Tag: Therapy

Be Kind to Yourself

Without fail, whenever I talk to therapists about issues they have with running their practices, they will say, “I just don’t understand why I find it so hard. I know I do good work. I sit in front of my clients and I know I can help them. So why is it so hard for me to put myself out there?” And often too, they’ll add, “What is wrong with me?” or “Why can’t I do this?”

Many of us find it easier to motivate ourselves on behalf of others than on our own behalf. kindness 2We find it easier to be positive and confident about our clients’ abilities and potential than about our own. We find it easier to see solutions to the problems of others than we do to our own.

There’s nothing wrong with us. It’s not some major flaw or block that needs fixing, it’s just that we are so engaged in the detail of our own lives, that we can’t see the wood for the trees. We have rehearsed the problems, the reasons, the difficulties so many times, that at some level we believe we can never get past them! We are often attached to our stories about ourselves to the extent that we believe that they are all we are.

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Counselling and Therapy: Vocation or Profession?

During a recent conversation with a colleague, I was talking about the 2013 IACP survey of members which said that the average billable hour is charged at €44, and that one in three charges €30 or less per hour. A more recent Uncommon Practitioners survey suggested an average of €60 an hour for Irish respondents. In both cases, the number of hours being worked was resulting in a gross income (before expenses) of approx €1,400 per month, not enough to run a home.

My colleague asked if perhaps therapists were less interested in earning a living than other business babyowners because therapy is a vocation rather than a profession. I know that I use the term profession about the practice of therapy, but also that others see it very much as a vocation. I wondered, what is the difference?
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Standing Up For Ourselves

Two years on from the publication of the IACP’s 2013 report following their members’ survey, and I’m still intrigued by the findings. For me the most striking comment is:

The major issue in the profession is the depressive effect of the recession, in terms of impact on clients and their Photo no (41)perceived inability to fund treatment. A near majority of respondents have difficulty attracting clients.

Note the use of the word “perceived.” Does the writer believe that this perception is a less than accurate one? It might be worth exploring that idea. A poll by the Irish Times showed how skewed our perceptions can be. If our perceptions of where the bulk of the social welfare budget goes, the number of immigrants living here, or the income tax paid by the top earners is flawed, isn’t it possible that our perceptions of people’s ability to pay for counselling or therapy might also be flawed?

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Changing it Up

I’ve spoken before about getting focussed, whether it be on what you want, on a niche or target market, or on the way you see yourself in your practice. Today, I want to talk about changing things a little. Why on earth would you want to do that?

I come from a big family, and getting us all to agree on a time and place to do anything is, as my sister calls it, like mousetrying to herd mice at a cross roads. I often think it’s like this in therapy or counselling practice too. Just when your week is beginning to take a regular shape, a client goes to shift work, and asks for flexible appointment times. Or you’ve just got the hang of what the child protection guidelines are, when another set of rules appears. Or you’ve got to know and like your colleagues at work, when someone announces they’re leaving. Like herding mice, it can’t be done, things change all the time, whether we like it or not.

Read more about how you can change it up

Contracting with a Therapy Client

handshakeOne of the first things we are taught in training to be a counsellor or therapist, is about contracting. One of the tasks of the first session with a client is to set out and agree the terms of the contract. Do you commit your contract to writing? It’s not essential, but certainly something you might think about.

Wait, more to come about client contracts!

Where Do I Start?

Being the one who  runs the practice, as well as the one who provides the service, means that sometimes there’s just too much to do in the available time. I’m sure you’ve had the experience, I know I have; the to-do list that just keeps growing no matter how fast or efficiently you clear the items, sometimes it just can’t be done.

There are many time management systems out there, thousands of books, computer packages and apps to help you “manage your time.” They all have in common a process of prioritising – you decide what’s most important, or urgent, and organise your tasks and your time accordingly.

They all work – once you decide what your priorities are. But for some people that’s the difficult piece, that’s the stumbling block, what do I prioritise?

Speaking with a friend this week she identified this problem, the things she should do for her practice, were not the things that were attracting her. Those things that were attracting her were family related and learning something new, both of which are important to her, but neither of which were going to progress her practice.

I’d love to be able to solve the problem for her, to magically slow down time, so that everything she has on her list gets done. But I can’t. I can tell her what I think she should do, but then that would be my priority wouldn’t it, not hers? Because here’s the thing, my friend, and only my friend controls what goes on the list. She and only she decides what to do, what order to do them in, and also what not to do. And while I can help her to be more efficient, I can suggest processes and strategies, I can’t actually decide for her what her priorities should be.

