Amy Prince and Amber Ladd once split a tiny rented office with a padded tumbling mat stood up vertically in the middle of the room. That was the divider. That was the whole setup. They each saw kids on their side, and the real estate company next door eventually asked them to leave because their clients, kids with behavioral challenges, were too loud.
Today, The Talk Team occupies just under 5,000 square feet in Fresno, California, with 14 therapists, a climbing wall, a swing, a trampoline, a dedicated feeding therapy room, and about 400 kids coming through the doors every week. They've also opened an ABA practice and are eyeing another 2,000 to 4,000 square feet of expansion.
How do you get from a church room on Wednesdays to a practice that size? Slowly. Deliberately. And with a willingness to learn every lesson the hard way.
Amy supervised Amber's clinical fellowship year at another private practice. When life changed and kids came along, they both left within weeks of each other. Clients followed. The two started seeing just two kids each after school, working on bedroom floors and at kitchen tables.
As word of mouth grew, the afternoons filled up. Driving home to home ate into their limited time, so they found a church willing to let them use a room on Wednesdays in exchange for 10% of their earnings. They hauled in cube chairs, toy boxes, and board games every week and hauled it all out again when they were done.
"We had no place to store files or materials or anything else that we needed in order to continue to do really good therapy."
That was 2006 to 2008. Both were still working full-time in local school districts. The side practice was growing, but neither was ready to jump. Not yet.
The Talk Team's growth wasn't a hockey stick. It was a series of small, sometimes awkward moves, each one driven by necessity rather than ambition.
The $250-a-month office with the tumbling mat divider lasted nine months before the neighbors complained. Next came a sublet with a tutoring company that gave them two small rooms and a pseudo-kitchen. Amy quit her school job and went full-time into the practice. Amber dropped to three days in the schools, keeping health benefits while pregnant, since both husbands were also self-employed.
Amy's fear response kicked in hard. She took on a caseload of 45 hours a week of direct therapy, seeing nine clients five days a week, refusing holidays, with kids at home who were six and eight. She credits her mother-in-law and husband for not killing her during that stretch.
"I was obsessive, but I was scared. I didn't want us to not be successful and it was scary to jump and hope for contracts."
At that point they weren't even billing insurance. They had regional center contracts, charter school contracts, and private pay. No advertising. All word of mouth.
One of the most honest moments in this conversation is Amy and Amber admitting they had no real handle on their finances for years. They knew how to bill clients but didn't reconcile payments against what they'd actually received. Money was in the bank, so they assumed everything was fine.
"It's that old saying, I had checks, so I must have money."
When they finally hired a part-time bookkeeper, he discovered $5,000 in unpaid bills that had been building up unnoticed. That was the wake-up call. He took over not just bookkeeping but insurance billing and reconciliation of accounts. For Amy and Amber, the financial side of the business was the area they left "most untouched" in the early years, and they're candid about the fact that they survived more on luck than planning during that stretch.
It's a pattern that shows up across speech therapy private practices. Clinicians are trained to be excellent therapists, not business operators. The billing, the bookkeeping, the HR, the legal structure: it all has to be learned on the job, and the learning curve can be expensive.
The Talk Team's approach to hiring is unconventional and effective. Both Amy and Amber supervise at CSU Fresno's clinic for children with autism. Graduate students rotate through their on-campus clinic, and the best get invited to intern at The Talk Team. About 60% of their current therapists came through that pipeline.
But the most interesting hire wasn't a clinician. It was a front desk person whose personality didn't quite fit the front desk. Instead of letting him go, they asked him to write his ideal job description. What he came back with was so good they created a brand new position: Director of Client Engagement.
He handles first-session consultations with parents, manages complaints, plans events and potlucks, and generally makes sure the 400 families coming through each week feel taken care of. He's the reason parents recommend The Talk Team by name when someone mentions speech therapy.
"If the hearts and the minds and the needs of the kiddos and the families coming through our door Monday through Friday are well taken care of, then when somebody mentions speech therapy, our name will come up."
They also invest heavily in continuing education. Twice-monthly lunch trainings, a coaching request system where therapists can shadow each other on specific cases, and a CE stipend with no fixed cap. When a clinician wanted to go through SOS feeding training, which is expensive, they covered it.
