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.

Adventures In Private Practice: Psychotherapist and Art Therapist Amy Tatsumi, LPC

Tell me a little about your practice... I am a board certified art therapist, licensed professional counselor and psychotherapist in Washington, DC. I see clients across the lifespan and specialize in working with Women Who Do Too Much.  I also see therapists in training and provide post graduate and post license supervision.  Through the creative process and talking, clients learn to connect their hearts and minds to live more wholeheartedly.

Why did you decide to open a private practice? 

I had a small private practice for a number of years while also working a full time job in public mental health.  After having my daughter and living in Japan for some time last year, I new that I needed a better work life balance.  In the summer of 2012, I decided to take the leap and step into the arena.  My mantra continues to be that things are happening in the right time and right way for my business.

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?

Some of the most challenging clients that I worked with were very angry and rightly so.  Underneath the anger was deep shame and fear.  This story  from Pema Chodron is one of the most special gifts those clients taught me: How To Defeat Fear: Once there was a young warrior. Her teacher told her that she had to do battle with fear. She didn’t want to do that. It seemed too aggressive; it was scary; it seemed unfriendly. But the teacher said she had to do it and gave instructions for the battle. The day arrived. The student warrior stood on one side, and fear stood on the other. The warrior was feeling very small, and fear was looking big and wrathful. The young warrior roused herself and went toward fear, prostrated three times, and asked, “May I have permission to go into battle with you?” Fear said, “Thank you for showing me so much respect that you ask permission.” Then the young warrior said, “How can I defeat you?” Fear replied, “My weapons are that I talk fast, and I get very close to your face. Then you get completely unnerved, and you do whatever I say. If you don’t do what I tell you, I have no power. You can listen to me, and you can have respect for me. You can even be convinced by me. But if you don’t do what I say, I have no power.”

What's your biggest pet peeve about private practice?

As with any new business, I would say mine is the growing pains.  I work in a heavily saturated mental health provider community.  I believe that there are enough clients for every provider.  Focusing on  building relationships in the community has been helpful to counterbalance the growing pains.

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

I know that many women are caught in many double binds and in the never enough culture.  Whether you a 20 something, single woman, a divorced working mother, a stay at home mother, a widow, or another woman in transition, I know that many women use people pleasing, perfectionism, numbing, and performing as a means of connecting, navigating relationships and settings, and as a guidepost for self worth.  In my practice, women learn to use their own heart~body~mind wisdom to meet and respond to destructive covert messages and to life's patterns and challenges, as well as value themselves and their thoughts, feelings and opinions.

In 2012, I started Dr. Brene Brown's Connections Certification process and provide a variety of related offerings.  The offering are especially supportive for adults and teenagers who feel stuck, unworthy, and never good enough and those who struggle with perfectionism.

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

Relationships with individuals and communities have really been the foundation for this start up phase of my private practice.  In Washington, DC, Jennifer Kogan started a network "DC Therapists Moms" for parents and people who would like to have children who are in the mental health profession.  It is truly a supportive and thoughtful community with over 400 members.  On Facebook, Julie Hanks's group, "Private Practice Toolbox" has be helpful for national and international brainstorming and information sharing.  Lynn Grodzki's book, 12 Months to Your Ideal Private Practice: A Workbook is a book that I cannot recommend enough.  It has practical and creative strategies to strengthen your practice from all perspectives.  Derek Halpern's blog : Social Triggers is direct and effective too.

What has surprised you most about being in private practice?

In the public mental health community, I had strong relationships, but my area of expertise for almost 10 years was in trauma and attachment.  In private practice, I have had start the relationship building process again, especially with securing referral sources. I have been filled with gratitude for my initial referral and cross referral sources.

Has your private practice helped you grow professionally?

Being a small business owner has reconnected me with parts of myself that I never knew.  At each point of developing my practice, I am having to acquire new skills from social media marketing to the business side of the practice to going through Dr. Brene Brown's Connections Certification process.

Has it helped you grow personally, too?

Finding the work life balance has been really been wonderful.  I am more present in my relationships and have more time for myself.  It takes work, but it is well worth it.

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

Finding time to just be is really restorative for me. Being an art therapist, I do try to make art regularly.  The creative process is centering for me.  Yoga Nidra is a form of meditation that I use.  I also love to be in nature, cook, practice yoga, and enjoy time with my family and friends.

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

I remember that failure is a necessary part of the creative and learning processes.  I see the failures as bumps in the road and try not to get stuck there.  People rarely get it right on the first try.  To find the best solution, one must keep trying with new approaches and strategies.

What personal strengths have helped you succeed in private practice? 

I believe in this work from a very core place.  I have witnessed so many lives changed, perspectives shift and relationships repaired and healed.  Staying grounded in the why I do this work keeps me in focused.

For more information on Amy's practice visit tatsumiandjones.com Join my Toolbox 2013 Therapist Blog Challenge and strengthen your online presence!

