Adventures In Private Practice: Family Counselor Barbara Flor, LPC

Just six months ago Pennsylvania licensed professional counselor Barbara Flor opened her private practice. What inspired Barbara to take the leap into being her own boss? What challenges and joys has she experienced in the process? Read on.

Tell me a little about your practice…

I am a sole practitioner with an office in my home, in Mechanicsville, Pennsylvania.  I live on several acres surrounded by tranquil farms and tree-lined properties, so it’s a very peaceful, private setting.  I provide individual, family and group counseling for children, teens and adults with an emphasis on improving interpersonal relationships and family dynamics.  My years of experience as a school counselor, educator and victim’s rights advocate, gives me strong insight into issues affecting women, children and families as a whole.

Why did you decide to open a private practice?

I started my practice about 6 months ago, after years of dreaming, planning and procrastinating.  When my children were in college and I was an official “empty-nester”, I realized it was now or never.  I have been in the field of counseling and education for over 20 years, mostly working for schools and colleges, but I also volunteered my time at a victim’s assistance agency and became trained as a sexual assault counselor.  I have a passion for issues that impact women and children.   Owning a private practice allows me to concentrate on that passion.

Clients that therapists find to be the most “difficult” are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

I have learned patience, empathy, flexibility and honesty. There is usually a reason people are the way they are.  Who am I to say that if I lived their life, in their environment, with the experiences they have endured, that I would be any different.  They are doing the best they can with the hand they’ve been dealt.  I need to do the best I can to help them with that and sometimes that means being honest and saying, “I’m feeling stuck, frustrated, confused...how can we move past this?”  With children, this can be even more difficult.  It’s imperative to meet the child on his or her developmental level and attempt to move forward from there in a manner that works for that child.  That may involve books, games, play, art, or talk therapy.

What’s your biggest pet peeve about private practice?

My biggest pet peeve in private practice is dealing with insurance.  I hope to someday become a private pay practice, but have found it is difficult to get started in my area without taking insurance.  I am competing with many other therapists who accept insurance.  I am on a few panels and am working consistently to get approved by more.  It is time consuming to do this and to do all the paperwork required to get paid.

How did you discover or develop your practice “niche”?

My passion is working with women and children.  While I do have several clients that fit in this “niche”, I also work with couples and families. I have to say I do enjoy the variety as well.  Many issues that affect women and children also affect couples and families, so the skills I have acquired over the years are helpful with all the populations I serve.  For many clients it comes down to relationships - relationships between parent and child, husband and wife, siblings, and other loved ones and significant others. We all have the basic need to feel loved, respected and to have a sense of safety, security and belonging.

What resource (book, website, person) helped you the most when setting up your private practice?

The Internet has been the overall, best source of help in my endeavor.  Between LinkedIn groups and Facebook groups for private practitioners, as well as numerous online resources and continuing education opportunities, I have massive amounts of information at my fingertips.  Specifically, Julie Hanks’ Facebook group, “Private Practice Toolbox” was the first resource I sought out and it helped me immensely.  I felt very comfortable and welcome in this group.  The members are kind and knowledgeable and are always there with helpful advice.  From there, I learned about other groups on LinkedIn, as well as books, websites and other people who have helped me along the way.  Joseph Sanok, a member of the “Private Practice Toolbox” Facebook group, helped me with the resources I needed to create my own website.  And many other members encouraged me to start a blog.  I could not have done all that I have in the last six months without these helpful, knowledgeable profession also.  It also hasn’t hurt to have a husband who is a financial guru.

What has surprised you most about being in private practice?

I am most surprised that I find being in private practice so fulfilling.  I truly love spending time in, and working on, my practice.  It is my “baby” and as they say, “If you love what you do, you never have to work a day in your life”.

Has your private practice helped you grow professionally?

I have learned so much about myself as a professional and the things I am capable of doing.  It has given me the self-confidence to continue moving forward, even on the rough days.

Has it helped you grow personally, too?

Personally, it is a great feeling to know you are a professional who can earn a living doing something you love.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?  

