Therapist Blog Challenge #21: Maintaining Space in a Relationship

I'm excited to present a blog challenge that has to do with one of my favorite topics: relationships. Specifically, you'll have the chance to explore the idea of how a person can maintain his/her own space (physically and emotionally) while also being in a relationship.

[Headline] Come up with a headline to give your readers an idea of what is to come. Here are a few examples:

"'Give Me Some Space!' Maintaining Healthy Boundaries in Relationships"

"Creating an Appropriate Amount of (Emotional) Space With Your Significant Other"

"Absence Makes The Heart Grow Fonder; How Spending Time Away From Your Spouse Can Strengthen Your Connection"

"Preserve Your Relationship By Taking Time For Yourself!"

[Strong Intro] Write an introductory paragraph to explain the topic more and lay the scene for your main points. You may write your own or use the following:

Movies and pop culture often portray two people in love as inseparable and completely enamored with one another. Some struggle when they realize that the experience of real life can be quite different. The truth is that almost everyone in a relationship needs a little personal space and even time away. But how can you get a breather while still maintaining your relationship? Here are some reasons why space is important and also ways to create boundaries and still keep your connection strong:

[Scanable Content] Break up your content to make it more digestible and easy to read. Under each point, flesh out your idea by elaborating on your thoughts.

1. Tune In To Your Feelings

Acknowledging your emotions that you need a little space in your relationship is the first step. Maybe you're feeling a bit cut off from other people or are even feeling a bit smothered. Some may be inclined to ignore such feelings or consider them "bad," but instead express to yourself if you are wanting a bit of a breather from your significant other.

2. Communicate About Your Needs

It may be a bit tricky, but tactfully communicate that you would like to branch out a bit. Be careful to let the other person know that you are not ending the relationship, but just want to find ways to enrich your life and experience. Express how you are feeling, and listen to your love's response; it's possible that he/ she is wanting the same thing!

3. Pursue Your Individual Passions

Take time to "get to know yourself" and do something that you enjoy (but perhaps have been neglecting). Go ahead and sign up for that pottery class, or recommit yourself to your exercise regimen that has suffered a bit. Encourage the other person to likewise engage in activities that he/ she likes.

4. Nourish Your Friendships

Although your spouse or significant other is likely your "number one," remember that no single person can fulfill all of your needs. We as humans are wired to connect, and we have something to learn from different people in our lives. Moreover, there is likely someone in your circle of influence who needs you, so take a break for a day or two and spend an evening with a friend.

5. Come Back Together Stronger Than Before 

If you need some space and give yourself permission to take it, you're practicing self-care and can become even closer to your significant other. Famed German psychologist Erik Erikson explained that "identity precedes intimacy." Paradoxically, your relationship can be strengthened by developing your self and then creating and maintaining space!

[Strong ending paragraph] Wrap up your post by summarizing your main points to conclude and then possibly offering a further idea or two for readers or a call to action. Here’s an example:

Relationships need a lot to thrive: time, love, honesty, and connection. But each person taking time for him/ herself is an important (and sometimes overlooked) component in creating and maintaining a strong and healthy relationship. Tune in to your feelings, communicate, spend time with your friends and doing what you like, and come back together stronger than before.

Additional reminders about the 2015 blog challenge

• Write and post your blog article in the next 2 weeks. If you miss the deadline or you read this article months later, that’s OK too. Post a link for this blog challenge in the comment section of this blog post.
• Read, comment, and share other therapist’s articles.
• Tweet your post using hashtag #therapistblog and tag @drjuliehanks so I can retweet it.
• Pin it on the challenge Pinterest Board. I’ve invited everyone who posted a comment on the initial blog challenge post as collaborators so you can pin onto the group board.
• Spread the word and invite mental health colleagues to join the challenge. Articles can be added anytime throughout the year.
• Write no more than 600 words, make it easy to read, use a conversational tone, and gear your articles toward your ideal client (not other professionals).
• The goal of a professional blog is to provide value to your website visitors, help them get to know your professional perspective, increase traffic to your private practice website, and build your practice.

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5 Reasons to Network With Other Therapists

As therapists, it’s easy to become isolated. We see our clients, fill out paperwork, perhaps read a book or two to brush up on certain skills, then go home. I certainly don’t mean to imply that the work of a clinical counselor is rote or is not stimulating, but as the nature of therapy is very private, it’s quite possible to get into a routine that greatly limits our interaction with other professionals.

