The Hazards Of Being A Therapist

Guest post by Regina Bright, MS, LMHC

I have been working in mental health for about 12 years. I listen to clients in crisis for many hours a day, providing support, empathy, interpretation and direction. As therapists, we can easily lose track of our own issues, ignore our own problems, and at times have difficulty shutting off the therapeutic processing.

In order to be a good therapist, it is necessary to take care of ourselves — our clients depend on it. Just because we know everything there is to know about stress management doesn’t mean that we are immune from becoming mentally exhausted. If you are feeling detached or apathetic toward your clients, yourself, or your relationships you could be experiencing emotional fatigue.

Here are some ways that I like to take care of my own needs so I can continue to support my clients:

I use my colleagues’ expertise regularly. We go to lunch and consult each other on difficult cases. We bounce around different techniques and approaches that could heighten the therapeutic process.

I belong to many professional organizations and am very involved in my community. I feel that if I have the support of my community, then I am not alone in my journey. I enjoy volunteering and giving back to my community whenever possible. It makes me feel good to see that I have helped others with a small donation of my time.

I enjoy spending time with my family. Going to the beach and reading or walking is especially refreshing. 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.

My family enjoys going on vacation. I take two trips a year with the family and then one with just my husband.

My practice is in my hometown. I have developed many friendships over the years. I enjoy spending time with many different groups of people. I am very thankful for the friendships that I have made.

In college, I had different goals. I could do and wanted to do everything that came to my mind. I achieved more things in one day than most people did in a week. My priorities have changed. I have a family now and I find it necessary to relax. Now, I want to balance giving and getting – attention to my family, friends, spouse, community, and solitude.

As a mental health professional, self-care is a minimum standard of professional practice. Your clients deserve to be served by a healthy, well-balanced health care professional. Every mental health professional has vulnerabilities, weaknesses, and needs. Take time today to identify yours.

About The Author:

Regina Bright is the owner of Stepping Stones Professional Counseling, a Mary Esther private practice. She is a Licensed Mental Health Counselor, a Clinical Supervisor, a Parent Coordinator and a Florida Supreme Court Family Mediator. At Stepping Stones Professional Counseling, they provide individual, group, couples and family counseling. Call 850-226-6430 or visit SteppingStonesCounseling.org

e/rol via Compfight

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

A Day In The Life: Meet Anxiety Expert Marla W. Deibler, Psy.D.

Peek into a work day in the life of private practitioner and licensed clinical psychologist Marla W. Deibler, Psy.D. Founder and Director of The Center for Emotional Health of Greater Philadelphia, LLC. Her outpatient behavioral health group practice specializes in the treatment of anxiety and obsessive-compulsive spectrum disorders.

She's also a wife and a mother of three children and has found a nice work/life balance working 2.5 days per week at her clinic, and spending time the rest of the time home with her children. Thanks to email, phone, and text, Dr. Deibler operates her business remotely "in spurt" during the days she's at her home. And apparently, she doesn't sleep much!

Here's a day in the life of one of Dr. Deibler's "work" days:

A Day In The Life

November 16, 2011

6:15am – 8:15am

Woke up and got my children ready for school and myself ready for work. Ate breakfast. Checked my email, responded to several emails, including an email to our web designer who is working on our new website (very exciting), and forwarded a few visual voicemail emails to my office manager for return phone calls later in the day. Quickly scanned personal and business Facebook newsfeeds and scanned my Twitter feed.

8:15am-9am

Took my second grader to board his school bus and took my 1 year-old and 4 year-old to day care.

9:30am-10am

Arrived at my office, large cup of caffeinated tea in hand that I brewed before leaving home.  Turned on all office lights and computers, collected billing slips and receivables, returned two phone calls, one from a potential patient who had a question and one from a TV network with whom I’ve worked. Review my clinical schedule for the day: it looks like I’ll be working with adults and children today with difficulties including, OCD, compulsive hoarding, tourette’s disorder, depression, panic disorder, and trichotillomania.

10am-11am

Saw a therapy patient.

11am – 12:45pm

Supervision meeting with one of my post-doctoral fellows. Discussed cases and other clinical and practice management issues. Discussed planning co-presenter workshop proposals for the Trichotillomania Learning Center (www.trich.org) annual conference in May 2012. The deadline is quickly approaching, so we have to finalize our proposals over the next 10 days.

12:45pm – 1pm

Pulled testing measures to create charts for this week’s pre-bariatric surgery psychological evaluations. Received incoming mail. Checked email and forwarded visual voicemail emails to my office manager for return calls.

1pm – 2pm

Weekly staff luncheon. Enjoyed great salads from a nearby restaurant that delivers while we discussed cases with one another and other practice issues.

2pm – 3pm

Supervision meeting with another post-doctoral fellow who has just returned to work on a limited basis from maternity leave. This was particularly nice, as she brought her 8 week-old baby while we discussed her cases and other work-life balance issues. I manage my facility in an employee-focused, family-focused manner; each clinician is valued professionally and given the flexibility to create their own schedule so that they can create happy work and personal lives (I whole-heartedly believe this happiness is reflected in their work with patients, so it’s a win-win approach to practice management). In this clinician’s case, she presently sees patients on Saturdays, when her husband is home caring for their child.  On Wednesdays, she brings him to the office for her weekly meeting with me.

3pm – 6:30pm

Saw therapy patients.

