Earlier this month, I was asked to speak to a group of new professionals interning at Aurora Mental Health Center.  The topic was on why it’s important to join your state and national professional associations.  Just in case you are hesitating, here are 23 reasons that I believe you should join your professional associations today.

1. This is your number one career development tool.
2. This is how mental health professionals get things done.
3. Often there are special resources available to you.
4. This is where you go to learn how to be a professional.
5. This is how you stay informed about your profession’s standards of practice.
6. This is where you learn about professional trends and mandated changes in practice.
7. This is where you can build relationships and expand your network.
8. This is where you get continuing education at affordable prices via conferences, workshops, and forums.
9. Often those continuing education opportunities include a free breakfast, lunch or dinner.
10. This is how you protect and promote your own profession.
11. This is where you increase others awareness of your practice or your employer’s visibility in the community.
12. Student memberships are often reduced or no fee.
13. There are always opportunities here to give back to / build up your profession by your volunteer efforts within the organization.
14. There are often opportunities for community service.
15. This is where you go to stretch your own thinking and stay creative in your work.
16. This is where you learn what others in your profession are doing.
17. This is where you can easily establish yourself as a leader.
18. This organization may choose to sponsor your work, research, or workshop.
19. Many organizations offer members free listings and links on their websites.
20. This is who negotiates for the best and most affordable liability insurance.
21. This is where you get free advice on ethics issues.
22. Many organizations offer job placement services.
23. This will allow you to know other professionals to consult with and refer to (and vice versa) as your needs dictate.

I’m sure there are more benefits / reasons to join.  Can you tell me why you’ve joined your professional associations?

Tags: Ethics, Insurance, Relationships, Workshop

If you market your services via the internet, television, radio, in print or face to face . . . even if you volunteer to man a booth for your community expo . . . you are engaging in direct marketing.  Ken McArthur has just posted new guidelines for direct marketing in the United States.  Tempted to put your head in the sand and ignore the guidelines?  Really??

"Apple Planet" by Jorge Elias

Here are some snippets from Ken’s post:

• Terms like “Free,” “Free Trial,” and “Risk Free” are to be avoided.
• So are potentially misleading offers.
• Don’t offer ‘false sense of urgency’ i.e. “Last Week to Purchase at This Price!” if the offer will continue.
• Endorsements must be honest and accurate depictions of likely use of your services / products.
• Affiliate marketing programs must make concerted effort to track participating marketers and minimize fraud.
• Opt-out procedures need to be written in 12 point font or larger.
• Pre-checked boxes are no longer allowed.
• Billing cycles are regulated.

Other issues addressed include Refund Policies, Up-Selling, Actual Descriptor of Merchants, Fulfillment of Transactions, and Requirements for Customer Service. Check out Ken’s full article, New Credit Card Merchant Account Guidelines for Direct Marketing.

With so much sleaze involved in marketing and online sales, I see this as a giant step in the right direction. What’s you opinion?

Tags: Best Practices, Direct Marketing

When you get ready to close your private practice, for whatever reason, you can’t just shut the door and walk away. Did you know that?  Attorney Richard S. Leslie has written a thoughtful article in the January 2010 issue of the Avoiding Liability Bulletin.  In it he details some of the following for your consideration when you decide to close up shop:

• Ask yourself who needs to be notified – clients, former clients, insurance panels, landlords, supervisees, colleagues and business associates, referral sources, and your licensing boards;
  

  "You Couldn't Have Planned This if You Tried" by Ken Douglas / Today is a Good Day

• Consider the possible circumstances that might result in you closing your door – retirement, geographical relocation, health emergencies, financial circumstances, your own death, your spouse’ or partner’s death,and other unforeseen circumstances;
• Your state may dictate certain actions that you must take when you close your practice;
• Your professional code of ethics and HIPPA will certainly have standards that you must adhere to when closing your practice;
• How to notify existing clients;
• Subsequent maintenance, storage, and access to records;
• How to provide public notice of the closing;
• When and how to notify former clients;
• Why you may not want to terminate liability insurance policies when you close your practice;
• And, in the event of your death or incapacity to handle these things, who does it for you?

Every mental health professional and every professional coach is required to responsibly close their private practice  – regardless of whether their closing is planned or unforeseen.  Whether you’ve been in business for years or you are just now getting started, now is the time to take the steps necessary to prepare for the eventual closure of your practice.