Adventures In Private Practice: Family Counselor Barbara Flor, LPC

Just six months ago Pennsylvania licensed professional counselor Barbara Flor opened her private practice. What inspired Barbara to take the leap into being her own boss? What challenges and joys has she experienced in the process? Read on.

Tell me a little about your practice…

I am a sole practitioner with an office in my home, in Mechanicsville, Pennsylvania.  I live on several acres surrounded by tranquil farms and tree-lined properties, so it’s a very peaceful, private setting.  I provide individual, family and group counseling for children, teens and adults with an emphasis on improving interpersonal relationships and family dynamics.  My years of experience as a school counselor, educator and victim’s rights advocate, gives me strong insight into issues affecting women, children and families as a whole.

Why did you decide to open a private practice?

I started my practice about 6 months ago, after years of dreaming, planning and procrastinating.  When my children were in college and I was an official “empty-nester”, I realized it was now or never.  I have been in the field of counseling and education for over 20 years, mostly working for schools and colleges, but I also volunteered my time at a victim’s assistance agency and became trained as a sexual assault counselor.  I have a passion for issues that impact women and children.   Owning a private practice allows me to concentrate on that passion.

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?

I have learned patience, empathy, flexibility and honesty. There is usually a reason people are the way they are.  Who am I to say that if I lived their life, in their environment, with the experiences they have endured, that I would be any different.  They are doing the best they can with the hand they’ve been dealt.  I need to do the best I can to help them with that and sometimes that means being honest and saying, “I’m feeling stuck, frustrated, confused...how can we move past this?”  With children, this can be even more difficult.  It’s imperative to meet the child on his or her developmental level and attempt to move forward from there in a manner that works for that child.  That may involve books, games, play, art, or talk therapy.

What’s your biggest pet peeve about private practice?

My biggest pet peeve in private practice is dealing with insurance.  I hope to someday become a private pay practice, but have found it is difficult to get started in my area without taking insurance.  I am competing with many other therapists who accept insurance.  I am on a few panels and am working consistently to get approved by more.  It is time consuming to do this and to do all the paperwork required to get paid.

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

My passion is working with women and children.  While I do have several clients that fit in this “niche”, I also work with couples and families. I have to say I do enjoy the variety as well.  Many issues that affect women and children also affect couples and families, so the skills I have acquired over the years are helpful with all the populations I serve.  For many clients it comes down to relationships - relationships between parent and child, husband and wife, siblings, and other loved ones and significant others. We all have the basic need to feel loved, respected and to have a sense of safety, security and belonging.

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

The Internet has been the overall, best source of help in my endeavor.  Between LinkedIn groups and Facebook groups for private practitioners, as well as numerous online resources and continuing education opportunities, I have massive amounts of information at my fingertips.  Specifically, Julie Hanks’ Facebook group, “Private Practice Toolbox” was the first resource I sought out and it helped me immensely.  I felt very comfortable and welcome in this group.  The members are kind and knowledgeable and are always there with helpful advice.  From there, I learned about other groups on LinkedIn, as well as books, websites and other people who have helped me along the way.  Joseph Sanok, a member of the “Private Practice Toolbox” Facebook group, helped me with the resources I needed to create my own website.  And many other members encouraged me to start a blog.  I could not have done all that I have in the last six months without these helpful, knowledgeable profession also.  It also hasn’t hurt to have a husband who is a financial guru.

What has surprised you most about being in private practice?

I am most surprised that I find being in private practice so fulfilling.  I truly love spending time in, and working on, my practice.  It is my “baby” and as they say, “If you love what you do, you never have to work a day in your life”.

Has your private practice helped you grow professionally?

I have learned so much about myself as a professional and the things I am capable of doing.  It has given me the self-confidence to continue moving forward, even on the rough days.

Has it helped you grow personally, too?

Personally, it is a great feeling to know you are a professional who can earn a living doing something you love.

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

Walk. Laugh. Love. I love to walk.  I try my best to walk at least 30 minutes a day, preferably outside if weather permits.  I love to laugh.  It is true that laughter is often the best medicine.  I make sure to try and laugh everyday, whether by watching enjoyable television shows, funny movies, or connecting with family and friends, I can feel the stress leaving my body when I laugh.  I recommend this to my clients as well.

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

I have had some very difficult jobs in my life.  When I am having a particularly difficult day, I think of those former challenges.   So far, nothing in private practice has been as stressful as some of those experiences!

What personal strengths have helped you succeed in private practice?

I have a strong business background consisting of an undergraduate degree in business, combined with experience working in business and with business start-ups.  This has been very helpful.  A private practice is a business.  Graduate school in the mental health field does not prepare you for the business side of private practice.  If you don’t have those skills, it is imperative that you get them, or find someone who can help you.

In addition, I have a very strong work ethic.  I am disciplined, responsible, and organized.  I have always lived by the motto, “Work first, play second.”  This has served me well.

 For more information about Barbara's private practice visit www.barbaraflor.com