Tag: therapy practice

The Big Drop – Have You Thought About A Pension?

Some years ago, one of the financial institutions ran an ad that asked, “Are you ready for the big drop?”

The big drop was, of course, the gap between our income before retirement and after retirement. The point being made was that some people have insufficiently provided for their pension.

piggy bankAre you one of those? Have you got a plan in place for when you are no longer willing or able to work? Have you decided how you would like your retirement to look, or are you struggling to meet your day to day commitments, with nothing left over to put aside for a rainy day?

The impact of the recession on investments has left some people with less than expected to look forward to in their future, at a time when they would hope to be able to relax and take it easy.

Employers are bound by law to make a pension fund available to you, even if they don’t contribute to it, but there’s no requirement for a self employed person to do it for themselves. When we first set out to start a practice, every cent of costs and income count, so often, there is little left over for putting into a pension fund. Later, we may not make it a priority, and if we don’t, we will find ourselves having to make do with the state pension.

A pension fund will give most return the earlier you start to contribute to it, ideally it is started while you are in your twenties. The later you leave it to start, the more expensive it will be to provide you with a reasonable income when you come to collect.

If you haven’t thought about it before now, maybe this is the time to ask your financial advisor or your bank manager about how you might provide for your future. Did you know that contributions to an approved pension scheme may be tax deductible? That means that it may not cost you as much as you might think. And when the big drop comes, you’ll be glad you were thinking ahead.

 

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Need to Attract More Clients? Just Ask

I was in the bank some time ago and a woman who was trying to encourage me to buy a pension gave me a box of mints with “Just Ask” written on it. It reminded me of how complicated we can make the whole looking- for-clients thing.

Earlier this week, a friend who was thinking of starting her own practice, said she was overwhelmed by the thoughts of what she had to do in order to get clients. She was talking about business cards, websites and letters to GPs and all that good stuff. But she hadn’t thought about the most obvious source of potential referrers, among people who already know her.

askI suggested she make a list of everyone she knows, (and yes, I do mean everyone!) and call them to say “I’m setting up in practice. If you hear of anyone who needs a counsellor, would you give them my number?”

Better still, write an elevator pitch and use the calls to friends and family to get familiar with saying exactly what you do and how you help your clients.

Therapists don’t really talk about their work. Well, we can’t, can we? So much of what we do is confidential. Unfortunately, and probably in an effort to make sure that we observe that confidentiality, we can wrap our work in a veil of secrecy, to the extent that those around us, family, friends, and former work colleagues can be afraid to broach it with us, and so, probably never think to mention our name to people they know who might benefit from talking to us.

If you need more work, JUST ASK!

Sometimes when I suggest this, people tell me that asking those closest to them is actually harder than asking a stranger. I am curious about this and if you feel yourself hesitating to take the step of telling those close to you about your work, perhaps you need to reflect a little on what’s behind your hesitation. Our nearest and dearest are more well disposed towards us than a stranger will ever be. Perhaps there’s a concern about observing appropriate boundaries? Look at it this way, every therapist has clients they can’t work with for a variety of reasons, so what do they do with those clients they can’t see? Yes, they refer them on to another therapist. You may not be able to help someone because the connection is too close, but if you refer it on to another therapist, that therapist will probably reciprocate when they have a similar problem. What goes around comes around.

If I can help you with any aspect of setting up or running your therapy, just ask! I’d be glad to offer whatever assistance I can. You can email me here with your query or question, to avail of your free 20 minute consultation, or to make an appointment.

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A Time to Act

A couple of years ago, I was visiting some family members whose barge was moored on the canal near my home. It was a wet, rainy afternoon. The barge was tied up to a mooring post in the grass bank, and to get on and off, we had to walk across a gang plank, four inches wide, and very slippery. As we were leaving the boat to go home, my 4 year old niece slipped and fell into the canal head first. I was closest to her, but was frozen in shock, unable to think what to do. Her mother standing at the back of boat was too far away, and it fell to my sister to push past me, lean over, grab the child by the back of her jacket and haul her out of the water. No harm done. She was wet and shocked, but thankfully alive. We were all hugely grateful for my sister’s quick action.

Frozen lingon 2I was reflecting afterwards how, since training as a therapist, that my ability to act quickly in a crisis had seemed to fall away, where my ability to be fully in the feeling experience had expanded.

