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Getting Paid: Professional Self Care—The Secret to A Successful, Sustainable Private Practice, Career Longevity & Happiness

8/29/2023

Lynne Azpeitia, LMFT

In the process of providing support to others, it's easy for us as psychotherapists to neglect our own well-being. This is where professional self-care comes in. The secret to a successful and profitable psychotherapy practice lies in our ability to care for ourselves as we care for others.

Professional self-care, including setting boundaries, taking regular breaks, seeking supervision or peer support, helps mental health professionals maintain emotional resilience and avoid burnout. When well-rested and emotionally balanced, we provide better care to clients, leading to higher client satisfaction and retention.

It’s also a path to personal growth and resilience. Counselors who engage in self-care activities like ongoing education, supervision, and personal therapy continue to develop skills and expand their knowledge base.

When therapists are overworked and stressed, they struggle to maintain appropriate boundaries, protect client confidentiality, and make sound clinical judgments. By prioritizing self-care, we can uphold the highest ethical standards in our practice, safeguarding our therapeutic reputation and profitability in the long run.

A therapist's own well-being can also directly impact the ability to facilitate positive change in clients—since clients who perceive a therapist as a model of self-care are more likely to engage in their own self-care practices. This leads to improved client outcomes and referrals, ultimately contributing to the profitability of our practice and career.

Self-care also nurtures a therapist's resilience and enables us to cope with the emotional demands of the job. Resilient therapists better adapt to changing circumstances, handle difficult cases, and bounce back from setbacks—all which are crucial for a thriving practice and career.

Professional self-care is not a luxury; it's a necessity. It isn't selfish; it's the foundation upon which success is built.

Here are 12 practical, supportive tips and inspiration for professional self-care selected from articles used with those I do practice coaching, training, supervision, and consultation. Links to the articles or books are included.

1.
May you be moved by passion and enthusiasm for your work, may you deeply believe that you deserve self-care, may you replenish yourself daily, may inspiration be a guiding compass to your days, may you know you are a bright light in a world that needs your presence, may you be an instrument of help and healing and may your cup overflow so that there is plenty to share.

Ashley Davis Bush, LICSW
Simple Self-Care for Therapists: Restorative Practices to Weave Through Your Workday

2.
I have always been better at caring for and looking after others than I have been at caring for myself. But in these later years, I have made progress.

Carl Rogers at age 75

3.
Self-care is living your life in a way that is physically and mentally sustainable. As a therapist, a good self-care practice allows you to maintain your well-being so that you don’t deplete your own energy to care for your clients.

Melanie Donohue, LCSW
Why Self-care Is So Important for Therapists

4.
We all have times when the stress of our clinical work causes us to become exhausted, anxious and agitated. Some of us are suffering now, or have suffered, from distress, compassion fatigue or burnout. All are occupational hazards. We’ve discovered that our inner reserves of empathy aren’t infinite. Becoming more self-aware helps us to know the limits of what is possible in our own lives as well as in the lives of our clients.

Vivian Baruch
Self-Care for Therapists

5.
Prioritizing self-care is not a luxury; it is a necessity for therapists. Engaging in regular and intentional self-care practices can have a profound impact on our well-being and professional effectiveness. When we take care of ourselves, we are better equipped to provide quality care to our clients.

Caroline Rou
Nurturing the Healer: Effective Therapist Self-Care Tools Unveiled

6.
What does true work-life-balance look like? How is it achieved? Having a healthy balance between work and your personal life means that you are practicing professional self-care. Prioritizing this type of self-care often takes practice, especially since work is a huge aspect of our daily lives. Sometimes it can be difficult to turn off our “working brains” at the end of a work day, and the line between our professional and personal lives begins to blur.
While a lot of forms of self-care are practiced on people’s own time, professional self-care is something that can also be incorporated into the work day.

OregonCounseling.com
Professional Self-Care: Self-Care Series (Part 2)

7.
When therapists neglect their own self-care by taking on more clients than they can reasonably fit into their schedules, working long hours to satisfy clients, and answering phone calls and emails around the clock, they may think they are doing clients a favor, when in reality they are setting themselves up for burnout.

Chris Howard, CADC-III, CCMI-M
Yes, International Self-Care Day is for Therapists Too

8.
Professional self-care shows in the habits and routines you use to keep a healthy separation between your personal life and your work, for example:

Being able to set and honor clear boundaries with your time—“These are the hours I work. These are the hours I’m available.”
Having restorative activities in your life other than work—You can take the time you need at day’s end to transition from work to home life. You can enjoy your personal time and close relationships without feeling intrusions from work.
Giving yourself access to consultation with colleagues--You have other clinicians to collaborate with; you can reach out to someone about professional challenges.
Making sure that you are well educated—You remain updated with approaches and skills to respond effectively during client interactions. You can rely on a full range of therapeutic tools and techniques that come to you naturally during sessions with clients, and you are nurturing your strengths.

