. So number one, if you're a practice owner and you are in the season of turnover, the first thing I want you to consider is to keep your perspective instead of panicking when people leave, the emotional reaction is real and fast.
Fear sets in, insecurity sets in. You start second guessing every decision you've made. Like even every decision you've ever made outside of the practice, it's easy to begin panicking. But as Christians, leaders we're called to respond differently. So before you did what I did and try to scramble to fix things, I want you to pause and pray.
Ask the Lord, what are you showing me through this? Sometimes departures are pruning God, making room for the right people. Other times the redirection. He's moving your practice toward a different vision. In episode 1 0 3 of the Wise Practice Podcast, I talked about transitioning to a W2 practice after eight years of being a 10 99 practice.
When therapists began to leave after the transition began, I knew, I knew that it would ultimately be a good thing, but man, was it hard when it was happening. I also had a sense that God was calling me to do different things in the practice, but I wasn't quite sure what yet. My season ended up being both a pruning and a redirection, and honestly, I do it all over again despite the pain it brought.
I always think of John 15 where Jesus says that the father prunes every branch that bears fruit, so it can be even more fruitful. Pruning is never comfortable, but it is always purposeful. And when you start from that place that God is not caught off guard by this, he's not surprised that your therapist are leaving.
You can approach the situation with more peace and less panic. Okay? But that also doesn't mean you just get to shrug and move on. You still need to get to the bottom of why these departures happened. And that takes us to the second consideration, honestly, investigating why people left or are leaving your practice.
And this part requires courage and humility. If you can do an exit interview, and I don't mean a defensive, why would you leave me conversation? I mean, a genuine, I care enough to hear your side of things, even if it's uncomfortable conversation. Some people leave because of personal reasons. Maybe they're moving.
Maybe God's calling them into private solo practice. Maybe they have family needs that that need to take priority. Others may leave because of culture issues, leadership missteps, or feeling undervalued. And here's the thing, you want to know if there's a pattern. When my therapist began to put in their resignation letters last year, I had meetings with all of them.
I did want to know why. The majority of them said it was because of the W2 transition. They just didn't want to be employees. They wanted to do their own thing in solo. They didn't want to give up their own LLCs to be a W2. With my group, a couple of them left because the family needs one of them moved out of state because her husband unexpectedly was medically retired from the army.
Another became fully licensed and wanted to move into agency work with Veterans Affairs, though the majority left because of the transition. I still wanted to know the why. I'm also gonna say this group, practice ownership and just practice ownership, period. Even if you're solo, can be very isolating. And if you're going through a season like this of high turnover as a group practice owner, don't go through the season alone.
Don't try to figure this out alone. Talk to your mentors. Talk to other group practice owners, your leadership team. Get in touch with a consultant. Reach out to your fellow members of the Wise Practice community. Just don't isolate yourself. Okay? Once you have some clarity on the why, it's time to look in the mirror.
This is the step that many leaders skip because it's really hard and doesn't feel good. But the third thing to consider if you're in a season of turnover with therapist is to reflect on your own leadership with humility. And I wanna be clear about this. This isn't about self blame, it's about self-awareness.
So ask yourself, am I casting a vision that excites my team? Do I address conflict quickly and biblically, like Matthew 18 calls us to? What do I need to do differently as a leader? Sometimes God uses challenges like this to refine us as leaders. I've learned the hard way that avoiding tough conversations, hoping problems will fix themselves, only makes them worse.
This is something that he has taught me through that season of turnover. I had to have hard conversations quite a bit. But let me give you an example of one. One of the therapists who ended up leaving my practice had been behaving out of character for a few months leading up to her resignation. Uh, she was already a bit unorthodox in her interactions with other folks in the practice, and honestly, she was sort of a liker, can't stand her kind of a person, if you know what I mean.
It was sort of one way or the other with her. But I pulled her aside one day and discussed my concerns with her as I was also thinking that some of her interactions just in front of me with other colleagues in the practice had become quite rude. She was apologetic and admitted that she was struggling with untreated bipolar disorder.
Well, you better believe that I told her she needed to start getting it treated, and I gave her several supports in this, along with a plan for accountability and check-ins over the next few weeks and months. What I needed to do though was have that conversation weeks before I actually had it because I had noticed the behavior a couple of months before I actually spoke to her.
But that hard conversation also helped to prove to me that I'm more than capable of having those conversations, and it's my duty and responsibility as the practice owner and leader to have them sooner rather than later. The conversation also showed grace and I understood an important lesson. I can't put off hard things that isn't good leadership.
So you've prayed, you've investigated, you've reflected. Now let's talk about how to protect the practice you've worked so hard to build. So the fourth thing that is important to consider if you're a practice owner who is in the middle of a season of turnover is how to protect the health of your practice.
The first priority is always client care, always. If clients feel abandoned, your reputation suffers. When therapists leave, communicate clearly, help with referrals and make sure the transition is smooth. With the therapist who left my practice, most of their clients followed them, though we've actually had quite a few return to us over this last year.