In life we walk two journeys, the internal journey, and the external one. The external journey is what we do, and how we do it, the practical piece of turning ideas into action, of turning thoughts into reality. The internal journey is focussed on our experience of our lives, how we think and how we feel about it. We travel both of these roads at the same time, a bit like going both directions on a dual carriageway at once!

In our practices, there are the things we do as a therapist and counsellor, and then there’s how we feel and think about doing them. As therapists we are very familiar with the emotional or mind-set journey. We understand how our past experiences can colour our present. We understand how our beliefs and fears can support or undermine our ability to function in the world. We sit with clients as they explore these aspects of themselves. The therapy session may be the only opportunity in their week where they take time out to visit that interior journey.

Sometimes, though, the opposite applies. I know for me, coming from a background in accountancy (very much in the action lane!), my training as a therapist moved me strongly into that other lane, asking me to reflect at length on my feelings, my motives, and my underlying patterns and beliefs. This process is now so ingrained, that on occasion I can get stuck in the feelings and forget that I need to take action. And the situation on the canal was a great example of that.

At other times, the interior world has been an escape for me. Sometimes it is easier to reflect on how a situation has impacted me, rather than take the courage to act. In other words, I can use how I look at and feel about my life as an excuse not to change it. Speaking to colleagues I know that I am not alone in any of this. On the dual carriageway of working as a therapist, there is a danger that my default response becomes “And how do I feel about that?”

We always have a choice about how we meet the experience of our lives. Exploring how we feel may change our view, our beliefs, or our relationship with our circumstances, but at some stage in the process, life asks of us that we engage with it at a practical level. If we are hungry, we can explore our hunger, we can analyse its origins, we can understand our process around it, but we are unlikely to satisfy it unless we go to the fridge and eat something.

My niece was unlikely to get out of the canal safely without an adult taking quick action. There’s a time when we need to acknowledge our feelings, and there’s also a time to move into action.  Both have their place.

Unsure what action you might take to move your practice forward? Perhaps I can help you to get started. Contact me here for a free 20 minute consultation or to make an appointment.

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Help! I Need A Room, Fast

The Buck Stops Here

Many therapists setting out in practice for the first time have closed their doors and gone back to working for someone else within three years. Not because they’re not good therapists, not because they aren’t helping their clients, but because they had no idea what it takes to run a business.

I learnt this lesson the hard way.

Portrait of senior owner of pet shop
Stock Unlimited

I was 26 when I became self-employed for the first time. I became a partner in the small accountancy firm in which I had been working for a couple of years. I had been managing for some years before that, and so I’d learned some of the tasks of running a business. The accountancy profession works much the same way as large families do, last year’s intake supervise this year’s, (or the older kids rear the younger ones!) So I knew the form.

I was 28 when I began to learn what it really meant to be self-employed.  After my second child was born, things changed in the practice. We embarked on a business venture that was new and untried, which put significant strain on the resources of the practice. Our practice overdraft started to climb steeply, and I realised for the first time what being a partner and therefore “jointly and severally liable” for the debts of the firm actually meant in practice. The much hackneyed phrase “The Buck Stops Here” means just that. If the practice went bust, I was at risk of losing my family home. I had two small children, one of whom was less than a year old. Now all of that “liable” stuff had been carefully explained to me by my solicitors before I signed the partnership agreement, and I had studied law as part of my training, so it wasn’t as if I didn’t know it. But at another level, I didn’t really know it at all. Up till that time, it had been an elaborate kind of game.

Fast forward two years, and the partnership had dissolved in acrimony and never ending legal battles and I was out of work for the first time since I was 17. I’m not telling you this to scare you, just to illustrate how difficult it is to know what’s involved in something until you’re actually in there. They say experience is something you get just after you need it!

One of the most difficult things to explain to anyone who is expecting a first baby is just how your life changes after the baby is born. No amount of reading books, or going to classes, or talking to other mothers really prepares you for

Baby, Human Hand, Mother.

it. You can imagine the fun and the joy of it. You can read about the sleepless nights, or the symptoms to worry about, but nothing can really teach you about being a parent except the actual experience of it.

It is exactly the same for setting up a therapy practice. You can learn the skills of working with clients. You can learn the management skills, as I did, but the mind-set piece of being self-employed, that realisation that I am responsible for this venture, and just me,  is something you have to do on your own.

