Why Private Practice Looks So Different Now | Lex E Santí | TPOT 433
The Practice of Therapy Podcast with Gordon Brewer
Release Date: 05/18/2026
Why Private Practice Looks So Different Now | Lex E Santí | TPOT 433
The Practice of Therapy Podcast with Gordon Brewer
Private practice has changed a LOT over the last few years… and therapists are still trying to figure out what comes next. In this episode, Gordon talks with Lex E. Santi about the evolution of therapy after telehealth, online platforms, insurance shifts, and changing client expectations. They dive into why more clinicians are entering private practice, why clients still crave in-person connection, and how companies like BetterHelp, Alma, and Headway are reshaping the profession. They also explore the pressure therapists feel to market themselves, build niches, and create an online presence...
info_outline
What to Say to Someone Grieving (Most People Get This Wrong) | Shelby Forsythia | TPOT 432
The Practice of Therapy Podcast with Gordon Brewer
Grief is something every one of us will face at some point, and yet most of us have no idea what to say when someone is hurting. In this episode, I’m joined by Shelby Forsythia, a grief coach, author, and host of the Grief Grower podcast. Shelby shares her own story of profound loss and how it shaped the work she does today, helping people navigate grief in a way that actually honors what they are going through. We talk about why so many common phrases miss the mark, what grieving people are really experiencing beneath the surface, and how grief doesn’t just affect your emotions, it...
info_outline
What It Really Takes to Run a Profitable Private Practice | Brandy Mabra | TPOT 431
The Practice of Therapy Podcast with Gordon Brewer
Thinking about starting a private practice in 2026? There’s a lot to consider… and it’s not as simple as it used to be. In this episode of The Practice of Therapy Podcast, I’m joined by Brandy Mabra, who brings nearly two decades of experience across private practice, corporate healthcare, and entrepreneurship. We dig into what’s really happening in the industry right now—from AI and changing business models to profitability and long-term sustainability. If you’re wondering whether now is the right time to start (or grow) a practice, this conversation will help you think more...
info_outline
Why A Lot of Therapists Struggle in Private Practice | Katie Piura | TPOT 430
The Practice of Therapy Podcast with Gordon Brewer
Thinking about starting a private practice… but feeling unsure where to begin? In this episode, Katie Piura shares the mindset shifts every therapist needs to make before launching (or growing) a successful practice. From burnout in agency work to building something aligned and sustainable, Katie breaks down the real challenges therapists face and why being a great clinician isn’t always enough. We also get into the business side of private practice that grad school never taught you, including money mindset, marketing, and why asking for help might be the most important step you take. If...
info_outline
How This Simple Method Transforms Private Practice Sessions | Tanya Dantus | TPOT 429
The Practice of Therapy Podcast with Gordon Brewer
What if the thing keeping your clients stuck isn’t what they’re talking about… but what they’re avoiding feeling? In this episode, I’m joined by Tanya Dantus, and we dive into a really practical way of helping clients move through what’s actually underneath the surface. Tanya shares her RIFRA Method, which stands for Root, Impact, Feel, Reflect, and Act, and how this process helps clients stop intellectualizing and start creating real change. We talk about why so many people struggle to access their emotions, how that shows up in therapy, and what it looks like to guide someone...
info_outline
Are Superbills Worth It in Private Practice? | Mark Florian | TPOT 428
The Practice of Therapy Podcast with Gordon Brewer
Thinking about taking insurance in your private practice or trying to figure out a better way to handle out-of-network clients? This is one of those decisions that almost every therapist wrestles with at some point. On one hand, insurance can help fill your caseload and make therapy more accessible. On the other hand, the admin work, lower reimbursement rates, and constant back and forth can leave you feeling stretched thin and frustrated. In this episode, I’m joined by Mark Florian, founder of Deputy Care, and we get into what is really happening behind the scenes with insurance,...
info_outline
Private Pay vs Insurance: What Therapists Get WRONG | Avivit Fisher | TPOT 427
The Practice of Therapy Podcast with Gordon Brewer
Private pay versus insurance is one of the biggest decisions therapists face, and honestly, it’s also one of the most misunderstood. In this episode, we’re breaking down what therapists often get wrong when thinking about these two models. It’s not just about money or convenience. It’s about how you want to run your practice, who you want to serve, and where you’re willing to spend your time and energy. If you’ve been going back and forth on whether to take insurance, go private pay, or try a hybrid approach, this conversation will help you think about it in a much clearer way....
