The Human in the Helper: I felt like my life had been thrown in a blender

Michelle is known in her community for helping colleagues become CE providers because she believes in what they have to share, she recognizes the freedom course creation brings, and she wants colleagues to have additional income streams. She is also known for her fun glasses and for being a breast cancer survivor. “I was diagnosed in January 2020.” Michelle describes a moment in her life that was sheer terror as she waited for official results. She recalls the experience as being told there was something abnormal and that they were pretty sure what it was, but required two weeks to formally confirm. “I would rather go back to chemo than relive those two weeks of hell.”

Michelle wasn’t sleeping. She felt dissociated. Her heart rate stayed high, even when trying to sleep. Her daughter kept waking up in the middle of the night worried and finding reasons to engage her mom to make sure she was okay. Michelle struggled with what to tell her clients. “I feel bad for the clients in that waiting period, I showed up the best I could.” It’s understandable that Michelle had a hard time being present as she waited for the game plan for fighting her cancer, which ended up being a very aggressive type of breast cancer with the worst prognosis. “I notified my clients about needing two weeks off to address my medical care.”

Once she had her plan, which included chemo, surgery, and radiation, Michelle focused on referring out her newest clients and her acute clients to other providers. “It was hard to make those calls while also trying to take care of myself.” Michelle kept clients she’d had longer on her caseload, who also had more rapport for this next season of her life. Then she experienced the pandemic shutdown. “It was sort of a blessing to move to working from home. I had lost my hair, I was wearing a wig.” She moved everyone to online and tried to keep up with her medical appointments.

Another challenge Michelle faced was maintaining boundaries around her cancer treatment with clients who were worried. “I let them know there was going to be a boundary and set the timer for five minutes. They could ask me anything they wanted regarding my cancer and treatment, but once the timer was up, it was back to being focused on them.” Michelle reports this worked well for clients. Some only wanted to know that she was okay, while others had more detailed questions to ask. She navigated this dynamic with her clients through ten months of treatment.

Michelle is in good health now, and has had time to reflect on her process. “I wish there was more support in our community for things like this.” She described wanting a way to notify a trusted colleague when awful things happen, someone who could make the calls and outreach the clients when their therapist has to pause or regroup. Michelle felt this need again when she got the call at the end of a client session that her father had died. “How do we let people know when life things happen? We worry about client abandonment. We worry about liability.” Until a tool that supports this communication is created, Michelle has some other ideas for colleagues. “Be gentle with colleagues online. We don’t know the whole story as to why they didn’t show up, why they didn’t call back. They could be going through something.” She hopes that mental health professionals can support connection and community with one another, two things that feel so important when coming back from crises that happen in our lives. We couldn’t agree more.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: I was a shell of a person

Laura is known as a leader in the mental health community. With her passion, wisdom, and integrity, she is showing colleagues ways to level up their practices. Yet her own practice had to take a pause when she found herself struggling with significant anxiety and OCD behaviors postpartum. “I anticipated that postpartum would be awful, and I was right,” she shared. Laura was struggling with sleep, and wouldn’t get the sleep she needed after nursing her daughter at night. “I went into my support group and asked them if they were sleeping and they all said they slept like logs. That’s when I knew something was wrong.” She described insomnia that would keep her awake and when she’d finally feel tired, it was time for her daughter to nurse again. “My husband would leave the house for work and I’d cry, knowing I was left home alone with my baby, I was so tired.”

Laura noticed that her insomnia contributed to her anxiety as she worried about the insomnia itself and not getting enough sleep each night. Then she noticed some OCD behaviors showing up in her life. “I think I was looking to feel in control of something,” she reflected. Laura found herself using an app to track all of her infant daughter’s activities, which isn’t uncommon. What felt disruptive was that she was methodical about logging every activity and exact times for all the activities, which she recalls felt obsessive and made her anxiety worse. “I focused on every minute and every activity. I was in the app all the time. “ She didn’t know how much of a hold it had on her until someone said to delete it. “It was when my daughter was 18 months old that a friend suggested I delete the app in not needing it anymore, and after some hesitation I did.”