Tags: Closing Your Practice, Ethics, HIPAA, Records & Documentation, Relocation, The Unexpected

"Looking Out" by Tyler Neu / Neuski

According to the American Counseling Association’s Code of Ethics, counselors are not required to diagnose a client if they believe that to do so would cause harm to the client.  Here is an online article in Counseling Today that addresses some of the ways that diagnosing may be harmful to your client.

Tags: Diagnosis, Ethics

I’ve mentioned in the past that one of the ways that I keep my marketing  fresh is that I borrow ideas from other professions.

This morning I was reading Erika Trimble’s blog, Physical Therapy Biz Success, when I ran across a great little post on setting priorities. She recommends the A-B-C-D-E Method for setting better priorities.

A = Critical and Urgent

These are the things that if you put off, will cost you your practice.

• Professional licenses and certifications
• The rent for your office
• Your mental – physical – emotional – spiritual health
• Transportation to and from work
• A way for your clients to contact you
• Securing your client records (to protect confidentiality)

B = Important

These are the things that really need to be done but they are not critical.  If you don’t do them in the short term, there are only minor consequences.  However, if you put them off indefinitely, the cumulative effect can bump these into the A = Critical and Urgent category.

• Vacuuming the office
• Networking
• Emptying the trash can
• Cleaning the windows
• Upgrading your computer to the most current Windows settings

C = Nice to do

These include all the niceties and, often, fun-to-do’s that can so easily distract you from your business-building tasks.  They may be of added benefit to you or your clients but if they don’t get done, you don’t incur negative consequences.

• Sending birthday / holiday greetings to your clients
• Heating up the coffee / tea pot for your clients
• Lighting the candle in your office
• Writing a new blog post
• Facebook chats
• Returning friends phone calls

D = Delegate

If you don’t do it easily and well, you need to give serious thought to delegating or contracting to get the task accomplished.

• Designing artwork for your new project’s marketing campaign (unless you are artistically inclined)
• Writing the copy for your website
• Billing clients / insurance companies
• Janitorial / building maintenance services

E = Eliminate when possible

These are often acts of repetition or 100% time wasters.

• Surfing the Internet
• Creating handouts for your clients over and over again
• Explaining your policies for payment, no shows, and late arrivals
• Some correspondence including letters of introduction, marketing letters, and reminder letters

As you are gearing up for 2010, make sure you take some time to re-think your priorities.  Assign each of your to-do’s an A, B, C, D, or E using Erika’s method of prioritizing and then let me know what changes for you.

What is it that  you think is important . . . to attend to, to delegate, and to eliminate as you build your private practice?

Tags: Critical & Urgent, Delegate, Priorities

Marketing and the Ethics of Advertising is a free 60 minute teleconference offered by CPH and Associates.  Take advantage of this free opportunity to learn.

Tags: Advertising, Free, Teleconference

The purpose of a professional disclosure statement is to inform clients about your professional background and the limitations of your professional relationship.  It is sometimes referred to as a document of informed consent.

It is important to note that the state you practice in may dictate what must be included in your statement of disclosure.

The following items are often included:

• Contact info
• Your qualifications including training, experience, licensure, and certifications
• Professional associations that you belong to
• Services offered
• Your theoretical foundation and counseling approach
• Fee structure including broken appointments and cancellation policy
• Whether or not you will file insurance / provide documentation for your client to file insurance
• How you handle emergencies and client needs after business hours
• Confidentiality and exceptions to confidentiality
• Client rights and responsibilities
• The professional code(s) of ethics that you adhere to
• How to file a complaint against you

Your professional disclosure statement is a living document.  By that I mean that it will grow and change as your experience, training, and practice changes.  It’s a good idea to review (and amend as needed) your disclosure statement at least annually.

When writing your disclosure statement, you may find it helpful to gather samples of other professionals statements.  You will find a copy of my disclosure statement here at my counseling website.

Tags: Disclosure Statement, Ethics, Informed Consent, Professional Association, Rights & Responsibilities

Everything you do for your client matters.  If and how you choose to diagnose your client matters a lot.  Amanda B. wrote in asking if it is OK to routinely give a diagnosis of Adjustment Disorder to her clients if they do not exhibit symptoms warranting a more serious diagnosis.  (She was trying to help them get reimbursed by their health insurance companies.)