Amy and Amber's advice to new graduates eager to open their own practice is blunt: "No, you don't. You might want to in five or 10 years."
Not because it's impossible, but because the business knowledge required to run a practice well is practically a second degree. They've lived it. They're less speech therapists now and more business owners who happen to have clinical backgrounds. They still each see a handful of clients per week to stay connected, but their day-to-day is operations, HR, finances, and culture.
Amber's addition to the advice is simpler: keep your heart in it. The slow growth was essential, but so was remembering why they started. They provide a place that brings happiness to clients, staff, and everyone who walks through the door. That's not a tagline. It's the reason 400 kids show up every week without a single dollar spent on advertising.
Scaling a practice from two clients to 400 kids a week means the business side can't be an afterthought. ClinicNote is a HIPAA-compliant EMR built specifically for private practices and university clinics, handling documentation, scheduling, and billing in one place so your team can focus on the families walking through the door. See how ClinicNote works.
Kadie: You are listening to Clinic Chats, the speech therapist's private practice podcast, a podcast full of personal journeys where we not only talk about success stories, but also real life struggles of small business startups. Clinic Chats is sponsored by ClinicNote, a HIPAA compliant, cloud-based EMR platform used specifically by private practice owners and university clinics. I'm your host, Kadie Jackstat, and thank you for joining me today. Today I have co-owners Amy Prince and Amber Ladd, the owners of The Talk Team. Thank you for joining me on the Clinic Chats podcast. How are you?
Amy: Good, thank you. Thank you for having us. We're excited to chat with you this morning.
Kadie: Yes, I am intrigued by how the practice began. If you want to take it away and kind of give me a little bit of background.
Amy: I was actually Amber's clinical fellowship year supervisor back when it was still a CFY. So I was able to supervise her and we worked together at another private practice. And then as we had kids, when our lives changed, we both decided we wanted to look for something different. And so we left the private practice we were working at kind of within a couple of weeks of each other. Had clients who told us that they didn't care where we were going, they were coming with us.
Kadie: Very nice. So obviously you each had a reputation with clients and they wanted to follow.
Amy: We both took jobs in local school districts and saw two clients each after school in their homes and worked with them on their bedroom floors or at their kitchen table. And as reputations grew, we started just gradually adding kids until it got to the point that we didn't have enough afternoons available any longer.
Kadie: Yeah. So I'm sure that was quite a juggling act if both of you had other full time jobs and then trying to do the work solely in the evenings or weekends, whatever it may have been.
Amy: And we found that traveling from home to home in the afternoons took up quite a bit of time. So it was about that period we decided we really needed kind of a home base.
Kadie: And so you decided and opened up an office location?
Amy: Actually funny enough, no. At that point, we reached out to a church. We were very nervous about paying rent. And so we reached out to a church and they allowed us to use a room on their campus on a Wednesday as long as we brought in all our own stuff and took out all our own stuff for just a tithe back from what we would earn. So we tithed back 10% of what we earned each week to the church. But this became really difficult when we were both seeing six clients on Wednesdays and we were carting in cube chairs and toy boxes and board games and we had no place to store anything. And we had to share a room.
Kadie: Yes. I imagine how difficult that was. And at this point, was it all private pay?
Amber: No. Well, yes. It was mostly private pay. And it was actually when we realized our stuff was too heavy was when we took on our first client through a charter school contract and our first client through a regional center contract.
Kadie: Oh.
Amber: And we had just made these two initial connections and things were growing and we didn't have any place to store files or materials or anything else that we needed in order to continue to do really good therapy.
Kadie: Wow. And what was the year that all of this started?
Amy: It must have been about 2008. Yeah. We started, we both started with our two clients in 2006. And it was probably around 2008 that we decided we need an office space. We need to be a more official business.
Kadie: Yes. Wow.
Amy: So here locally where we live, they have small offices that you can rent for like $250 a month. They're all connected to each other, but they include all your utilities. So we thought this was a good option for us. We were still both only doing one day a week. And so we rented a small office and we worked on the same day because of course that made it more fun. But in order for both of us to see kids in this tiny one room office, we put a padded tumbling mat vertically in the center of the room and that was our separation from each other. We were very fancy.