Although Laura was able to break away from the app and the behaviors associated with it in her postpartum recovery, she shared that it took her longer to recover from the sleep deficit of motherhood and insomnia. “It was probably a solid four years before my sleep was back on track.” The thing that helped her most was getting trained in CBTI, Cognitive Behavioral Therapy for Insomnia, which she used on herself as well as with her clients.

Laura is honest with herself that her postpartum journey was challenging and that her experience isn’t everyone’s experience in becoming new parents. She does have some advice for therapists who are planning for maternity or paternity leave, however. “Save for your leave.” Laura identified that she was fortunate to have saved enough for several months of maternity leave, which allowed her to be more honest with herself on her timeline of coming back to work. “If I’d come back at 12 weeks, I wouldn’t have been a very good therapist. I was a shell of a person.” Through her saving and thanks to a supportive spouse, Laura was able to extend her maternity leave to allow herself more time to adjust, before slowly easing back into private practice two days a week to start. “Set aside money for your leave, you don’t know what your postpartum will look like.”

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: I found out on Facebook

Cathy has a disarming, warm personality that shows up well on video and in person. When she’s not writing her next book or offering workshops, she’s enjoying her dogs or recording new content for her online classes. Cathy isn’t afraid to talk about things that feel heavy, like being scammed or death and dying. It’s one of the many things that makes her the ideal person to talk to therapists about professional wills. She also has the lived experience of losing two colleagues suddenly. “Grant and I worked together on projects and I asked him to be the executor of my professional will,” Cathy shared. Grant said yes, and asked Cathy to be his executor as well. But then Grant didn’t get around to writing a will before he died suddenly. “Amidst my grief, I had to find a way to get his files.” Cathy went on to describe how she learned of his sudden death. “I found out on Facebook. It was sad and difficult.”

Cathy shares how she had to compartmentalize her grief in order to take care of things for Grant. “I had to figure out how to reach his family. I had to find his calendar to notify his clients.” Cathy describes a frantic search for Grant’s files, which were in three different places. She worried about clients showing up to sessions and wondering where he was. She worried that clients would find out about his death through social media too, adding a traumatic layer to their loss. “Every phone call was hard,” Cathy named. She held space for Grant’s clients in their grief and helped them connect with new providers, which felt like a process for both her and them.

That wasn’t the end of Cathy’s grief. Two years later, a second colleague died suddenly. It was another tragic example of someone who didn’t have a professional will in place. Although Cathy wasn’t the executor for this colleague, she had some realizations from her experiences of loss. “I knew my professional will wasn’t going to cut it.” She also realized that more colleagues needed to understand the importance of a professional will, for themselves, their clients, and their families. “I needed to take some action,” Cathy shared.

Cathy began gathering materials for a more in-depth professional will template, in honor of her experiences with Grant and her second colleague who had died. She started offering workshops to help therapists craft their professional will, and noticed how her experiences with colleague loss had changed her profoundly. “I noticed that I didn’t shy away from saying death or dying.” C

Cathy saw firsthand how crafting a professional will triggered her colleagues. It caused a fear of death to surface, and it asked people to look at their own mortality. “It showed up in every single workshop,” Cathy named. She describes how some colleagues needed to take a break, while others wanted to pause and come back to writing their will at a later time. Cathy recognizes this is a difficult but necessary process for many.

“Just get something written down,” she says. “Anything helps. Talk to a colleague, or tell someone where you keep your key.” Cathy shares how the more someone can plan and get into the details, the more it helps others. She also suggests exploring the wording of what you want your executor to say about your death. Are details important? Is there wording that feels least harmful to the clients left behind? Professional wills represent more than just details of where to find your files or client information. “It’s something to guide a colleague,” Cathy says, “it shows care for your clients, it shows care for the person doing this process for you, and it shows care for your family members who are in grief.”

