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Blog Post: Private Practice Chronicles, Part 2: Change It Up

Blog Post: Private Practice Chronicles, Part 2: Change It Up

When I wrote my original business plan, I had a concrete vision for what I wanted my private practice to look like and the clients I wanted to serve. Adults, 18 and above only, 8-5, Monday through Friday. Period. This was my plan from the beginning, and whenever I closed my eyes and pictured my clients, that was what I saw. Although I had experience working with youth in during my graduate school clinical rotations and previous agency work, I was calling my own shots now and wanted to see only the clients who I wanted to see. And that meant adults, 18 and above only.

Did I say that I only wanted to see adults, 18 and above only?

Rookie mistake Numero Uno.

Guess who my very first, paying client was? One who called and wanted my very first available appointment, same day or next day, if possible? You guessed it. The parent of an 8 –year-old boy.

My next call was for a teenage girl. Then my next call was a middle-school aged girl. And the call after that was for a teenage boy at-risk for substance use and abuse.

Well, you get the picture. None of these calls were for adults. None of these clients were over 18. But guess what? They all wanted to see me. And I had many slots to fill in my practice. And since empty slots don’t pay the rent, I booked the appointments.

The teens and tweens, as I like to now call them, starting coming in. And a funny thing happened. I was enjoying my work with them. They gave me a new energy and excitement that spilled over to my counseling approach and to my practice. There’s something awesome about a kid bouncing into your office, kicking off their shoes, plopping down to LIE on my couch, covering themselves in one of my blankets and stating, “Mind if I just lie here and be a load today while we talk? I have a lot to tell you and I need to be comfy!” Adults simply don’t do that! And it’s great.

I began reading up on the latest research on cutting, social media trends among middle and high school kids and brain development through the ages. I ordered games that encouraged talking and interaction, stocked a shelf with coloring books and colored pencils and printed out many “worksheets” for 8-18 year-olds that focus on core values, anxiety, anger management, gender/sexuality and depression. I attend “teen-centric” CEUs on bullying, cyber bullying and social media. I now assign journaling, and keep up on Netflix Series such as “13 Reasons Why.”

So much for my practice of adults, 18 and above only.

My business plan changed just like that, and I changed along with it. At this point, nearly 10 months in my private practice, more than half of my clients are under the age of 18. My hours are heavy from 3-8, Monday through Friday, and occasional Saturdays, not 8-5 as I originally thought. Kids can’t miss school for therapy, so I accommodate them as needed. I still see many adults, 18 and above, per my original plan, but I love love love working with my tweens and teens.

If your business plan veers off in an unexpected direction, or you find a niche that needs to be filled – go with it – as long as the clients you serve are within your scope of expertise. Change it up when and where you have to ensure success – and a full schedule. If I didn’t change it up, I would’ve missed out on these great kids. And the personal and professional growth that they’ve brought – most unexpectedly – to my career.

Blog Post: Why I Hate the Phrase “Get Over It”

Blog Post: Why I Hate the Phrase “Get Over It”

The woman looked at me with tears streaming down her face. “I know I should be over this already,” she said. “But I’m getting worse.”

This particular woman had lost her healthy husband of 40+ years suddenly in an accident. About six months had passed when we spoke. We discussed many things about the death and their relationship leading up to it. The accident was particularly horrific and it made many people around her uncomfortable to discuss it. She found herself resentful of other’s good health and as a result, was feeling guilt comingled with sadness and anger just about every emotion in between. She also had children and grandchildren that were grieving and felt responsible to be strong for them, and in the process, pushed her own grief aside.

In my work with clients and grief, I have discovered there is no clear-cut formula, no “correct” timetable of events or feelings to check off a list. And I hate the phrase “get over it.” I just hate it. People grieve at their own pace, in their own way. Grief is deeply personal and manifests itself differently in everyone. One person might want to talk about the loss at length to process it; the next person might retreat inward and not want it mentioned at all. Grief is fluid, and hits at certain, random times – usually when its least expected.