Amber: For Amber and I, the nature of what we are passionate about is kids with behavioral challenges, kids who are behavioral communicators. And that also posed us a bit of a problem because we had neighbors. And when kids yell and scream, the real estate company next door doesn't love you.
Kadie: Yeah. Yeah. So we were very kindly asked to leave after about nine months. Then what was next?
Amy: Well, it was interesting because us being asked to leave kind of coincided with me deciding I was ready to leave my job in the schools. And so we did some searching and we found a tutoring company that primarily used their office only from three to eight at night or three to nine at night. And so we entered into a sublet contract with them and it got us two small rooms that were just ours and there was a kind of sort of pseudo kitchen, which was really exciting for us.
Kadie: Yeah.
Amy: And so we moved there and right about that time, I put in my letter of resignation to my school district and jumped full force, both feet into private practice.
Kadie: Wow. And is that Amy or Amber?
Amy: That's Amy, yes.
Kadie: Okay. And then so Amber was still employed elsewhere as well.
Amber: I was. And at that point, I went down to three days a week in the schools and was seeing kids privately two days a week. So it was a good balance and I was pregnant at this time. So keeping myself in the school district and having full health benefits was pretty important as both of our husbands are also self-employed. Having that security at that point in time was necessary.
Kadie: Absolutely. But it seems like everything was happening kind of gradually and taking things at your own pace so you could grow in a secure way without any huge risks, it sounds like.
Amy: Definitely. It was for the most part. And I feel like when I said I put in my letter of resignation, it was June. I finished out my school year and spent that summer seeing how many clients we could get onto my caseload. And fear response, I decided that I would see all the kids, anyone who would come our way. So I took on a caseload of four to five hours a week of direct therapy because I was scared. I saw nine clients five days a week. I refused to take holidays. My kids must have been eight and six, maybe. And so I'm very grateful to my mother-in-law and my husband that they didn't kill me during that period of time because I was obsessive, but I was scared. I didn't want us to not be successful and it was scary to jump and hope for contracts. And at this point, we weren't even billing insurance. We only had regional center and charter school and private pay.
Kadie: Gotcha. As the business grew and grew, obviously clients were coming your way. Did you have to do much advertising or was this all natural because of your reputation and word of mouth already?
Amy: That point, it was all word of mouth. We did not do any formal forms of advertising at all.
Kadie: Oh, wow. It was already successful as far as keeping you both a full caseload or getting close to it per se. And then so at what point did you decide to hire on?
Amber: So the first point that we thought we needed someone, I was pregnant. This is Amber. I was pregnant with my second child and leaving any of my clients for any period of time felt scary like they would disappear. And we were very strong willed in the fact that we both wanted to have the chance to stay home with our kids for at least three months. So we did hire someone part time to come in and take over my caseload while I was on maternity leave. And then she stayed on with us part time when I came back to work. She was with us part time for quite a while. And then after that, we actually had our first therapist that we hired on full time emailed us and knew about our practice and was working in a different town and asked us if we had ever thought about hiring someone. So we took her to dinner and interviewed her and thought, sure, we like you. We'll hire you. Let's go for it.
Amy: Well, and this is Amy. At that point, we realized not only were we out of room because we'd been sharing these two offices at the tutoring company, the landlord, he was just odd. He was a very unique individual. And we weren't comfortable with the idea that we needed to use more time there and more space there. He wasn't easy to interact with. There was just a variety of problems. So we moved literally across the street into what we considered a huge office. It had four rooms and then a great room and a little bit bigger kitchen, and it had its own bathroom, which we were very excited about because we had never had that before. So this was a really big deal for us. And when we moved in, we walked around, we looked at each other and said, how are we ever going to fill four rooms? Like possibly we bit off more than we could chew. We're being a little crazy here.
Kadie: Yeah. And were you worried about finances at that point? Or did you know you had enough to make it work?
Amy: No, we were definitely worried about finances. And Amber and I, one of the things we always talk about is that one of the areas that we left the most untouched early on in our practice was financial well-being. We didn't, we knew how to bill our clients, but we didn't always go back and reconcile. Specifically, if you were doing a mass billing, so for multiple clients through regional center and multiple sessions, we didn't necessarily go back and put the billing against what money we'd received and make sure that everybody had come in and all accounts were up to date. And so we thought that we were okay financially and there was money in the bank. So therefore, you know, it's that old saying, I had checks, so I must have money. So we thought we were doing very, very well. And I think we got lucky during that period of time because we increased our rent, we decorated a bigger office. There were three of us, one room was empty most of the time. And we did, we never had any trouble making ends meet, but I would say for us, it was more really luck than planning at that point.