You don’t have to do this by yourself. Access Cathy’s online course for writing your professional will HERE.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: My clients didn't know

Sharon loves using humor in her therapeutic work, which serves her well considering she works with a variety of clients including children to older adults. It’s also helped her navigate almost four years of medical challenges. “I had three medical issues in a row!” Sharon shared. She reflected on needing serious medical care that felt disruptive to her work-life balance for several years. “It was hard. Sometimes it was great to be with clients because I needed to think of things other than the pain.”

Even as Sharon was attempting to navigate her pain, most of her clients didn’t know she was going through so much. “Clients would be shocked to know what I went through. They had no idea. I had to think about if it would hurt or help clients to know,” she said. This was possible due to her offering telehealth sessions where clients couldn’t see the medical changes or recovery equipment in her life at that time. Sharon went on to describe how she didn’t want to reinforce attachment traumas for certain clients or cause them to worry about her, resulting in clients attempting to caregive her rather than focusing on their own stuff in therapy. “We have to be curious about if honesty is helpful, or if it just makes it about us, “ Sharon warns.  It helps us reflect on the purpose of self-disclosure when things are happening in our personal lives, exploring the impact on our client work from multiple viewpoints.

Sharon isn’t saying that clients come first, however. When it comes to medical care and health and wellness needs, she recommends therapists treat themselves likes CEOs. “Be the CEO of your business where your needs come first, then your client care.” She named how making her health a priority actually helped her get better, and allowed her to serve her clients better when feeling well again.

An important part of Sharon’s recovery in needing medical care was her own support system. She reflects on how embracing vulnerability and sharing her struggles with colleagues helped her reduce her caseload with thoughtful referrals when she was feeling tapped out. She named gratitude for a spouse who encouraged her to do what needed to be done in order to get better.  “There’s a strength in saying there’s no way I can get through this on my own.”

Sharon is celebrating that she’s in a better spot with her health today, and recognizes that the lived experience of multiple medical concerns has made her a better clinician in some ways. “Having to sit in the question of ‘is this it?’ myself allows me to sit in this heaviness with clients.” Whether it’s aging, end of life, or the loss of a loved one, she feels prepared to slow down with clients and feel the big emotions that come with mortality and loss. She continues to hold passion for her client work and gratitude for her experiences, and names a willingness to keep her health a first priority amidst her calling as a clinician. “As long as I can take a break from any surgeries or medical crises in 2024,” Sharon grinned.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

The Human in the Helper: I was going to be resentful and hateful of the field

Alex loves traveling, his husband, and his fur babies. He’s known within his community as a committed mental health leader, dedicated group practice owner, and compelling TEDx speaker. Most importantly, he embodies a genuineness and passionate energy you don’t often see when working within hardened systems that focus on significant trauma and addiction. Seeing how much he’s accomplished in the past few years, it may surprise you to know he was starting to lose his passion and soulful work to the burden of busyness. “It was consuming me,” Alex shared.

Alex describes an imbalance where work was the top priority. He was fielding calls, putting out metaphorical fires, and always having to check his phone for issues, even while on vacation. “I didn’t look forward to coming home [from vacation]. I was stressed at the thought of coming home.” Alex knew something had to shift, but he felt he was committed to his group practice’s growth and goals for the next few years. His spouse described the agency as Alex’s baby, taking his full attention and energy since it was still in an infancy stage of growth.

“That hurt to hear him say,” Alex said, “but it didn’t cause a pivot.” At least, not yet. Alex had been considering a career adjustment for almost two years before he hit his limit. “I was in Oregon on a ropes course and had dislocated my shoulder,” Alex remembers. He recalled how he noticed he was attempting to talk himself into pushing through and finishing, all while in immense pain. “I asked myself, who do I need to prove myself to? Tapping out is okay.” Then Alex felt a flood of emotions as he realized this urge to keep going and pushing through was part of his experience as a group practice owner. He had finally come to a decision, it was time.

Although his community saw the end result as an announcement to close his agency, Alex disclosed several factors that influenced this pivot away from group practice ownership. “I want my husband to be my top priority. I want to do soulful work again. If I didn’t pivot, I was going to be resentful and hateful of the field.” Alex reflected on how his five domains of self—something he presents on often within his community—were suffering under the experience of too much busyness. “Now I’m paying attention to what feels in alignment with my values.”

