The Hazards Of Practicing Mental Health: What Our Colleagues In Mental Health Know . . . That Our Friends And Families Do Not

Jan
10
2012
by Tamara Suttle

I was hanging out on Google+ last night when I ran across a link to Stretched, this fabulous post on WhatAShrinkThinks about the tolls of doing business as a mental health professional. The therapist / blogger references terms like “working in secrecy,” “empathy-fatigue,” and “talking binges.”

What does this have to do with Image of The Hazards of Mental Healthattracting clients and building a healthy private practice?  It has everything to do with it. If we fail to engage in the self-reflection and self awareness necessary to keep our relationships outside the office safe, healthy, and secure . . . , we certainly aren’t able to do that with our clients in the office.  And, if we can’t mitigate those hazards, we can’t build and maintain strong and vibrant businesses.

Self-reflection.

Self awareness.

Self care.

As we practice it, we can teach it.

What are the potential professional hazards of being a mental health professional?  And, what is it that you know you need to practice so that you are able to teach it today?


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When Motivation To Market Your Private Practice Wanes

Sep
19
2011
by Tamara Suttle

Once the newness and excitement of private Image of Golden Carrotpractice has worn off, you may very well find yourself twiddling your thumbs with way too much time on your hands. That’s when the real work begins . . . .

Julienne B. Derichs, LCPC from Highland Park, Illinois wrote in asking how to stay motivated long term in your marketing efforts . . . .

I love your blog and I have read a ton of great tips that have sparked some ideas and direction for my private practice. I have a question for the “Ask Tamara” section. I have a fee for service practice and work with couples both together and individually. I run a peer Practice Building Group and we meet once a month. My question is: How do you (others) motivate yourselves to go out and meet new practice partners, to get out in the community and spread the word. I used to be so much better than this…now not so much!”

Julienne, I’m so glad that you are finding Private Practice from the Inside Out to be helpful!  The depth and breadth of our online community here continues to grow.  Every day, new voices show up to share their journeys and their support.  Thanks to everyone who contributes in big and little ways to the curation of  both information and inspiration to help us all build strong and vibrant practices.

When Motivation for Marketing Wanes

Staying motivated to connect with your community when you just don’t feel like it is critical . . . and, sometimes it’s really hard to do. In my mind, running out of energy and enthusiasm for marketing- especially if that’s something that I’ve excelled at in the past – is a big red flag that I am not taking care of me.  (See if any of this rings true for you.)  When I start to change gears and move toward procrastinating or avoiding activities that I’ve been fully engaged with in the past, I consider the possibility that I may just have gotten a little sloppy with me.

I’ve charted my energy level and patterns long enough to know that I work best when I am surrounded by new ideas and new information.  I require brain food.  It’s stimulating to me and it’s energizing.  And, when I fail to feed my brain, I start to stall in my clinical work and in my marketing, too.  New information and new ideas are lifelines for me.

I also require adequate rest and food and exercise . . . and regular visits to my doctor and dentist and . . . . You get the picture, don’t you?  If I’m not taking care of my 51 year old body, my clinical work and my marketing both pay the price.  And, my bank account does, too.

My spirit also requires feeding.  For me, that’s about a way of being that allows me to feel connected to friends, to my home, to my dogs, to my family,and nature.  It’s more than that though . . . . It’s about being aware of the meanings that underscore the things and experiences and people in my life.

What Works for Me

How those mind-body-spirit needs get met for each of us can be very different.  My brain gets fed through reading and professional development opportunities and my amazing peer consultation group.  My body gets fed by going to sleep early in the evening and then getting up early to walk, walk, walk.  And, my spirit gets fed by engaging in my spiritual practices, reading, writing, and meditating.

What Works for You

Your mind-body-spirit may get fed very differently and I hope you will drop in here to let us know how you are taking care of you.   (And, if you’ve forgotten to take care of you, then you may want to check out The ABC”s of Self-Care for Psychotherapists or The Balancing Act – Self-Care for Mental Health Professionals.)