Amber: Well, and we hired a part-time bookkeeper at this point, and he came in and let us know that we were missing around $5,000 that had been built up, never received. So that was a little bit of a wake-up call, but we felt really confident in the fact that we had hired him and he took over not only the bookkeeping, but the insurance billing and reconciliation of accounts at that point.
Kadie: Well, good. So from the very beginning in your partnership as owners, did you have some sort of business plan as far as shares split evenly, or did that conversation not necessarily happen till down the road when you had more success?
Amy: That conversation didn't happen until maybe five years ago. We've been in business for 13, obviously. It happened about five years ago. We've always operated 50-50. Even today, we're now officially 50-50. We've both always taken, when we were seeing clients, we were paid for the number of hours we worked. So I think when Amber was working one day a week and I was working four, I took 80%. She took 20% at that point. But the ownership of the business was always 50-50. And we started out legally as a partnership. So it wasn't until we decided to file as a corporation that I think we had that technical conversation. And now, sorry, we had to sit down with a lawyer and we have insurance policies on each other and all kinds of stuff that we never, ever would have expected to exist.
Kadie: Oh my goodness. So things must have grown again since that four-room office.
Amy: Well, so we in that office had our first intern from our local state university reach out to us and ask us if she could be our intern for her medical externship placement. And so we said yes to that and kind of had a steady stream of interns after that point. And we just started hiring them as we had them interacting with us.
Kadie: Oh, wow.
Amy: It was only about 18 months after we moved into that four-room office that we then outgrew it. And this is Amy, we laugh because we got so lucky with outgrowing this one too. We didn't ever think about the consideration of parking. And that office had a total of four spots per business and there were four businesses. So we had four spots for four parents. Our therapist had to park around the corner. But again, the things you don't think about. And so we got very lucky that a business started looking at buying the entire four business area and they asked us if we would like out of our lease. And we jumped up and down and did a happy dance and said yes and found the home we're in now, which at that point, when we moved into the office we're in now, it had, I believe, eight offices. And so we had our own office, which we were really excited about. We'd never had that before. And then we had space for each of our therapists. We had a room that we were able to dedicate to feeding and food aversions. We had a staff room with a real kitchen and a real table where we could sit down and eat together.
Kadie: Wow.
Amy: So we have a climbing wall and a swing and a trampoline and a place dedicated to that. So we didn't have a trampoline just in the middle of the office anymore. We have a waiting room. Just a lot of things came from that move. And we moved in and it was Thanksgiving weekend of 2014. We moved in and same thought, we moved in and we thought this is amazing and we're never going to fill this much space. This is things we shouldn't talk about anymore because by August of 2015, we had to take over another couple thousand square feet. And so now we currently occupy just under 5,000 square feet in our building. We have 14 active therapists who are either on site here with us, or we do have a secondary site about an hour south of us as well.
Kadie: Oh, wow. And are they all employees or contractors? How has that looked?
Amy: California won't let them be contractors unless we make them all contractors. And that wasn't what our team has ever advocated for or wanted. So every one of them is an employee. We do have some hourly employees. So some of ours that only see three or four clients a week, we have two of those. But the rest of them are salaried full time employees.
Kadie: And so now I'm sure you have your billing personnel. I'm sure you have an office manager who's doing the scheduling. What are your roles at this point?
Amy: We wish we knew that every day. I think the biggest thing we've learned along the way is the idea of slow to hire and quick to fire, which is a horrible thing to say out loud. But when it comes to that team of people, the team that run your business, it's hard to find people that are skilled and committed and can love our kiddos as much as you need to love our kiddos, even if you're just the one submitting their insurance billing. We've had a scheduler and we've had to go through a couple, but we're training one right now. And so we do have a schedule coordinator. We also do have a billing person who does the bulk of our insurance billing. And then we have one full time front desk person. And then we have an evening person because we do have sessions that go till seven some days. So we have somebody who covers that evening span. And then we just most recently created a position for somebody who was on our team. He's essentially the director of client engagement. So he does lots of those first session talking to parents about what to expect. He can take complaints if they come in. He does culture issues with us. He does events, potlucks, things like that.