The short answer is “No it’s not.” As tempting as it may be to slap an Adjustment Disorder diagnosis on to every client who is dealing with normal life transitions, it’s not wise and it’s not OK — clinically, ethically, or legally.

"Worried Woman" by HikingArtist.com / Frits Ahlefeldt-Laurvig

The clinical implication is this . . . by intentionally giving your client the wrong diagnosis, in this case a more serious diagnosis than is truly warranted, you pathologize your client.  This is like going to your primary care doctor for a mosquito bite and him diagnosing you with an infection.  Mosquito bites happen just like life happens.  Misdiagnosing does nothing to empower your client.  Nor does it inform her about the real nature of what’s going on or lead her toward useful strategies for managing the transition at hand.

Ethically you’ve failed . . . to provide honest, accurate and useful information to your client if you’ve told her she has something different than what is true.  You’ve also set yourself up to provide inaccurate information to others i.e. physicians, lawyers, etch.  that may gain access to your records later on.

And, legally, you’re setting yourself up for big trouble. When you choose to list an inaccurate diagnosis on health insurance claims forms and submit them, you have just committed insurance fraud.  Should you choose to put the inaccurate diagnosis into your clinical record, you have falsified documents and failed to meet the professional standard of care.

If knowing all of this you are still tempted (perhaps you believe with good intentions) to misdiagnose a client, seek clinical, ethical, and legal consultation.

[Update 10 Dec. 2009 5:54 pm - Of course, mental health professionals are not the only one fudging on diagnoses.  Check out The Last Psychiatrist blog post, "How Am I Going To Get Paid If It Isn't Autism?"]

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Tags: Diagnosis, Documentation, Ethics, Fraud, Standard of Care

If you are getting ready to start shopping for a clinical supervisor, here are 10 more questions you need to ask before you invite them to work with you.

"Question Mark" by Segozyme

1. What professional associations are you a member of?
   Don’t assume that they are telling you the truth.  Make sure that you verify their membership through your state licensing board.
2. How are you involved in these associations?
   Does she hold an office in the organization?  Remember to verify that your prospective supervisor is as involved as she represents herself to be.
   A supervisor who is actually involved in a professional association (rather than just paying her membership dues), is better able to help develop you as a professional in the field.
3. Why did you choose to join these organizations?
   Was it about the membership fee?  The purpose of the organization?  The benefits of membership?  This can tell you a lot about what is important to your prospective supervisor.
4. Do you expect me to be involved in a professional association?
   If so, then you will want to know which organization and how involved.
5. How will you monitor my client’s welfare?
   Your supervisor may monitor you through a one-way mirror, ask you to audio / video record your sessions for review, obtain self-reports from you, contact your clients, etc.  Most clinical supervisors use a variety of methods to monitor client welfare.
6. How do you insure my compliance with ethical, legal, and professional standards?
   This is a critical task for your supervisor and you want to make sure that she has a solid plan for this to take place.  In doing so, your client as well as you will be protected.
7. What do you expect of me as your supervisee?
   Yes, your supervisor will have expectations of you and the best way to meet them is to go in informed.  A professional clinical supervisor will have a written contract that stipulates your supervisor’s expectations (as well as your own).  Don’t accept a supervisor who does not have this in place.
8. What conflicts typically arise between you and your supervisee?
   Everyone has conflicts.  You want a supervisor who is aware of them and comfortable enough to talk about them openly and honestly.
9. How do you handle conflict when it arises with a supervisee?
   You want to know that your supervisor has basic problem solving skills.
10. How do you address counter transference between me and my client?
    As a new therapist, it is likely that you may not have much experience dealing with this predictable but sticky issue.  You’ll want a clinical supervisor who doesn’t flinch, judge or shy away from helping you develop skills to deal with issues of transference and counter transference.

Are you finding these questions to be helpful?

These questions came from the Institute in Counselor Supervision taught at the University of North Texas’ Counseling Program by Carolyn W. Kern, Ph.D., LPC, NCC and Cynthia K. Chandler, Ed.D., LPC, LMFT.

Related Posts

10 Questions You Must Ask Your Prospective Supervisor

Clinical Supervision and Money Gouging

Tags: Contract, Counter Transference, Professional Association, Transference

As I was reading Jung at Heart, one of my new and favorite blogs by Jungian psychotherapist, Cheryl Fuller, I ran across her post on the importance of boundaries in scheduling.

