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Most therapists and care-based business owners didn't get into this work because they dreamed of managing budgets, navigating staffing challenges, or developing policies. They wanted to help people. To create meaningful change. Maybe even to do things a little differently. But somewhere between building a team, managing finances, and keeping the doors open, it's easy to lose sight of the values that brought us here. And that's worth paying attention to. Values Are More Than W

I didn't set out to become a speaker. I set out to build a practice grounded in grace — and somewhere along the way, other people started asking me how. How do you grow a group practice without losing the values you started with? How do you make hard staffing decisions without abandoning the people-first culture you claim to believe in? How do you lead when the work itself — therapy, care, service — was never supposed to be about scale in the first place? I started speaking b

If you're a Christian clinician who integrates faith into your work, I want to name something plainly: how you do that matters as much as whether you do it. "Christian counseling" can mean a therapist quietly imposing their theology on a vulnerable client. Or it can mean something much more rigorous, much more ethical, and — I'd argue — much more faithful to what Christianity actually teaches. This is a call to do the second one. The distinction that matters Faith-based care,

Mental Health Isn't Just Personal. It's Also About the System You're In. Here's a question I get to sit with a lot in my work: why do we so often treat mental health like it's purely an individual problem? Someone's anxious, so we tell them to meditate more. Someone's burned out, so we tell them to set better boundaries. Someone's struggling at work, so we send them to a workshop on resilience. All of that can genuinely help. But notice what it doesn't ask: what about the sys

Running a group practice is equal parts compassion and chaos management. Between supporting clients, leading teams, and planning community events, the right tools can make all the difference. I'm often asked, "What programs do you actually use and love?" So here they are — my go-to resources that make practice ownership a little smoother (and my coffee a little stronger). Some of these include affiliate or referral links, meaning I may earn a small thank-you if you sign up —

Here's something I had to learn the hard way: you can't culture-fix your way out of a bad hire. I've tried. I've invested in training, mentoring, difficult conversations, and more grace than I probably should have extended. And sometimes those things work. But more often, when someone is fundamentally misaligned with the values of your practice, no amount of onboarding saves it. You end up spending enormous energy managing the friction instead of building the thing you set ou

Discover how relational leadership helps therapists, faith leaders, and organizations build healthier, more sustainable teams rooted in connection and values.

By Kate Fish, LMFT, PMH-C | Kate Fish Consulting I love a good conversation that starts in one place and ends somewhere you didn't expect. Recently, I had the pleasure of connecting with Brent Stutzman, the owner of TheraSaaS, and what began as a broader conversation about practice operations turned into a genuinely engaging deep dive on a topic I find myself returning to again and again: the ethics of Google reviews in behavioral health. It's one of those subjects that sound

And why “good enough” in supervision just… isn’t. Stepping into supervision is one of the most meaningful transitions we make as clinicians. It’s a shift from doing the work to shaping the people who will go on to do the work — and that responsibility is sacred, powerful, and, honestly, a little intimidating. When I first moved into a supervisory role, I knew I wanted to show up with intention, not assumption. I’d been well-trained as a therapist, but supervising is a differe

A note for group practice owners who've been told "no" because of their for-profit status Let me tell you something that took me years of community building, a few grant rejections, and a lot of relationship-tending to fully understand: You don't have to be a nonprofit to access nonprofit funding. I know. Stay with me. At Graceful Therapy, we've built partnerships with more than ten nonprofit organizations — churches, school districts, NAMI affiliates, and organizations servi

By Kate Fish, LMFT, PMH-C There's a phrase I've been sitting with for a while now: profit first. If you've spent any time in the private practice world, you've probably encountered Mike Michalowicz's Profit First — a cash flow management system that flips the traditional accounting equation on its head. Instead of Revenue − Expenses = Profit, Michalowicz argues the formula should be Revenue − Profit = Expenses. In other words, you allocate profit before you spend, building fi

There's a word I come back to again and again — in my work with clients, in conversations with my husband, with friends, and with the practice owners and leaders I consult with. That word is congruence. Carl Rogers used it to describe the authenticity that exists when what's happening on the inside matches what's happening on the outside. And while it's a concept rooted in therapy, congruence is one of the most powerful — and most underutilized — frameworks in leadership. Wha

A systemic therapist’s perspective on relational healing, burnout, and building sustainable, justice-oriented care systems.