What do the following topics have in common?
- a mother who has a child consistently breaking curfew – and she has found pot in the child’s room
- a parent insisting on random UAs for their child who has been dabbling in various substances
- a couple assigning tasks to their blended large family which include household chores and limits on when they will drive and pick-up kids from unplanned or spontaneous plans
- a client being reminded to be on time for appointments, or they will be charged for a full hour
They all involve boundaries – either lack thereof or the need to enforce them. Lately, I’ve been discussing boundaries at length with clients, co-workers and friends.
Mention the word “boundaries” to anyone and people usually cringe. For some reason, the word has a negative connotation and sometimes, reaction. The opposite is, in fact, true. Boundaries, when reasonable and clear, set expectations and limits within all of our relationships – be it romantic, work, friend or parent/child. Boundaries set a standard and ensure a baseline of trust, which is a necessary component for any successful relationship.
One thing that makes me simply nash my teeth to powder is when a parent tells me, when discussing boundries, is, “Well, they’re over 18, I have no say,” or “They’re an adult, I can’t do anything about it.”
Um, huh? What? Did you really just say that? You can and need to do everything about it.
So parents, I ask you this: do they live in your house? Yes? Then set boundaries.
Are you paying for their living expenses? Yes? Then set boundaries.
Are they going down a path that is high-risk? Yes? Then set boundaries. Now.
A father recently came to my clinic to talk about his oldest child, an adult, who moved back home after years of heroin use. The child has been in and out of rehab. Nothing is sticking, and the using is getting worse. The child stayed clean for a bit of time, but recently relapsed. The child was stealing from his parents and lying to cover up the substance use. We discussed treatment options. I suggested that based on the current status of things, it was probably time for an intervention to take place.
“Well, I don’t want to kick a dog when it’s down,” the father said. “I’m not sure now is the time for that.”
Boundaries are severely lacking in all aspects of this child’s life. We talked about boundaries as a gift, not a punishment. I added to the father that if this didn’t happen, his child might not have another chance to steal money from him – because the child most likely will succumb to his addiction. In this case, boundaries will more likely than not serve as a life-saver.
I struggled with boundaries soon after opening my private practice. I had clients that would text me at all hours of the night and if I was up, I would usually engage in texting with them. But it was taking an emotional toll on me. I can’t be available 24/7, and I wasn’t doing my clients any favors. So, I stopped answering texts and calls after a certain time at night and let those clients know that I was not available during those times. It was a boundary I needed to set, one they respected, and it benefitted us both in the long run.
So set your boundaries, and never apologize for doing so. Your relationships will thrive – not suffer.
It’s been exactly one year – today – since my first paying client walked through my private practice office door and sat on the couch. It’s been a great year, and I’ve been doing a ton of reflecting on the past 12 months. There are things I’ve done right, many I’ve done wrong and just about everything in between.
I’ve loved writing about my experience in my “Private Practice Chronicles” series, and due to the positive feedback I’ve received, I plan to continue to write about the things I learn in the upcoming year.
For this anniversary post, I’m sharing a few thoughts on my past year, and the most important things I’ve learned:
You Can’t Network Too Much – My daughter is a competitive baton twirler, and when she complains about practice time, I always remind her that no one has ever gone to a competition and said, “I practiced too much.” But the opposite is certainly true. The same goes for business networking – you can’t do “too much” of it! My networking has been an important and crucial part of growing my practice. The coffees, lunches, tours, emails, cold calls and meetings have been invaluable for making new contacts in my industry – as well as referrals.
Trust the Process – When I graduated from my Master’s, one of my favorite professors gave me a bookmark and wrote this phrase on the back. I didn’t quite understand what she meant at the time, but now I do. Therapy is a process. Owning a business is a process. There are ups and downs, and quite honestly, some days are better than others. Mistakes are made, but you learn from them and move on. But you must trust the process, and each and every lesson it teaches.
Diversify – Besides my private practice, I also write this blog, contract with a local opioid clinic and write and handle social media for other therapists. I am also working on a few other collaborative therapy-related business ventures. Don’t pigeon-hole yourself into only seeing clients in your clinic in case there is a slow month (and there will be slow months!) Have other options – and other revenue sources.