Robyn E. Brickel, MA, LMFT
Good Self-Care for Therapists

9.
Micro Self-Care Vs. Self-Violence. The hard truth is that when you don’t take care of yourself, then you’re doing harm (violence) to yourself. It’s time to start thinking of self-care as a form of self-love and self-respect. It is not selfish to take care of yourself; it is necessary. So, the next time you find yourself skipping meals, not drinking water, or working long hours without a break, remember that you are worthy of self-care.

Laura Reagan
Micro Self-Care for Helping Professionals

10.
When counselors are isolated, whether working in rural areas or working as sole private practitioners, maintaining wellness can pose an even bigger challenge. Without other colleagues to learn from, vent with or lean on for support, stress is more likely to build unimpeded. Experts say finding a support system, whether through formal supervision or an informal network of other professionals to meet with for consultation and camaraderie, is vital.

Lynne Shallcross
Taking Care of Yourself As A Counselor

11.
My best tip for self-care is to never, ever let it fall to the back burner. It always has to be top of mind. As care givers there will be many times in your career that you will feel that you should put your self-care last in order to take care of others. It’s never a good idea. Think about your longevity in the profession and your future clients, and make self-care decisions very, very carefully.

Jessica Sweet
WishingYouWellCoach.Com

12.
The practice of self-care is an ongoing endeavor. We are never done with self-care; it must be engaged in throughout our careers. As our life circumstances change over time, so too should our self-care practices.

Jeffrey E. Barnett
Distress, Therapist Burnout, Self-Care, and the Promotion of Wellness for Psychotherapists and Trainees

Lynne Azpeitia, LMFT, AAMFT Approved Supervisor, is in private practice in Santa Monica where she works with Couples and Gifted, Talented, and Creative Adults across the lifespan. Lynne’s been doing business and clinical coaching with mental health professionals for more than 15 years, helping professionals develop even more successful careers and practices. To learn more about her in-person and online services, workshops or monthly no-cost Online Networking & Practice Development Lunch visit www.Gifted-Adults.com or www.LAPracticeDevelopment.com.

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Getting Paid: Introducing & Talking About Sliding Scale — The Words You Use Make a Difference

8/29/2023

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What’s your sliding scale? Do you have a sliding scale? How low is your sliding scale? What’s your discounted rate?

These words are often the first thing a therapist encounters when a potential client calls, emails, texts, or DMs about therapy. It’s no surprise that mental health professionals find this a jarring and highly awkward beginning to an interaction about starting therapy—and that therapists, themselves, have many questions about the best way to respond effectively, both clinically and professionally, to these potential clients during this important first contact.

In fact, the most often asked question I encounter in Money Matters Workshops and at LA Practice Development Lunches is: “What’s the best way to respond when the first thing a caller—or a text, email or message—asks about is a discounted rate or sliding scale?”

Responding to callers and clients who are asking, but don’t really need or qualify for a lower therapy rate, is a very different type of conversation than the one clinicians trained for and are familiar with—people who genuinely have, a financial need.

Just because clients are anxious about the price or cost of services doesn’t necessarily mean therapists should automatically give a price accommodation. The price a client can afford and the price a client wants to pay may not always be the same thing.

It’s often hard for us as helping professionals to remember that helping a client doesn’t always have to mean giving everyone who asks a reduced rate or routinely offering the lowest possible price for therapy. It also can mean helping people find a lower priced type of treatment and referring them.

While I wholeheartedly support the values that the term “sliding scale” represents, that professionals can help people in need by sometimes--at their discretion and when their schedules allow it—charging less or making other specialized arrangements, so that people can still get affordable help when they need it, I also firmly support mental health professionals charging and being paid a fair price for the professional services they provide to clients.

As therapists, our task is to find the right balance of how, and how much, we can adjust session prices, for which clients, and how many—and not go out of business. In the current climate, navigating talking about prices with these clients takes more specialized skills and requires a totally different mindset, approach, and vocabulary.

As in any clinical endeavor, the words you use to describe your services do make a difference. Yes, the meaning our words convey can either increase or decrease the amount of money we earn and are paid for our professional services. You’ll find that more people will pay in full and out of their own pocket for your services, when they believe you are the professional who can give them what they want—and the wording you use to describe your services conveys that.

