20 Ways Shrinks Stay Sane

It's mental health month! Like many of you, I've been actively sharing mental health information as a way to increase education and reduce stigma surrounding mental illness. While it's an honor to be in a profession that focuses on supporting the mental health of others, being a therapist often requires regularly going to "dark" places with clients, and that can take a toll on our own mental health. After nearly 20 years in the field, I've noticed that a lot of therapists (myself included) tend to be caretakers, people-pleasers, and self-sacrificers, making us particularly vulnerable to neglecting our own mental health in the name of caring for others. I have learned to become fiercely dedicated to self-care, self- awareness and to maintaining my own relationships in order to protect and nurture my own mental health.

I wanted to reach out beyond my own experience to therapists around the world to see how they nurture their own mental health in a profession that can be emotionally and mentally exhausting. Here's what they had to say.

1. Live in the present

"I make myself more present by asking 'Where am I in space right now? What do i hear? What do I feel? What do I taste and smell? What do I see?' " Natalie Robinson Garfield.

"I find 20 minutes a day to escape from the world and enjoy the peace and quiet." Deborah Serani, Ph.D.

"I meditate regularly and journal about my dreams."  Dr. Will Courtenay

2. Surround yourself with positive people

"I rid myself of toxic relationships and situations immediately and I engage in religious activities, especially prayer," says Leticia R. Reed, LCSW.

Surrounding yourself with positive people also includes you. Kim Olver, LCPC checks the stories she tells herself about her own life. "If they serve me great, if they don't I'll change them. I'm the one who makes them up after all," says Olver.

3. Go to your own therapy

"I go to my own therapy on a regular basis." Dr. Will Courtenay

"I take care of my mental health by checking in with my own counselor when I need someone objective to bounce things off of and get centered or grounded." Xiomara A. Sosa

"I have entered therapy 3 times since my core training. 3 different styles to suit the issues I was experiencing. I also do workshops and retreats throughout the year for personal/spiritual development." Jodie Gale

4. Get moving

"I have two Labrador retrievers who demand a lot of attention. I find a great escape just going out into the backyard and throwing the Frisbee for an hour." Regina Bright, LMHC

“I salsa dance! I rely on the nonverbal connection with my partner and happy music to get through some challenging weeks.” Dr. Amy E. Keller

"Every day I take time to meditate or participate in Pilates or yoga." Diane Petrella, MSW

5. Nurture a sense of humor 

"I try to maintain a good sense of humor and find ways to laugh during life’s challenges." Ashley Bretting, LMFT

"My spouse and I attend a comedy show every week."  Stacey Kinney, LMFT

6. Maintain friendships

“I make sure to have tea or lunch at least once a week with a friend that is supportive and makes me laugh." Nerina Garcia-Arcement, Ph.D.

"I find that participating through friendship in the life of someone outside the field is even more refreshing and grounding than the peer consultation we used to do." Mark E. Sharp, Ph.D.

7. Take a break

"I love vacationing to Costa Rica."Dr. Amy E. Keller

"I enjoy watching funny and/or inspirational YouTube videos." Hugh A Forde, PhD

"Hiking is a great activity that helps reduce my stress levels." Dr. Karen Sherman

8. Catch some zzzz's regularly

This one is an important one for me. I try to take a long naps every Sunday afternoon.

"My goal is to get at least eight hours of sleep every night." Stephanie Moulton Sarkis PhD

9. Uplifting media

"I like to read books, listen to music, and subscribe to inspirational Facebook pages." Dr. Matthew Clark

10. Reach out to those in need

“I do volunteer work with Mission Outreach, a non-profit group that collects unused medical supplies in the United States and sends them to third world countries. Being able to help others in such a simple, easy way does wonders for one's outlook on life.” Sujatha Ramakrishna, M.D.

11. Create fun each day

"I ask myself, 'Have I had fun today?' If the answer is no, then make it happen before the night is over!" Natalie Robinson Garfield

“I pursue my hobbies of photography, painting, and jewelry making.” Stacey Brown 

12. Say no

"I have found that out is easier to say "no" when I realize that if you say "no" to one thing, you are always saying "yes" to something else. If I say "no" to a new client, I am saying "yes" to time with family and a less busy mind." Joseph R. Sanok, LPC

"I hold stringently to my practice days and hours—keeping mornings for myself to exercise and write, using afternoon to early evening for clients, and taking off Fridays for whatever I want to do." Karen R. Koenig, LCSW, M.Ed.