Walk. Laugh. Love. I love to walk.  I try my best to walk at least 30 minutes a day, preferably outside if weather permits.  I love to laugh.  It is true that laughter is often the best medicine.  I make sure to try and laugh everyday, whether by watching enjoyable television shows, funny movies, or connecting with family and friends, I can feel the stress leaving my body when I laugh.  I recommend this to my clients as well.

How do you cope with the inevitable stressors involved with being your own boss?

I have had some very difficult jobs in my life.  When I am having a particularly difficult day, I think of those former challenges.   So far, nothing in private practice has been as stressful as some of those experiences!

What personal strengths have helped you succeed in private practice?

I have a strong business background consisting of an undergraduate degree in business, combined with experience working in business and with business start-ups.  This has been very helpful.  A private practice is a business.  Graduate school in the mental health field does not prepare you for the business side of private practice.  If you don’t have those skills, it is imperative that you get them, or find someone who can help you.

In addition, I have a very strong work ethic.  I am disciplined, responsible, and organized.  I have always lived by the motto, “Work first, play second.”  This has served me well.

 For more information about Barbara's private practice visit www.barbaraflor.com

Adventures In Private Practice: Play Therapist Pam Dyson, LPC, RPT

"I provide practical solutions to child behavior problems," says Pam Dyson, LPC, RPT of St. Louis. What parent couldn't use some practical solutions?

As a child development expert, parenting coach, licensed professional counselor and registered play therapist, Dyson is clear about her mission to help children and families through play therapy and parent coaching. Learn more about Dyson's private practice journey, how she manages the ebb and flow of income impacted by the school year sessions, and how play plays a role in her own self-care.

Why did you decide to open a private practice?

I entered graduate school in mid-life with the goal of opening a private practice. Having been an early childhood educator for many years I knew there was a need in my geographic area for a therapist specializing in working with children 3-10 years of age.

I knew how to reach my target audience and I knew there was a market for additional specialized services such as consulting and coaching.  I also wanted the freedom to set my own hours. I knew that only by having my own practice would I be able to achieve all of those goals.

Clients that therapists find to be the most "difficult" are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

Young children with challenging behavior problems try the patience of parents and caregivers and can be challenging for therapists. The younger the child, the less they have the ability to express their feelings and their needs.  Play therapy gives a child the freedom to express their feelings through toys and play materials.

By being with a child and observing their play I gain an understanding of what the child needs. Once a child is heard and understood we can begin implementing strategies to meet the child’s needs and overcome challenging behaviors.  Understanding the child from the child’s perspective is the key to the process.

What's your biggest pet peeve about private practice?

The unpredictability of steady income. There are cycles when I’m busy and when I’m not.  Mine is related to the school year. When school is not in session during the summer and holiday breaks children are not being brought to therapy. My busiest times of year are in the fall after school starts and after the winter break. I supplement my income with consulting services to schools and other professionals, parent coaching and play therapy training to mental health professionals.

How did you discover or develop your practice "niche"?

I was an early childhood educator before I became a therapist. When I enrolled in graduate school I knew I wanted to work with children using play therapy. I took course work related to counseling children, completed an internship at an agency specializing in child therapy and attended seminars and workshop specific to play therapy. Once I was licensed and opened my practice I already had a solid skill base as a play therapist. Having been a teacher I also had the skills necessary to work collaboratively with parents. It was a natural fit.

What resource (book, website, person) helped you the most when setting up your private practice?

I stumbled across an article by Lynn Grodski in Psychotherapy Networker Magazine that inspired me to pursue private practice. I felt she addressed my questions realistically so I read more of her writings and subscribed to her email newsletter.

What has surprised you most about being in private practice?

How much I enjoy every aspect from seeing clients to paying the bills. I anticipated not enjoying the routine, mundane tasks but I take pride in overseeing every detail.

Has your private practice helped you grow professionally? How so?

