Adventures In Private Practice: Child Therapist April Forella, LMHC

Tell me about your practice...

I am a solo practitioner with an office in beautiful Palm Beach Gardens, Florida. I opened my private practice a year ago. As an experienced child, adolescent and family therapist, I understand how difficult it can be to find resources and help for children and adolescents who are suffering from emotional and behavioral issues. In my private practice I specialize in working with children 6+ and adolescents who are experiencing difficulty in their functioning and ability to navigate life’s challenges and relationships. I enjoy seeing children and families learn how to respectfully express their emotions and improve communication. Children and adolescent’s unique situations are addressed with a deep understanding of today’s youth and their specific challenges.

I am an Accredited Standard Triple P Provider (Level 4 & 5).  Triple P is an evidence-based multi-level family intervention and parenting support strategy which is designed to reduce the prevalence of behavioral and emotional problems in children and adolescents.

Why did you decide to open a private practice?

I entered graduate school in mid-life with the goal of opening a private practice. My twenty years of experience working in business (advertising & marketing) prior to entering the field have assisted me in knowing how to reach my target audience. I also wanted the freedom to set my own hours and to foster hope and build relationships with my clients. I knew that having my own practice would allow me to achieve all of these goals.

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?

Young children and adolescents with challenging behavior problems try the patience of parents and caregivers and can be challenging for therapists. I have learned from the most “difficult” clients the importance of meeting them where they are, along with being patient and finding ways to connect and build rapport. By being with a child and engaging them in art, play or games I gain an understanding of what the child’s interests and needs are. Once a child is heard and understood we can begin implementing strategies to meet the child’s needs and overcome challenging behaviors. Understanding the child from the child’s perspective is the key to the process.

What’s your biggest pet peeve about private practice?

The fluctuating streams of income. There are cycles when I’m busy and when I’m not.  I continue to learn and expand my knowledge of marketing utilizing social media and networking to grow my practice. I supplement my income with offering trainings to schools, other professionals, and coaching.

How did you discover or develop your practice “niche”?

My passion in working with children and adolescents has been important to me before enrolling in graduate school. I took course work related to counseling children, completed an internship at an agency specializing in working with at-risk children. Once I was licensed and opened my practice I already had a solid skill base as a child, adolescent and family therapist. I also had the skills necessary to work collaboratively with parents. It was a natural fit.

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

I attended a training by Lyn Kelley, Ph.D., LMFT, CPC “Promote Your Practice Exclusively to a Well-Pay, Fee-for-Service Clientele”, consulted with other professionals and utilize the internet to find other successful private practice clinicians, including Julie Hanks, LCSW's “Private Practice Toolbox”, Tamara G. Suttle, M.Ed., LPC “Private Practice from the Inside Out—All Things Private Practice”. The book The Paper Office by Edward L. Zuckerman, Ph.D has been helpful in getting organized and developing good professional habits. The book provides forms, guidelines, and resources to make your practice work ethically, legally and profitably.

What has surprised you most about being in private practice?

I have found my life’s purpose in helping others. I am truly passionate about coming along side my clients and find it rewarding in so many ways.  The hard work in building my practice is all worth it when I see clients grow.

Has your private practice helped you grow professionally?

I have gained self-confidence not only in my ability to provide quality therapeutic services but in my ability to manage the business side of my practice. I continue to set goals to challenge myself personally and professionally. I plan to present at conferences and seminars to develop public speaking skills, and begin blogging and continuing to utilize social media to develop my practice.

Has it helped you grow personally, too?

On a personal level it has made me aware of the importance of pursuing my passion and the fulfillment that it brings me.  It’s a privilege to come along side the amazing people that I work with and the things they teach me about life.

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

I make it a priority to have time alone to relax, pray, read the Bible and recharge myself. My support system is an amazing loving family and lots of great friends. I enjoy spending time at the beach, listening to music, regular massage to release stress and tension in the body, and going on walks.

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

I handle all of the day to day details of my practice myself. I am an organized person and rely on to-do lists. It can be overwhelming at times! However, the rewards of having flexibility and freedom to make my own schedule out way the stressors.

What personal strengths have helped you succeed in private practice?

My social skills are strong and connecting with people is natural for me. I like to network and build relationships. My business experience has helped me to understand marketing. I also understand that growing and maintaining a private practice is a process that takes a lot of work, perseverance and the need to reach out to my peers for support and encouragement.

To learn more about April Forella’s private practice visit www.aprilforella.com.

A Day In The Life: Meet Divorce Counselor Misty E. Vogel, MA

A ten year career in the mortgage banking industry not only prepared Misty Vogel, M.A., NCC for many of the business aspects of self-employment, but also for managing the intense emotions that come with major life transitions.

