Counselor Self-Care Practices

Guest Post: Hollie L. Hancock, M.S., CMHC

Reflect on how well you take care of your own needs. Help me learn more by filling out a counselor self-care practices questionnaire.

While attending an ethics conference last week, I took the opportunity to solicit participation from my fellow counselors and psychotherapists for my dissertation research.  As I described the study, and as the words “counselor self-care” crossed my lips, a loud and obvious laugh erupted from various corners of the large ballroom where the conference was being held.  From the front of the room I saw people looking at one another, laughing, and rolling their eyes; I even read the lips of one man in the front row as he said to the woman next to him, “Yeah, right!”

Honestly, I was not surprised.  In fact, I almost expected this type of response.  The laughter, snickers, and side-ways comments are exactly the reason I am researching counselor and psychotherapist self-care practices.

As therapists, we use our education, training, and skills to help patients live more rewarding and healthy lifestyles, independently.  Ironically, many therapists seem reluctant to offer themselves the same kind of understanding and care.  Yet, in reality, it is this self-care, both personal and professional, that ultimately is the most important, not just for patients, but also for we as therapists as well.  It is quite possible that mental health professionals are one of the few professions that does not purchase or utilize their own product.

Lack or absence of self-care practices among mental health professionals appears to be almost synonymous with compassion fatigue and burnout.  The literature seemingly suggests that by mentioning self-care – counseling professionals are burned out or experiencing compassion fatigue to some degree.  Do a small research study of your own: Conduct a Google search using the words “counselor self-care”.  You are likely to find half of the top results include the word “burnout”.

Participate in my dissertation research on counselor self-care practices

In an effort to understand the possible phenomenon of the lack of self-care practices among counselors and psychotherapists, I am asking colleagues across the nation and even around the world, to provide responses to a brief questionnaire created for my dissertation research.  Therefore, you are cordially invited to participate in a study that will ask questions about your experiences with self-care practices as a counselor or psychotherapist. This inventory is called The DEFT Questionnaire. “DEFT” represents what counselors and psychotherapists “do” for self-care, how they “experience burnout”, how they “feel” about their self-care practices, and finally what counselors and psychotherapists “think” about self-care. The purpose of this study is to explore whether or not there is a correlation between self-care practices and burnout among counseling professionals.  Completing the questionnaire will take about 15 minutes of your time.

To be better clinicians in our roles as counselors and psychotherapists, we owe it to our patients, and more importantly ourselves, to be aware of our self-care needs, and adjust our behaviors accordingly if necessary to avoid impairment, burnout, compassion fatigue, and even post traumatic stress disorder.

I have provided the link to the questionnaire below.  I respectfully ask that you take 15 minutes of your time to complete the questionnaire.  Then, please share the link with your peers and colleagues.  I thank you in advance for contributing to the body of literature available regarding counselor self-care practices!

Fill out the counselor self-care survey here:

https://acsurvey.qualtrics.com/SE/?SID=SV_cvWrM4l8iqBWU1D

The questionnaire will be available until March 31, 2013

Hollie L. Hancock, M.S., CMHC is in private practice at Iron Mountain Counseling is a Doctoral Candidate in Counseling Psychology, Argosy University, Salt Lake City, UT

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

Therapist Roll Call: Join The Private Practice Twitter List

I recently blogged about ways to use Twitter to build your private practice, and encouraged you to tweet your elevator speech/basic practice message in 140 characters or less. Those posts got me wondering, "How many therapists in private practice are actively using Twitter?" So, I'm taking a roll call to help you use Twitter to connect with other like-minded therapists around the world to share ideas, resources, and referrals. Only licensed mental health therapists will be listed.

Here's what I'd like you to do...

Post a comment below and include:

1. twitter handle & link
2. your city and state
3. specialty area

As the comments come in I'll post comments and paste your info in the body of this post below.

Therapists on Twitter

@julie_hanks Salt Lake City, UT: women's emotional health, EFT couples, family therapy, private practice consulting, media

@soultenders1 Arcadia, CA: marriage/couples, domestic violence, anger management, parenting

@soulhealr Studio City, CA: trauma, abuse, grief, loss, anxiety, stress, yoga therapy, teens and adults

@drtrentevans Baltimore, MD: anxiety, depression, anger management, bariatric surgery, cognitive/mindfulness

@metrocounsellor Perth Western Australia, Mount Lawley and Duncraig: Family,couples, teenagers, children and relationship counselling

@Grevgatan24 Stockholm, Sweden:, 6 psychotherapists, PDT, CBT, Affective Shortterm, individual/couples, systemic, crises/trauma

@juliejeske Portland, OR: relationships, intimacy and sexuality

@DrMarsha Washington DC: neuropsychology, and mindfulness

@LisaKiftTherapy Larkspur, Marin County, CA: Individual (family of origin, emotional health) and Couples (communication, infidelity, premarital education)

@JoelCarnazzo CBT, Motivational Interviewing, Family Systems Therapies, depressive disorders, anxiety and panic, & substance abuse