I struggled with this for a long time myself, and some days I still do. The first breakthrough came for me when I realised I never get to the end of the list. There are always more items, more tasks, more ideas to be added to it. And even if I get someone else to do some of it for me, there will still be more on my list than I can possibly clear.

I have to make a choice, and keep making choices, minute by minute, hour by hour, day by day about what I want, about what I’m making important for me, right now. I can decide not to choose, or I can sit here looking at my list waiting for the right choice to emerge, or I can just start somewhere. Which leads me to the second breakthrough.

That came when I realised that the point of my life is not to get things done. The doing is merely the road I’m choosing to walk down in order to have the experience. The experience, what I learn, and who I become in the process, they’re the point. So what I do, or say or think, only has the importance or meaning that I give it. I get to choose that too!

My father told me when I was a teenager, “If you want to live your life, you have to get out of bed in the morning.” I’ve long forgotten the context of his advice, but the principle still applies. So I get out of bed. And photo  (43)then I look at the list. I choose, and go from there.

Choosing is painful at times. It raises all sorts of fears about getting it wrong.  What if I make the wrong choice and regret it?  What if I make the wrong choice and someone else disagrees with me? What about the loss of the things I don’t choose, or the things I never make enough of a priority to do? And so on, I’m sure you could add a few of your own!

Not choosing is also a choice, and a valid one. And it brings up exactly the same fears and feelings. And maybe the most important thing for me to do today is to do nothing, or to do something that isn’t on my list at all, but makes me feel good, like meeting a friend, or playing with a pet, or just sitting on the sofa in my pyjamas. Maybe the most important thing for me today is staying in bed (Sorry, Dad!)

If you struggle to know where to start when it comes to any aspect of growing or running your practice, I’d love to help. Contact me here with your query, or to avail of your free 20 minute consultation.

More About Accounts – Balance Sheet

Photo no (39)What’s a Balance Sheet?

A Balance Sheet is a statement of the assets and liabilities of a business or entity at a point in time, expressed in money. Assets are things owned by the business. Liabilities are things owed by the business.

Although the contents and layout may vary according to the size and nature of the entity, generally speaking, a Balance Sheet will contain the following sections:

Fixed Assets

Current Assets

Current Liabilities

Long Term Liabilities

Owner’s Capital or Investment in the Business

Fixed Assets are assets held over a long period of time (more than one year). They are generally, but not always tangible in nature, such as premises, furniture and fittings, motor vehicles. Fixed assets also include long term investments.

Current Assets are those owned by the business, that are likely to be held for less than one year, such as bank accounts (which change day to day) or outstanding monies owed by clients (known as debtors.)

Current liabilities are those debts due by the business that are payable within the next year, such as outstanding bills for services (creditors) or short term bank borrowings (overdraft or short term loan.)

Long term liabilities are those amounts payable by the business in more than one year, such as longer term bank loans.

The extent to which there are more assets than liabilities, represents the owner’s accumulated capital or equity in the business. This includes any direct investment in the business, through money put in, and accumulated profits, less any amounts withdrawn from the business for the owners own use (drawings.)

Together with the profit and loss account (or income and expenditure account), the Balance Sheet shows a reader how healthy a business is financially at any point in time.

For more information about financial accounts please see my post Accounting 101.

Limiting Beliefs

One of the ways in which we can limit ourselves, whether in the context of our practice, or in life generally, is through our unconscious beliefs about money. Most people are unaware that these beliefs can be running in the background, subtly influencing how we live our lives. Therapists will probably be more aware than others of the “I’m not good enough,” one, but I wonder if any others might strike a chord for you?

1675463Other common beliefs that impact how we interact with our clients include:

Ÿ  I’m not deserving

Ÿ  It’s better to give than to receive

Ÿ  Others are more important than me

Ÿ  There is not enough to go around

Ÿ  If I have more someone else will have less

Each of these beliefs can show up in difficulties negotiating and holding boundaries with clients, in relation to money and time, and can stop us from deciding and asking for what we want.

One interesting aspect of these beliefs is the absolute nature of them. The words “always” and “never” are there, even though they’re not stated explicitly, and consequently, when faced with a situation where putting our own needs before those of others is appropriate, for example, where we feel tired and unwell and should really cancel, we feel guilty. A useful way to soften these absolute beliefs is to exaggerate them by deliberately using the “always” and “never” words.