Enjoy Yourself – opening up your own business is scary, and there are lots of unknowns. There’s no steady paycheck, paid vacation time, insurance benefits or matching 401(k). There were times in the past year when my phone was silent and my clinic was empty, and other weeks where I couldn’t keep up with the demand. Through it all, I’ve enjoyed every minute of it and am excited and energized to see where my business goes -and grows – in the upcoming years. I love what I do, and the best feeling in the world is when a client tells me how much I’ve helped them or changed their life.
I can’t imagine going back to work for someone else again after taking the plunge and venturing out on my own. It was a long and thought-out decision, and one I’m happy I made. I find it an honor and a privilege to work with my clients. I love meeting and connecting with new people in my industry. Every day I walk into my cozy office and I can’t believe I get to do what I do for a living. I’ve never been more energized or excited about my work.
Happy Anniversary to me, and hopefully, many, many more!
I have two little secrets to share with all you other therapists out there, especially those thinking of starting a private practice. I hate just giving these secrets away, but I’m going to, because they are pretty valuable, and both are something I wish someone would have shared with me before I started out.
Ready for it? Alright, then sit down. And get your egos in check, people. ‘Cause these are some tough truths I’m telling you, but you need to know them and it’s better to figure this out sooner rather than later.
Secret Number One: Not everyone is going to like you.
I’m serious. Not everyone is going to like you.
And that’s ok.
Because here’s the deal – the real deal, the one that no one told you in your expensive graduate school classes, the one that no fancy PhD research study has revealed, the one you are simply gonna have to face: You are not the right fit for everyone that walks through your door.
And that’s ok.
The entire process of therapy revolves around the therapist-client relationship. It has to feel good for both parties involved for it to work. Haven’t you ever had a client that just adored you, but you’d cringe when you’d see them on your schedule? Of course you have!
And that’s ok.
I tell everyone in their intake – especially my teens and tweens – that therapy is a two-way street. The client must feel comfortable with me, and be able to be real with me….otherwise, the whole thing just won’t work. So unless they feel that way, I don’t want to waste their time and money.
But it’s hard. It’s not easy to have someone come in for an appointment, and never call and schedule another one. At first, it hurt my feelers. And made me doubt it I was an effective therapist….and if my practice would make it.
Which leads me to Secret Number Two: It’s not about you.
If they don’t like you, than the therapy process most likely won’t work. And that’s not about you. That’s about the client, and what they need. Maybe the therapy process scared them. Maybe there simply wasn’t the comfort level on their end. Or, maybe it was a good-old fashioned case of Secret Number One.
And that’s ok.
Early in my practice, I saw a client for one session, and never heard from her again. In my opinion, it was a good session (I can usually tell if the session is not working, or the client and I simply aren’t gelling). I was somewhat perplexed that she never called back. My SOP is to give a client after the intake one shout-out (via text or email), then leave them alone if they don’t respond. She never responded, so I thought, well, ok, it most likely wasn’t about me, I just wasn’t a good fit.
Don’t get me wrong. Even if I know I’m not the right fit or someone never comes back after the initial intake, I wonder if they went elsewhere, or I ruminate over the session, wondering if I said something that offended the client or if didn’t ask the right questions. But then, I focus on my clinic full of clients that I do serve, that have seen me for multiple appointments, and are happy enough to refer me to others. At the end of the day, I only want what’s best for my clients. And if that’s not me, then I truly hope they find the right fit for themselves, and get the help they need.
That client I thought clicked? She eventually called me back….for a couple’s session! Seems that was more of what she wanted and needed.
And that’s ok.
I hope these secrets are helpful. If you have any little secrets that you’d like to share about your private practice, I’d love to hear them!
I’m near the one year mark – one year! – of owning my private practice. It was a dream and ultimate career goal from the time I decided to go back to grad school in 2010. Seven years later, an opportunity arose, in the form of a sudden and unexpected (boy, I didn’t see that one coming) job layoff, some office space that became available, a person willing to share the rent and just like that, a dream became reality.
Shy of one year in my practice, I just re-signed a lease (solo, yikes!) and couldn’t be happier. I’ve had some big successes co-mingled with a lot of hard lessons. Here are five rookie mistakes for you to avoid if/when you are thinking of opening your own private practice.