What I know is this . . . . If  I’m losing steam and no longer motivate to do the things that have historically worked for me, I’m probably not getting my own needs met.  At that point, I need to go back to basics.  And, Julienne, I’m betting you do, too.  Take some time today to reflect on your own routines of self-care and note what needs of yours could be better met.  While it’s true that we do change over time, it’s not likely that our basic needs will change – at least not significantly – and not without a lot of work.

Make sure that your needs are being met fully, one hundred percent of the time.  You deserve – and your clients deserve – to have you fully operational.  And, then, I hope you will drop in here to let us all know how you take care of your mind-body-spirit and what the implications of doing that are for you.

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The ABCs Of Self-Care For Psychotherapists

May
19
2011
by Tamara Suttle

A Guest Post by @DorleeM

(If you want to guest post on this blog, check out the guidelines here.)

I hope you will take a moment out of your busy day, to slow down long enough to read what she has to say, add your own thoughts, and visit her blog.  It’s worth your time to check her out.]

Image of Broken Pencil

One of the occupational hazards of being a psychotherapist is burnout. Psychotherapy is a demanding profession and the successful therapist must be able to tolerate the emotional depletion, isolation, the threat of lawsuits and other job-related frustrations.

A burned-out therapist is likely to have low energy, reduced interest and satisfaction, as well as a dread of work. The burned-out therapist’s emotional exhaustion may manifest itself as a detached attitude toward his or her patients.

Burnout may occur to both neophyte and seasoned therapists alike. It is the leading cause of the high rate of depression, drug and alcohol abuse and suicide among psychotherapists.

Prevent Burnout with Self-Care

  • Engage in your own therapy
  • Consult with others and/or seek supervision
  • Employ different psychological theories and draw from other disciplines (to assist clients with different needs)
  • Join a professional organization for both support and to be kept up-to-date on relevant information
  • Take continuing education courses
  • Develop non-professional interests
  • Take periodic vacations to recharge

Aside from the above-mentioned long-term recommendations by Dr. Zur on burnout prevention, there are also some small things that you could do on a day-to-day basis that may help you to refuel.

Some Simple Ways to Recharge During the Day

  1. Talk to a friend on the telephone
  2. Text a friend
  3. Have lunch with a friend or co-worker
  4. Connect to social media
  5. Exercise for 20 minutes (walking counts too!)
  6. Go outside and watch the clouds
  7. Walk/play with your pet (or offer to walk someone else’s)
  8. Play a solitary game (video, cards etc.)
  9. Read a book, magazine, newspaper or poem
  10. Take a 20 minute nap
  11. Meditate
  12. Do some stretches
  13. Listen to some music
  14. Eat some chocolate (or some other food you enjoy)
  15. Make yourself a nice hot cup of tea, coffee or soup


What are some things that you do to help yourself re-energize during the day? Are there other things that you would recommend doing to prevent burnout? 

References:
McKay, M. et al. (2007). The Dialectical Behavior Therapy Skills Workbook. New Harbinger
Publishers Inc. (for ideas of things to do on a daily basis)
Zur, O. (2011). Taking Care Of The Caretaker: How To Avoid Psychotherapists' Burnout.
Online Publication by Zur Institute. Retrieved 5/13/2011 from
http://www.zurinstitute.com/burnout.html
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What To Do When It’s Time To Raise Your Fees

May
16
2011
by Tamara Suttle

Once you’ve worked hard to build your Image of Piggy Bank w Blackboardpractice and you’ve been on your own for several years, at some point you are going to need to raise your fees.  (Uh-oh . . . another area that didn’t get talked about in graduate school!)

It’s not a dilemma that you will face often but it is important to know how to handle it when the time comes.  Here’s the steps that I take and the choices I make when it’s time to raise my fees.

Step 1
How much do I need to raise my fees?

I have raised my fees about 10% each time I have raised them.  Whatever your increase, be prepared to justify the amount.

