The Balancing Act – Self Care for Mental Health Professionals

Feb
17
2011
by Tamara Suttle

Self-care is different from selfishness, self-absorption, or self-indulgence. . . . Given the fine line between the therapist’s personal and professional self, self-denial or self-abnegation is neglectful not only of real self needs, but ultimately of patient care.”
~  Ellen K. Baker, Ph.D. ~

The Care and Feeding of a Mental Health Professional

I made it all the way through graduate school Image of Work Life Balance Signpostwithout ever hearing about the self-care of mental health professionals.  However, that was 20 years ago and just within the last two years I’ve been inundated with workshops, articles, and collegial conversations about the critical need for therapists to engage in an active plan for self-care.

As a mental health professional, today your own self-care is considered to be a minimum standard of professional practice.  Your clients deserve to be served by a healthy, well-balanced, health-care professional.  And, you deserve to take the time to take care of your needs before you begin to take care of your clients’ needs.

Establish Health Routines of Self-Care

Every mental health professional needs and deserves to establish routines of self-care.  With that in mind, I’m wondering what your routines of self-care entail . . . . Here are some questions for you to consider:

  • How does your stress manifest in you physically?  Mentally?  Emotionally?  Spiritually?
  • When are you at your best physically?  Mentally? Emotionally?  Spiritually?
  • When are you at your worst?
  • What are your personal limits?
  • What are the personal factors and experiences in your life that have most affected your work?
  • What are the professional experiences and factors that have most affected your personal life?

Every mental health professional has vulnerabilities, weaknesses, and needs.  Take time today to identify yours.

Better yet, take these questions back to your supervisor or your consultation group to have a series of discussions about these things.  And, then, develop your own plan for establishing routines of self-care.



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When Mental Health Professionals Mock Their Clients

Aug
24
2010
by Tamara Suttle

“Fat . . . Borderline . . . Retard . . . .”

It is always shocking to me how easy it is for medical and mental health professionals to reduce their clients to less-than-desirable and less-than-accurate one dimensional labels behind closed doors.  I’ve heard excuses that range from Image of Loserminimizing (“oh-he-knows-I-don’t-mean-it”) to intellectualizing (“it’s just a short-hand way to refer efficiently to a particular group of symptoms).

Whatever the reason . . . ignorance, mean-spiritedness, or just plain old laziness . . . if you’ve been tempted to mock a client or speak derisively about a client behind closed doors, you might want to check out Tara Parker-Pope’s post on professionals mocking their clients. It’s one of those things that wasn’t discussed in my ethics classes  but probably should have been.  After all, if we are reducing our clients and all of their complexities to a simple one word label, it’s likely we don’t have our client’s best interest at heart.

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Things To Consider When Working From Home

Apr
26
2010
by Tamara Suttle

Miles Halvorson of Fargo, North Dakota  asks,

Is it possible for a psychotherapist to start a private practice out of one’s home, rather than rent office space? What are the drawbacks and limitations?”

Hi, Miles!  Thanks for writing.  You ask a really good question.  The short answer is “Yes, it’s possible” but the longer answer is “. . . but I highly advise against it until you have considerable and varied experience behind you.”  Here’s some questions for you to consider when deciding whether or not to work from home:

Do you have a separate entrance to a professional and private home office and bathroom? You, your family, and your clients deserve a professional and private space in which to do your clinical work.Image of Study

Where will clients wait to see you? Do you have a waiting room?  In their car?  On your front porch?  Will they have privacy from your neighbors while they wait?

How will you deal with door-to-door salesmen, postal workers and other deliveries that show up while you are in session? Those interruptions actually happen all too often unless you take steps to prevent them.

What plans do you have for dealing with threats or violence? Your unhappy clients, their unhappy spouses, and their unhappy friends can show up.  You need to be prepared with a way to keep everybody safe.

How will you handle clients who have lousy boundaries? Clients will call at 2 AM and they will show up without appointments and they may wander through your home or refuse to leave when they are upset.

How will you handle clients (or wanna-be clients) who decide to stalk you? And, how do you explain to your family and neighbors without violating confidentiality.  (Yes, this really does happen.)

How do you protect your non-work time when you are at home 24-7? Boundaries tend to come with experience  – lots of experience.

How do you protect your client records and your workspace from prying eyes? Will your office be off-limits to guests and other family members?  Even when there are sleepovers and you are needing the extra space?

Are you willing to put in phone lines and designate a computer solely to your work? You can’t expect to appear professional if your phone is answered by a 10 year old or by your partner.  And, neither can you share your computer with others if it has confidential information on it.

What are the tax implications? Yes, there are some financial benefits but there are also some financial costs to officing at home.

Here’s the bottom line . . . . Most clients that seek psychotherapy have a trauma history and most clients with trauma histories struggle with boundaries.  Until you have impeccable personal and professional boundaries of your own and are experienced enough to effectively manage your client’s boundary issues, I would advise you against hanging out your shingle on your own front door.

Related Post:  7 More Considerations for Working Out of Your Home

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Cautionary Tales For Psychotherapists In Social Media

Apr
19
2010
by Tamara Suttle

Are you a psychotherapist who uses Facebook and Twitter?  Do you blog or engage in other forms of social media?  If so, you need to consider the Image of Caution02sticky situations that you may stumble into without any ill intent.  Here is one article by Dana Scarton in the Washington Post that highlights examples of what I’m talking about.

I’ve begun to look for mental health attorneys to join us here on occasion at Private Practice from the Inside Out to help us tackle some of these choice points in private practice.

Let me know if you think this would be helpful to you and if you have a favorite mental health attorney to recommend.

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Reduced Fees, Sliding Scales, And Lessons Learned – Part 3

Apr
5
2010
by Tamara Suttle

This is the 3rd  post in the series
Reduced Fees, Sliding Scales, and Lessons Learned.
The series actually begins here.

If You Choose to Provide  a Reduced Fee, How Long Should You Do So?

I’ve had clients who were unemployed when they began working with me, so I offered my services at a reduced fee.   Later, when they secured six figure incomes, they continued to pay the reduced fees.

Lesson learned?  Yep . . . .

Lesson #1

My own issues with money got in the way.  Otherwise, when it came to my attention that my clients were in better financial situations, I would have addressed it directly with each of them rather than feeling taken advantage of.  If that is true for you, you have some work to do and a good therapist can well be worth her full fee to get that cleaned up early.

Lesson #2Image of Money Puzzle

What is understood to be “less than enough” by one person may appear to be “more than enough” to another . . . and vice versa.  Get really clear about the circumstances under which you are comfortable providing reduced fees.

Lesson #3

Reduced fees need to have time limits.    Unless you are operating as a charitable organization, consider how long is “long enough” to help someone access your professional services. Limits are good for your client and they are good for you.

Lesson #4

If you offer anyone a “good deal,” they’ll probably take it.  Make sure to think through the offers you want to make before you make them.

Drop me a line and let’s talk about if / how you provide services to clients at a reduced fee.  What does that look like in your practice?  Is it working well for you and your clients?

[The next post in this series can be found here]

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