Archive for the tag 'Self Care'

Mistakes Happen . . . What’s A Therapist To Do?

Instructors nor colleagues ever spoke to me . . . in a classroom, as a supervisor, one on one, or even in a text about therapists’  mishaps and what to do about them.  No one ever spoke about them being opportunities for learning and growth.Image of Oops

Instead, when errors were made, I was taught that they were embarrassments, shameful, and dangerous for any mental health professional. They were things to be talked about behind closed doors with an attorney or forgotten about and not to be discussed with clients and colleagues and under certain circumstances maybe even lied about . . . .

Then, several years back, I attended a workshop at an annual conference for the Association of Women in Psychology. The workshop focused on discussing those very things that I was taught should not be discussed . . . clinical misjudgments, errors in thinking, and client-related mishaps.  It was, for me, a practice-altering experience . . . to be in the presence of counselors, psychologists, and social workers candidly speaking about their professional and sometimes costly gaffs.  It was also a very healing experience . . . to learn that other professionals (many more experienced than me and a few quite well-known) also made mistakes . . . as we grappled together with how to responsibly and ethically admit our mistakes, make amends for our transgressions, and learn from our own misjudgments.

Ours is not the only profession that struggles with how to undo any damage that we may have caused.  Physicians are also taught to play it safe when errors are made and keep their gaffs to themselves.  However, research is increasingly showing that it is often in a client’s  best interest for medical professionals to ‘fess up and admit mistakes made.  Check out When Doctors Admit Their Mistakes and also Risk Management: Extreme Honesty May Be the Best Policy.

Here’s my point . . . . I am a better therapist when I am able and willing to tell the truth . . . the whole truth to myself, to my colleagues and to my clients.  I am a better person when I am able to tell the truth.   And, my clients deserve the best therapist that I can be . . . 100% of the time.  Until the mental health professions are able to create a culture and space in which we can take responsibility for and  learn from our own mistakes, we are not the professionals that our clients deserve.

Surely I’m not a lone voice for shedding the embarrassment over clinical misjudgment and shelving the self-imposed shame of making errors with clients.  When well-trained therapists with good intentions make choices that, in hindsight, are not the most helpful ones to our clients,  I believe it should be the standard of our professions to create a space for owning our mistakes and making amends to our clients with dignity and heartfelt regrets.

It’s time for our professional associations and our graduate institutions of learning to model healthy and appropriate ways to create spaces for dialogue and healing and forgiveness when therapists err.  It’s the right thing to do . . . for our clients, for ourselves, and for our profession. If you, like me, have ever made a mistake and felt the tug to do the right thing and yet have also felt the fear of doing the right thing, today is a good day to start the dialogue.





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A Facelift For Your Private Practice

Are you looking back to the “good ole days” when your practice was shiny and new . . . ? Remembering when your appointment book was full and you had a two week waiting list and wondering where all the clients have gone?

Well, I’m here to tell you that they are all still right here . . . right around the corner from you and they are wondering whatImage of Hmmm happened to their bright and enthusiastic therapist that you used to be!  That’s right!  You heard me!  Any client will tell you that s/he would rather return to the same therapist s/he’s seen before rather than change to a new one.  They only change when they have no choice but to go elsewhere to get the help they are seeking.

If your old clients are going elsewhere for their counseling services, then it might be time for you to give your practice a facelift and that means taking a fresh look at your office, your office practices, and yourself.

Outside the Office

  • Take a look at the appearance of your building.  Has it fallen into disrepair?  Does it need trim work or to be repainted?
  • Is the landscaping well-tended?
  • Is the parking for your clients easily accessible and is the lot well-lit?  Does it feel safe?
  • Are the windows clean?

Inside the Office

  • Inside the office, take a look at the paint on the walls.  Is it dingy?
  • Is the carpet dirty or stained?
  • How does your office smell?
  • Is the lighting warm and welcoming?
  • Is your office well-insulated for privacy?
  • Is the temperature in your office comfortable?