It’s a question of taking ownership, of committing, as they say in the marriage vows, for better or for worse.  It doesn’t mean that it’s always going to be hard, or that you’re going to have to struggle. It’s not so much about the doing, as the being. Without the commitment to the business of your practice, you’re going to struggle to find the energy, the interest and motivation to do what you need to do. The beauty of it is, that when you do move into that mind-set, it all becomes easier. It’s like finally accepting something you’ve been denying for ages, there’s a peace and a certainty that descends, and a knowing that it’s going to be okay.

If you’re struggling to take ownership of your practice and need some support, I’d love to help. Please contact me here to make an appointment or to avail of a free 20 minute consultation.

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What Does a Successful Practice Look Like For You?

The first step in establishing a therapy or counselling practice (or indeed any other kind of venture) is to envisage it. Since most people who set out to do something do so with an attitude of wanting it to go well, I am assuming that you want your practice to be successful.

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Stock Unlimited

What would tell you that your practice is successful?

  • A client arriving in distress and leaving in confidence and happiness?
  • More clients than you can handle?
  • Earning a decent living?
  • A deep and rich understanding of the issues that your clients are facing and a confidence that you can help them?
  • A master’s degree or a post graduate diploma certificate hanging in your consulting room?
  • Clients telling their friends and family how much you’ve helped them?
  • Your colleagues coming to you for advice and support?
  • Avoiding a legal or disciplinary action?

Maybe some or all, or maybe none of these things. The point is, you need to have some idea of what success means for you, in order to have some chance of achieving it.

Looking at these questions forces us to focus on what is important to us, really important to us. I know for myself this is not as clear as perhaps it might be. My thoughts can be very sticky. For example, when I consider which of the above criteria is most important to me, I find it can depend on my mood, or the state of my bank balance, or may be influenced by the last person I spoke to, or something I read. The good news however, is that we don’t have to nail it to the floor. For now, a general idea of what we’d like to achieve will suffice to get us going.

Take a moment now to reflect. Imagine yourself in five years’ time:

  • Fiber optic cable running above ground in the British Countryside
    Stock Unlimited

    If you are already in practice, how do you imagine your practice will be different from how it is today?

  • If you are just setting out on this journey, and your practice is still an idea rather than a reality, ask yourself what you’d like to achieve in that period. How would you like your practice to look five years from now?
  • How many clients would you like to be seeing?
  • Do you have a preference for working with a particular age or gender of client?
  • What issues will you be dealing with?
  • How many hours a week do you want to work, and when? Do you want to be free at weekends, or to work in the evenings?
  • What income would you like to be earning?
  • How would you like to feel about yourself as a therapist?
  • Where would you like to be practising from? A centre with other therapists? Or perhaps a place of your own? Perhaps you’d like to be working over the phone or the internet?
  • What additional skills or knowledge would you like to have acquired?

These are just some of the questions you might like to think about as you imagine your future. Can you really have what you want? Notice your “yes, buts…” as you consider these questions.

Unsure where to go next? Perhaps I can help you to get started. Contact me for a free 20 minute consultation at http://thisbusinessoftherapy.com/contact-us/

Are the Therapist and Client a Good Match?

I have written before on the subject of client and therapist needing to be a good match. (See here) There can be a tendency when first starting out in practice to take any client that comes along, out of fear that there will be no more. That is understandable, but may be a mistake. Some clients are just not a good fit for us.

While seeing a new client for the first time, I was aware of a strong, sharp pain in my stomach. After the session, the pain lingered, and it took me a couple of days to shake it off. I knew it was a tension pain. I could feel the stress elsewhere in my body, and a sense of being disconnected.

During the second session, the same thing happened. I told the client that I was aware of discomfort in my stomach as he spoke, and sure enough, it mirrored something that was happening for him.

Shortly before our third session, the client rang to cancel, and when I probed a little for the reasons, the client said he was not going to continue. I tried to persuade him, and then stopped myself. I felt an overwhelming sense of relief that I wouldn’t have to endure that pain again.

It really was very strange, I thought, that I had been working to retain a client with whom I had had such a physical reaction. Stranger still was a sense of lack in me, that I had to hold onto him at all costs, as if there would never be another client. Ironically, I’m very busy just now, so it’s not that I need the money, and I have a good stream of client referrals so there was no fear that I would have no work to do. I was reminded of a colleague speaking recently about “heroism” among therapists, and feeling we had to be a certain way.

1293055Reflecting afterwards, I realised that I really didn’t want to work with this client, not because I disliked him, or was unable or unwilling to help him. I didn’t want to work with him because the energy between us caused me great physical pain. And I can’t see any situation in which sitting with a client that has such an effect on me can be good for either of us. It certainly got in the way of me being fully present to him.