Through my 13 years in private practice and 20+ years in the mental health field, I have come to understand the power of networking with like-minded professionals. Networking is cultivating relationships to facilitate the exchange of information (which may be related to the nature of the profession and/or to career and employment). For our purposes, it simply means being in frequent and meaningful contact with other therapists! This strategy has greatly benefited my practice and also me personally and professionally in numerous ways.

Here are 5 reasons to get out of your office and begin networking with other therapists:

1) Client Referrals        

Perhaps you've recently opened your practice and need to build your clientele. If you know others in the area and have begun to create those relationships, you have a valuable resource to draw upon. Introduce yourself to other practitioners in your area in case they know anyone seeking a therapist with your speciality (it's not self-serving; it's smart). Conversely, if you have a thriving practice and have the wonderful dilemma of having a higher demand for your services than you are able to provide, generously referring out is a way you can serve individuals even though you are not seeing them as clients. Network to learn of others you can contact if/ when this occurs.

2) Combat Loneliness 

We teach our clients about the importance of self-care, but are we tending to our own emotional needs as well? We understand from attachment theory that we innately need connection with others; isolation is quite literally a form of torture, and many therapists I've worked with feel a real sense of disconnection seeing only clients all day. Reach out to others in order to fight loneliness and feel emotionally supported (read more here about this idea).

3) Career Opportunities      

Beyond your work as a clinician, you can use your skills and talents to serve your community in other ways (such as through writing or consulting), and many of these opportunities present themselves through your relationships with others. Perhaps a colleague has suggested or inspired you to expand your activities. Networking has brought me personally many opportunities that I wouldn't have otherwise had. It's quite amazing the possibilities that can open up to you if you devote time and energy to cultivating those professional connections.

4) Collaboration        

Going along with the previous point, finding ways to apply your skills other than by seeing clients is often best done in collaborative efforts. Combining your knowledge and experience with others in the mental health field is a great way to enrich and contribute to the professional community while simultaneously expanding your outreach. This very blog is infinitely more valuable because it contains not only my experiences, but those of others with whom I've networked and created relationships. Reaching out and working with others in the field can enhance your career accomplishments.

5) Communicate About What's New      

If you're sitting in your office all day with only minimal contact with the outside world, it's unlikely that you'll hear about new developments in the field. But through continual networking and staying in touch with other clinicians, you can become aware of and familiar with new therapies and strategies that may enhance your practice. Regular contact with others can help you keep abreast of these new ideas, and you as well can offer your feedback on current topics and controversies relating to therapy.

What are reasons YOU network with others?

How has networking benefitted you?

Stay tuned for an upcoming post about therapist-friendly strategies to effectively network.  

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Counselor Self-Care Practices

Guest Post: Hollie L. Hancock, M.S., CMHC

Reflect on how well you take care of your own needs. Help me learn more by filling out a counselor self-care practices questionnaire.

While attending an ethics conference last week, I took the opportunity to solicit participation from my fellow counselors and psychotherapists for my dissertation research.  As I described the study, and as the words “counselor self-care” crossed my lips, a loud and obvious laugh erupted from various corners of the large ballroom where the conference was being held.  From the front of the room I saw people looking at one another, laughing, and rolling their eyes; I even read the lips of one man in the front row as he said to the woman next to him, “Yeah, right!”

Honestly, I was not surprised.  In fact, I almost expected this type of response.  The laughter, snickers, and side-ways comments are exactly the reason I am researching counselor and psychotherapist self-care practices.

As therapists, we use our education, training, and skills to help patients live more rewarding and healthy lifestyles, independently.  Ironically, many therapists seem reluctant to offer themselves the same kind of understanding and care.  Yet, in reality, it is this self-care, both personal and professional, that ultimately is the most important, not just for patients, but also for we as therapists as well.  It is quite possible that mental health professionals are one of the few professions that does not purchase or utilize their own product.

Lack or absence of self-care practices among mental health professionals appears to be almost synonymous with compassion fatigue and burnout.  The literature seemingly suggests that by mentioning self-care – counseling professionals are burned out or experiencing compassion fatigue to some degree.  Do a small research study of your own: Conduct a Google search using the words “counselor self-care”.  You are likely to find half of the top results include the word “burnout”.