6:30pm – 6:45pm

Left the office for the day and drove home to my family. My husband is also a psychologist. He works at a special services school, so he gets off from work at 3:30pm and tends to the children until I come home (Mondays and Wednesdays I work late).

7pm-8:30pm

Spent time with my husband and children. Ate dinner. Ensured that homework was done. Put the baby to bed. Supervised bath time for the older children. Read bedtime stories and tucked the big kids in.

8:30pm-9:30pm

Sat with my husband in our bedroom, while each of us spent some winding down time on our Apple devices –We love this technology. (My husband read news and such on his iPhone, talking about some of the day’s events with me), while I logged into my electronic medical records system (www.carepaths.com), signed off on billing, reviewed and signed off on clinical documentation written by post-doctoral fellows, and submitted batched electronic insurance claims for the day’s in-network patients. Contemplated a run on the treadmill, but today is usually a “rest day” for me and I have too much to do this evening, so it will have to wait until tomorrow.

9:30pm-10pm

Brewed a cup of tea and planned our Thanksgiving dinner menu (as well as ordering our turkey and when I’m going to grocery shop—I’ve got to begin with making butternut squash soup this weekend). I cook Thanksgiving dinner for my family and my brother’s family every year.

10pm-2am

Procrastinated work a bit here and there, intermittently throughout, by checking and returning emails, both personal and professional (needs to be done anyway), checking Facebook, and exploring professional and practice growth opportunities.

Reviewed a post-doctoral fellow’s lengthy forensic report. Completed business accounting tasks for the week. Created to do list with particular attention to the insurance claims/pre-authorizations about which I need to inquire.  Filed a freelance writing/consulting application.

2:30am

Went to sleep (Yes, it is very late. Wednesday is by far my latest night of the week; it’s a worthwhile tradeoff for more time with my family on other days). Tomorrow is a new day. I’m home with my two youngest children to enjoy time with this and take care of household tasks, while managing the practice via email/phone for the day.

For more information on Dr. Deibler and her practice visit www.thecenterforemotionalhealth.com, or connect on Twitter, YouTube, or Facebook.

Getting 3 'Fs' In Private Practice Is A Good Thing!

My motivation for starting my private practice, Wasatch Family Therapy, was very clear. I wanted to create my ideal work environment and I knew that no one else could do that for me. I felt called to help people heal themselves and their relationships.  I knew that I wanted work with therapy clients who valued my services and time, and who were dedicated to working hard to improve their life. I wanted the flexibility to set my own schedule and take time off to be with my children and attend school and sporting events. I wanted to do paperwork that was relevant and helpful for treatment. I wanted to invite other clinicians into my professional space who were gifted therapists, genuine people, and who I enjoyed spending time with. I wanted to work as a social worker part-time and make a full-time income (a lofty goal in a profession where many work full-time and make a part-time income).

I know why I chose to go into private practice but I was curious if other therapists and counselors around the country had similar motivation opening private practice. I recently asked several therapists about their reasons for taking the leap into the business world of owning their own practices and noticed three common themes emerged. I call them the 3 "F"s of private practice: flexibility, freedom, financial opportunity.

1) Flexibility

Therapists who take the leap into private practice value flexibility in their work schedule to better balance work and family life, and to pursue other interests.  Dr. Mary Sidhwani, a psychotherapist in private practice since 2000 in Ellicott City, Maryland opened her practice so she could have the flexibility to care for her two young children. "I wanted to be able to balance both my professional and family life; to be able to spend as much time with my children as possible while they were young."  Social worker Diane Spear, LCSW-R of New York City said, "I had worked at an agency with wonderful colleagues, but private practice gave me the opportunity to set my own hours and fees."

Of his decision to open his own practice psychologist Dr. John Duffy says, "I wanted to go into private practice as I wanted control over my career: my schedule, niche, fees, client base, whether I accepted insurance, and so on. I also wanted to be able to write, consult, speak, and expand my practice, or take fewer clients, as I went along."

2) Freedom

Freedom to select a particular client population to work with and choose your own approach to treatment has drawn many therapists to open a practice. After agency work left her overworked, underpaid and burned out, Esther Kane, MSW of British Columbia chose to open a private practice because it allowed her to focus on her passion - women's issues. Kane says she loves the "autonomy and flexibility of not having to answer to anyone."

Spear says she appreciated being able to choose who she worked with and how she approached treatment. "I wanted to choose level of pathology I want to treat, choose the theoretical orientation and supervisor I'm most comfortable with, and set the environment as I prefer. In short, autonomy, autonomy, autonomy!"

3) Financial Opportunity

It's a risk to open your own practice, but when it grows, you are the one who benefits most from the financial growth. Private practitioners have the opportunity to grow their income in ways that are unlikely to happen when you work for someone else. New York City therapist Emma K. Viglucci, CFT, LMFT, CIT experienced the growth potential first-hand. Since opening Metropolitan Marriage & Family Therapy, PLLC she says, "I've grown the practice to the point where I had 10 clinicians working with me as part of our clinical team. My practice has become an Internship Placement Site for MFTs in training."

Financial need helped Lisa Gomez MA, PLC of Surprise, AZ transition from part-time to full-time private practice. After being laid off from a full-time staff position due to budget cuts Gomez says it was "the perfect opportunity to take the step of faith into full-time private practice. I love private practice because I can be as successful as I want or as flexible as I want."

What motivated you to start your private practice?

If you're thinking about venturing into private practice, what do you hope to gain?

photo credit: Leo Reynolds