Office Practices

  • Does your office staff greet your returning clients as warmly as they greet your new clients?
  • Is your staff well-trained on respecting clients’ privacy?
  • Are you records safely locked away out of sight so that clients do not see information about other clients?

Self Check

  • Are you taking care of yourself outside of the office?  Eating and exercising?  Getting enough rest?  Attending to your personal relationships?
  • Are you arriving at the office in time to get settled in and appear calm and focused when your clients arrive? Or are you rushing in harried at the last minute?
  • Are you scheduling your clients far enough apart that you have time to attend to phone calls, go to the bathroom, and complete your notes in between appointments?
  • Do you have a plan for continuing your professional competency and are you following it? Are you continuing to learn new and interesting things to help you in your clinical work?

These are useful things to discuss with your peer consultation group.  A fresh pair of eyes can help you identify areas that need a bit of a facelift.  And, that, in turn, may help you re-engage some of those wayward clients.

Can you think of other areas in your practice that may need a facelift?  If so, I hope you will let me know!












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Reduced Fees, Sliding Scales, And Lessons Learned – Part 1

Published under Money Matters

This is the 1st  post in the series
Reduced Fees, Sliding Scales, and Lessons Learned

When I first went into private practice, I tripped over several issues when offering my services for a reduced fee.  Before you begin advertising that you reduce your fees for clients, there’s a few things you may want to take into consideration to avoid the same mistakes that I made.  Here’s the first one . . . .

Are You Meeting Your Own Financial Needs?

Generosity is certainly admirable  . . . if you can afford it.   Airlines tell you to put your oxygen mask on before you try to help someone else with Image of Money Puzzletheirs.  And, you cannot afford to give your services away if you cannot afford the rent and electricity for your home and your office.

There are other ways to do good in this world and hopefully you are doing them.  But make sure that you are financially sound before you go trying to meet your clients’  financial needs.

And, if you are out there already doing good in this world without or in addition to reducing your fees, why don’t you take a moment to let us know about your good works!

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20 Questions To Ask Other Therapists

When I left employment to begin my own private practice in 1991,

Question Marks on the Wall by Lone Black Rider / Filip Bunkens

"Question Marks on the Wall" by Lone Black Rider / Filip Bunkens

I started by identifying therapists that I believed to be highly successful.   Then, I picked up the phone, introduced myself, and asked if I could take them to lunch or coffee to pick their brains about being in private practice. Whether you are just starting out in private practice or are wanting to revitalize your practice, that’s a good place for you to start, too.

Most mental health professionals will be flattered if you call.  Let’s face it, it’s an ego boost when someone else thinks that you are successful.  And, many mental health professionals really enjoy mentoring others in the field.

Once you’ve made your phone calls and scheduled your lunches, here are 20 questions for you to ask:

