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!

Seven Steps to Changing Your Business Name as a Therapist

Photo by Kelly Sikkema on Unsplash

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!

The Human in the Helper: Long COVID changed me as a person and as a therapist

Amanda likes to dance in the rain, enjoys live music, and prefers to be barefoot in the grass. With her love of dogs and nature, you might be surprised to learn she used to identify as a workaholic. “I’ve always worked two to three jobs at a time. I was in flight mode.” Amanda is describing the go-go-go of the hustle culture so many of us embraced after graduate school. “I felt like I’d been hit by a truck leaving grad school, I felt so unprepared.” Now Amanda chooses to see 3-4 clients a day in private practice to support rest and health, although the journey to this current pace of life was unexpected.

“I had a full time job, a small private practice, and was supervising a team,” Amanda shared. Then she got COVID-19 in May of 2020. “I was bedridden for the first five months of my 3.5 year healing journey.” Amanda describes being dizzy and fatigued most of the time, having to close her private practice and work her full time job from her bed. “I took calls laying down. I did supervision on the phone laying down. I did zoom meetings laying down.” Amanda could only sit up for an hour at a time and developed new symptoms every month.

“My body wasn’t strong enough to push COVID out,” Amanda says. She was forced to slow down in order to take care of her health. “Being a COVID long-hauler stopped me in my tracks and I was forced to stop abandoning myself and attune to my needs. The road to recovery has been painful and defeating. It seems like when I take two steps forward, I then take 10 steps back.” Amanda quit her full-time job and reopened her private practice, pacing herself each day to avoid a health flare-up or crippling fatigue. She describes feeling pressure in the beginning to push herself beyond her limits or risk letting others down. Then she came to realize the importance of putting the oxygen mask on herself before putting it on others. Pacing to avoid a flare-up has been a difficult journey and full of sacrifices. Flare-ups can still happen. “I still wake up sick. Sometimes it feels like dizziness, other times like the flu.”

Yet, Amanda has learned so much having long COVID and has changed aspects of her life for the better. She is grateful to have the resources and support she needed for this significant change. Many COVID long haulers and others with chronic illnesses have lost jobs, spouses, housing, etc. “Others have not been as fortunate as I have been to recover to the point of being able to start their own business. This experience has made me acutely aware of the blessings I have been given and I’m determined to never take privilege, support, resources, and my health for granted again.” She says it helped her realign her priorities to health, nature, and family. It helped her slow down and engage in “being” more than “doing”. Her clients have similar experiences to her own, where she gets to help them find balance and unsubscribe to the hustle culture as well. “Clients want to know we are human,” Amanda shared. “Notice when your body says no,” she says, “ chronic illness has been so misunderstood. It made me a lifelong advocate and cracked my world open to many things, including how our society has unchecked ableism which can cause harm.”

Being present and curious about our urges to overwork or chase a dream is something Amanda wants colleagues to think about. “Doing our own work is so important,” she says. She suggests that noticing and honoring our limits make us better, as humans and as helpers. “Long COVID changed me as a person and has made me a better therapist,” Amanda disclosed. She has also benefited from doing her own work in therapy. She reflects that she may even been more emotionally healthy now as a COVID long-hauler than when she was a workaholic, which says a lot about how workaholism can cause harm. Amanda encourages colleagues to slow down and be present. “You’ll be a better therapist for it.”

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 Signs of Scarcity in Private Practice

Photo by Danie Franco on Unsplash

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.

What You Need to Know When Offering CEs to Counselors

I want to offer Continued Education Credits (CEs) to mental health counselors. What are my options?

It’s a question I’ve received more often lately by Colorado professionals. I’ll preface my answer by sharing that each State and designation (LPC, PsyD, LCSW, etc.) is different. Please do the research for your state and designation or consider credentialing at the National level. When approached with this inquiry by the community, I ask the following questions to better understand their goals:

Why Offer CEs as a Professional?

Perhaps you have the goal of creating secondary income streams. Maybe you feel passionately about the content you’ve created. Whatever the reason, CEs allow professionals to enhance their leadership and public speaking skills, not to mention open doors to new opportunities, including paid speaking gigs, podcast interviews to enhance exposure to your brand and services, program partnerships, and project collaboration!

What is Your Content Area?

The first thing to consider is your content. Is your training content specific to mental health competencies like group work, clinical supervision, or a theory or modality? If so, you may be eligible to apply for a national CE provider designation.

If your content is more closely connected to business aspects such as marketing, private practice growth, and secondary income streams, these areas are still valuable to share with the community, but cannot be branded as CE opportunities due to them not meeting the traditional definition of continued education credits.

Do You Want to Offer In-Person or Online Events?

This is a logistics question that will help narrow down your application options. Some organizations are only approved to do live or in-person events. Others have permission to offer webinars and on-demand content. Consider what is most important to you. Do you like the feeling of being in front of others speaking? Would you rather develop an on-demand course people can take at their own pace? Take some time to consider the possibilities before answering the remaining questions below.

What is Your Mental Health Background?

It’s easiest to apply to offer CEs through your own professional affiliation, such as through NBCC (counselors), NASW (social workers), APA (psychologists), NAADAC (addiction professionals), etc. Visit their website to learn more about their application process.