Kadie: Wow. Okay. So what kind of experience did you look for in this person?
Amber: You know, funny, he came on with us as a front desk person and it didn't match his personality style. I really think that we ended up creating the position based on his strengths after he had been with us for a while and realizing that our role used to be that contact person. And we would be the ones to make sure that we did consultations with the families, made sure they felt comfortable coming in and were kind of their contact person and realized that as our position has grown, we really needed someone to take that over. And that was a natural strength of his. So it kind of was the progression that led into that position existing.
Amy: Very cool. Well, it was interesting. We actually gave him some power when we started to see his strengths. We asked him if you could write your perfect job description, what would it look like? What would it be? And he wrote out, honestly, it's beautiful. Like if somebody else needs to hire this person, we can totally share because he wrote out an incredible description where we were able to say, yeah, you're right. These are areas we need and this is a perfect fit. And so it's unique. I don't know that I ever would have created the position without him being a part of our team and this happening, him inventing that position. But we're super excited about, he's the one who plans the holiday party and things like that where when we've got on an average week just in the Fresno area office, we have about 400 kids come through the doors. And you need somebody who's appreciating them and we're not always here, so.
Kadie: Yes, so he's kind of boosting the environment, the morale and keeping things fun for the kids. What a great thing. I mean, is it bringing in any extra revenue?
Amy: You know, the honesty might be no, but it's necessary when you're a practice of that size, I imagine. Well, and I think that more than bringing in extra revenue, it's maintaining our current clientele. And still to this day, we do almost no advertisement.
Kadie: Wow.
Amy: And so it's all word of mouth. And if the hearts and the minds and the needs of the kiddos and the families coming through our door Monday through Friday are well taken care of, then when somebody mentions speech therapy, our name will come up. We is almost our advertising budget. Advertising, we make sure that everyone feels really well taken care of. And I think that's what gets our name out there.
Kadie: How fun. Any other extra employed people to keep things moving and functioning as needed?
Amy: Not really. I mean, we do have, so we've got a lot of things that are on a, I want to say on a contract basis. Like we were lucky enough that we've got an HR firm that is contracted to us. So they serve a variety of other small businesses, but we have access to them on an as needed basis for a flat monthly fee.
Kadie: Oh, okay.
Amy: Yeah, we do have an accountant and a lawyer, same idea. They're available to us on an as needed basis. The person who runs our 401k. So there's a lot of those kinds of things, but none of them are employees of ours. They're just contracts. We do have one SLP in-house, which has been awesome. She's newly licensed and she's incredible.
Kadie: Nice. And as far as hiring on all these people, particularly your speech therapists, does the accountant, the lawyer, did all of them kind of help construct the hiring process as far as documentation and payments, et cetera?
Amy: They definitely help with the internal structure. I think the thing that's helped us the most with, well, the hiring process for our speech therapists, and it's been an interesting relationship for us, but Amber and I both supervise at our state university at CSU Fresno. And we have supervised, I think I'm going on 13 years of supervision. I think Amber's close to that as well. We supervise a clinic on campus for children with autism. And all of the graduate students in our program have to go through on-campus clinic. And so a handful of them, somewhere between eight and 12 a year, come through our clinic. And if we like them and they show amazing potential, we invite them to do an internship, which is also a requirement of graduate school. And if their internship goes well, we typically offer them a job. So I would say 60% of our current therapists were also in our clinical placement on campus. And were also in an internship with us prior to us hiring them.
Kadie: Wow. I guess for a practice this large, it's just confusing for someone who was very small, solo practitioner to think about keeping all of those hiring documents correct. And if there's any formal training, do you provide CEUs? Tell me a little bit about that.
Amy: I think for our onboarding process, we do have an employee who has worked with the HR company that we have on retainer to make sure that we have all that documentation done correctly. So we do have that piece that they have helped us build. And then once they are in our system, that's when we kind of use those contracted people to make sure that they're set up with their retirement and their health insurance. And we kind of have a pool of people to help with that.