I’ve gained a lot of experience as a play therapist and two years ago I put those skills into training other therapists in the modality of play therapy by founding the St. Louis Center for Play Therapy Training. www.stlplaytherapy.com  As an approved provider of continuing education for the Association of Play Therapy www.a4pt.org I offer training opportunities for mental health professionals who are pursing credentialing as a registered play therapist.  As word of the quality of my trainings has spread I’m receiving requests to bring play therapy training to locations across the country.

Has it helped you grow personally, too? How so?

I’ve gained a lot of self-confidence not only in my ability to provide quality therapeutic services but in my ability to manage the business side of my practice. Presenting at conferences and seminars has helped me develop public speaking skills.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?

When I lock client files in the file cabinet at the end of the day I symbolically lock away my emotional connection to them as well. It ensures I don’t take my work home with me. I make it a priority to do things that are fun and playful such as listening to music, going to concerts and making handcrafted items. It would be challenging to be an effective play therapist if I didn’t make time to play.

How do you cope with the inevitable stressors involved with being your own boss?

I handle all of the day to day details of my practice myself. I’m a very organized person and I rely on to-do lists. While it’s time consuming it’s not overwhelming.  I network with other private practice therapists for support and encouragement regarding the challenges of private practice.

What personal strengths have helped you succeed in private practice?

Growing up on a farm in Kansas helped me develop a strong work ethic.  I’m not afraid to push up my sleeves and tackle whatever needs to be done in order to be successful.  My social skills are strong so networking and marketing come easy to me.  I also have a lot of self awareness and recognize that growing and maintaining a private practice is a process that takes a lot of patience and perseverance and that I sometimes need to reach out to my peers for support and encouragement.

To learn more about Pam Dyson's private practice visit PamDyson.com

If you'd like to be featured in "Adventures In Private Practice Column" please submit a practice summary, and answers to the above questions here.

Adventures In Private Practice: Vocational Social Worker Dawn Vincent

Specializing in vocational rehabilitation and work/life issues, Australian social worker Dawn Vincent has been  in the mental health field for 25 years. Like many therapists, she considered opening a private practice, but says she lacked the confidence to actually do it. Read how one private practice course helped her muster up the courage to open her private practice in Camberwell, Victoria, Australia where she helps clients work toward mental health and well-being and navigate changes and choices in life and in work.

Why did you decide to open a private practice?

I had thought about it for about 10 years, but lacked the confidence to go ahead.  After spending over 20 years in vocational rehabilitation I decided to take my long service leave and think about my options.  After an overseas trip I came home and enrolled in an Introduction to Private Practice course run by the Australian Association of Social Workers.  At that time there were only a small number of Social Workers in private practice and it was still somewhat controversial here in Australia.

The profession has a very strong welfare orientation where most Social Workers are employed by the Commonwealth or State governments or work in hospitals and community based settings. Having worked for a large government bureaucracy myself, I liked the idea of the independence and autonomy private practice seemed to offer. I had been a bit of a workaholic and I wanted to move to a better work/life balance and be able to work my own hours.  The course helped me to decide that private practice was what I wanted and I committed to this goal.

Clients that therapists find to be the most "difficult" are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

Before private practice I had worked with clients with physical, intellectual and psychological disabilities, helping them to enter or re-enter the workforce after injury or disability.  At times it was very challenging and distressing working with people with acquired brain impairments and severe physical disabilities, particularly the younger ones whose lives were permanently changed.

I found I was drawn to the mental health clients and tended to specialise in this group and continue to do so in my private work. Working with people with disabilities reminds me how lucky I am to be fit and healthy and not take this for granted. It has also taught me about the dignity of risk and courage and resilience in life. Helping people overcome their barriers and live a full and meaningful life is incredibly rewarding. I learn from my clients daily and I am a better person from my interactions with them.

What's your biggest pet peeve about private practice?

The uncertainty of income. There are obviously times of the year when referrals are quiet and I used to worry about when I would get my next referral. Over recent years I have become more relaxed about this and accept it as part of the natural seasonal variations. I do get annoyed when clients cancel at the last minute when I have made a special time to see them outside of my normal schedule, although fortunately this does not happen often.  As a member of both the Australian Association of Social Workers and the Career Development Association of Australia I have double fees and professional development requirements from these bodies which becomes very expensive.