info_outline
Thoughts on AI and Tech Platforms in Private Practice | TPOT 426
The Practice of Therapy Podcast with Gordon Brewer
What happens when you open the floor and let your audience ask anything? That’s exactly what we did in this episode, and the questions did not disappoint. We’re diving into the big ones therapists are quietly asking right now. Is AI going to replace us? Are companies like BetterHelp helping or hurting the field? And how do you actually stand out when clients can talk to a chatbot instead of a human? I’m sharing my honest thoughts on where all of this is headed, what most therapists are getting wrong about AI, and why the human connection in therapy still matters more than ever. If...
info_outline
Helping Clients Navigate Digital Overwhelm in Private Practice | Eli Singer | TPOT 425
The Practice of Therapy Podcast with Gordon Brewer
Most of us know the feeling. You pick up your phone to check one thing and suddenly twenty minutes have disappeared. For many people, this has become a daily pattern, and it is starting to show up more and more in therapy sessions. In this episode, I sit down with Eli Singer to talk about digital overwhelm and the complicated relationship many of us have with our phones and devices. Eli has spent years working in the digital world, including building one of the early social media agencies in North America. After stepping away from that work, he began focusing on helping people develop...
info_outline
How Therapists Can Use Social Media Without Feeling Fake | Jazzmyn Proctor | TPOT 424
The Practice of Therapy Podcast with Gordon Brewer
Marketing can feel uncomfortable for a lot of therapists. Most of us were trained to be neutral, private, and to keep the focus on the client. So when someone tells you that you need to show up on social media or talk about your work publicly, it can feel a little strange. But visibility matters more than ever when it comes to building a private practice. In this episode, I’m joined by Jazzmyn Proctor, a therapist, podcaster, and marketing mentor who helps clinicians show up online in ways that feel authentic and sustainable. Jazzmyn shares how she started building her presence while still...
info_outlinePrivate practice has changed a LOT over the last few years… and therapists are still trying to figure out what comes next.
In this episode, Gordon talks with Lex E. Santi about the evolution of therapy after telehealth, online platforms, insurance shifts, and changing client expectations. They dive into why more clinicians are entering private practice, why clients still crave in-person connection, and how companies like BetterHelp, Alma, and Headway are reshaping the profession.
They also explore the pressure therapists feel to market themselves, build niches, and create an online presence in a rapidly changing industry. Toward the end of the conversation, Lex shares how writing, narrative therapy, mindfulness, and storytelling intersect in his clinical work and creative life.
Resources Mentioned In This Episode
Use the promo code “GORDON” to get 2 months of Therapy Notes free
Meet Lex E Santí
Lex Enrico Santí is a therapist, clinical supervisor, and the founder of A Key Therapy PLLC, where he works at the intersection of evidence-based practice and the deeper human questions that bring people into therapy in the first place. Trained as a licensed clinical social worker and currently completing his doctorate at the University of Kentucky, Lex brings a grounded, integrative approach to his work — drawing on modalities like CBT, ACT, and mindfulness alongside his own framework for healing he calls the AMI model.
The son of Cuban immigrants and a former Peace Corps volunteer in Romania, Lex carries a lifelong fluency in crossing cultures — literally and emotionally. He speaks three languages and brings that same attunement to difference, displacement, and belonging into his clinical work. In the therapy room, he holds space for individuals navigating anxiety, identity, and the transitions that quietly reshape a life. He also supervises emerging clinicians, teaches workshops on meditation and understanding anxiety, and is building A Key Therapy into a group practice rooted in presence, curiosity, and care. He believes that good therapy — like good writing — is about learning to tell a truer story about yourself.
Beyond the therapy room, Lex is a published author with an MFA in Creative Writing from George Mason University — the author of four books of poetry and a collection of short stories and essays. A meditator and someone who thinks seriously about the spiritual dimensions of mental health, he lives in the Finger Lakes region of New York with his family. He is a proud husband, father, and has another child on the way.