The rub was that I felt really guilty that I didn’t want to work with him, and ashamed of my reluctance and guilt. So I covered it up by working really hard to hold onto him, even when he wanted to leave.

There is a difference between a client who stretches us and a situation which takes us so far out of our range that we lose connection to ourselves. In this case, it was the latter.

I was not a good fit for this client, and I’m glad he realised it, even if I didn’t at first. My wish for him is that he finds someone who is better suited to him.

My wish for myself is that next time, I’ll be a bit more aware of listening to my body.

Ahh, it’s good to be wise in hindsight. If you’re struggling to get enough clients to pay the bills or to have the life you’d like, perhaps I can help. Contact me here to make an appointment or browse my services to see how I can help.

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RELATIONSHIPS WITH LOCAL DOCTORS

Doctors and other medical professionals are a good source of work. They see people who are vulnerable, and at times of crisis in their lives, when counselling or therapy may be one of a range of possible solutions. It’s a good idea therefore to establish a connection with them, and let them know how your services can help them.

When my colleague and I first set up in practice, we compiled a list of all the doctors in our local area from the Golden Pages, local directories and from the internet. Our approach was to write to them advising that we had recently started to practice in the area, and saying we’d like an opportunity to meet with them.

Photo no (34)We followed up our letter about a week later with a phone call asking for an appointment. Some doctors like to keep non-patient appointments with anyone other than patients to a particular time of the day. Some don’t make appointments at all, and we were told to come along and sit in the waiting room and they’d see us when they were free. Be prepared to be flexible. After all, if you make a good impression, it may help you down the road.

If the gap between your letter and your phone call or appointment is too long, the doctor will have forgotten what you said in your letter or your call. Send out the letters at such a pace that the follow up is manageable for you. If you find it hard to call strangers, write out what you want to say before you start. Try it out on a friend first, and then, when you make the call, stand up while you do it. Standing gives a greater feeling of confidence and power.

Don’t assume that everyone sees counselling and psychotherapy the way you do. Some doctors are very open to the idea as a complement to their own work. Some are not. Some are interested but not convinced. Some see our work as too alternative, perhaps a threat to what they do, and can be defensive. Keep it light. Hard sell sells nothing. Don’t expect to win everyone over to your way of thinking the first time you meet.

If you have been given an appointment, they are probably not completely against the idea. A good rule of thumb is to focus on them. Ask questions that draw out their problems and what they might need. Invite questions and comments on their perspective of what you do, and their experience of it. Don’t try to convince them that your way is the only way. Be willing to appreciate that there are many roads to healing and yours is just one.

If you are pushing against a closed door, don’t waste your time. If there’s a sense that the door could open a little further, go gently. A good book to support you in this process is How to Win Friends and Influence People, by Dale Carnegie. Although it is many years old, it is still a good source of practical advice about talking to strangers, and is easy to read and absorb.

Some doctors have no interest in meeting counsellors or therapists, but may ask you to send in some details. Have something ready in advance so that you can follow up your phone call. It doesn’t necessarily have to be a glossy brochure. A one page outline of your background, qualifications and experience, and the sort of issues you work with will be fine to start with.

You might also be interested in this article on preparing to meet local doctors.

Have fun with it!

If I can help you with any aspect of your practice, please contact me here for your free 20 minute consultation, or to make an appointment.

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Creating a Website

Do you need a website? Many therapists do not use one, and seem to get on okay without. So if this is a huge deal for you, don’t scare yourself with it at the first instance. Much can be done without one. Hold it as a possibility for the future, when other options have bedded in a bit for you.

My own personal view is that the internet is the place of first research for anyone under thirty, and probably under forty, and many over forty as well, so in the long term, it’s good to be in there.

If and when you decide to get a website, there are a number of approaches that you can take to getting a web site up and going. You can do it yourself, or you can employ the services of someone who does it professionally. Which route you choose will depend on:

  • Ÿ  What sort of site you wish to have
  • Ÿ  Your own technical ability and confidence
  • Ÿ  How much you want to spend
  • Ÿ  How much time you have to spare on the project

It’s worth spending a bit of time deciding what you want. Look at the sites of others in the field that you know and that you don’t know. What do you like, and what turns you off? Look at the images they use and ask yourself what your emotional response to them is. What message are you trying to convey with your site? What do you want your site to do? Is it going to inform people? What will they get from visiting your site? What do you want to say to them?

