Women-Owned Psychotherapy Practice Redefines Work

A Conversation with Dr. Kristina Harter, Founder 1A Wellness

by Lily Willis

When Dr. Kristina Harter took time off from her private practice in 2019, she knew something had to change. The opportunity to reflect on her own career gave her an idea: to start a group practice, where therapists like her could work together to create something better than they could on their own. Now, she runs 1A Wellness, a psychotherapy practice that prides itself on being woman-owned, woman-run, and trying to redefine workplace expectations, one provider at a time.

Women’s History Month traces its roots back to 1978 when it started as Women’s History Week, aimed at shedding light on women’s issues. Since then, it has evolved into a month-long observance, yet it merely scratches the surface of the multifaceted experiences that define contemporary womanhood. Recognizing, honoring, and embracing the myriad experiences within womanhood is a continual process that extends far beyond the confines of this designated month.

In honor of the end of Women’s History Month, I sat down with Dr. Harter to talk about what the possibilities are for a woman-owned and led psychotherapy practice, and how Dr. Harter is using her position to redefine work for providers and better client experience.

LW: When you opened 1A Wellness, what was your vision?

Dr. Harter: Simply, to create the workplace that I wish I had when I finished my postdoctoral training. A place where women were in leadership and core relational principles like curiosity, kindness, clear communication and care in the workplace were valued. I wanted to cultivate a work environment in which mental health providers, particularly women who do a lot of heavy lifting as caregivers in their personal lives, could be well-supported and enabled to provide exceedingly high levels of patient care without burnout or erosion of their passion for doing transformational work across the different seasons of their life.

Lily Willis: You talk about some of the things you saw in your own training that could have been done better. What was the problem you saw?

Dr. Harter: It felt off to me that the higher levels of leadership in the established organizations I considered working for were largely made up of men and applied hierarchical models of leadership, which seemed disconnected from the relational and inclusive frameworks that you adopt as therapists.

Early in my career, I found myself in highly demanding work environments in which I loved the populations I served, but felt devalued or silenced by the systems in which I was working. Therapists were asked to over-function to make up for deficits within the larger institution, and there was a sense of deprivation and an overvaluing of some aspects of what makes you a good therapist, such as having a strong work ethic,and neglecting others, such as the need to have sustainability in the workplace to be effective.

Lily Willis: How did you want to go about changing it?

Dr. Harter: But wanting to create a utopic vision for a group therapy practice is one thing. Actually doing it is another. There were many things to take into consideration, from how healthcare plans would work for the employees, to how to compensate clinicians for non-clinical hours. The model was based off of what wasn’t working in a lot of the places I had seen, which left a lot of room to think about what I did want.

I made the decision to share the professional “equity” that came with my age, training, and experience with other highly-skilled clinicians who had not yet had the opportunity to grow their professional networks. I prioritized the quality of our work environment at 1A Wellness and the quality of care, over larger numbers and growth for growth’s sake.

My approach to business has been essentially relational, and each person on our team matters to the larger whole and the quality of care of each client as an essential priority. I do not know how to do good business another way and do not want to. Keeping the practice on a small scale and having a relationally-focused business has proven successful.

Lily Willis: What would you say are the key points of the way you think about work in a way that’s different from your competitors?

Dr. Harter: We care for the caregivers on our team, considering them as whole people with complex lives of their own, and invest in a sustainable work environment for them so that they have what they need to provide excellent therapy. And the way this unfolds is that each of the clinicians are considered individually so meeting needs happens in a very personal and individualized way.

We put a significant portion of revenue back into the therapist’s ongoing consultation and learning. We are a team who cares a great deal about our clients and we also come from highly academic backgrounds, so staying current on best-practice is non-negotiable.

Therapists are not chosen by degree alone. Although each therapist brings a particular expertise, we all have 4 things in common 1) we think and go deep/we understand development and how the past shows up in the present 2) we love our work and understand the power of the therapy relationship 3) we know how to move the ball forward in therapy, and have practical skills for doing so (we don’t just sit and validate) 4) We value kindness, and leave our egos at the the therapy room door.

Lily Willis: You talk about the male-dominated leadership sphere you wanted to help correct. How has being a woman and a mother affected the way you think about business, your work, and leadership?

Dr. Harter: Creating a position where people are paid a competitive salary for this kind of work, while also providing benefits that one wouldn’t otherwise get, such as an hour of paid rest and self-care to do something like yoga during the work day, is not easy. Like any small business, the risks are high when our margins are so low.

Becoming a mother was a paradigm shift for me. After years of investing in a career that often reflects on the “shortcomings” of mothers, I was one myself. That connected me to other mothers at a very basic level, giving me much more compassion and understanding for all that they manage and hold.

It is commonly said that it is one of the most important jobs, and I agree. Having invested over a decade of my life to the transformational work of therapy before becoming a mother, I was confronted by the dual and intersecting challenges and rewards of these combined caregiving “professions.” The acknowledgement of the importance of motherhood had to be central to our mission, and I was not going to ask therapists to function as if they did not have important demands in their personal lives or children at home.

Lily Willis: Why do some people choose an out-of-network therapist when seeing someone in-network is often more affordable?

Dr. Harter: Like almost everyone on the 1A team, I began my career working in community mental health and working with individuals with acute needs and limited resources. I loved this work and when I transitioned to private practice I readily got into health insurance networks so that I could provide access to a range of clients. Unfortunately for all of us, there were too many hurdles to jump. Payments were progressively reduced over time while paperwork and care-justification was significantly increased. Plus, policies were implemented which can negatively affect a client’s livelihood (where a diagnosis of mental health treatment for common symptoms like depression could lead to denial of things like a life insurance policy and even employment.) With such a small and carefully selected team, I could not retain therapists with a high level of training at the rates of reimbursement that the insurance companies were offering. So I focused on what was within my control and influence and made the difficult decision to go out of network and to recruit exceptional therapists who would further our mission to provide excellent care.

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Note on Health Insurance

1A Wellness is a self-pay out-of-network practice. As such, we do not accept health insurance. But if your healthcare plan includes an out-of-network option, partial reimbursement may be available. See our FAQ section for more information.

Note on Health Insurance

1A Wellness is a self-pay out-of-network practice. As such, we do not accept health insurance. But if your healthcare plan includes an out-of-network option, partial reimbursement may be available. See our FAQ section for more information.