Money Talk: Words & Phrases to Consider
Here are some examples of words that can make a difference in income when a clinician talks, writes, or communicates about therapy or money matters—and how and why these words can affect the perceived value, and subsequently, the amount a person is willing to pay for the therapy services provided as a clinician.

This information applies equally to face-to-face conversations in real time or virtually, to emails, texts, social media postings, and what’s printed in marketing materials or is on your website. Each one of these words and phrases can have a direct effect on the amount a client pays you for your clinical services.

As you read the following information, be sure to remember:

Only do and say things that fit for you, your clients, and your practice—and always within legal and ethical guidelines.
You can ignore everything written in this article and still be successful. Discover what works for you, your clients, and the practice setting you work in.

Words & Phrases to Consider for Presenting Pricing & Adjusted Pricing
These days the term “sliding scale” seems to come with a lot of baggage for clinicians, clients, and those seeking therapy. For many lay people, the word “sliding scale” means: the price can slide all the way down to zero; the rate will, of course, upon request, always be adjusted to the lowest possible price regardless of the financial need or available resources of the asker; and therapists will always give a lower price to anyone who asks because it’s their job to take care of people’s needs.

An alternative to using “sliding scale” is to use more definite or declarative wording:
For those with a lower income or who demonstrate a financial need—and are eligible, pricing based on lower income . . . special arrangements . . . specialized price/prices/pricing . . . price accommodation(s) can be discussed/made. The adjusted price for a 50-minute session of therapy is . . . The charge for your therapy session is . . .

Here are three examples of what can be said when callers or clients ask about or mention a sliding scale, discount or reduction. These are meant to be tailored to what works for you, your practice, and clientele.

Example 1

There are A/1/2/3/couple/few places/spaces/openings when my schedule allows it
For clients who pay/receive/qualify for/ are in need of
An adjusted fee/alternate price /special rate/economy rate, etc.

and
Those are filled/there aren’t any openings/I can put you on the waiting list

or

Those are reserved for low income and those who have a financial hardship when possible/when available/ when my schedule allows
To qualify for those, you’ll need to submit proof of your household’s income—pay stubs/ tax return/bank statements etc.

Example 2

There are A/1/2/3/couple/few places/spaces/openings/slots when possible/when available/ when my schedule allows it
For clients who pay/receive/qualify for/ are in need of
An adjusted fee/alternate price / special rate/economy rate
You don’t seem to qualify for those.
We can talk about other options to be able to manage paying the session cost—less than weekly sessions/shorter length sessions/group therapy/family loan/ credit card payment
If you’re not able to work out paying the session price/If you don’t want to pay the session price
I can refer you to a low-cost counseling center, free clinic, training center, or counseling practice specializing in low-income clients.

Example 3

If you’re not able to pay this session price
I don’t offer a sliding scale or adjust the price for a session
I can refer you to a low-cost counseling center, a training center, free clinic, or counseling practice specializing in low income/financially limited clients.

By using this type of wording, the therapist will be conveying the message that the stated cost of services is the actual price and not just a negotiation starting point when no fee adjustment is realistically needed—but that some pricing accommodations are available to those in need of them. As a result, of making this wording change the clinician’s money conversations are usually shorter and the amount decided upon is usually higher but still what the client can afford.

Only Do What Fits You, Your Clients, and Your Therapy Services Best
Confidently take charge of money conversations about prices by using any of aforementioned professional and clinical language recommendations that work with your client population and clinical practice. Focus on the value, cost, worth of the therapy service to the client and their life.

Remember to keep the language, wording, and focus of the clinical and professional money matters conversations on the client responsibility for payment for services needed, received and provided— not on what or how much the therapist gets or charges or how much the number is. Allow the client to pay a fair price for the therapy benefits they receive from you, the highly skilled and trained professional that you are.

Lynne Azpeitia, LMFT, AAMFT Approved Supervisor, is in private practice in Santa Monica where she works with Couples and Gifted, Talented, and Creative Adults across the lifespan. Lynne’s been doing business and clinical coaching with mental health professionals for more than 15 years, helping professionals develop even more successful careers and practices. To learn more about her in-person and online services, workshops or monthly no-cost Online Networking & Practice Development Lunch visit www.Gifted-Adults.com or www.LAPracticeDevelopment.com.

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Getting Paid: Professional Self Care—The Secret to A Successful, Sustainable Private Practice, Career Longevity & Happiness

Lynne Azpeitia, LMFT

Getting Paid: Introducing & Talking About Sliding Scale — The Words You Use Make a Difference

Lynne Azpeitia, LMFT

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