13. Celebrate nature

"I love to spend time in nature by walking through the woods or listening to the birds chirp." Sujatha Ramakrishna, M.D.

"I work in a professional office setting and need to be reminded that I am an animal. Getting out to a park or the beach or a hike in the mountain, or even a drive up the coast with the top down are instant healing techniques." Nancy B. Irwin Psy.D

14) Express yourself creatively

"I nurture my own mental health through my other profession which is as a comic/writer....in writing my own material I get to see the humor in almost every situation and in performing it, I get to bring laughter...one of the greatest stress reducers of life....to others." Jane Stroll

"I write in a journal often." Xiomara A. Sosa

"I take a writing class, so that I can stay creative and do something that's just for me!" Janet Zinn, LCSW

15. Get pampered

My personal favorites are a message and a pedicure. I try to do at least two pampering activities a month to help me relax and to nurture myself.  Ashley Bretting, MFT gets pampered by having her hair washed by someone else. Whether it's a hot bubble bath or a leisurely walk, do something that feels nurturing on a regular basis.

16. Be a kid

Ashley Bretting "I bring out her inner child by coloring with crayons or paints!"

“I spend time with animals and children. The unconditional, pure love and affection from these creatures soothes the soul.” Nancy B. Irwin Psy.D

17. Get out of your head

“I bike to work as much as I can -- this is a 30 minute commute by bike, 20 minutes by car.  In doing this, I ensure that I arrive at work very relaxed & calm (having just spent time close to nature -- hearing the birds chirp and the wind blow and seeing green around).  When I leave the office at the end of the day, all of my worries get worked out by the time I get home.  So, I arrive at home very relaxed also!” Sally Palaian, PhD

18. Process your feelings regularly

Karen Hylen, Ph.D, of Summit Malibu Treatment Center suggest regularly sharing  your feelings with a friend or a loved one to avoid emotional explosions. Hylen shares this analogy:

When you bottle up your emotions, you are figuratively assembling a bomb in your head. Each feeling you bury in your head is you  putting together another piece of the bomb. Keep enough of your feelings to yourself and before you know it you'll have an emotional explosion.

19. Focus on family

I enjoy spending time with my family. Going to the beach and reading or walking is especially refreshing. I take two trips a year with the family and then one with just my husband. Regina Bright, LMHC

"I make sure I make time for my loved ones. It is an anchoring force," shares Dr. Anandhi Narasimhan.

20. Consult regularly on difficult situations

When I first went into independent practice I set up to have lunch or breakfast with a colleague also in independent practice every couple of weeks. It allowed us to bounce ideas off of each other and not feel so isolated in our work. Mark Sharp, Ph.D. I want to hear your mental health tips! Post them below

Why I 'Broke Up' With Managed Care (Part 2)

Several months ago I wrote a post titled, "Why I Broke Up With Managed Care" that stirred up some passionate discussion! While I understand that it's not the route for every private practitioner, I have continued to build a private practice free of managed care and recently hired my 12th therapist.

While we don't bill insurance directly, we do give a superbill to clients so they can seek reimbursement from their health insurance so they can still use their benefits. As I've continued to write this blog, I've come across several therapists who have also "broke up" with managed care and asked them why they decided to build a fee-for-service therapy practice. Here's what they had to say:

Increased Reimbursement Rate

I've been in private practice for over 15 years. So, I experienced the first major transition of health care to "managed" care. I had friends and colleagues who began working in the managed care industry, and it quickly became clear to me that despite all the rhetoric about the necessity for evidenced-based care (which can be a very useful model of care), managed mental health care was really about making corporate the work of individual psychotherapists.

I also did the math. The last time I checked, insurance reimbursement was the average rate charged by psychotherapists in the 1980s. Today, I can afford to have two additional office hours available for new clients, by taking just one fee-for-service patient. This also allows me more discretion in seeing clients who are needing a low fee. Will Courtenay, PhD, LCSW "The Men's Doc"

Control Over Therapeutic Work

I wanted the freedom to determine, along with parents, the course and length of treatment and felt managed care would impede on that. Pam Dyson, LPC, RPT

My training is in social work, which is the source of the old adage "start where the client is at." That's my barometer for treatment, not where an insurance company believes my client and I should start or end our work. Will Courtenay, PhD, LCSW "The Men's Doc"

Increased Client Commitment to Therapeutic Process

Being a Christian counselor, by law I cannot bill insurance, even if I could I think private pay gives each person responsibility in the therapeutic efforts. When people  have to pay it makes them take their  therapy more seriously. Natalie Davis

