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!

10 Things I Accidentally Did Right In Building My Private Practice

As I reflecting back on 10  years in private practice I did a few things right, mostly by chance.

With a business license, professional license, and big dreams, I opened a private practice ten years ago. Having never taken a business, marketing, or management course, I have learned "on the job" how to be a small business owner. Hopefully, you can learn from what I accidentally did right and intentionally apply them as you build your private practice.

1) Start small, think big

At the time I opened the doors I was a solo practitioner. Those of you in solo practice know that means I was the receptionist, the billing manager, the webmaster, the marketing specialist...Being a "one woman show" for a few years not only taught me what it takes to run a practice, but also how to teach others what I had learned as the practice grew. My vision was to grow my practice into a group with several practitioners and over time, that has happened.

2) Grow slowly

I didn't know it then, but one of the main reasons new businesses fail is because they grow too quickly. As a mother of 3 children at the time, I was fine growing slowly so I could manage the multiple demands on my time. Turns out it was good for business too. Growing slowly allowed me to build a business without loans or going into debt.

3) Charge more than you think you're worth

From my first day in private practice I have always charged a higher fee than I felt I was worth. This forced me to deal with my own money issues, and to learn to value my own services and skills more highly. I came to understand the value of the perceived value of my services as clients assumed that I must be very skilled in order to charge at the high end of the scale for my location.

4) Think like a business owner

My family of origin tends to have an entrepreneurial mindset where self-employment, flexibility, and freedom are highly valued. This framework helped me to be able to think like a business owner and a therapist and to find an emotional place where those two roles weren't mutually exclusive. Although they are occasionally in conflict, I've found that that is a rare occasion. Thinking like a small business owner has helped me to set better therapeutic boundaries with clients as well.

5) Trust your gut

In all areas of practice, from office location, to logo design, to who to hire, to which practice software to purchase, after researching the best options I ultimately followed my intuition in making key decisions for my private practice. While the path hasn't been perfect, I can't think of one decision where I trusted my gut and regretted it.

6) Hire qualified people that you trust with your reputation

One of the scariest things in growing from a solo practitioner to a larger practice is hiring people who have the power to impact  your professional and business reputation. In addition to hiring very qualified staff, also hire people that you'd trust and train them how to present themselves in a way that builds your credibility.

7) Set strong boundaries with money

Whether it's following through with your office policies regarding collections, or saving for those dips in client numbers, I have tried to be consistent with money policies. This also applies when hiring employees. My tendency was to give away a little too much at first, because of my inexperience. I soon learned that there is a cost, emotionally and financially, to having employees, and that I deserve to get paid for management time and for holding all of the liability in the practice setting.

8) Create a home away from home

Creating a comfortable yet professional office space has helped me, and my clients, to feel welcomed and safe. I've found self-expression in my private office environment and decor helps foster a sense of safety and nurturing and creates a space where I feel at ease.

9) Integrate your passions into your practice

I have always integrated current interests and passions into my private practice. If there's a film that I really like, I'll use that with clients. More recently I've become a tech geek, so I've integrated technology into my private practice by launching an online therapy division, moving to electronic records, and building a social media following.

10) Take good care of you

Personal self care has always been high on my priority list. I've known that if my own needs were going to get met it was my job to make it happen. Whether it's scheduling exercise, bringing healthy food to work, making time for social events, or attending my own therapy, I am fiercely committed to making sure I am taking care of me. I think those habits have allowed me to energetically continue investing in my clients, my practice, and my employees without feeling burned out.

What things have you accidentally done right in building your practice? Please share so we can learn from each other!

Why Some Shrinks Fly Solo

In past posts I've explored the the positives and negatives of joining a group private practice. Now, it's time to focus on the pros and cons of running a solo private mental health practice. When I opened Wasatch Family Therapy nearly 10 years ago, it started out as a solo practice that slowly built over time into a group practice. While I like being "in charge" and autonomous, I'm also an extravert and I highly value my connections with others.

I reached out to other private practice therapists who practice alone to see why they chose to "fly solo."