  1. How long have you been in private practice? This is really important.  you want to identify therapists who have longevity in the field.  They are who you can really learn from.
  2. How did you learn what to do when you were ready to go into private practice? If it worked for him, there’s a good chance that at least part of his learning can work for you, too.
  3. What do you know now that you didn’t know when you got started about being in private practice? You might as well learn it now rather than wait.
  4. How did your clients initially learn about your services and how do your clients learn about your services now? You want to know about how it was in the beginning for them.  Back then, they were probably on a shoestring budget at best (perhaps like you are now) and still they survived.  In the process of learning what they did back then and what they do now to get clients, you’ll most likely hear how their income and their efforts have changed and refocused.  
  5. What mistakes did you make in your early years of private practice? Find out now so that you don’t have to reinvent the wheel.
  6. What critical decisions did you need to make about your private practice and why? You may choose to make different decisions but it is often helpful to understand why someone in private practice makes the decisions that they make . . . about policies, workload, billing and fees, etc.
  7. Did you ever have a mentor?  Do you now? And, how did you find one? One of the fastest ways for you to jump start your practice is to have a personal mentor to shepherd you on your journey.  Hiring a business coach is one way to find a mentor but it is certainly not the only way.
  8. How much time do you set aside to work on the business (not the clinical) of private practice? Successful therapists in private practice spend time visioning, developing, and implementing new ways to grow their businesses.
  9. What is your biggest challenge now? Challenges continue throughout the life cycle of a private practice.  Challenges happen; they do not disappear.
  10. How long did it take you to turn a profit? The Small Business Administration says that most small businesses fail within the first 5 years and that most successful small businesses take 3-5 years to turn a profit.  I’ve certainly taken it take less time to break even or fail.  However, be wary of those who promise that you’ll be earning big money fast.  Research clearly shows to slow and steady is the way to build a strong foundation for a long-term practice.
  11. What do you believe causes a practice to succeed?
  12. What do you believe causes a practice to fail?
  13. What type of clients do you see? Remember this when you need to refer a client of your own to another therapist.
  14. What type of clients do you refer out? If this is a population / issue that interests you, make sure this therapist knows that.  If it is not, then keep an ear open so that you can refer another professional to this therapist.  This is how you network.
  15. What resources can you recommend to me as a new therapist that can help me get started on the right track? He may have a favorite website on developing a private practice or an online diagnostic code finder. He may know another therapist looking to share an office or a CPA who can help you set up your quarterly tax payment.  Or, he may have a favorite book or magazine or office supply store to send you to.
  16. What do you do to take care of you? Balancing work and home (much less children and additional schooling) is one of those topics that is hardly addressed while you are in school.  Take time to identify now how you will put systems of self care in place.
  17. How has your practice changed over the last X (number) of years? It’s important to understand about the life cycle of a practice.  Once it’s up and running, it doesn’t necessarily stay up and running at that level.  Change happens . . . a group practice moves in next door, the local school system has an unexpected need for counselors, an army base closes, you get new clinical training, etc.  Your practice’ life cycle will be different than the therapists’ that you are interview but it is helpful to be reminded that change happens and what you need to do to recognize it as another opportunity for growth.
  18. What is the hardest thing about being in private practice? Again, what is hard for him may not be hard for you but knowing about the challenges helps you prepare for them from the beginning.
  19. How is your personal life affected by being in private practice? Your professional life and your family’s lives will be impacted by your decision to practice mental health.  When you are in private practice, that impact is even greater.
  20. What precautions do you take to keep you and your clients safe in your office? This is another area that is not adequately addressed in graduate school.  There are many things you can do to increase your safety.  Learn about them now.

Remember to take pen and paper with you so that you can take notes.  I’m sure you’ll think of more questions along the way!

If you use this list, I hope you’ll drop back in and let me know how the questions worked for you.  Are there other questions that would be helpful to ask other therapists?

And, if you are a therapist who has been in private practice for a while, why don’t you drop in here  and answer all 20 of these for us.  It’s a good way to introduce yourself and your practice to our community!

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3 Ideas For Your Marketing In September

If you’ve been following AllThingsPrivatePractice from the beginning, then you know that a marketing calendar is one of my secret weapons.    Here are a few ideas for your September marketing calendar . . . .

September 16 is Working Parents Day.  How about partnering with a drop-in childcare facility.  You can offer a free workshop for the most overlooked of working parents . . . stay-at-home parents while the childcare facility offers free or low cost childcare!  Consider topics that might be of interest to stay-at-home parents like Finding Time for Self Care, Holding on to Your Dreams While Holding on to Your Little Ones, and Raising Feminist Boys.

Another marketing opportunity is International Day of Peace on September 21.  This is a day set aside to promote

Islamic Peace by Trey Ratcliff / Stuck in Customs

"Islamic Peace" by Trey Ratcliff / Stuck in Customs

peace and non-violence.  Offer to facilitate a book study for other therapists based on Marshall Rosenberg’s book, Nonviolent Communication:  A Language of Life.

Yom Kippur, the Jewish Day of Atonement, begins at sundown on Sunday, September 27 and ends at nightfall on Monday, September 28, 2009.  This is the most important of all Jewish holidays.  It is traditionally spent worshiping and fasting.  If you are not Jewish, consider offering to take call or cover other work-related duties for you Jewish colleagues in mental health.

Can you come up with other ideas to market your private practice in September?  Drop me a note here to share them.

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