Who is Your Audience?

Is your hope to serve fellow mental health professionals in your state? Or reach further? In Colorado, CEs can be developed for counseling professionals statewide with the following structure in mind:

A. A sign-in sheet recording participants in attendance

B. Provide a certificate of attendance/participation that outlines the following:

            I. Title of Event

II. Contact information for the Faciliator including Name, Credentials, Address, and Phone

            III. Duration of the event in CEs, with one CE equal to one contact hour

            IV. Identifying if the event was live (in-person) or virtual

In other words, Colorado is pretty easy for folks to offer CEs. Other states may not embrace this same structure in having their own rules and parameters of what can be branded as CEs, so be careful to confirm what’s allowed based on where your audience is located. This also becomes important in marketing your course or content accurately.

What’s Your Timeline?

Many people are motivated to develop and launch a CE opportunity in a matter of weeks. That may be possible for Colorado, but for offering CEs in other states and/or at a national level, be prepared for the process to take six months to a year!

For example, to become an Approved Continued Education Provider (ACEP) through the National Board of Certified Counselors (NBCC)—which means offering CEs for counselors nationwide—the application requires several examples of the workshop or training already being offered, with sign-up sheets and evaluations from participants submitted with your application. This means that for many, test driving your content with a local audience to get the feedback you need to apply is necessary.

What if You Don’t Have the Time or Bandwidth for this Process but Still Want to Offer CEs?

Consider partnering with an established CE provider who has permission to develop coursework with partners in the community. This usually means bigger organizations like community mental health agencies, treatment centers, mental health hospitals, conferences, and training centers.

I’d like to personally give a shout out to the following organizations that provided a professional platform for my workshops before I became an ACEP Provider, who made the process easy to reach fellow clinicians around quality content:

A. Harmony Foundation, Inc.

B. Sandstone Care

C. Continued.com

D. Highlands Behavioral Health

Organizations are always looking for additional speakers or presenters to offer new CE content. By researching organizations in your area that offer CEs, you can pitch your idea to them and work to get on their CE event schedule.

So there you have it! Although there may be some lingering questions about offering CEs, these elements are worth reflecting upon when identifying your ideal path for trainings or workshops offered to the mental health professional community at large. I encourage you to continue to track the requirements in your state and designation for ongoing changes and prepare for the long haul when starting the application process. I can assure you it will be worth the effort if you feel passionately about your content being connected to more professionals!

Seven Tips for Building Rapport with New Telehealth Clients

Telehealth is a necessity in the face of COVID. Professionals and clients alike are feeling grateful to have this option to provide space for services and support clients with change, uncertainty, and the unknown. If you are like me, you weren’t fully prepared for the shift to telehealth back in March. Perhaps it wasn’t part of your business model as a therapist. Maybe it wasn’t an interest for you as a professional. Nevertheless, as we adapt to continue this meaningful work, let us take a look at some helpful tips for rapport and by-in when engaging new clients through telehealth.

1.     Look at the Camera Frequently. It’s hard not to feel self-conscious being on a screen. Invest in a light ring and elevate your camera so you are looking forward instead of down. Be sure to look at the camera directly when asking questions and when closing the session, as it encourages connection in feeling like you are truly looking at the client instead of looking at an image of you or them.

2.     Explain Loss of Eye Contact. You don’t have look at the camera the whole time. In fact, you need to be able to glance down from time to time to see how the client is presenting when it comes to body language. Be sure to name why your gaze is shifting, such as writing notes or referencing something in their initial paperwork.

3.     Review Documents. Review their initial documents beforehand and reference them in session. Not only does this show you are paying attention, it prevents your client from feeling like they have to repeat themselves.

4.     Obtain Consent for Telehealth. Engage your client in reviewing the telehealth software and protocols to obtain their consent. This includes emphasizing how their information will be protected and what to do when a call is dropped or requires another method due to connectivity issues.

5.     Encourage Questions. When building rapport via a screen, encourage your client to ask questions. This allows them to address any anxiety or worry about the work and permits them to feel like the conversation isn’t one-sided. Summarize goals and next steps for feedback and to demonstrate active listening.

6.     Explore Therapy History. A powerful question in building rapport can be normalizing that therapy is not a one-size-fits-all approach. Encourage your client to open up about what works for them by asking what they liked or disliked about past therapy experiences. Are they brand new to therapy? Ask how you’ll be able to gauge if something you say or do upsets them. This highlights our humanness as providers and encourages new clients to be honest and self-aware about triggers for upset as well as opportunities for therapeutic repair.

7.     Be Transparent. As the intake session comes to a close, summarize what you’ve heard them share, including what they want to work on and scheduling needs. Are they open to weekly therapy? Biweekly? Did you capture their initial goals? Scan and share your intake notes for complete transparency, inviting them to provide corrections or feedback as appropriate.

These tips are by no means an exhaustive list. However, the hope is that they compliment your own experiences as a professional adapting to telehealth. Allow these ideas to support your best work by providing a meaningful first impression. Your clients will be grateful for your attention to detail and your efforts will encourage their active participation in scheduled telehealth sessions going forward.