"Wall of Clocks" by rustman / Russ Morris

Check out her inspiration for the post, her own post, and then drop back in here to share your thoughts about scheduling clients and the transition in between them.

Tags: Boundaries

If your post-graduate supervision is not all that you had hoped for, there may be a really good reason.  Do you know that clinical supervision is different from administrative supervision?

An administrative supervisor typically operates from a business model rather than a clinical model.  His priority is to make sure that the organization (or her department) runs smoothly. There are local, state, and federal regulations  (like the EEOC guidelines and the Disability Act) that impact his decisions concerning her supervision of you.

Administrative supervisors are often

"In Which Zac Never Realized . . . " by Zac Peckler

what you encounter as a new graduate entering the workforce through an agency, hospital, or school setting. You will recognize an administrative supervisor because he will emphasize paperwork and productivity, managing your caseloads, scheduling, and accountability.

An administrative supervisor must train employees to systematically complete basic paperwork, manage crises, work within systems, and deal with large numbers of clients needing many different things at the same time.  There is much to be learned from an administrative supervisor that will serve you well throughout your career but this is NOT clinical supervision.

If you are frustrated with the quality of the supervision you are receiving, perhaps you assumed that the supervision you would be receiving from your supervisor would be clinical supervision rather than administrative supervision.  Here are some things that you can do to insure that your experience under supervision is all that you want it to be.

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9 Steps You Can Take to Insure a Great Supervisory Experience

4 Things to Consider if Your Supervision is Less Than Ideal

Supervision or Consultation?

Tags: Client Load, Crisis, Documentation, Schedule

I was checking out posts at one of my favorite blogs,  Shrink Rap , when I ran across this little jewel.  Oh, ok, it’s not directly about building your private practice but it is about critical thinking and moral decision making and that is what we are called to do and to help our clients do on a daily basis.

"Justice" by YO lXl YNTL

What I’m talking about is . . . Justice with Michael Sandel, one of Harvard’s most popular courses.  This twelve class series is now available on line at no cost to you – complete with an episode guide, reading assignments and discussion guides.

Take a peek and see if this is something that can enrich your professional life.  If so, drop back in here at Private Practice from the Inside Out and let’s talk about it!

Tags: Critical Thinking, Decision Making, Ethics

New therapists often use the terms “supervision” and “consultation” interchangeably.  The problem is that they refer to very different relationships and obligations.  Do you know the difference between supervision and consultation?

Supervision is hierarchical. It often occurs

"Hierarchy" by brka / Kristijan Brkic

within the context of your schooling, employment or post-graduation when you are attempting to satisfy client contact hours for licensure in your state.  If you are under supervision, then you are required to comply with any directives given to you by your supervisor.

Consultation occurs between colleagues or peers and is often used as a way to expand a therapist’s ideas for working with a client.  Consultation is also considered a risk management tool but obligates you to take no specific action other than that based on your own professional judgment.

Related Posts

10 Questions You Must Ask Your Potential Supervisor

9 Steps You Can Take to Insure a Great Supervisory Experience

4 Things to Consider if Your Supervision is Less Than Ideal

Tags: Consultation, Supervision

When you decide to seek clinical consultation, there are 5 things that you should document in your clinical notes.  They are the 5 W’s:

• When you seek consultation;
• Why you are seeking consultation and why now;
• Who you are seeking consultation from;
• What opinions / information / recommendations you are receiving from that person even if they contradict your own clinical judgment;
• What your final professional opinion / plan is and why you are / are not going to go along with the recommendations received.
  

  "Questions" by Tim O'Brien / Oberazzi

In other words, your clinical rationale all along the way needs to be documented in your notes.  Why?  To protect both you and your client.

Should you end up in a malpractice suit (which is quite possible), your proper documentation will assist you in explaining your thought process concerning your work with your client.  Likewise, should anything happen to suddenly prevent you from continuing to work with your client, your general direction of treatment can more likely continue seemlessly because you have taken the time to thoroughly document your clinical rationale and intent.

Tags: Consultation, Documentation

What is your off-the-clock strategy for managing your private practice?

• Do you use an answering service?

• Do you remain on call 24/7?

• Do you refuse to speak to clients when you are out of the office?

• Do you trade off with other professionals?

I’m eager to hear what you do to cover your practice and how it works for you.

Tags: Coverage, On Call