Alex shared that although he’s grieving the change, it’s a joyful process to see the meaningful differences in his day to day life. “I get to work and do something I love and spend time with my husband.” Alex doesn’t want to live with regrets, especially as he helps his spouse navigate a recent decline in health. “I’m not going to compromise who I am as myself or for my husband for the profession.” In other words, Alex is embracing a shift towards prioritizing relationships and health over work.

A pivot in practice ownership is something Alex wants to normalize for his colleagues. “You don’t owe anyone any explanations. You don’t owe it to anyone but yourself.” Alex went on to describe that pivoting is a normal experience as priorities in life change. How do you know if you need to pivot? Alex has a suggestion. “Imagine you are on your death bed. Will you be happy with how things are now? Or will you have regrets? You can pivot!” Alex doesn’t want to feel like he has ignore warning bells when things are out of alignment, and he doesn’t want other clinicians to respond this way either. “Notice what you are saying to yourself. To tap out is okay.” In support of balance, Alex plans to continue to speak and consult on burnout and soulful work with other helping professionals. It’s a way he can give back to the profession without burning out, which is something he hopes to inspire in colleagues on their own path of self-discovery as well.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

Seven Steps to Changing Your Business Name as a Therapist

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It can feel like a stressful process to change your business name, much like it can feel overwhelming to change your last name. What steps do you need to take? What order should you take them? What are you forgetting? Since I’ve experienced both a business name change and last name change, I wanted to share some steps to make the business name change that much easier for everyone else to navigate as private practice therapists and small business owners.

Step 1: File a request to change your business name with the IRS. You will get an updated EIN letter reflecting the same EIN and new business name, which will be used to submit changes to other organizations electronically.

Step 2: Change your business name with your business filing in your state. Here in Colorado, it’s the Secretary of State where you can login and request an update, found in the same portal as your annual business filing requests.

Step 3: Complete forms and/or notify insurance panels of the name change. This could take weeks to months to update, which if they are writing you checks, could become a problem if not tackled just so. Don’t forget to update your CAQH profile at the same time since insurances will cross check that!

Step 4: Update your EHR to reflect the name change in your consent forms, your disclosure, your scheduling tool, and your practice information. Notify your clients of the name change in writing so they don’t get confused.

Step 5: Update your bank information to reflect the new business name. Oftentimes this requires an in-person meeting with a banker at your bank to provide the documentation required to make the change. When you schedule your appointment, confirm what you need to bring to make the meeting as efficient and painless as possible.

Step 6: Notify your professionals of the name change, including your biller (if you have one), your accountant, your financial advisor, your tax person, your practice lawyer etc. Notify your malpractice insurance so they can re-issue your insurance for the updated practice name.

Step 7: Update your marketing materials. This includes:

-Your website

-Your logo

-Your social media accounts

-Your Facebook business page

Now you are ready to announce the change to your community! Even though there is excitement in the change, it can also feel daunting, especially knowing that not all of these steps will go smoothly. Give yourself some grace and a significant runway to implement all the changes before announcing it officially. It can feel like a long process to get everyone up to speed on the new name, however once it’s done, the excitement of pivoting will return, allowing you to look forward to the next meaningful chapter in your business!

Exploring Secondary Income versus Passive Income in Private Practice

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Many mental health professionals are exploring additional income streams. Whether it comes from a place of wanting more freedom, supporting burnout prevention, or a desire to have greater flexibility than seeing 20-25 client per week, diversifying income is an important consideration in a successful, balanced private practice.