@SentierTherapy Couples & Family therapy, teens/adolescents, parent consultations, sexual abuse/assault

@Mindful4Health Milton, Ontario: depression, anxiety, stress, major life changes, chronic illness, Mindfulness-Based Cognitive Therapy

@jeffbrandler Mountain Lakes, NJ: addiction, couples, anxiety, mood disorders

@daryljo Trinidad & Tobago, West Indies: EAPs, Adults, Teens, Couples Counselling

@aposterioris Manhattan, NY: helping children and adults, as a disabled person I can also help those w/ disabilities

@emmakviglucci NYC: Self and Relationship Expert pre-marital, codependence and being stuck, infidelity

@DrRanjanPatel Burlingame, CA: Couples counseling, depression/anxiety, chronic illness/pain, grief/loss, mindfulness training

@DrTanyaHilber San Diego, CA: life balance, middle-aged women, children/teens with ADHD or Autism/Asperger’s spectrum

@pnetworker Psychotherapy Networker: Learning, Connection, Community for Psychotherapists Year-Round

@brucenystrom evaluation/therapy clinical, forensic, disability, ADHD, medical compliance, law enforcement, critical incident stress management

@marianneclyde Warrenton, VA: relationship issues, anxiety/depression, eating disorders, stress, trauma, Holistic approach

@geoffsteurer St. George, UT: pornography and sexual addiction recovery, affairs, marriage counseling, men's issues

@rhetter Plano, TX: Marriage and Family, latent adolescent/emerging adulthood, adolescent boys, spiritual issues

@drkkolmes San Francisco, CA: Anxiety, depression, relationships, sexual problems, working with LGBTQ, poly, kink

@TherapyWithJen Salt Lake City, UT:  Marriage and Family, anxiety, depression, parenting, communication skills, trust, LDS-based therapy

@cesargamez Phoenix, AZ: Eating disorders, Marriage/Family, Teens/Adults, Group Therapy

@johnleemsw Chattanooga, TN: individual & family therapist, children and adolescents, emotional intelligence

@josephab100 Mechanicsburg, PA: Online Relationship advice; online life and business coach.

@njpsychotherapy & @debrafeinberg Maplewood, NJ: Relationships, anxiety, gay & lesbian issues, multicultural issues, Internet Marketing consultant for therapists

@JaniceMaddoxMFT Reno, Nevada: couples and family counseling, individuals w/ anxiety, depression and adoption related issues

@Betrayalcoach, marriage and relationship counseling, psychotherapy for intimacy, trust,conflict, and issues of infidelity

@luciacassar Rio de Janeiro, Brazil: psychoanalytic psychotherapy. Teenagers, adults and elderly

@kamahiner Private Practice in Boise, ID: Individuals & Couples- Anxiety, Depression, Trauma, Sexual Issues/Addictions, Autism/Behavioral Consultations

@crutherfordphd psychological and neuropsychological assessement, test report writing software

@bbhabash Gaithersburg, MD: Individual & Family Therapy for children 3-12yrs, Child-Centered Play Therapy, Parents, Teens & Young Adults with various mental health disorders/life transitions

@pamdysonmalpc St. Louis, MO: Parent coaching, play therapy for children 3-12 years of age

@drkipmatthews Athens, GA: Sport and Performance Psychology, Consulting, Career & Life Planning, Mind-Body Health

@InfertilityMind @psych0synthesis Northern Beaches, Sydney, Australia: eating disorders and addiction, infertility and alternative parenting paths, anxiety and depression, life crisis and relationships

@KatMindenhall Lakewood, CO: CBT, SFBT – Parenting, depression, couple/family

@BCordermanMFT Brea, Orange County, CA: Empowering teen girls and women; pre-marital & couples counseling; family of origin work; co-dependency; trauma

@taoi_uk Merseyside, United Kingdom: A psychosexual and relationship therapist working with all kinds of sexual and relationship issues

@stlcounselor  Webster Groves, Mo: Marriage child and Family, couples counseling. expert child and teen counseling

@drjlgibson, Holland, Michigan psychologist specializing in adult psychotherapy for depression, anxiety, and relationship concerns.

@onlinecounselor London, UK: Accredited Psychological Therapist providing Online Counselling, Telephone Counselling & Face to Face Therapy.

@JasonEsswein I specialize in individual psychotherapy with men.

@fystherapy Kim McLaughlin, LMFT Licensed Marriage and Family Therapist in Roseville, CA: specializing in therapy and counseling for compulsive and binge eating disorders.

@DrReginaMendoza Licensed Psychologist in Miami, Florida. Psychological testing and individual therapy for children, adolescents, and adults.

@GregDorter Toronto, ON. Therapist specializing in helping people overcome depression, anxiety, stress & low self-esteem through CBT and mindfulness.

@DrCunninghamMFT  San Diego, CA, Family Systems expert specializing in couples and individuals challenged by relationship issues.

(I'll add your Twitter info here...)

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?