Participate in my dissertation research on counselor self-care practices

In an effort to understand the possible phenomenon of the lack of self-care practices among counselors and psychotherapists, I am asking colleagues across the nation and even around the world, to provide responses to a brief questionnaire created for my dissertation research.  Therefore, you are cordially invited to participate in a study that will ask questions about your experiences with self-care practices as a counselor or psychotherapist. This inventory is called The DEFT Questionnaire. “DEFT” represents what counselors and psychotherapists “do” for self-care, how they “experience burnout”, how they “feel” about their self-care practices, and finally what counselors and psychotherapists “think” about self-care. The purpose of this study is to explore whether or not there is a correlation between self-care practices and burnout among counseling professionals.  Completing the questionnaire will take about 15 minutes of your time.

To be better clinicians in our roles as counselors and psychotherapists, we owe it to our patients, and more importantly ourselves, to be aware of our self-care needs, and adjust our behaviors accordingly if necessary to avoid impairment, burnout, compassion fatigue, and even post traumatic stress disorder.

I have provided the link to the questionnaire below.  I respectfully ask that you take 15 minutes of your time to complete the questionnaire.  Then, please share the link with your peers and colleagues.  I thank you in advance for contributing to the body of literature available regarding counselor self-care practices!

Fill out the counselor self-care survey here:

https://acsurvey.qualtrics.com/SE/?SID=SV_cvWrM4l8iqBWU1D

The questionnaire will be available until March 31, 2013

Hollie L. Hancock, M.S., CMHC is in private practice at Iron Mountain Counseling is a Doctoral Candidate in Counseling Psychology, Argosy University, Salt Lake City, UT

The $12,000 Mistake Many Therapists Make

Ending sessions on time or charging more for extended sessions not only models good boundaries, it's good for your business.

What's the big deal about giving a few extra minutes to your clients? After all, we are in this field to help others and we are generous souls by nature, right? Yes, we are. However, an on-going pattern of giving away a few minutes each session adds up over a year's time.

Let's say you see 10 clients for 50 minute sessions per week= 500 minutes. If you go over 10 minutes with each client you're doing 600 minutes of therapy and only being paid for 500 minutes. That means you're giving away 100 minutes of therapy every week. After one year of giving away 100 minutes every week you are giving away 5200 minutes of free therapy. 5200 minutes is the equivalent of 104 free 50 minute sessions every year. If you charge $115 per session your practice is giving away $11, 960 of free therapy a year!

In addition to thousands of dollars of lost income, therapists who have a habit of giving away their time carry the stress of running late for other sessions, not taking adequate time for self-care, and falling behind on clinical notes and other administrative tasks. These chronic patterns may ironically lead to you being a less effective therapist with a less successful practice.

Now, just to be clear, I am all for pro bono work. The problem with this kind of "pro bono" work is that therapists don't realize they're giving it away and clients often don't realize they are being given a gift of therapist's time. Clients may come to expect 60-minute sessions because therapists have taught them that this is the norm and may then feel ripped-off when their therapist decides to start setting firmer boundaries.

Setting firm boundaries with session ending times, and charging for additional time allows you to consciously take on pro-bono clients, because you have more time, energy, and resources to offer free services. If you struggle to end sessions on time, here are a few suggestions to help you.

Suggestions for setting boundaries with session length:

1. Set the expectations from the very first session. It's a lot easier to set the norm of ending sessions on time, than to bring it up later in the course of therapy.
2. Keep your agreement. In your initial consent for treatment paperwork be explicit about how you will handle longer sessions. Let the client know that if they need more time they will have to pay more. If I am in a session and it seems like the client would like to go longer, and I have the flexibility of giving additional time, I might say something like, "Our session is just about over. It seems there's more here to work on. I have an additional 15 available today, would you like to keep going with session even if it adds additional cost?"  Since I charge $150 per 45-50min session. If a session goes 15 minutes over I charge an additional 1/3 of the session fee.
3. Recommend scheduling longer or more frequent sessions. For clients who seem to have difficulty processing their issues and containing their affect in a 45-50 minute session, schedule longer sessions (75 or 100 minute sessions), or offer to see them an additional session per week.
4. Start wrapping up 10-15 minutes before end of session. Give them explicit verbal cues like, "We have about 15 minutes left in the session. Let me tell you what I've heard today..." Physical cues like sitting up straight in your chair or standing up when the session is over may help you send a congruent message that the session is over.

Eric Gjerde via Compfight

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!