No Diagnosis Required

My services are specialized in that I will work with children as young as three, something many therapists in my area will not do. The problems child clients present with are often not clinical but rooted in the parent-child relationship. I feel strongly that young children do not need a diagnosis on their permanent health record. Pam Dyson, LPC, RPT

More Time With Clients (Less Time Doing Paperwork)

I had worked in a managed care setting in the past, and I decided that in my practice that I want to avoid the incredible amount of paperwork, defending sessions, and over-diagnosing.  I also think it provides clients with more privacy. Sara Levitsky, LMSW, Birmingham Counseling For Women

Paperwork was the other major decision (in building a fee-for-service practice). I put a great deal of time and energy into my work with clients outside of our scheduled hours, including receiving professional consultation on a consistent basis. I have no time or patience for administrative busywork. Will Courtenay, PhD, LCSW "The Men's Doc"

More Flexibility To Offer Reduced Fees

Like Dr. Courtenay mentioned earlier in this article, when his practice is doing well financially, he has more (not less) time to devote to seeing clients at a reduced fee. I have found the same to be true. As my practice grows I am able to offer more free community workshops and do more pro bono work.

Do you run a fee-for-service mental health therapy practice? What led to your decision?

Therapist Media Cheat Sheet: Get More Clients By Maximizing TV Interviews

While TV interviews and appearances rarely lead to an immediate increase in new clients, they do raise awareness of your private practice and your specialty areas, expose thousands of people to your practice, and set you up as a credible expert in your field. Marketing experts say that it generally takes 7 exposures to your business brand before a client will actually try your products or services. In recent posts I share how to get TV interviews and how to present your best self during interviews. Here are some tips for getting the most mileage out of interviews to build your credibility and increase referrals to your practice.

1) Be explicit about how you'd like to be introduced

Reporters aren't worried about your branding, they're concerned about their story. It is your responsibility to protect your practice name and brand by being explicit about how the interviewer should refer to you on camera. After having a few interviews where they say my practice name incorrectly, or didn't mention it at all, I've learned to clearly spell out how I want to be introduced. In email correspondence with media contact I request something like this:

Please refer to me on camera as "Therapist Julie Hanks LCSW, Director of Wasatch Family." I also request a lower-third banner (the text box graphic that pops up at the bottom of the screen during interviews) with my name, credential, practice name, and website during the interview. Here's what I ask for: "Julie Hanks LCSW, Director of Wasatch Family Therapy, WasatchFamilyTherapy.com".

2) Request a link to your website

Always request that the interviewer mention your website address during the interview and shows your website address on  a lower-third banner. You want to make it as easy as possible for potential clients to find your practice website, and ultimately, set an appointment. Additionally, if the TV station posts a web article or video online request that they post a link to your website. Having large websites link to your website improves your visibility Google searches.

3) Capture the video to post on your website

I suggest keeping an archive of all TV interviews so you can use them on your own practice website. Many TV stations post the interviews online and allow you to imbed them on your own website without uploading and converting the video. If the interview is not available online, you can request a DVD copy of the segment from the TV station.

4) Post on social media

Social media video sites, like YouTube, allow TV interviews to reach beyond the live TV viewership. I upload every TV interview to my YouTube channel and set up feeds to my websites and social media profiles and pages. The Men's Doc Will Courtenay, PhD, LCSW says that many clients have viewed his interview clips online before actually meeting with him:

Now that we can post TV interviews on websites and YouTube, they're really a great opportunity for marketing. And it's really the best kind of marketing, because the television show or news station has identified you as an expert. Today, many people search for and Google psychotherapists to see what they can find out about them before they meet with them.

Psychotherapist Terrence Alspaugh, LCPC says that YouTube videos give potential clients a feel for his style and expertise giving them the confidence to set an appointment.

I had the interview posted on YouTube with a link from my website, and that exposure has helped to attract new clients. Several prospective clients told me that they watched the YouTube clip first, and as they were favorably impressed, they contacted me about couples counseling. The interview has been watched by over 400 people, so it serves as a way for prospective clients to see me in action before meeting me.

Private practice therapist with YouTube channels

Enjoy watching these private practice therapists videos on their YouTube channels.

Dr. Will Courtenay

Eileen Kennedy Moore, PhD

Shift You Life Now Tracy Latz, M.D., M.S.

Julie de Azevedo Hanks LCSW