How did you discover or develop your practice "niche"?

As mentioned above, my background is in vocational rehabilitation specializing in working with people with psychological disabilities.  I always enjoyed working with this client group and was fascinated by the workings of the mind.  When I entered private practice I was naturally drawn to working with mental health clients. Originally I had intended to focus on general counselling and psychotherapy, but I found that some of my colleagues were referring clients to me for career counselling.

With my experience in general counselling and vocational counselling it made sense to continue to use my skills in both areas and mix the two streams of work.  I now see approx. 70% of clients for personal counselling and psychotherapy and the other 30%  for career counselling, although sometimes there is an overlap as people may have psychological issues which impact on their career decisions. I find the career work provides some “light relief” from the common presentations of anxiety, depression and relationship problems as it is shorter in nature and less intense.

What resource (book, website, person) helped you the most when setting up your private private?

The Introduction to Private Practice course I did was based on Lynn Grodzki’s workbook Twelve Months to Your Ideal Private Practice. I worked my way through this workbook and reported back to the group each week. I found this helped me to be well prepared for the realities of private practice.

I still frequently refer to Lynn’s books when I need to focus on how to develop my practice further. One of the social workers who ran the course allowed me to rent her room for half a day a week and on the days I went there we would spend some time talking about my practice and she provided ongoing support and advice to me as I waited for my client base to build up. My husband was incredibly supportive and encouraging.

What has surprised you most about being in private practice?

The number of people who have been prepared to help me learn what I need to know about running a business and the amount of resources available to support this.

I belong to several business networks which have been very useful in making contacts with various professionals with expertise in website development, social media, business systems, coaching etc.  It took me a while to find these, but they are out there if you ask and look.

Has your private practice helped you grow professionally? How so?

Every day I am learning new things. The longer I am in private practice, the more I realize there is to learn. Working with people and studying the human condition  is  exciting and stimulating. My skills and knowledge are continually growing as no matter what I may know about any topic or therapeutic approach, there is a constant stream of new knowledge out there.

Being in private practice makes me resource myself. I am responsible for my professional development – no one else, so I seek out opportunities to grow my knowledge and skills so I can continue to provide my clients with the best service I can and deepen my satisfaction at work.

Has it helped you grow personally, too? How so?

Absolutely. My confidence and self belief  have developed as a result of taking a risk and putting myself “out there”.  I could have continued in my former job with a safe, secure income and never grown to be the person I am now.   It is great to have been able to overcome my own fears and insecurities and put in the hard work required to realize my dream.

I have had to learn about marketing, networking, managing a business, budgets, Business Plans, etc.  I am more independent and I have a better understanding of myself, what I need and what I am capable of.   I am happy doing work that I love and which I believe makes a difference in people’s lives.  It is for me the perfect combination.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?

I am a great believer in self care and I constantly talk to my clients about this so I make an effort to practice what I preach.  Some days it can be emotionally draining working with human pain and giving out to people. I debrief with professional colleagues as needed and I attend monthly private supervision. I try to exercise regularly, get enough sleep and eat healthily.  My husband and I love travel and we visit our daughter in New York annually and have mini breaks in between.   I make sure I catch up with family and friends on a regular basis.  I use mindfulness breathing and meditation to help me relax and I listen to music and go for walks or do some gardening to unwind.

How do you cope with the inevitable stressors involved with being your own boss?

I love being my own boss so I don’t find it too stressful, but I imagine you are referring to having to do everything myself. I have no office assistance so I manage my appointments, type my invoices and reports, do my own marketing, pay the bills etc.  I’m pretty organised and I am a bit of a control freak so it does not bother me to do all this myself. Sometimes I think it would be nice to have someone take on some of the small practical things while I focus on the things only I can do.

What personal strengths have helped you succeed in private practice?

Well, I think I am persistent and resilient and if I make up my mind to do something I don’t give up easily.  I am quite disciplined and conscientious and hardworking. I am happy spending time alone so although I sometimes do miss having a team of people to work with, I operate better when I have time to think, reflect and plan. Private practice requires a lot of this.