There are lots of sites that help you to create your own site, if you are minded to do so. Many of these will let you be up and running for little cost. For example, WordPress.com or Vistaprint both have low cost options for starter websites that you can create yourself, ranging from no cost to about €20 per month.

Another option is to have a web site set up for you. You can have a basic website set up for you at www.fiverr.com starting at $5 for a four page basic site with text and images. (Sounds too good to be true? You’ve nothing to lose except $5!) Nothing lasts forever, so no matter what you choose, it will need to be updated and refreshed as time goes on. One disadvantage of getting it done professionally, is that you may have to get even the slightest changes done for you, such as a change in telephone number, address or email address. Depending on the agreement you have, there may be a cost for making the changes.

Bear in mind that in order to attract traffic, there probably needs to be some dynamic (changing) content on the site, so it is worth learning your way around it. I use WordPress.com for this site, and found it easy to learn.

When we were setting up the practice, we got the basic website done for us, and over the next year or so, I learned how to make minor changes myself.  It was rather daunting at first. However, it got easier.[1] Our most recent website[2] was also designed and created for us, but we can add content ourselves, making it the best of both worlds.


[1] If you’re interested, the story of my journey from complete website novice to slightly less complete novice is recorded at http://beckytucker50.wordpress.com/2012/05/11/internet-mania/

What Should I Charge?

This is an interesting question, not only for newly qualified therapists starting out, but also those in practice for a while. And there’s no right answer. You are free to charge what you want. I personally believe that it is important that some fee changes hands, even if it is a nominal one, but it really is a matter for you to decide for yourself. Don’t forget to be clear with your client up front about what your expectations around fees are.

Here are some points to consider:

  1. You are not bound by what others are charging. If your rate is somewhere within the broad range of that charged by others it is likely that there will be clients available to you at that price point. If your rate is significantly above or below the majority of your peers, then you may have to work harder to get clients, as you will be going against the market’s expectations.
  2. You can charge different amounts for different clients. You can offer a sliding scale depending on the client’s Photo no (1)circumstances.
  3. How you structure the fee can make a big difference, for example, are you going to charge for cancellations? If so, what is your policy? How many days notice do you require, and are you willing to rearrange the session, rather than charge a cancellation fee?
  4. One option is to charge on the basis of sessions attended, with no charge if adequate notice of non-attendance is given. Another option is that the fee is payable for a set number of weeks of the year, whether the client comes or not.
  5. The client is making a commitment that may last several months or even years. You can retain the same fee level throughout a client’s relationship with you, or you can change it. The possibility of future changes can be flagged at the outset of the relationship.
  6. Your starting figure, whether increased over time or not, will form the base line for the fee structure during your work. If you start too low, you will find it difficult to raise it substantially. If you aim too high, they may be put off before they start.
  7. A client’s financial situation is not your responsibility. Their situation may change during the course of your relationship depending on circumstances, and you may wish to be flexible, particularly in the short term, in order to enable the work to continue. Or you may not.
  8. Don’t assume that you know where the client is coming from as regards the fee. Some clients will make the decision about whether to start therapy with you based on what you charge. However, clients vary, and so do their circumstances, so while the cost will be a major factor for some, it will not be an issue at all for others. There are clients for whom €10 a week is too much, and there are clients willing to pay €100 or more. You choose who you want to work with.
  9. The level of fee you charge will be affected by your beliefs about what is appropriate and possible, and what you believe you have to offer and what that’s worth. It is useful to spend some time exploring these issues. Some of the limiting beliefs I have explored for myself around the fee include:
  • Ÿ  I can’t charge more than (someone I know), who has years more experience.
  • Ÿ  There’s something wrong in taking money for this work, when people are in so much pain.
  • Ÿ  No one’s going to pay me that much, I’m just listening, not really doing anything.
  • Ÿ  There’s a recession on, no one can afford to pay full whack for anything.

10.  Consider how you intend to increase your fees over time. If you are planning to be in this business for a long time, you are unlikely to keep charging the same amount forever.

And remember, the choice is yours, and it doesn’t have to be one you stick with forever. One of the big advantages about being self-employed is that you get to make the rules. So what do you want to charge?

If you struggle with this or any other aspect of running your practice, maybe I can help. Contact me here with your question or query, or to avail of your free 20 minute consultation.