For example, if you become aware that you are dragging your heels about taking a break from the work because you’re concerned about letting down or disrupting a client (“others are more important than me” and “I’m not deserving,”) try putting it this way “I never deserve a break” or “Others are always more important than me.” Get the idea? Put it like that and of course, it sounds daft! And helps us get things back into perspective.

Try it yourself and see how you get on.

Pocket.
Pocket.

Where else might these beliefs be playing in our lives? Take the one about giving and receiving, for example. How easy is it for you to receive gifts or help? It is the nature of our work, that we often put the feelings of our clients before our own, so the giving place is a familiar one to us. And it is lovely to give a gift or to offer help to someone who needs it. Unfortunately, with “It’s better to give than receive” playing in the background, receiving can often be quite challenging. I like to think that receiving, whether it be a gift, or help, or a compliment, it is also a gift back to the giver, when we can receive it as generously as it is given. However, you’ll know if you have been following these posts for a while, that it’s something I can struggle with! I like to think that I can do it all myself, now there’s a limiting belief!

If you’d like to explore more about how beliefs about money affect you, you might like to attend our workshop “Starting and Growing a Thriving Therapy Practice.” Click here for details. Or if you’d like to talk about any aspect of your practice, please contact me here for your free 20 minute consultation.

What Horse Riding Taught Me About Therapy Practice: Part 2

Jumping, Ambivalence and the Power of Making Choices

I’m the wimp of our family when it comes to any risk of physical injury. Where my brothers and sisters inherited the “neck or nothing” gene, I seem to have missed out. While they hunted and rode as children, I fell off and got such a scare that I refused to go back. I was ten or eleven. I have been making excuses for years for not skiing with them (the usual excuse is my knees), but the truth is, I’m terrified of getting hurt. Not some intellectual head based fear this, I’m talking wet hands, shaking body, palpitations, no speech and liquid insides. Read more

Feeling Low? (Soap Box Warning)

You’ve heard the saying about the cobbler’s children haven’t you?

So many therapists tell me they enjoy what they do. They speak warmly of the growth they see in clients, the tiny surge of excitement when something changes, and the joy of seeing someone move on to better things.

However, sometimes after that first rush of enthusiasm I hear, “but…” Sometimes they go on to talk about the challenge of earning enough, or of getting clients, or of balancing their work and home lives, or the challenge of working with one or more clients. Or maybe some or all of the above.

If you enjoy your work, great. Good for you. If not, do something about it. The impact of doing work we don’t enjoy is highly stressful and leads to burn out and compassion fatigue.

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Stock Unlimited

Often a small change in the short term can have a big result. Take some time off, change the balance of your client portfolio, do a workshop or take up a new hobby. Take more exercise, eat less sugar and fat, drink less alcohol, have more sex and laugh more.

If these don’t work, or you’ve been feeling like this for a while, you may need to get help. And before you tell me you’re a therapist and know about these things, it might interest you to know that I wouldn’t be the first to suggest that mental health professionals are at least as likely as their clients (if not more so) to suffer the issues they work with. (Don’t believe me? Check out some of the articles below.) And like many other professionals, we also suffer from being unable to take our own advice.

You are your practice’s most precious asset. Self-care is probably the most important discipline you can practice. In my view, it should be a core part of CPD. And while supervision might give you some support around client issues, it is not a substitute for getting appropriate medical or psychological support if the situation calls for it.

There’s a reason why they tell you on airplanes to put on your own air mask before attending to children or other passengers. The reason is that if you can’t breathe yourself, you’re not going to be much help to anyone else.

Full length of sad businessman sitting on path outside office
Stock Unlimited

If you’re wondering why I’m being so dogmatic about this, I’ve learned this lesson the hard way. In fact I’ve learnt it several times over, until I got it drummed in to my head, and will probably need to learn it again. Last time it happened, struggling with the impact of working with a certain client, I found myself overwhelmed emotionally and did nothing about it. However, my body stepped in and took charge of the situation. I put my back out, and it took weeks to recover. I’m glad it did, because bloody minded as I am, I would probably have gone on ignoring the obvious.

So, if you’re feeling low, don’t keep it to yourself. Do yourself, your family and friends, and your clients a favour, and tell someone. Just Ask!

ARTICLES

A small sample of articles suggesting that as a profession we’re not immune from mental health issues:

http://www.psychologytoday.com/articles/200909/why-shrinks-have-problems

http://psycnet.apa.org/journals/pro/24/1/83/

http://psycnet.apa.org/journals/pro/16/2/305/