Helping clients buy homes seems far from providing therapy, but the process of helping mortgage clients navigate intense emotions that surface during home purchasing has been added to Vogel's therapeutic skill set.

Fresh out of graduate school, Vogel is just starting to build her practice in Denver and in Evergreen while she continues to work as an extern at Evergreen Psychotherapy Center, a practice specializing in treatment of attachment disordered children and families.

In her private practice, Vogel combines her experience doing attachment work with her passion to help children and families navigate the difficulties of divorce and custody issues. Vogel's own parents divorced when she was 5 so she knows first-hand the impact divorce can have on the entire family. Peek into a day in the life of a therapist just beginning to build her private practice and see what it takes!

A Day In The Life

February 13, 2012

6:30AM

Alarm is sounding and my husband is up and out of bed quickly. I, on the other hand, reach for my phone which is next to me on my nightstand, easy to check email from here. I turn on the local news to check the weather. No snow and warmer temperatures… happy about this, as it means I can go for a walk later (self-care).

7:00AM – 8:15AM

Getting ready for my day includes planning lunch and a change of clothes. My externship is located in the foothills outside of Denver in Evergreen, about a 30 minute commute on a good day.

8:15AM – 8:50AM

On my commute to Evergreen! I can’t complain, this drive is often quite picturesque – many times the moon is setting to the west, or the snow capped mountains are glistening in the sun rising upon them, and, more often than not, I am fortunate enough to spot wildlife – buffalo, coyotes, elk, hawks, and even eagles once in a while! I also am lucky to use this time to make a few phone calls. (When I was still studying for the NCE exam, I used this commute to listen to Dr. Rosenthal’s study CDs!)

9:00AM – 12:00PM

In session, an intensive at my externship. Our current family is in real crisis. Mondays of the second week can be very tense because the families have just spent a couple of days outside of treatment and often they fall back to old patterns. Unfortunately, in this case, the crisis may not be diverted and it appears this week is going to be a tough one.

12:00PM-12:50PM

An hour with an individual client – my own client, not part of the externship. Without a break between the intensive and my individual session, I am feeling some hunger pains! Those almonds didn’t quite cut it.

1:00PM – 1:30PM

Commute back to Denver, meeting up with an old co-worker and friend who has a networking group she wants to introduce me to.

1:30PM – 2:45PM

Lunch with friend. Networking is essential at this stage of opening my own practice. I also attend a Private Practice support group as well as numerous workshops and conferences.

3:00PM – 4:00PM

Changed into walking clothes at the restaurant and went for a walk at the park. This is my self-care time!

4:15PM – 6:30PM

Back at my home office. I make finishing touches to my post card announcements for my new practice and two offices. Order those online – some will be mailed to a small database and the rest will be distributed in local coffee shops and local hang-outs. Post a quote on my business Facebook page – I find that if I do this every day, people are more likely to remember me and my practice. Open up the project I am currently dreading…building my website. I am trying to determine if I chose the right web page host; it hasn’t been a user-friendly experience thus far.

6:30PM – 7:45PM

Cook and eat dinner with my husband. Catching up on one another’s day. He is working on a start up company and we are also beginning the journey of seeking out fertility options. The journey has just begun – I filled my husband in on the task at hand getting in for a consultation with the fertility doc, information gathered on a phone call during my commute this morning.

7:45PM – 9:00PM

Took a little time to read up on divorce and attachment. I had downloaded a few articles over the weekend. I am considering writing a blog targeted to this population.

9:00PM-10:00PM

Both my husband and I are exhausted. We treated ourselves to a few TV shows on the DVR. Turning off our brains before heading to bed tends to produce better sleep!

10:00PM

Turning in – thinking about the family I’ll see tomorrow at Evergreen. They have been on my mind a great deal this afternoon.

Find out more about Misty's practice at  www.mistyvogel.com.

If you'd like to submit a day in your life for this series, please contact me here.

Are You Comfortable Asking Clients For Money?

During my graduate school practicum placements I never had to think about the financial aspect of seeing clients. Billing specialists took care of collections. That was their job. After graduation I worked in a private practice setting where I was required to ask clients directly for...money. It was awkward at first to have clients share their pain with me, open their hearts, and be so vulnerable, and then ask them to pay me.

Adding to my money anxiety was the fact that I was charging the same rate as my clinical supervisor and I didn't believe my services were worth it. My supervisor helped me gain confidence by explaining that clients aren't just paying for my time and skill, but they're also paying for her years of expertise. I hadn't thought about it from that perspective before.

My supervisor also helped me to view myself as a professional. Even though I wasn't licensed to practice independently I did had a graduate degree and two years of practicum, and I was licensed to practice under supervision. I had valuable experience, knowledge, skills and tools to help my clients.