So let’s talk about passive income versus secondary income. Passive income is something that once launched, makes you money without much effort. Things like:

Book sales

Digital downloads

Online courses

Digital workbooks

An App

Secondary income is a bigger bucket of possibilities, but they also take time to build, effort to maintain, and require time allotted to produce regularly, meaning a more significant shift in your client schedule to avoid feeling overextended. Things like:

Professional training and workshops

Professional speaking

Podcasting

Radio show

Online merchandise or swag*

Retreats

Hosting conferences

Group practice

Video series

Group therapy

Intensives

Supervision

Consultation

Online memberships*

Teaching/Being a Professor

*Depending on how they are built, these could become more passive

Why should we talk about both passive and secondary income streams? As someone with 16 current income streams, the differences and options within private practice matter! For colleagues who connect with me in consultation on this piece, they want to work less so they are seeking passive income streams. Which is great, I’m all about it! And perhaps they are surprised to hear that it can take 4-5 years to see the passive income really flowing well, where additional effort or time isn’t required to maintain them. So then we start to look at secondary income streams together to make a faster, satisfying shift in their money story, with momentum towards a passive income stream in the near future. The ability to bring in additional income is an important skill in business, and thus a skill to master in private practice as well.

Want to know one question (of many) that I ask colleagues in these types of consults?

What’s one pain point for your clients that you already address?

Pain point being defined as an area of hardship, difficulty, or discomfort. Seeking a solution. Is the thing you do (exercise, skill, tool, technique) replicable and scalable to a larger platform for increased reach and income? Let’s talk about it in a consultation!

Both passive and secondary income have a place in the equation of private practice success. Honestly, my favorite type of consultation these days is helping colleagues identify their interests and passions and turn them into possibilities that generate new income. What’s holding you back from dreaming about these possibilities? Maybe you have ideas but aren’t sure how to implement them. With so many colleagues creating amazing things, you are closer than ever to finding your additional income stream(s). Reach out to one of us that speaks to what you are dreaming about. Before you know it, you’ll be one of the professionals showing others that diversified income is possible and maybe even necessary to avoid burnout in our field.

Three Things to Consider When Creating a Course for Others

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As mental health professionals, it’s not uncommon to be asked to create a course for others based on your specialties, interests, or populations you serve. It could be a health company wanting a training on suicide assessment, or an HR firm looking for a workshop on burnout prevention. It may be a school wanting strategies for addressing self-harm in teens, or a church community looking for grief and loss resources from a professional within their community. Or perhaps you’ve been outreached by a continued education company that is looking for fresh faces to create quality trainings they can add to their subscription library for current members. Regardless of the audience, here are a couple things to explore before embarking on the journey of creating courses for others.

1.     Have a Contract

Any company or organization serious about working with you to provide a course should have a formal contract outlining the parameters. It’s not enough to have a verbal or email exchange, it’s about having something in writing that gives expectations on things like:

a.     Length of the final training

b.     Deadline for training materials

c.     Format of training being webinar, modules, video, audio, etc.

d.     CE components like learning objectives, references, and quiz questions if required

e.     Intellectual property clarification including that they aren’t hindering you from making similar content for others if you desire to do so

2.     Know the Numbers

In addition to a contract outlining various expectations of you as the creator, it should also house some very important numbers for you to consider before saying yes to the project.

a.     Proposed payment for the completed training (lump sum vs. hourly)

b.     Royalties for the completed training if applicable (percentage earned on the course purchase price)

c.     Affiliate link if applicable and percentage earned off each sale

d.     Timeframe (in months, quarters, or years) for royalties to be earned, and how often they are paid out

3.     Check Boundaries on Your Time

Based on the contract and numbers above, the next step is to compare the creation opportunity to the value of your time. Although most organizations are going to offer a lump sum for course creation over your hourly rate, how do the numbers break down? For example, if they are asking for a 2 hour course for $300, how does that compare to your private pay rate? Does that factor in additional hours of preparation, recording, formatting, and editing content if applicable? Just because the finished product is two hours doesn’t mean it’s going to take you two hours to create it, so sitting in that possibility is important before agreeing to start the course.