Autonomy

Florida social worker and healthy eating expert Therapist Karen R. Koenig, LCSW, M.Ed. grew up as an only child, so she's used to being independent and working alone. That autonomy and comfort level has helped her to succeed. “I love being in private practice. I make my own schedule, decide whom I want to see and whom I don’t, set the fee schedule and slide if I want, and get to have an office in my home which makes both life and work easy,” Koenig shares.

Self-expression

Creating an environment that accurately reflects who you are is important to North Carolina therapist Erika Myers, LPC. "Having your own space in which to practice in a way that feels authentic to you, building an individual reputation rather than relying on a group name for recognition,” are reasons why Myers chooses to practice in a solo setting.

Flexibility

Illinois counselor Melanie Dillon, LCPC of Center For Wellness, Inc. practiced independently for 17 years. Of her experience she says, "Private practice gave me a very flexible schedule and autonomy. It also helped me grow to learn all aspects of being a small business owner. It was ideal for parenting and having a second income.” Eventually Dillon developed a mind/body group practice with two chiropractors when she found herself as a single mom and needed to provide a stable income.

As the second oldest of nine children in my family of origin I am used to being "in charge" and in having close connections with others. So, it makes sense that eventually, I grew my own solo practice into a group practice where I am still the sole owner and decision maker. Guess I just can't get away from being the "bossy" older sister.

photo credit: cuatrok77

Poll: Do You Work In A Group Or Solo Practice?

I've recently blogged about the pros and cons of group practice.  Watch next week for more on running a solo practice. Until then, I'm curious how many of you practice in a group practice setting versus a solo practice. Take this poll and please pass it along to colleagues.

Do you practice in a group or solo practice?   (c) Can Stock Photo

Pros And Cons Of Group Practice (part 1)

A common private practice question is whether a therapist should join a group practice or venture out on their own as a solo practitioner. The answer is different for everyone depending on your strengths, goals, personality, financial needs, and many other factors.

There are also other options in between solo and group practice, like sharing an office space with other practitioners while maintaining your own practice. "There are numerous ways of forming a group practice including cost/office sharing, partnership, and employment as associates under a licensed provider," according to Kansas Psychologist Wes Crenshaw PhD, ABPP of Family Psychological Services, LLC.

To help make your decision easier, here are some of the benefits and drawbacks of joining a private practice group.

Benefits Of Joining A Group Practice

1) Established business systems

If you're considering joining an established practice, a huge benefit is that they already have office systems in place to support the practice. Michigan therapist Jacquelyn J. Tobey, MA, LLP of  Sollars and Associates says, “I have benefited from joining a group because many of the business practices such as marketing and billing are already established.”

2) Shared expenses and responsibilities

Sharing the costs of operating a business can be appealing. Therapists often underestimate the financial requirements when starting a private practice. Sharing operating costs, office space, equipment, marketing, and administrative expenses are just some of the benefits that North Carolina counselor Erika Myers, LPC enjoys about group practice.

Tobey has learned what it takes to run a business by first joining a group practice. She likens a group practice to renting a furnished room in a house that is already built, whereas private solo practice is more like  designing and building the house on your own. I think that is an excellent analogy.

3) Consultation and camaraderie

Meyers enjoys having colleagues to consult with on difficult cases as well as the camaraderie inherent in interacting regularly with colleagues. "The work we do can be isolating, so having fellow professionals around can help you have more social contacts beyond the professional consultation," Meyers says.

Melissa J Templeton, MA, LPC, LMFT compares working in a group setting to a good relationship. “Like a good marriage, it is the ‘fit’ of the various personalities that determines whether the cohabitation is going to work and work well,” shares Templeton.

4) Referral sources

Illinois counselor Melanie Dillon, LCPC, at Center For Wellness, Inc values the internal referrals generated within her multidisciplinary practice.

My business partners are both chiropractors. One provides acupuncture/Chinese medicine and the other chiropractic care/sports medicine. We have also employed a massage therapist. This way we have created a system that supports internal referrals. The other benefit is that all expenses are now shared, and that my income is no longer dependent on how many clients I see, but on the group as a whole.

Now that you have a feel for the benefits of joining a private practice group, check back later this week for part 2 - the drawbacks of group practice.

(c) Can Stock Photo From your experience, what are the benefits of joining a private practice group?