I have good people skills and I have no problem forming trusting relationships with my clients. I network well and I seek out other people when I need social contact, but I don’t need a lot of people around me all the time. I am not afraid to ask for help when I need it and I am committed to life long learning.

To learn more about Dawn's practice visit her website http://www.dawnvincent.com.au

Adventures In Private Practice: Pastoral Counselor Rev. Christopher L. Smith, LMHC

The Reverend Christopher L. Smith combines his spiritual insight as an ordained minister in the Presbyterian Church with impressive mental health and marriage and family therapy training in his New York City private practice Seeking Shalom.

Christopher offers a variety of mental health, EAP, and consultation services with the overarching theme of helping clients and professionals seek peace in their life. See how Christopher balances his ministry and private practice.

Why did you decide to open a private practice? As someone who has been gifted in different ways and who enjoys the peace that comes from balancing different interests, I was interested in working on a part-time basis and to preserve some degree of flexibility.  The easiest way to do this while being able to maintain control over the way I would practice in helping others was to formalize my own practice.

Formalizing a practice in the same building that I also serve as a pastor both added a degree of efficiency in my work as well as adding to the quality care in a community (Harlem and Washington Heights) that was lacking in some of the services that I offer.

Clients that therapists find to be the most "difficult" are sometimes the ones who can teach them the most. What have you learned from your toughest clients? "Difficult" clients come in a variety of forms.  Difficult clients with complex symptoms motivated me to seek training, consultation and supervision in new areas strengthening the breadth of my knowledge and abilities.  Clients that are difficult in terms of their methods of interacting with people (especially those who are working on or need to work on personality disorders) strengthen my own interpersonal skills, especially around boundaries and providing clear expectations, which then makes me better able to work with a wider range of individuals.

Clients that are difficult because their situation touches on personal issues help me both develop better boundaries (remaining focused on the client and not working on my issues through the work with the client) and to learn of areas that I need to work on for myself in other ways.  Then there are those difficult clients that have helped me learn my limits whose tough issues had to lead to the end of the therapeutic relationship in order to protect my own physical safety.

What's your biggest pet peeve about private practice? My biggest pet peeve is the way that economies of scale cannot be reached in private practice, especially on a part-time basis.  This is exacerbated in my case, as New York requires me to practice through two professional corporations as I am licensed in two mental health professions that are not allowed to be practiced in the same professional corporation.

How did you discover or develop your practice "niche"? I was fortunate that my "niche" is what led me into being a mental health professional.  My motivation began within counseling and pastoral care work within the seminary building on other experiences that made this calling evident to me. While my career has involved practicing outside my "niche", there was no question that pastoral counseling would be the focus of my own practice.

What resource (book, website, person) helped you the most when setting up your private private? There was not one resource that most helped me while setting up my private practice.  My original private practice was small to help maintain my skills and was possible because of the support of a number of pastors.  In developing a larger (but still part-time) practice that is more formalized, a wide variety of resources were helpful.  Probably most critical, though, was the encouragement and faith of a number of people in my relationship circles.

What has surprised you most about being in private practice? The largest surprise has been that the clients that have been attracted to my practice have almost exclusively been ones within the area of my niche.  Prior to moving in this direction, most colleagues have talked about needing to start out with a broad base of clients to make their practices work.

Has your private practice helped you grow professionally? How so? Being in private practice has forced me to become much clearer and to be able to more concisely describe what I do professionally.  This clarity is clear professional growth.

Has it helped you grow personally, too? How so? Being in private practice the way that I am has helped in my overall balance.

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health? While I care for my emotional and psychological health in the standard ways (such as meditation, walking, music and friends) that are the case for other therapists whether they are in private practice or practicing in a different form.  As my practice is in the same building as another role, I do not have to see large blocks of clients without breaks.  I am able to see clients for a little while, then go down to my other office and do something different as a respite before coming back to work with another client or two.  Additionally, I take time each week to be out of town.  While away, I am engaged in another role but it also tends to provide sort of a weekly mini-retreat.