1) Find a Niche – I was all over the map when I started. Honestly. As a therapist, you can’t be everything to everyone. So don’t make the mistake of taking all business just for the sake of taking business. Figure out your strengths (and weaknesses), find your niche, and work on perfecting it. Refer cases beyond your expertise to others in your community. In time, they’ll refer back to you.
2) Stay Organized – Owning a business means you are all departments – IT, accounting, scheduling, marketing and everything in between. This is a constant challenge for me. When I’m not seeing clients, I schedule time in my day for meetings, marketing, social media management, paperwork or general planning, depending on what needs to be done. Set up systems that work for you so that your practice can run efficiently.
3) Safety First – I’ve taken new clients at 8:00 p.m. and weekend slots where my usually-bustling office building was desolate and I was isolated and alone. Looking back, considering the line of work I’m in, some of those clients would have been better for me to see during normal business hours until I got to know them better. Looking forward, I only schedule my known and established clients during my irregular times.
4) Have a Business Plan – I’m going to make all you MBA-types (and my accountant) cringe right here: I didn’t write one. Well, not an official one. Oh, I had a list of things to do (website, PLLC, business accounts, etc) and lots of ideas swimming in my head. But get your business plan down on paper, including all start-up costs, projected expenses, and number of clients you need weekly to break-even, turn a profit, and cover expenses. Refer to your business plan monthly, and make revisions as needed.
5) Don’t Panic – Owning a business has its ups and downs. Some months are better than others. Case in point: my most profitable month was one where I was off for a week on vacation. The next month was slow (and I mean, slooooooooow). During this slow month, someone approached me coming to work for them – notice I said “for” not “with.” I considered this offer for a few days (what if I don’t make it? what if business continues this slow? What if what if what if?) but decided to continue working to build my practice. Sure enough, not two weeks after turning down the offer, some well-paying, substance-use contract-work came my way. If I had panicked and thrown in the towel, I would have been giving up not only my dream, but this other, better-suited opportunity.
I’m still making mistakes, and learning from each and every one. Mistakes are simply par for the course of owning your own business. Don’t dwell on them. They happen to everyone – just don’t repeat them, and learn from them. Best of luck with your own practice, and I hope reading about my rookie mistakes help you avoid making your own.
When I moved to Texas from the north 13 years ago, I had no idea what plants worked in the hot climate and Hill Country rocky soil. So I did what any good Yankee would do and went to the local nursery to find out. This black thumb (and I mean, I can kill a plant just by looking at it) asked the worker that saw me wandering lost and clueless among the aisles of unknown shrubs for the most resilient Texas plant.
Knock-out roses, she said. You can’t kill ’em even if you tried.
Watch me, I promised.
But she was right. We bought some knock-out roses, red ones, and boy were they resilient. They thrived and grew despite how much or how little water or sun or attention they got, and they were beautiful. Every house I’ve owned in Texas (and there have been three so far) I have planted them because, well, even I can keep them alive, no matter what.
I see these roses daily, in my own yard and on my runs throughout various areas and neighborhoods. They bring me such pleasure, especially knowing how hard they need to work to survive.
I talked about these roses with a client the other day. This client has experienced some particularly horrific life events, more in her young 18 years than most have in a lifetime. This client’s story is one that could have gone in a way different direction, but instead, this client is graduating high school and heading off to college and planning a future that is greatly unknown but wide open with possibility.
In our session, this client was running down on what she perceived to be negative qualities, such as “I’m self-destructive in relationships,” “People don’t like me as much as I like them,” “I hate most of my appearance,” and so on and so forth.
You need to give yourself credit, I replied. I compared her to a knock-out rose – resilient under the most trying of circumstances, and even thriving through it all. That’s a gift that you have, I told this client, and something that no one can ever take away – the ability to persevere and keep growing despite everything and everyone else.
At the end of the session, she was smiling. “I guess I am pretty resilient,” she said. “I hate that I always have to be, but I am.” We talked about where resilience can take you in life, and how she has already, unknowningly, applied it to her own life in many different areas.
I know I will think about this client every time I see those roses. And I know that she’ll be okay, no matter what comes her way. (more…)
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