Step 2
Whose fees are going to be raised?

That’s right – you have choices.  Barring any contractual constraints, you may choose to raise the fees only for new clients, for all of your clients, or for only certain hours or types of services (like groups or family therapy).  I have chosen to keep my fees the same for current clients and increase fees just for my new clients.  When a client terminates with me and then returns for services 12 months later, s/he is charged my new (and higher) fee.

Step 3
How should I inform my clients and how much notice should I give them?

Once I decide that I am going to raise my fees, I mention this to my clients at the end of counseling sessions.  I let them know that they will be receiving letters from me that will formally notify them of my intent to raise my fees on a specific date.

It is important to provide ample notice to each of your clients.  I typically give a full 90 days notice in writing.  You may choose to give less notice but I would recommend always giving at least 30 days notice in order to allow your clients ample time to reassess their financial situation, make other financial arrangements, or find another therapist if needed.

Step 4
What’s the result of my change in fees?

After initially mentioning my intent to raise fees and again after mailing the written notice of my intent, I make a point to check in with each of my clients to make sure that they understand why, when, and how much fees will increase.

At the same time, I am also checking out how that fee increase is affecting my client . . . . Is it met with understanding or apprehension or resentment or something else?  The truth is that all of us have lots of emotional baggage related to money.  Therapists do.  And, our clients do, too. Changes in money – plus or minus – typically bring up baggage.

Taking care of yourself – financially, physically, emotionally, spiritually – are what you are ethically required to do.  That means that if you are successful in private practice for the long haul, you will need to raise your fees at some point.  When it comes time to raise your fees, don’t let your money-related baggage get in the way. 

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How To Manage The Administrative And Clinical Juggling Act

Apr
25
2011
by Tamara Suttle

Beth K. Peterson, MSW, LICSW has been running her own practice in Hutchinson, Minnesota for over a year. Like many new solo entrepreneurs, she is still trying to balance the demands of time related to the clinical and administrative tasks that come with being in business for yourself.  Here’s how Beth describes it . . . .

My difficulty is that I have Acrobatsyoung kids at home that I really want to be with and so I want to avoid the 40-50 hour work week. Often I find myself doing paperwork at home or making calls on my commute… not the best. And I always feel behind.

I know this is somewhat of a subjective question as everyone works at a different pace, but is there any formula out there to expect X amount of hours of work for every client hour?

I am going to try to schedule this time in my week in versus fitting it in at the beginning or end of my day – or even hoping for a no show just to get some stuff done! Gross!”

Thanks, Beth, for bringing up what is actually two different topics that every mental health professional must learn to manage – one is obviously time management and the other is therapist self-care – both of which impact not only our quality of life but also impacts our client’s quality of care.

The answer Is YES!  There is a formula or ratio for administrative to clinical time in the office!  And, I think you are going to be shocked to learn that 1:1 is the typical experience for mental health professionals.  By that I mean . . . for every clinical hour you spend in the office, you can expect to spend another full hour doing the many administrative things that we do . . . the phone calls, documentation, networking, correspondence, billing, scheduling, building / office maintenance, marketing, drafting of new documents / articles, purchasing / restocking of office supplies, maintenance / repairs on office equipment, housekeeping, consultations, formal and informal professional development, taxes, etc.

If you are seeing forty clients in a week, then YES, you should be exhausted!  You are probably working an eighty hour work week if you are actually doing everything you are supposed to be doing! (And, by the way, a “full practice” is considered to be 16-20 clients per week.)

So Beth, here’s my suggestion to you . . . . Take a week or two to consider how many hours per week you really want and need to be working.  Then, and only then, adjust your schedule accordingly.

And, if you have difficulty doing that, feel free to drop back in  here to chat. You are welcome to contract with me to help you problem solve or develop a plan or simply help hold you accountable to doing what you plan on doing to take better care of you, better care of your family, and better care of you!  I’m always happy to help!



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