How do you cope with the inevitable stressors involved with being your own boss? These stressors are not things that I cope with as they are positive stressors for me.   Rather than coping with them, I enjoy the challenges and exploration of the possibilities.

What personal strengths have helped you succeed in private practice? Patience, self confidence, motivation, my own spiritual understandings of vocation and social networks are probably the personal strengths that have most helped me to succeed in private practice.

To learn more about Rev. Christopher L. Smith, LMHC visit SeekingShalom.org

Adventures In Private Practice: Parenting Expert Dr. John Duffy

When it comes to parenting and family relationships, particularly during the tween and teen years, Clinical Psychologist Dr. John Duffy has become the go-to expert. Not only does he have a thriving private practice in the Chicago area, he also published a book last year called The Available Parent: Radical Optimism for Raising Teens and Tweens (2011), and blogs regularly for The Huffington Post on relationship topics.

Learn more about how Dr. Duffy parenting niche found him, how he manages the stress of being "the boss" and how he's built a thriving private practice.

Why did you decide to open a private practice?

From the day I began grad school, I knew I wanted a private practice. To be honest, it started much earlier as I idealized characters played by Bob Newhart and Judd Nelson. Later, I realized it was the model I could thrive in. I had spent many years in a VERY corporate environment working for other people, and I knew I wanted to work for myself.

Clients that therapists find to be the most "difficult" are sometimes the ones who can teach them the most. What have you learned from your toughest clients?

I’ve learned patience, empathy, and compassion form my toughest clients. I’ve also learned that, once you familiarize yourself with another person’s back-story, it becomes very difficult to demonize them, and much easier to relate to them. I frequently tap this skill in my private life as well.

What's your biggest pet peeve about private practice?

I miss the camaraderie and dynamics of a group. I have a number of friends in group practice, and I find the idea of a staff meeting to hold some appeal on occasion.

How did you discover or develop your practice "niche"?

My niche actually discovered me. As I began my practice, I became friendly with a number of social workers at area high schools. Teens, tweens and parents became my demographic, and I’m so grateful to discover that I have a great deal of passion for working with families. I’ve been lucky enough to have a waiting list for the past several years.

What resource (book, website, person) helped you the most when setting up your private private?

I learned most from colleagues already in practice, willing to share their stories and struggles. I’m very lucky to have had their help early on.

What has surprised you most about being in private practice?

I’m most surprised by the opportunity that private practice presents. Not only do I see about 40 clinical clients a week, but I do a great deal of public speaking, mostly to parents, I published my first book this year, I’ve done TV, radio, print and other media, and blog on the Huffington Post. None of this would have been possible is I did not have the experience of my practice to rely on.

Has your private practice helped you grow professionally? How so?

Along with the above, I’ve learned more about how to live life from my clients than almost anyone else in my life. I’ll never forget the young man who decided to write the “better story” every day of his life. I think about that mantra most every day.

Has it helped you grow personally, too? How so?

I live that advice, and being in practice also keeps me far more aware of the ways in which I choose to live my life, and when my choices are maladaptive. Hopefully, I have pretty good advice for myself on how to implement change!

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?

I work out regularly. I consult with a few close colleagues. I stop for a while to strum my guitar. And I laugh with my family, every day.

How do you cope with the inevitable stressors involved with being your own boss?

I remind myself of the freedom my practice affords me. I make my own schedule. I work hard Monday through Thursday, protecting Fridays for writing and other activities. I limit the amount of paperwork I do, as best I can. I stay organized as well. My iPhone is my virtual office.

What personal strengths have helped you succeed in private practice?

I’m an empathic, patient guy. I’m a pretty good listener, and my attitude is typically quite positive. I also feel that I have the patience to draw answers from my clients, instead of throwing out my solutions to their problems which, in the end, may not be useful at all. I truly do find that the less I think I know for sure, the more effective a therapist I am.

It's great to connect with and to be inspired by other therapists in private practice!

To find out more about Dr. John Duffy's clinical practice and book visit DrJohnDuffy.com.