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

Do You Need Permission To Succeed?

As a recent private practice consultation group that I was leading came to an end, we took a few minutes to celebrate the growth and successes of each group member. I asked what each group would take away from their consultation group.  One therapist turned to me and said, "Thank you for giving me the permission to succeed."

I have never really thought about my private practice consulting services as giving colleagues "permission to succeed," but it seemed to fit. I asked myself, "Where did I get the permission to succeed?"

As I thought about it, I realized that my dad had modeled for me personal and professional success. As a child, I watched his music career flourish, how much he was energized through self-expression, and how he was motivated to inspire others through his work. My Dad's modeling taught me that I, too, could create a professional life where I could express myself, be creative when faced with challenges, and inspire to make positive change.

I grew up believing that everyone had permission to have an amazing, creative and fulfilling life. I think that's partly what inspired this blog. I want you to create a thriving private mental health practice that fills you with joy, that works for your life, and that reflects who you are.

When I saw my Dad a few weeks ago, on Father's Day, I made a point of thanking him for giving me permission to succeed. I let him know that I really valued that gift that he'd given to me -- the belief that I could find success and personal fulfillment in my professional life.

Do you need permission to succeed in your private practice?

Permission granted.

Who's Talking About You Online? Find Out With Google Alerts

Do you know who's talking about you and your practice on the web? If not, you should. My favorite way to to track who's talking is through Google alerts. Google alerts sends me an email whenever they come across "Julie Hanks" or "Wasatch Family Therapy" on the web. It's a quick and easy to see what information your name is being associated with, where you're being mentioned, who's quoting you, and more. If nothing pops up about you and your practice on the web via Google Alerts over several months, that's helpful information too. If Google can't find you, then it's likely that you're potential clients can't find you either. To learn more about Google searches read my article Does Google Love Your Therapy Practice?.

Click here to set up your Google Alert. You can set up your alert to filter different sources like blogs, news, video, discussions, or everything on the web, how often you'd like to be alerted, and how many results you'd like to receive. When you're name pops up on the web, you'll be alerted via email. You'll also find out what other people who share your name are up to on the web, which is amusing, and sometimes annoying.

I found out last week, through a Google alert that I had been named the #1 online influencer making a difference for depression by Sharecare, an website founded by Dr. Oz and Jeff Arnold, founder of Web MD. That's information that I'm glad I didn't miss!

Here's the Google alert email I received last week:

So take a few minutes today to set up Google Alert. You might be pleasantly surprised at what you find. Please post links to what you find below! I'd love to see where other private practitioners are popping up on the web.

To Tweet or Not to Tweet? Using Twitter To Grow Your Therapy Practice

What is Twitter?

Twitter is a popular social media platform where users can send short updates that are up to 140 characters long.  Twitter is basically the equivalent of a Facebook status update newsfeed. If you have no idea what a "newsfeed" or "status update" is, then you may want to stop reading here and start by setting up a Facebook account.

Facebook is THE social network site and is the most effective way to build your practice through social media because of it's high number of daily users. Here's an article on how to set up a Facebook Page for your practice.  If you want to know how to use Twitter, here are a few suggestions on how to effectively tweet to build your practice.

How can Twitter help you build your practice?

Twitter, like all social media platforms, is a forum for conversation and connecting with other people online. It is also a great way to spread the word about your practice, to educate the public about issues you care about, and to share your areas of expertise. The point of social networking sites like Twitter is...uh...the social networking. If your Twitter followers find value in your tweets they will share them by retweeting your information their Twitter followers. Over time you can grow a network of people who are sharing your tweets which helps you get the word out about your private therapy practice.

Ways to Build Your Therapy Practice Through Twitter

1) Follow local businesses and professionals

Following potential referral sources on Twitter can help you build referral sources.  If you specialize in helping clients with chronic pain, then you may want to search for pain clinics, chiropractors, and other health professionals in your geographic area and start a conversation with them about your services.