But the important thing is to ensure that you have a system in place that helps with therapist and client transfers. That is crucial when it comes to client care. And let me tell you. By the time the night therapist left my practice, I had my system of client and therapist transition down real good.
Let me just say that I had it dialed in, but next thing during this season is to take a look at your contracts, policies and systems, not from a place of fear, but from stewardship. Are your contracts and employee agreements clear? Or your onboarding process is thorough. How about your hiring policy? What might need to be tweaked in that?
Do you need to change your EHR or your billing system? After the dust settled last year and the night therapist left in October, I was open with my team about what I was going to do while I waited for word from God about next steps, I made necessary changes to practice systems. I changed the way we bill.
I changed our phone, fax, text communication platform. I changed our hiring policies, the type of therapist we hire, and the biggest change of all. I officially became a Christian private practice. I changed the information on our website. I changed all the information and added it to our informed consents with my leadership team.
I wrote a brand new mission statement and vision statement, and we refined our core values. Guys, I'll admit it has been a whirlwind of change these last 18 months, and there are days when I'm just so weary, but I'm so glad God has taken me on this journey. The fruit of all of this hard work and pain is beginning to be shown.
I just recently hired three therapists because I will tell you, God has faithfully been keeping the referrals coming, and my team and I have been so busy with clients this last year. But these three therapists will be onboarded at the end of August. I'm actually recording this episode in mid-August, so in about, actually it's a week from tomorrow that they'll be having their new employee orientation with us.
Those three therapists put my team to nine therapists. My sweet spot is actually around nine to 10 therapists, so we will see what the Lord chooses to do with that number, but I'm not really focused on that right now. My focus and what I love is that my practice is now in full value alignment and I enjoy coming to work again every day.
Also. Something to consider as a practice owner is due to the departures of those nine therapists, I had to increase revenue, so I ended up taking on more therapy clients. We had so many referrals coming in. The five therapists I had left couldn't handle the load, so I decided to take on on therapy clients again, but that's also been a blessing.
I've rediscovered the why of being a therapist and even having the practice. There's been a lot of blessings in the pain. Something else to be thinking about. If you've got some turnover there though, and even if you don't have turnover, just if you're a group practice owner, something that needs to be on your radar all the time is just recruiting.
Always be recruiting. This is not my analogy. I read it in a book a few years ago, but I've, I've, I use it for my recruiting process, and so I want to share it with you. I like to use the analogy of a sports team. I like to keep a running list of people, counselors who were on my bench. It might not be the right time for them to work at Dover Counseling, but I keep in touch with them and when the time comes, I pull them up from the bench and I can put them in the game.
I was able to do that with a couple of therapists when the other nine began leaving last year, and it just helps to not start from zero if change happens. So once the immediate fires are out, your next job is to reignite hope in the team that's still with you. And that takes us to the fifth consideration for a practice owner to be looking at if they're in a season of turnover, how to move forward and hope when turnover happens, your remaining staff may feel anxious.
They might wonder who else is leaving. Is the practice unstable? Do I need to go look for another job? Is Amy. Okay? I had a couple of therapists tell me that last year that they were a bit worried about me when we had the bass exodus from the practice, but this is your moment to be the shepherd. Gather your team, pray with them and speak hope over them.
Remind them of the mission and let them hear where you believe God is leading the practice next, and that you trust him as well as how grateful you are to them for sticking with the practice's, mission and values. God kept putting this verse from Isaiah in front of me last year, and you have probably heard this verse so many times that he would put it in front of me.
A devotional, uh, I would hear it just randomly on the, on the radio station. I would see it on maybe an online devotional that was in my inbox, but it seemed like every week he was putting this verse in front of me. And it's from Isaiah chapter 43 verse 19. Behold, I'm doing a new thing now. It springs forth.
Do you not perceive it? I will make a way in the wilderness and rivers in the desert. Ah, I love that verse. New growth often starts in the soil of loss. And here's what I've also found. When you lead with faith, humility, and vision, people rally. They wanna be a part of what God is building. And the team that stayed with me when the other nine therapists left behind left, they are the people who have helped me build the practice over the years.
My practice has been in existence for 10 years, almost 11, and the ones who stayed behind are the ones who have been with me almost from the get go. That says a lot too. So if you're walking through a season of turnover, remember these five steps, I want you to consider how to start with perspective and not panic.
Investigate the real reasons, reflect honestly on your leadership, protect the health of your practice and move forward in hope. God is not surprised by your turnover. He's using it to shape you, refine your leadership, and set the stage for new growth and maybe a new vision that brings honor and glory to him.
Thanks for joining me today. If this episode encouraged you, share it with another Christian practice owner who might need a reminder that God is in the details. Even in the departures, if I can be of any help or exist assistance to you. If you're interested in consulting with me or joining my mastermind later in the year, drop me an email amy@wisepracticeconsulting.com.
I love connecting with other Christian practice owners. Until next time, keep your eyes on him and your heart open to the new things that he's doing in your practice. I'll see you next time.