Amber: We do something that we have called cohort coaching, and we offer trainings typically once or twice a month at lunch on Wednesdays. And we either have speakers come in, or we have our current therapists who have different specialties present on areas in their expertise. So we do a lot of continuing education. And then our therapists also have the opportunity to submit for coaching requests. So anyone on staff that they would like their expertise within a session, they will submit that request, and then we will try to block their schedule so that they can go in and coach on specific kiddos. Part of their employment package have a continuing education stipend. We don't attach a number to it because we've had clinicians who wanted to go through something like SOS feeding that is extremely expensive, and it was appropriate. And so we do financially support that training. And then we've had clinicians who haven't been interested in a ton in a year, and they've only done a couple of small local ones. But we do take care of continuing education the best we can for them in a variety of both online platforms and in-person platforms.
Kadie: Yeah, that's super, super nice. That's definitely what I was kind of inquiring about as far as just the stipend, but just having those in-person sort of trainings as well and resources is a really nice perk. As you continue your business journey, what do you think the future will hold? Do you see yourselves having to move again?
Amy: Well, the funny thing about that, so we opened actually an ABA practice. Technically, we started teen clients in September. Both Amber and I are dually certified SLP BCBAs and have been for, mine was in 2009 and Amber's was in 2010. And we avoided ABA. It wasn't where we wanted to go. It wasn't what we needed. We just feel that the complement of understanding behavior and how to modify behavior with the amazing skill of helping children develop language just goes well together. And so we worked through that and we opened the ABA provider. And that of course is increasing the number of kids that come through our door, but we're lucky enough that we're in a building that is 12,000 square feet and mostly vacant. We are unlucky because our landlord is horrible. Yeah, he's non-responsive. He's adversarial. He's argumentative. So our building is currently for sale and we attempted to buy it. And he was again, non-compliant completely, but there's another buyer who we're completely unrelated to, but who's apparently interested in not only the building, but in keeping us in the building. Our fingers are crossed and our toes are crossed and we're saying our prayers and we're sending out positive energy that this transaction goes through and we can take more space in the building where we are. And we're probably in need of somewhere between 2,000 to 4,000 additional square feet within the next year.
Kadie: Such fast growth and just amazing where the journey has taken you, especially thinking back to the one room divided by a gymnastics mat.
Amy: Exactly.
Kadie: Is there any words of advice that you could share before we finish up here?
Amy: I honestly think my biggest advice is to take it slow. We meet people often with our hands being in grad school. We'll meet people who are first year of grad school. They're like, I want nothing more than to open my own private practice. And we laugh and we say, no, you don't. No, you don't. You might want to in five or 10 years, or you might want to see two clients privately while you learn to navigate this profession. And maybe take a business class or two because the amount of work that Amber and I have put in to be successfully running a business could really result in us having a whole other degree. Honest to goodness, we have worked ourselves very hard because we're less speech therapists now and we're more business owners. And if you don't know how to do business side right, you'll fail. You'll fail your clients, you'll fail your employees and you'll fail for yourself.
Amber: I agree 100% with what Amy just said. I think the slow growth was imperative to our success. But I also think really keeping your heart in it and recognizing what you're doing it for because it can get overwhelming and get really hard. But I think knowing that we provide a place that is really providing happiness for not only the clients, but for our staff and everyone who walks through the door is really, I think what's made us as successful as we are.
Kadie: You wear several hats and I'm sure your reputation as great therapists is what led you to be able to grow. But like you said, then you had to switch and become business women and you're maintaining your passion for the clients. It's just in a different way and ensuring that the care is still there.
Amy: And we both do still hold on to, I see three clients a week and Amber sees one to two. And then it's not unusual to find one of us hanging out in a session to help, to coach, to meet the family, to meet the kiddos. It's definitely part of what we do in any given week because we can't be hands-off and still be relevant to what we want to build.
Kadie: Absolutely. Well, thank you both so much for taking the time to talk with me today. Your story is definitely inspiring and I know others will appreciate hearing all about it.
Amy: Awesome. Thank you so much, Kadie.
Kadie: Thank you for joining me and listening to Clinic Chats, the speech therapist's private practice podcast. If you have a moment, please leave a five-star review for Clinic Chats to help other SLPs find our podcast. If you'd like to share your own personal journey through private practice, please email me kadie at clinicnote.com. That's K-A-I-D-E at clinicnote.com.