The client and I continued to talk. I was pretty direct with my response. “Why do you need to be over it already?” I asked her. “It was a tragedy. You’re still in shock and grieving. You lost someone you love and you miss him. Don’t put a timetable or expectation on yourself to be a certain way at a certain time. Allow yourself to grieve and don’t ever apologize for it – to anyone.”

I know this woman is still grieving, and will be in some stage of grief forever. And I hope she feels permission to do so.

If you are grieving: grieve. Don’t apologize for it. Ever. Sometimes, there is no “getting over it.” There is coping, sure, and figuring out how to move forward in an unexpected direction. But getting over it? That’s simply at times impossible. And an unrealistic expectation that can minimize and impede the grieving process.

If a loved one is grieving, don’t judge their grief or tell them how to grieve; be a safe place for them to rant, vent, laugh or cry. Never tell someone to “get over it “ or that “it’s time to get over it.” People deep in grief need people that can listen to them on the good, bad and ugly days. Above all, encourage them to see a professional counselor or therapist that specializes in grief, and can be there to help them navigate their journey forward.

Blog Post: Productive or Destructive?

Blog Post: Productive or Destructive?

Recently I had a client facing a tough weekend situation – a family reunion of sorts, and he had no idea what the outcome would be after the visit. Of course, he knew what HE wanted the outcome to be……a reconciliation…….but had zero clue which way it would fall out. Because he is at high-risk for relapse, there were many concerns on my end how this client would handle an end result that wasn’t what he would consider to be a positive one.

In session, I talk a lot with my clients about feelings, actions, reactions, thoughts, emotions……well, you get my drift. I did the same thing with this client regarding pretty much every potential scenario. At the end of the session, I told him his motto for the weekend, no matter what happened, was this: productive or destructive.

This technique is pretty simple, and easy to implement in any facet of our lives. I ask clients to stop and consider these four questions, which apply to most situations:

  • Are my words or actions productive or destructive?
  • Do I consider the other person’s words or actions productive or destructive?
  • Will I frame my reaction in a productive or destructive way?
  • Can I change something from destructive to productive? Or is it not possible?

From this point on, I’ll refer to this technique as POD.

ACTIONS There’s nothing worse than doing something we either instantly regret or stew about for days. Of course, once our actions are out there, we can’t take them back or change them. But we can prevent them from happening by pausing to think if the action will be POD, then act accordingly to the result we would prefer, or on which side of the action coin we would rather be.

REACTIONS Of course, it’s Counseling 101 that we can’t control anyone else’s actions. What we can control is our own reaction. This is where POD is extremely helpful. If someone is being destructive, how helpful is it to respond likewise? What is the reaction(s) that would be most productive in x, y or z situation?

WORDS Much like our actions and reactions, we can’t change them once they are said and done. Words (spoken, written, texted) must be thought out and used mindfully and carefully. Before you send that email, text, or say that snarky reply to your partner, consider if those words will make the situation POD. How will those words be received?

RELATIONSHIPS I use POD often with couples in solving or working on conflict. I ask couples to think about the characteristics of their relationship that are productive, and the ones that are destructive. We focus on why certain aspects are productive, and how we can take the destructive ones (if we can) and move them into the productive category.

WORK What is your style at work? Are you a productive co-worker or a destructive one? How do you handle POD bosses? Is your overall work atmosphere POD? Many times clients talk about work issues, and we use the POD technique to sort out myriad challenges and issues. POD can also be used to assess whether it’s time for a work or career change.

But back to my client. POD helped him through his situation, even when the outcome wasn’t necessarily what he wanted. He also used POD to apply a productive, positive coping skill, instead of resorting to his past destructive one of self-medicating with drugs.

This week, if faced with something challenging, hard or unexpected, stop and think to yourself: is my reaction going to be POD? Will my words make turn the situation POD?

I hope everyone has a productive week.