Last night I was chatting on Facebook with marriage and family therapist Uriah Guilford about getting caught up in “the numbers” while trying to build a private practice. 
Then I realized that I wanted you guys, too, to hear what I was sharing with him.
This is how I learned to ride the waves in private practice.
The client numbers, income, website traffic, newsletter subscribers, etc. are always going to go up and down.
There will never be a flawless trajectory upwards.
I’ve learned to not look at those numbers very often.
I track them – ideally monthly – but I’m tracking for the annual picture not the monthly or weekly picture.
In fact, for short amounts of time, they really mean very little.
It’s like looking at them out of context.
I’ve also learned that in order to have a successful private practice, I needed to learn to ride (and to some extent even predict) the waves.
I think of it like this . . . .
When I was a kid my parents used to take us to the Gulf of Mexico.
I remember my sister and I standing chest-high in the water, rigid as wooden boards, and trying with all our might to not move when the waves hit us.
It never worked.
They always knocked us down.
Then one day I learned to stand “softly” in the water and allow the waves to gently lift me up and move me over and set me back down a foot or two away.
I learned to “ride the waves.”
In private practice it’s important to know that the waves will come . . . .
And, it is important to prepare in whatever ways you can for when they come.
And, when they come, don’t resist or be afraid.
Be soft . . . and ride them.
They always recede.
There is always time to catch your breath . . . even as you prepare for the next one.
It took me 5 years in private practice before I figured it out.
And, when I did, I quit being afraid.
How are you learning to ride the waves?
Care to share?
In your experience, are there predictable times of year when fewer clients come to therapy? I seemed to have a lull in the Summer and am also having one right now…
Hi, Rune! Welcome to Private Practice from the Inside Out! The answer is YES and NO!
Not all therapists have the same lull and flow in private practice and not all therapists who work for example with children or adults will have the same lull and flow.
However, you CAN figure out your own lull and flow by tracking just two numbers each month – the number of billable hours (NOT CLIENTS) and the income you bring in. This is a blog post I wrote several years ago that addresses this – Track Client Stats Now.
Rune,
I agree with Tamara in the sense that each practice has their own pattern in when times are slow or busy, although I will say that the holidays are usually a slower time in both the community agency and group private practices where I work. Summer can also be slow, but I also find that sometimes that evens out when school is in session again.
Thanks, Lauren, for sharing your experience here! Hope your Fall is going well!
Hey, Rune – I just noticed that you don’t have a little photo of you that shows up with your comments here (and on other blogs, too). They are called “gravatars.” Using a gravatar helps others get to know and trust you quicker.
Here’s a link to a quick tutorial that shows you how to set up your own gravatar http://www.allthingsprivatepractice.com/how-a-tiny-picture-of-you-can-help-drive-traffic-to-your-website-or-blog/ . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Tamara, I loved your visual of riding the waves. It reminded me of growing up on a farm in Kansas and collecting bales of hay from the field and stacking them on a moving hay rack. If I was the person designated to stand on the rack and do the stacking I had to learn how to stand with slightly bent knees. Straight knees would get you tossed to the ground if the driver of the tractor hit a bump.
As a child therapist I have a lull in clients in the summer months and during the holiday break. Over time I’ve learned to diversify my work so I’m not limited to relying only on seeing clients for income. Teaching, training, supervising and consulting fill the void during the lulls.
Pam Dyson! WHERE IS YOUR GRAVATAR?! Here’s a link to a quick tutorial that shows you how to set up your own gravatar http://www.allthingsprivatepractice.com/how-a-tiny-picture-of-you-can-help-drive-traffic-to-your-website-or-blog/ . (Don’t worry! It’s so easy that even I could do it and it’s absolutely FREE!)
Your bent / straight knees story reminds ME of how I felt when I first tried to RIGIDLY adhere to theory when I started counseling. It felt awful and I was thrown every time. Once I learned to “stand on the (moving) rack” using that theory turned out to be great!:) Thanks for a different analogy!
And, thanks for underscoring again how diversifying your work and streams of income can strengthen your business as a mental health professional.
Hi Pam and Tamara,
Thanks for this reminder that ebb and flow is something I’ll need to get accustomed to if I make choice to give up the golden handcuffs of a stable ‘day job’ salary and work exclusively in my private practice. To that end, I wonder, do you think it’s wise to begin planing for multiple income streams even when a practice is new/limited in scope? I love to idea of doing consulting/trainings/etc. (and have been doing some of this already), but I wonder if it would be a better use of my time to work exclusively on building a client caseload, given that the time I’m able to dedicate to the practice right now is so restricted. I’d love to hear your thoughts on this!