So now that you’ve explored the details of your course collaboration, are you ready to sign the contract? Are you feeling overwhelmed or like the timing is off? It’s important to be honest with yourself on all aspects of this endeavor. If you find yourself interested in the project but are not feeling quite confident, maybe there is something that needs to be ironed out before you can give an enthusiastic ‘yes!’ If the company has a restricted budget where they can’t increase your payment, try to negotiate. Here are some ideas of what to ask for:

A.    A longer payout for royalties, such as 3-5 years instead of 2 years

B.    A copy of the recording(s) to use in your own practice or consultation business

C.     Your contact information listed on their site(s) with a backlink to your website to increase your SEO

D.    A copy of their logo to use in your own marketing as a course creator

Each of these suggestions can increase the value of course creation to a busy professional. The process of creating something that expands reach to more people can be exhilarating and rewarding, not to mention it adds credibility to your professional brand. It can also serve as a lead magnet where folks may want to continue to work with you in some capacity, so I hope you’ll take this opportunity to explore course creation as a secondary income stream in your growing private practice!

A Caution When Setting Different Rates in Private Practice

Disclaimer: I am not a lawyer. This content does not replace a professional consultation with a legal representative.

What do I need to consider when setting my rates?

It’s a common question I’m asked as a Financial Therapist to therapists. Although there are multiple factors to explore when raising your rates (join us in our upcoming workshop!), there is another piece to the puzzle that’s been on my mind lately.

For therapists in private practice who take insurance, there are parameters they agree to as part of signing a contract and being in-network. One of which is that Balance Billing is illegal in Colorado. Balance Billing describes billing your full rate to insurance, being paid your contracted rate by insurance, and billing the client the difference. This is a no-no in Colorado.

An example:

Your private pay rate is $150

Insurance pays you $121

You invoice your client for the difference, which is $29

Seems pretty straight forward that this won’t fly. But what about in private-pay practices? Are you allowed to charge different clients different rates?

Yes and no.

For different services, it is common and accepted to have different rates. For example, your individual therapy rate may look different than your couples or family therapy rate, EMDR intensive rate, or 60 versus 90 minute session rates. Some folks are charging a higher rate for “premium times” like evenings, which feels a little sticky unless it’s in writing and known to all clients when scheduling for them to make an informed decision regarding their therapy.

What about charging a client a “supply fee” for being in-person? This feels like a gray area in private pay practices.

What feels even more sticky to me is setting different rates for in-person versus telehealth sessions, which has come up more often as professionals explore hybrid practices where they offer both.

For example:

A therapist charges $150 for a 50 minute telehealth individual session.

They charge $175 for a 50 minute in-person individual session.

The cost difference is that they want to charge more for in-person to offset costs like office space or rent, or gas and supplies like coffee and tea that are utilized for in-person services. As a business owner, I understand that thinking. And yet, the bottom line is that those expenses are tax deductions and part of doing business.

Here are two reasons I would caution a therapist against having different rates for telehealth and in-person sessions.

1.     It feels discriminatory

That’s right, this could put you at risk of being accused of discrimination. What if your client has a disability that requires or prevents them from in-person sessions? Does in-person at a higher rate convey a message to an able-bodied person? There are aspects here to think about as a private practice therapist.

2.     It encourages insurance companies to follow suit with wanting to pay providers less

I can tell you how upset the therapist community was when certain insurance companies suggested a lower reimbursement to therapists for telehealth after the pandemic. The argument against this? We are still doing quality work via telehealth and continue to support meaningful client outcomes towards their goals via video. So if we support a different fee structure for in-person vs. telehealth in private practice with private-pay clients, are we not encouraging insurance to reignite this initiative too? As you can imagine, this would have a negative ripple effect on therapists who want to be paid fairly by insurance, and in response, might limit their number of telehealth sessions which reduces access to care for clients.

So what can you do? Rather than charging different rates for telehealth vs. in person, consider raising your rates overall to address the added expenses of in-person services. Not sure what this needs to look like? Join us August 15th from 12pm-130pm MT to engage in a live webinar workshop on raising your rates.

Raising Your Rates Workshop Objectives

1)    Remove money blocks to raising your rates

2)    Identify factors for raising your rates

3)    Explore strategies for implementing new rates

I hope I can convey that my goal in writing this is to support you as a business owner AND therapist. To hold space for multiple views while also owning that I’m risk-adverse. Raising rates is one aspect to consider in response to added expenses in practice, while knowing that things are constantly changing, which means revisiting ideas often to support your business growth.