Almost 10 years ago I started a solo private practice. Suddenly, I was the therapist, the receptionist, the webmaster, the marketer, and the billing specialist/collections department. I realized that I had to get even more comfortable bringing up money with clients if I was going to build a successful practice. Through the years I've become extremely comfortable addressing the financial aspect of clinical practice with clients. Here are a few things I've learned to help you get more comfortable with money in your private practice.

1) Value your expertise

Keep in mind the time, money, energy, and passion you've invested in your education and training. The more confident you feel in yourself, the easier it will be to accept client's payments and comfortably bring up money issues.

2) Think of money as energy exchange

Money can be such a loaded topic, fraught with baggage from your own upbringing. It may help to reframe money in a more emotionally neutral way, as energy. You are offering your gift of investing energy in the therapeutic experience in order to help your client, and they are offering you their energy resource called "money."

3) Ask for payment at the beginning of the session

I've found that it works best for me to bring up money related issues at the beginning of sessions before delving into deeper therapeutic issues. It's awkward to ask for money after a client shared deep pain during their session.

4) Set firm payment policies and stick to them

Clients will take your lead with money issues. Setting consistent policies regarding payment from the onset of therapy teaches your client what you expect in the therapeutic relationship. If you're anxious about asking for money, your client will feel uncomfortable too. If you're confident, they'll likely respond positively. My clinic policy is that if you are one session behind in payment your therapy is on hold until your account is up to date. Also, we charge full fee for no shows and late cancellations, even on initial sessions, unless there is an emergency.

5) Money is a clinical issue

If you have clients who resist paying you, who "forget" their checkbook, who cancel at the last minute and don't want to pay you, treat the resistance as a clinical issue. Consider how the client's money patterns are part of the larger issues brings them into therapy and address it openly in your session.

6) Write a "money script" and practice it

I've recommended to several therapists I've supervised or consulted with who feel anxiety bringing up money with clients to write down a brief script and role play. Here's an example of the phrases I use in my practice.

At the beginning of the session, before walking into my office I ask, "How would you like to pay for your session today?"

When potential clients ask, "Do you work with my insurance company?" I respond, "While we don't bill insurance directly, I'm happy to provide you with a receipt to submit for reimbursement from your insurance company. You may want to check with them and ask if you have out-of-network mental health benefits."

Do you have money anxiety? What blocks do you have when it comes to asking clients for payment? How have your overcome them? Feel free to post your thoughts and comments below.

photo credit: 401K

5 Tips For Overcoming Blogophobia

Blogging is a great way to talk to potential clients about your private practice services and specialties. You can set up a blog account for free at wordpress.com, blogger.com, and many other blogging sites. Since blogs are search engine friendly and blog posts are easy to share on social media sites they are a great tool for attracting new clients to your therapy practice. In addition to reaching potential clients, blogging is also an avenue that allows you to provide valuable resources for current clients. In spite of the many business benefits of blogging, many therapists are hesitant to venture into the blogging world. This hesitation or anxiety about blogging is known as "blogophobia."

When I first started blogging a couple of years ago, I suffered from self-doubt and nagging questions. What if I spend all of this time writing a blog and no one reads it? What if I sound dumb? What if I get mean comments about my posts? Where do I start? What should I blog about? How often should I blog? If you're a therapist wanting to start a blog, or you have a blog that is rarely updated, here are some quick tips to help you gain the confidence to blog consistently and reach more potential clients with your practice message.

1) Keep it short and sweet

Blog posts are generally between 300-500 words. Blog readers want quick and easy information, not long discourses. You've probably written emails that are longer than 300 words. Compared to the length of papers,  thesis, or a dissertation, blogging will be a piece of cake.

2) Let go of perfectionism

Read your post aloud to catch any errors and to make sure that your writing flows. It may also help to have a colleague read through it before you publish to proof for errors you may have missed. If you find mistakes after your blog post is published you can always edit them after the fact.

3) Use your authentic voice

One of the reasons why blogs are so popular is that you get to "know" the blog writer. Unlike professional papers, blogs are often written in first person.  Write about topics that you're passionate about in your own voice so potential clients can get a feel for your therapy style, your strengths, and your theoretical orientation.  Authenticity will draw your ideal clients to your therapy practice.

4) Set a schedule

Blogging regularly is an important part of overcoming your anxiety, of gaining confidence,  and of keeping visitors coming back to your blog for new information. Build time into your schedule to blog as part of your private practice marketing strategy.

5) Recycle content

Start blogging on topics you've already researched and written about. You likely have dozens of research papers, articles, or special projects that you've written during graduate school or your professional career. Take those topics and repurpose them for blog articles.

One final note...make sure you have your contact information on your blog site and at the end of every post so potential clients can visit your website,  or contact you via email or phone.

I'd love to take a peek at your blog posts and see what you're blogging about and share them on social media to help you spread the word about your private practice. Feel free to post links to your articles comment box below.