I definitely encourage you to start planing now for multiple streams of income. Some of the speaking engagements I did when my practice was new brought me new clients. Putting myself in front of large groups of people gave me visibility and that turned into more opportunities for training, consulting and supervision. I enjoy that part of my work and it has grown significantly to the point where I now see fewer clients.
Thanks, Pam, for taking time to drop in and share your experience!
Hi, Rose! It’s great to find your voice here and you’re asking a really great question.
The answer, in my mind, is yes . . . no . . . maybe.
What I think is wise is that you enter private practice with the expectation that there are many potential streams of income and to notice which ones are fueled by your passion and clinical interests.
Beyond that, I think the answer depends.
There isn’t one right answer.
If you have the ability to fully commit to investing in multiple streams of income including your clinical work at the same time, then there’s certainly no reason to not do just that.
However, it has been my experience that many of us enter private practice with a sense of urgency to begin doing clinical work; and, when we are unable to work with clients as regularly as we imagined we would, many of us feel discouraged and begin questioning our career path.
What I know is that if you are feeling discouraged you may quit too soon or burn out too quickly.
And, for many of us, it is critical that we begin earning a decent living as quickly as possible.
If I get spread out too thin, I am ineffective at everything.
On the other hand, Pam has just indicated that it was a wise move for her.
If you’ve got serious questions about this, Rose, you might want to consult with me or someone else about what might work best for you.
I commented using a link to my training web site instead of my practice site which is the one that I normally use and it’s connected to the gravatar.
🙂 Got it! Good to know about both! I didn’t even know about your training website! Thanks for sharing!
🙂 Got it!
Hi Tamara,
Thanks so much for the wave metaphor. It’s one I often use with clients when talking about how emotions come and go, don’t destroy us, and can exist only for a moment if we can just ride the wave and remain open to a new emotional experience. Applying the same metaphor to my own experience of starting a private practice is hard work but worthwhile!
It is so easy to get wrapped up in fear, shame, doubt, and all those other negative emotions that aren’t often helpful. I find it helps to notice the waves in a big-picture context. Numbers go up and down but there are also so many aspects to the business side of running a practice that don’t change as much, or that do remain in our control.
I am using “downtime” to develop relationships with colleagues and to build my website. I am also taking some time to read books that will broaden my clinical skills and perspective.
Hi, Jeremy! Welcome back! You are exactly right – there are lots of things that are directly within our control that can result in the growth of our businesses! I appreciate you sharing ways you deal with that (sometimes unwanted) “downtime.”
I can’t help but ask . . . What books are you reading right now . . . and would you recommend it to others?
Hi Tamara! Two books I’ve read in the past few weeks and would recommend are The Divided Mind by John Sarno and Drama of the Gifted Child by Alice Miller. I found both very thought-provoking and worthwhile.
Good morning, Jeremy! Thanks so much for taking time to share these books! I know John Sarno’s work but haven’t read The Divided Mind! I’ll have to check it out! I am familiar with Drama of the Gifted Child! That’s a classic,isn’t it? Anyone who works with childhood trauma should definitely check that one out. So much of the work that we do can be understood through Miller’s work.
Dear Tamara,
I always enjoy your blog, and I absolutely love the story and metaphor that you have shared! Right now my practice is slow, and I am enjoying it, I am adjusting to motherhood, and that takes a lot out of me, but makes me better in everything I am trying to accomplish! Becoming a mother also made me more discerning as to whom I choose to work with, as in a past I was working with everyone who would call me, now I make sure to listen to my heart more! Motherhood in a way made me more authentic as a person, woman and therapist and I am enjoying these changes and looking forward to see what visions the 2015 will bring to all of us!
Hi, Nelly! It’s great to find your voice here!
I love your word choice here – “discerning . . . ” YES!
I think for therapists who are open to it . . . Those little developmental stages like love and parenthood and loss, etc. really do afford self-reflective therapists an opportunity to develop their discernment.
The same is true for therapists who are open to learning to ride the waves . . . . There are lots of things that can be learned through such experiences . . . Mostly about ourselves.
If we are open . . . .