Like all people, therapists come in lots of different flavors. As the facilitator of small clinical consultation groups, I have a bird’s eye view of a variety of personalities and work styles in our field. The beauty of our field is that this diversity allows us to grow and learn from each other which benefits not only the clinicians but also the clients.

Let’s look at a few examples of the types of clinicians out there:

Clinician 1: You have a big heart and sense of obligation in serving many clients to the best of your ability. Sometimes you take on too many clients for a sustainable case load. This may feel like it makes you a committed and caring clinician but it also can lead to burnout and it muddies the waters at times about who you bring into your practice and if/when/how you decide to refer out.

***If this is you, imagine, having an intimate, trusted group of colleagues who see you and help support you in making decisions about some of these blind spots. They are able to help you assess and address the need to refer out some potential clients or refer out current clients who need something different than what you offer. These colleagues value you as a clinician and understand that this is difficult for you and provide gentle support and helpful guidance in making these decisions.

Clinician 2: You have very clear perspectives about your scope of practice, which clients you see, your fee structure, how you get paid (private pay vs insurance vs a hybrid model). You have clear thoughts about decisions such as policies for no show/late cancellation fees but your views are shifting and you don’t know how to handle it. Your previous firmness with these things is causing issues that are becoming apparent to you. You have realized that this field is not one size fits all and that not all policies or practice structures work for your clients but you don’t quite know what to do about it.

 ***If this is you, imagine that you have regular consultation with clinicians you trust so you are able to talk these issues through knowing you will get a variety of supportive ideas and suggestions, as well as some insight about solutions you would not have thought to consider. They know you and your work and will give you space to figure this out.

Clinician 3: You have been doing this work a long time. You are very well regarded and effective in your clinical work. You even supervise pre-licensed clinicians with very good results. You feel confident in most of your clinical decisions. But every now and then you have a case that gives you pause. There’s a dynamic that is worrisome that you can’t quite conceptualize so you don’t reach out to a colleague because you are unclear about what you need or you worry it will impact the way others view you.

 ***If this is you, imagine leaving work with peace of mind, knowing that your clinical consultation group is meeting soon. You know they will help you process the case, offer supportive insights and differing perspectives. You love that you get to benefit from meeting with clinicians with a variety of skill sets and theoretical orientations. You trust them and know there will be no judgement about not having a specific question, or way to conceptualize the case, since we all face that at times.

Clinician 4: You are an experienced clinician and most days feel great about your work. But every now and then you experience imposter syndrome and feel embarrassed by it. You don’t have anyone you feel safe being vulnerable enough to sharing this with, or you worry colleagues will think less of you.

***If this is you, imagine knowing just who to process this with. Your small clinical consultation group whom you’ve grown to know and trust are able to validate this issue. They reassure you it has nothing to do with your skills. And because they know you, they are able to offer suggestions to help you feel more confident in your work.

Clinician 5: You are well-rounded, have built the perfect private practice for yourself and love doing this work. But as a solo or online therapist, you find yourself feeling lonely. You miss the camaraderie of having colleagues down the hall to chat with, get clinical advice or get support with cases where you are doing good work but the client’s circumstances are difficult and you worry that you should be doing more (even though logically you know you are doing a great job with a sucky situation).

***If this is you, imagine showing up to your consultation group and sharing about your case, the difficulties the client is struggling with, and your feelings that you want or need to be doing more. But your colleagues have all had similar cases and are able to offer empathy and to normalize the discomfort you are feeling. They are there to affirm you are doing good clinical work and remind you that aspects of our field, such as this, are difficult and take a toll on us.

That’s 5 different clinician profiles…not an exhaustive list by any means. Did you identify with one or more of these examples?

Do you feel stuck in needing support to address concerns like those examples but don’t know how to go about getting what you need?

If you are not getting clinical consultation on a regular basis or don’t have a trusted group of colleagues to consult with, commiserate with or just laugh with, you may want to consider how this type of support can help you level up as a clinician and help you love your work even more.

As I shifted into private practice work years ago, I stumbled upon some things that were the norm where I worked but I eventually realized were not working for me. The insight came when I was completely burnt out and very unhappy with my workplace dynamics.

I hope these tips will help you avoid some of the angst I experienced as I transitioned into private practice.