Don't limit who you follow to only mental health or other psychotherapists. Referrals can come from any kind of social networking relationship. Let your definition of an ideal client help guide who you follow on Twitter so you can attract the kind of client you want to work with. Twitter can also be used a search engine to find other businesses or people in your area and see what they talking about.

2) Don't just tweet, have conversations

Don't just send out information or tweets into the social network universe. Take a few minutes each day to respond to others who mention you or who retweet your tweets. "Mention" other users by using the "@" sign followed by their twitter handle and it will show up on their Twitter page. This builds rapport and relationships. For example, my user name is @julie_hanks. If someone posts a tweet and mentions me, I will be notified of it and it gives me a chance to respond to them.  I've found Twitter to be a source of professional support too, meeting therapists all over the world and sharing ideas. I've found some therapists in private practice featured in recent articles on Twitter.

3) Tweet links to your practice website

Increase traffic to your therapy website by tweeting links to your website. If you have a website blog, you can automate your site to tweet every new blog post. Here's a screenshot of my Twitter page. The yellow text are links that mostly go to on of my websites or blogs to increase visitors and provide helpful information.

4) Use hashtags to attract followers interested in your expertise

A hashtag is a "#" followed by a topic. For example, if you're specialty area is parenting, you can use #parenting on tweets about anything related to parenting to make it easier for others interesting in parenting to find you. When you click on a hashtag it will bring up other tweets mentioning the same topic. Hashtags make it easy to find, follow, and converse with others who have similar interest or expertise.

Do you use Twitter as a mental health professional? What are your suggestions for using Twitter to build your practice?

5 Self-Care Tips For Therapists

You take good care of you clients but are you taking good care of you? Being a therapist in private practice is incredibly fulfilling and very emotionally draining. While it's an honor to be trusted with client's deepest fears, pain, and vulnerabilities, it can take an emotional toll. Therapists seem to be particularly vulnerable to putting our own needs on the back burner to attend to others. It's why we're good at what we do. It's also why prioritizing self-care is crucial to professional and personal success, and to avoiding burnout.

At work and at home (I'm a wife and mother of 4 children) I emotionally and physically nurture others, so I've had to work hard to figure out what I need and how to prioritize self-care. Here are some ways that I've learned to take good care of myself as a private practitioner.

1) Start and end sessions on time

Build in 10-15 minutes in between clients to take a bathroom break, do some deep breathing, have a snack, clear your head, or consult with another therapist. Don't give away your time to clients at your own expense or you'll end up resenting them because your needs aren't being met.

2) Remember to eat and drink

This sounds so basic, but I've had times when hours would go by before I realized that I was parched and famished! I used to book  8-10 clients a day without scheduling a break assuming that someone would cancel or no-show. On the days where no one did I'd work straight through. Exhausted and starving I usually grabbed junk food and a sip of water. I've learned to build in time to eat and drink so I can maintain my energy level.

3) Schedule transition time after work

Take a few minutes to clear your head so you don't bring the emotions of work into your personal time. If you have a commute you may want to listen to relaxing music on your drive home. There was a period of time where I'd work out at the end of my work day to help release the stress of the work day before heading home and that worked well. Take a few minutes to "shift gears" after work.

4) Get consultation and supervision

It's crucial to build in support for your emotional and professional needs in order to prevent burnout. Meet with colleagues to process countertransference and consult on difficult cases so you don't internalize your client's issues. This is particularly important for solo private practitioners to prevent isolation.

5) Solve recurring complaints quickly

If you have chronic complaints about your practice, act quickly to resolve them.  If you hate your office space, start looking for a new one. If you are overwhelmed by paperwork, reports, and managed care authorizations, consider hiring office help. Take action when something is bothering you so it doesn't drain your emotional energy.

One of the benefits of being in private practice is that you are in charge of your own schedule. Be sure to build your self-care into your schedule. We are modeling self-care for our clients so let's make sure we're practicing what we preach.

What do you do to "fill your own bucket" during your work day so you can continue to feel energized, to be effective with clients, to manage your practice, and maintain a personal life? I'd love to hear your ideas and suggestions. Feel free to comment below.

photo credit: rofanator