I was hanging out on Google+ last night when I ran across a link to Stretched, this fabulous post on WhatAShrinkThinks about the tolls of doing business as a mental health professional. The therapist / blogger references terms like “working in secrecy,” “empathy-fatigue,” and “talking binges.”
What does this have to do with 
attracting clients and building a healthy private practice? It has everything to do with it. If we fail to engage in the self-reflection and self awareness necessary to keep our relationships outside the office safe, healthy, and secure . . . , we certainly aren’t able to do that with our clients in the office. And, if we can’t mitigate those hazards, we can’t build and maintain strong and vibrant businesses.
Self-reflection.
Self awareness.
Self care.
As we practice it, we can teach it.
What are the potential professional hazards of being a mental health professional? And, what is it that you know you need to practice so that you are able to teach it today?
My mantra is to never expect my clients to do something I’m not willing to do myself.
Hi, Pam! NIce mantra!
Has anyone had experience with the therapy-referral site, Theravive? Please email me at the address above.
Joe
Hi, Joe. Thanks for dropping in today. Have you checked out my post from last year, 2011 List of Online Directories for Mental Health Professionals? It might be worth your time to read the comments on that post – I suspect that someone at least referenced Theravive. And, that might also be a better place to leave your question related to this topic.
What you and other readers may not know is that you can search this entire website topically just by going to the search box at the top of the left column and typing in what you are looking for. What pops up is a list of all content (including comments) that may be relevant to your search topic.
http://www.allthingsprivatepractice.com/2011-list-of-online-directories-for-mental-health-professionals/
Hi Tamara,
Great post, can you elaborate on the term “talking binges”? This is the first time I have heard of this term.
Hi, Aaron! Thanks for dropping in this afternoon! You would have to ask WhatAShrinkThinks to get her opinion. However, both my partner and I would tell you that because I spend a lot of time actively listening during the work hours, it’s not uncommon for me to feel the need to “run off at the mouth” i.e. talk a lot after work hours. I use a lot of words anyway and sometime feel almost entitled to talk talk talk after a long day listening.
Can anyone else out there relate that these “talking binges”?
I completely relate to needing Talking Binges. I think that was one of the first things that I felt as a therapist in-training. After all the time spent listening to others, and talking about their needs, I NEEDED to talk about me, or my experiences. Now, I usually keep up with enough self-care that this is not a dire need nearly as often, though when I notice the need I work on filling it quickly so it doesn’t grow too fast. 🙂
Hi, Desi! It’s good to have your voice here! Ha-ha. Yes, those talking binges trip up a lot of us! My partner says it’s amazing how much I can talk some days! Poor her! I dropped in to your website hoping to find a blog – Your site must be new because right now you have a blog orphan. I was thinking that that might be a good place for some of your words! I know that blogging, for me, has really cut down on my need to vent out the mouth . . . and there’s no one there to say “Enough already!”
I was guilty of talking binges before I ever became a therapist! I’m much like you Tamara in that I need to talk after spending so much of my day listening. My husband is a good sport about it. When he’s not around I talk to my dog!
Hahaha, Pam! I must admit that I, too, have a propensity for talking! However, I think that sitting in silence so much of the day really does exacerbate that tendency. I tell my partner that somebody in the relationship has to listen!
Interesting, thanks for answering the question.
Thanks for continuing to drop in and chat, Aaron!
I find the “talking binges” concept very interesting. When I was working 10-hour days with a very large case load I felt the opposite need. I felt that I listened to the equivalent of verbal trauma/chaos for hours at a crack and at the end of my day I had an overwhelming desire for silence. No TV unless it was comedy (but really, not even that), no talking, no requests from others (even simple stuff). I felt “tapped out”. Eat dinner and read (for pleasure, not work-related stuff). Blessed, blessed quiet.
I know this is a delayed response to this discussion and it may not be interesting to anyone anymore. I’m just trying to get the hang of this stuff since I’ve gotten a new computer and new internet server (speed!!!).
Welcome, Lisa! I’m so glad you took time to add your voice to this discussion! Isn’t it funny how we are each affected differently by the work that we do?! I’m all “listened out” at the end of a big work day and can be even a bit distant as I try to start to focus on my own needs. Unfortunately for my partner, that means that while I can’t talk about my work experiences, she sometimes gets the fallout! I believe she has referred to it as . . . “verbal diarrhea!”
Hi, Tamara.
What a lovely website and chat room you have. I found you quite by accident. It’s so nice to see that there is this supportive chat room for therapists who are struggling with the vicissitudes of “mangled care.” I especially liked how on your website you listed the various theoretical underpinnings of your clinical work. And your site conveys compassion and kindness.
I have been working part-time as a licensed psychologist in an outpatient clinic where I am on the Medicare and Medicaid panels (as well as a few private panels), and silly me, I thought I could use this part-time income to financially support starting my mananged-care-free private practice. But, unless I’m mistaken, I cannot opt out of Medicare and Medicaid in my private practice and continue to work in the outpatient clinic where they do take Medicare and Medicaid due to federal law prohibiting this. I believe in government oversight, but this seems ridiculous! There goes my plan to work part-time to help fund getting my private practice off the ground! And so, in a nutshell, I am scared to take the leap into private practice, as it means cutting off my current source of income. And yet I simultaneously feel the need to do so. There is just so much to learn about starting a practice, it feels overwhelming at times!
I am curious as to how you inform potential clients about your reasons you do not take insurance. Do you refer them to your website? Or list the reasons over the phone? Or send them a brochure? And the potential clients take the time to listen/read?
On another note, I’d like to offer a sliding fee scale in my private practice. It seems to me that it is preferable to slide my fee down rather than spend fruitless hours chasing down insurance companies and begging for the pittance they pay. Does anyone “out there in chat room land” think this makes sense?
Thank you all,
Meredith L.
Meredith! Welcome to Private Practice from the Inside Out! I’m so glad that you have joined us! It really is a supportive online community here and I’m thrilled to see so many voices come to the table as we continue to grow in numbers. You can subscribe to get the updates right in your email inbox if you wish or just drop in when it’s convenient to you.
I believe, Meredith, that you are mistaken about your practice and Medicare / Medicaid. My understanding is that you are allowed to practice differently and under different rules in those two settings. However, I am not a mental health attorney and I would suggest that you check in with one for a brief 15 minute consult about this over the phone. Better yet, contact your professional liability company. They should be able to provide free and accurate advice on this specific to your state and your practice situation. Don’t assume – and don’t take your boss or your colleagues’ advice on this. For less than $100 you could find out that you can easily charge in your practice more than double what you are getting paid my mangled care.
I discuss my fees during the first phone call. I tell them that I provide receipts for my services but do not interact directly with managed care. I explain the reasons that I have chosen not to do so – that it’s in the client’s best interest – and details some of those. In 15 years, I think I’ve had maybe 2 potential clients choose not to work with me for this reason. I believe that most therapists are afraid to take this position and, as such, don’t. However, if you talk to many of us that are cash-based practices only, I think you will find that this is very do-able. I have be insurance-free for almost 15 years now and it’s hands down the best decision I’ve ever made in my practice.
I’ve written about reducing fees here and here and here and you may find these useful.
Meredith, I do hope you will drop back in often to share your thoughts and let us learn from you, too!