So here are my recommendations for 5 Things Every Private Practice Clinician Should be Mindful of:

1. Lunch – You should eat lunch every day or at least take some breaks between clients. I used to see 12 clients back to back and only had lunch or a break if someone cancelled. It’s tempting to overschedule to allow for cancellations but this is not a healthy solution. This leads to burnout fast!
2. End sessions on time –If you are coming from agency work where there are often different expectations about how long sessions or client work should last, learning to end on time can be challenging. Figure out how to begin wrapping up your session at least 5 minutes before the session ends. This can be done by beginning a recap of the session or with a phrase you use. “Well, I see we are out of time today” is not my favorite but if it works for you, great! There will obviously be times when a session needs extra time but that should be the exception instead of the rule.
3. Handling no shows and late cancellations – Decide what your policy is or learn about the policy where you work, and check in with your values. Does this policy feel fair to you? Would you be OK with this policy being in place with a provider you see? Are there times you can choose to make an exception? Getting clear in your mind about this with yourself and with your clients is a must do. Holding boundaries is important but there may be times you decide to waive your policy or choose not to charge for them at all. Just be really clear with yourself and your client about why you are waiving it and about the expectation moving forward.
4. How you feel about reducing rates – This was a doozy for me at one time. I had to define when and at what rate I would reduce to for clients in need. The last thing you want to do is give someone a reduced rate, with no time-limit to reassess the need, and then feel trapped and annoyed because they keep telling you about the new shoes they just bought. (Yes, this happened to me.) If you are gifting a reduced rate, set a time period to reassess the need then understand that their values may differ from yours around how they spend their money.
5. Set boundaries around your schedule – In the early days especially, it’s easy to take clients whenever they are available. Over time though, this can create chaos in your life. Set your schedule and stick to it (emergencies aside of course). And remember, it is perfectly OK to change your schedule to accommodate your life. Clients sometimes need to change their appointment to accommodate their lives and with enough notice, you can do that too.

I fully recognize that there are LOTS of opinions out these about these things. The bottom line for me is, check your values, be super clear to yourself and your clients about the parameters, and understand that others will do it differently.

Different is OK.

It’s nice to learn about other options for managing some of these things but ultimately, you need to practice in a way that works for you!

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Due to repeated requests, I am forming BRAND NEW groups for pre-licensed therapists!

These groups will run just like my current CollabOasis consultation groups except all group members will be pre-licensed. Members participate in closed, facilitated groups of 6-8 clinicians who meet virtually twice a month to get consultation on cases, discuss ethics, get business tips and resources, and find supportive colleagues you will get to know and trust.

The focus of these groups is on supporting each other and creating a place of benevolence to establish trust and get the clinical support that is so vital in our work.

The monthly fee includes 2 small group meetings per month. And once you are licensed, you will get 6 months at a reduced rate for the groups for fully licensed members as you work at or build a private practice.

**Please note, these hours will not count towards licensure since this is not supervision.

If you want to learn more about it, please set up a chat with Jeanene by clicking on the Contact Us tab of this website.

If you asked a dozen therapists their views about self-disclosure, you’ll likely get a dozen different answers. For most of us, our training and treatment modality informs whether or not you think this is a good or bad thing. But have you considered that there are 2 types of self-disclosure?

Let’s break it down…

1. Voluntary self-disclosure

This occurs when a therapist shares something personal with a client. Those who do this, hopefully, assess the benefit to the client for the sharing it, and recognize the shift in the relationship that can occur because of it.

Most therapists I know who have been in practice a while, will tell you their views on this has changed over time. And the view may be client specific; you will disclose with some but not others. And that’s ok.

Keeping the therapeutic value in mind seems to be the common denominator with those who do occasionally self-disclose.

2. Involuntary self-disclosure

This type often occurs when there is some type of visual or auditory clue that the client picks up on. For example, your growing belly is likely a good sign you are pregnant or having something going on with your body.

Some other examples include moving into a new office or changing practices, traveling while working, a change of hairstyle or other outward feature, going on medical leave or being in the media (in a good way or not so much).

So what do you do about the involuntary-types of self-disclosure that sometimes occur in our work?

First, it’s important to think ahead about these types of things so you can determine how you want to respond.

You may choose to share some or all of the details or you may choose not to. In either case, it’s helpful to come up with specific language around your decision so you don’t have to figure it out on the spot.

For example, early in my career I got a very different haircut than I had previously had and was wholly unprepared for the deluge of comments and opinions I received from clients.

Wardrobe choices at times have fallen into that same category. “What carpet did that dress get cut from?” (On the upside, no matter how you handle those situations, it might be an indicator that you have developed trust with the client and there can be lots of therapeutic value in how you respond.)

Next consider that you will likely benefit from discussing this with colleagues. Consider the type of involuntary self-disclosure you will be experiencing and how you plan to respond.

When you run it by your colleague, they may have input you find helpful which can either help you feel confident in your decision or help you decide you want to handle it in a different way.

It’s hard to do this work in a vacuum so if you don’t have colleagues to bounce things off of, you should consider ways to meet other therapists and/or join a clinical consultation group.

After a few encounters, assess how it is going. If you get unanticipated responses, you may need to rethink your position or how you are conveying the information.

Again, this can be a great time to reach out to a colleague.

Like it or not, we are in a field that relies heavily on our relationship with our clients. That can make our exchanges with them more personal than we anticipate or desire.

By having an awareness of these types of possibilities, you give yourself the advantage of planning ahead, considering both your needs and those of your clients, and hopefully, you won’t experience feeling shell shocked in a session by something you didn’t see coming.

If you have experienced involuntary self-disclosure, comment below. I’d love to hear about it and how you handled it.