Seven Signs of Scarcity in Private Practice

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Scarcity can be defined as “there’s not enough.” As a mental health therapist and Financial Therapist serving fellow therapists and small business owners, I often detect scarcity in the way folks speak their fears out loud. For example, “there’s never enough clients,” “not enough referrals,” or “there isn’t enough money.” With these beliefs come stress and resulting problematic behaviors. Let’s take a look at some warning signs for therapists in private practice that show when scarcity may be driving.

#1 You say yes to a client who’s not a good fit.

Taking on any and every client that calls can be a sign of scarcity. As therapists, we aren’t a good fit for everyone, so we should use caution and practice pausing before taking on clients that aren’t within our wheelhouse. It can also become an ethical concern if we take on a client that would benefit from a speciality that we aren’t trained in.

Scarcity Solution: Identify your ideal client(s) and market to them!

#2 You schedule a client on your lunch to make their schedule work.

I’ve been guilty of this. The client shares that they have a limited schedule, so you offer them your lunch hour to make it work. This could become a recipe for burnout in not taking the much-needed break to rest, eat, and reset during a day full of clients.

Scarcity Solution: Block out your lunches and honor them.

#3 You schedule a client at a time that’s not your ideal schedule.

Your client shares that their schedule is changing and that their original appointment time isn’t going to work any longer. So you respond by offering a Friday or later evening appointment you don’t actually offer to other clients on your caseload. This response of “fitting people in” could lead to burnout or resentment if they begin to expect scheduling exceptions on a regular basis, especially since you set your schedule for valid reasons, such as family, self-care, or other obligations.

Scarcity Solution: Commit to a work schedule to see how you like it. When you identify that schedule, honor it with new and existing clients. You can always change the schedule later as you see fit, it’s a benefit of working for yourself!

#4 Do you feel uncomfortable with a blank spot in your calendar so you seek to fill it?

Perhaps you find yourself nervous with too many open appointment slots in your calendar so you attempt to track down clients who haven’t scheduled in a while, or seek out projects to keep you feeling busy.

Scarcity Solution: Lean into the discomfort. Schedule self-care or a fun project in the free space. Embrace boredom as the catalyst for creativity.

#5 Do you see a lighter schedule so you take on more clients than you actually need to.

As a result, your efforts to take on new clients or add in new commitments leaves you feeling stretched too thin the following week when folks are scheduling regularly again.

Scarcity Solution: Identify a mantra or phrase you can say to yourself when things feel light and anxiety-provoking, that helps you hold fast against an urge to take on more or be overly busy.

#6 You hesitate to raise your rates or move to private pay from insurance because you’re afraid you’ll lose clients.

It is possible that you could lose a handful of clients when shifting away from insurance or raising your rates, and preparing for that possibility helps one feel in control of next steps in response. It’s important to recognize that avoiding a change that would benefit you, your practice, or your family from a business or burnout standpoint is a textbook example of scarcity in private practice.

Scarcity Solution: Gently remind yourself that folks don’t like to start over with new therapists if they can make things work financially. Revisit your numbers to clarify why a pivot to private pay or a higher rate is worthwhile to you in your practice, then make a conscious plan for the transition that supports both you and your clients through the change.

#7 You see colleagues as competition rather than collaborators.

You notice a colleague is doing something similar to you, such as serving the same client population or offering a course or training with similar content. To feel threatened and respond as if they are competition is a sign of scarcity. Instead, recognizing that you each have your own style and that cross-referring could be a helpful to reaching more folks wanting services or content, could result in a beautiful collaboration where you both win!

Scarcity Solution: Recognize that you have your own spin on things and that there are plenty of people looking for what you offer. Network with that colleague to get to know them better. This reduces the internal narrative that they are a competitor and instead helps you see them as a fellow professional.

It's natural to have moments of scarcity in private practice because you are working hard to make your business successful. Therefore it’s important to recognize the signs of scarcity and respond to them in ways that lessen the pull to play small or overwork yourself, instead responding in authenticity and awareness that will build your business best.