Practice Part 1

Pregnancy in Private Practice: 4 Key Questions To Help You Prepare For Maternity Leave

4 key questions to help you prepare personally and professionally for managing maternity leave in private practice.

I'm a mother of four children. My first two children were born during my educational journey and my last two were born while I was in private practice. Being in private practice provides many perks for balancing work and family life. The flexibility of being my own boss has been wonderful. However, taking time off for extended periods of time, like maternity leave, can prove to be tricky.  Unlike working for an agency, in private  you don't get paid leave in private practice,  you still have expenses to pay even when you're not seeing clients, and you have unpredictable income as you "wind down" to take time off and then build your client load back up after taking family leave.  Becoming pregnant while in private practice and planning for the new addition in your family requires some extra planning, coordinating, and saving.

How Much Time Will You Take Off?

These little babies can be a BIG adjustment. It's important to really think about taking enough time for you to adapt to being a parent to this new, little person. Dr. Jennifer Fee, psychologist from California found that one of the most helpful things was taking sufficient time off after giving birth. She suggests coming back gradually and not carrying a full load for awhile.

"Rushing back [to work] while you're adjusting to and bonding with a new baby is not good for you, your baby, or your clients. The great thing about private practice is that it's not an 'all or nothing' business. You can start practicing with a few clients rather than jumping back into a full load," says Dr. Fee.

Determining the length of your maternity or paternity leave can be extremely important in keeping your practice thriving. If you are a sole practitioner, taking a three month leave could potentially leave you with very few clients upon your return. You must decide not only how long is financially feasible but also how long works for your family and your clients.

Who will provide services to your clients in your absence?

It's important to consider who will provide clinical services to your clients while you are on maternity leave. If you are in solo practice, consider reaching out to another trusted private practice colleague who has openings to provide services to your clients while you are on leave. Make sure that your clients have the contact information of the therapist who'll be covering for you. I suggest that clients in crisis have appointments set up with this therapist before you take time off.

I recently talked with a private practice colleague who is pregnant with her third child. I suggested that she consider hiring another therapist to cover her clinical cases and also to generate income for her practice while she is on maternity leave.

When will you stop taking new clients?

You'll also want to think about when you will stop taking new clients. If you plan on taking new clients up until your leave I suggest that in your first conversation you inform them that you will be taking time off so they can have the option of seeing someone who can provide uninterrupted services.

Jennifer Venable-Humphrey, LCSW of Social Work Solutions stopped accepting new clients one month before her due date. When put on bed rest with her third child, Jennifer used Skype or phone sessions to check in with current clients that she had to stop seeing earlier than planned.

How will you cover your fixed expenses and lack of income?

Taking time off in private practice is tricky because you have to plan not only for lost income but for paying the fixed expenses of maintaining a practice while you are on leave. Expenses like rent, phone, internet, or perhaps the cost of support staff may need to be paid whether you are practicing or not.

Joseph Sanok, LLP, LPC of Mental Wellness Counseling in Traverse City, MI suggests considering the cost of being away from your family once you have returned to your clients. Sanok decided to increase his fee when his wife became pregnant. "For me, I knew that working in my practice was going to be difficult when I had the draw of a wonderful new addition. By raising my rates, it made it easier to give up the time."

I'm curious to learn more about the changes you made or creative ways that you found for your transition to parenthood in your private practice. Share those here!

Multiple Income Streams Soothe Therapist's Financial Anxiety (part 1)

Relying solely on direct clinical hours may leave private practitioners financially vulnerable to income instability. Since client hours in private practice can vary greatly depending on the time of year, state of the economy, number of new referrals, and several other factors, developing multiple income streams can help you to create a more stable income. "By having the other income streams in place, I have been able to be less susceptible to the ebbs and flows that occur in private practice during difficult economic times," says The Rev. Christopher L. Smith, LCAC, LMHC, LMFT. In addition to providing income stability, diversifying your professional activities with multiple income streams allows therapists to explore a variety of interests, to express creativity, and to get paid for their passions.

In addition to clinical hours, I own and serve as clinical director of a private therapy clinic where I oversee and supervise 10 therapists, write for PsychCentral and other publications, work as a relationship and emotional health media contributor, do public speaking, provide consultation to therapists building a private practice, and I'm currently writing my first book.  Curious about what other private practitioners are doing to add to income stability I reached out to several successful colleagues to see what additional income streams they've developed. Here's a sampling of what other therapists are doing to diversify their professional life and achieve greater income stability.

Write and publish a book

Many therapists have taken their clinical expertise and turned it into a book. For example, Frank J. Sileo, PhD has  written three children's books, including Bug Bites and Campfires: A Story for Kids about Homesickness (Health Press, 2009). Clinical Psychologist Dr. John Duffy took his passion for parenting and authored a book The Available Parent: Radical Optimism For Raising Teens and Tweens (Viva Editions, 2011). What areas of expertise could you write about?

Write for print publications

Supplementing clinical work, Terrie Browning, LPC, CFC, DCC writes for a column "My Healthy Mind" for a local magazine My Metro You. Not only does it provide additional revenue but she says it's also personally fulfilling. Of writing for publications she says, "Writing allows me to share knowledge on topics that are a concern for many people and offers a way for me to network myself."  Therapist Karen R. Koenig, LCSW, M.Ed. has successfully written for professional publications including Social Work Focus, Social Work Today, Addiction Treatment Forum, and The Newsletter for the Society for Family Therapy and Research, adding an additional income stream.

Create a therapeutic product

Have you considered creating and selling a product based on your clinical expertise? Stephanie Ann Adams, M.A., LPC of Beginnings Counseling & Consulting, created a hybrid counseling/video series for premarital counseling through Twogether in Texas. To help families deal with the stress of relocation Jill Kristal, President of Transitional Learning Curves, developed a game and book series called 'Our Move'.

Develop a professional online network

The internet allows for many options for therapists to create passive income through membership sites. In addition to writing a local magazine column and providing clinical work, Browning, with the help of her adult children, developed a professional wellness center online called Experts Now. This online center offers wellness experts an avenue to offer services and sell products for a commission creating additional income for Browning.

Contract as a consultant

Consider asking yourself, "Which companies or organizations may want to tap into your areas of expertise?" Therapist Dr. Mario Kirk, LPC, Director, A Blessed Child, LLC, performs psychological testing for local attorneys and schools. Women's reproductive health specialist Pec Indman EdD, MFT consults and trains for county health programs and for the US Federal government.

Are you developing multiple streams of income to supplement your direct care hours? Please share your ideas in a comment below.

Watch for multiple income streams part 2 later this week!