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!

Benefits Of Blogging For Your Private Therapy Practice

I recently had a delightful chat with Australian counselor and consultant Clinton Powers via Skype about my evolution as a blogger. We talked about the many benefits of blogging as a marketing strategy, unexpected benefits that I've experienced through blogging, how to find your blogging voice, and how to address ethical concerns. I hope you enjoy the interview. Below, I've summarize the main points of our lively discussion.

What are the benefits of blogging as a practice marketing strategy?

  • Grow your practice by making it easier for clients to find you
  • Build your brand online
  • Fresh content improves SEO for your practice website
  • Establishes you as a credible expert in your field
  • Online networking with other mental health professionals
  • Positive impact on readers all over the world

What are your tips for developing your blogging voice?

  • Start where you are
  • Reject perfectionistic tendencies
  • Remember that you can edit
  • Re-purpose previously written content (papers, presentations, other media interviews)
  • Read and model after other therapists blogs

Where do you find inspiration for blog post topics?

  • Share your philosophical background
  • Write about themes you're seeing in therapy
  • Write about related news and current events
  • Summarize new research and add your take on it
  • Share other experts' content, including videos

How do you make time to write?

  • Write about the things that energize you and sound fun
  • Schedule time to blog once a week

How do you avoid ethical concerns?

  • Don't share client information
  • Don't share personal information

This interview first appeared on

Adventures In Private Practice: Healthy Eating Expert Karen R. Koenig, LCSW

When I launched this blog in July I had no idea that one of the perks would be connecting with so many amazing therapists who've created successful practices. I've been inspired by shrinks around the globe who demonstrate the varied ways to make a living, and make a difference with their clients and I thought you'd be too.

I'm thrilled to interview Karen R. Koenig, LCSW for the first in an ongoing series "Adventures In Private Practice" so you can learn from her experiences to improve your practice. I first learned of Karen's work when I bought her  "Food and Feelings" workbook that I used with several of my eating disordered clients.

I've been impressed by Karen's passion for helping clients struggling with food issues, while writing to raise public awareness of how to relate with food in a healthy way, and maintaining excellent self-care.

Tell us a little about your practice...

Although I have been doing general psychotherapy for 30+ years, my expertise is in the psychology of eating--the why and how, not the what of it.  I teach troubled eaters the life and appetite skills they need to eat "normally" and attain and maintain a healthy weight for life without dieting.  I also do Skype and telephone coaching on eating and weight concerns.

Why did you decide to open a private practice?

After graduating social work school and working at a methadone clinic for six years in MA, I decided I wanted more time to try my hand at writing fiction, which meant working for myself.  I applied to be a provider on insurance plans, joined the MA social work chapter’s private practice support group (and learned a lot), and was fortunate to find a peer consultation group that fit my needs.

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 learned to, as my second year internship supervisor advised, “get my wind out of their sails.”  I think we try to control our most difficult clients more than easier ones which only creates more of a backlash.  Through them I’ve learned patience and to expect as much work from them as other clients.  My biggest shock has been working with clients who in many ways aren’t awfully functional, only to find they’re way ahead of me on a thorny issue.  I always get a kick out of that.

What's your biggest pet peeve about private practice?

Working with numbers.  I’m pretty pathetic when forced to do math and have anxiety about even filling out forms for my accountant at tax time.  I just know I’m putting in the wrong figures.  Also keeping up with my license fee, social work dues, malpractice and commercial insurance payments.

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

After recovering from my own binge-eating problems, I taught in a training program for troubled eaters.  After class, students would ask to meet with me privately and I soon had a small practice.  That’s when I realized that if I was going to do therapy, I needed more training and returned to pursue an MSW.  Shortly after that, I started writing books about eating and weight and teaching my own workshops.  After many decades and books and clients, I became an expert.

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

I can’t say there was one thing.  To start a practice in MA, I took a class on opening/running a private practice and that was useful for the basics, and also talked with other practitioners.  One in particular was very generous with her time and let me call her when I had questions.  I think the NASW private practice group was enormously helpful with financial and ethical concerns.  When I moved to FL six years ago, I started all over again.  I decided to take only self-pay clients, which meant lots of marketing work was ahead.  I joined the local social work chapter (unimpressed, I dropped out fairly quickly), but networked with therapists I met here and there, especially in the field of eating disorders.  I volunteered to do talks on eating and did as many book signings as possible.  Slowly my practice grew and continues to flourish.

What has surprised you most about being in private practice?

I've been surprised at how my client load stays fairly steady. I do a tremendous amount of marketing—such as answering requests like this one, hiring someone to manage my social media and pr, doing talks, running a message board, blogging twice weekly, expanding my therapy practice to worldwide eating coach via Skype and the telephone, writing online articles.

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

My books, articles, and talks on eating and weight feed (pardon the pun) my practice and my practice boosts my book sales.

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

Well, it’s made me face this I’m-bad-with-numbers perception I have.  I still do get anxious, but I’m pretty on top of things.  When I’m really in a panic, I ask my husband (the math guy) for help.  I love being responsible for my own schedule. I’ve learned to manage time well and to balance work and play.

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

I now don’t treat clients on Fridays.  At 65, though, I can’t imagine retiring any time soon.  I get energized from my work and rarely feel emotionally exhausted because I no longer see back-to-back clients every day.  Instead, I teach occasionally, write articles, am in the middle of writing two eating manuscripts, and am working with an agency to develop a Facebook eating app.  Switching gears and not having only a private practice keeps me feeling creative.

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

I don’t feel that stressed except if I have more than three clients in a row.  As I said, I’m fortunate that I don’t need to have a large caseload because I make money other ways.  But I set up my life this way because I didn’t want to be drained and there were other things I wanted to do.  I’m very good about managing my time, though I work many hours and often through the weekend on projects I enjoy (I’m starting to write songs suddenly—lyrics and melody!).  I only wish I could clone myself to do all I want to do which would include a bit more down time.

What personal strengths have helped you succeed in private practice?

I had two neurotically organized parents so I inherited that strength.  I am good at starting and ending sessions on time, maintaining email contact with clients between sessions at a pace I can tolerate and which meets their needs.  I like things easy and accessible so I work at home and have a separate wing of my house for my office and a client bathroom.  Every day I follow a routine of blog writing, checking emails and my message board, then exercising, and getting ready for the day.  I work during the hours I have the most energy 12:15-7:15p, turning away morning clients or those who need appointments at night.  Because I get to meet my needs, I don’t feel resentful.  My biggest strength is taking excellent care of myself and picking a husband who is extremely supportive of all I do.

To learn more about Karen's work and practice visit

If you'd like to be interviewed and featured in "Adventures In Private Practice" contact me here.