Articles & Trainings

Nurturing the Self: Unveiling the Distinction Between Self-Love and Self-Care for Therapists in Private Practice

We can never say this enough: as a therapist in private practice, your dedication to supporting others on their journey toward wellness is remarkable. We at HAM could not be more appreciative of the work that you do to help Mainers build resilience and enhance their quality of life. Amidst the demands of the profession, it’s crucial to cultivate your own mental and emotional health. The word “self-care” immediately comes to mind. It’s a buzz word that comes up often. In supervisions, in trainings, in society in general. But what we don’t hear a lot about is self-love. In this blog, we explore the nuanced difference between self-love and self-care, offering insights into how therapists can navigate these concepts to enhance their personal and professional lives.

So, what’s the real difference between self-care and self-love? As Andrea Conley, HAM’s executive director says, “self-care is like makeup. Self-love is how you truly feel about yourself.” 

Understanding Self-Love 

Self-love is a holistic acceptance of oneself. It goes beyond the superficial and encompasses a deep appreciation for one’s strengths, weaknesses, flaws, and uniqueness. When you have a strong sense of self-love, you understand your own value, treat yourself with kindness, and know you are worthy. Therapists, often immersed in the art of understanding others, may neglect the importance of extending the same compassion towards themselves. Embracing self-love involves acknowledging personal worth, practicing forgiveness, and fostering a positive relationship with oneself.

What does that look like? In addition to our advice below, you can find great insights from researchers like Brené Brown. 

Ideas for Developing Self-Love

Define Your Self-Concept: As you start to nurture your own self-love, you may want to start by asking yourself, “What is my self-concept? What do I truly think about myself – my capabilities, my fears, my insecurities, my strengths, my weaknesses?” Embrace your own vulnerability, dare to really get to know yourself and to accept yourself for the unique human being that you are. 

Cultivate Self-Compassion: Therapists, like everyone else, are susceptible to moments of self-doubt. Practicing self-compassion involves treating oneself with the same kindness and understanding extended to clients facing challenges.

Set Boundaries: Healthy boundaries are a cornerstone of self-love. Therapists must learn to say no when necessary and prioritize their well-being, ensuring they have the energy and focus to provide quality care to clients.

Celebrate Achievements: Recognizing personal and professional accomplishments is crucial. Whether it’s completing a challenging case or achieving a personal goal, therapists should take the time to celebrate their successes.

Understanding Self-Care

While self-love involves the emotional and psychological aspects of self-acceptance, self-care is the tangible, intentional actions taken to maintain physical, mental, and emotional well-being. Sure, acts of self-care can include bath bombs and date nights, but we see it more as maintaining a proactive approach to nourishing oneself and preventing burnout, a common concern for therapists dealing with the emotional weight of your work.

Ideas for Self-Care

Prioritize Physical Well-Being: Regular exercise, a balanced diet, and sufficient sleep are foundational elements of self-care. These practices contribute to overall health and resilience, enabling therapists to navigate the challenges of their profession with vitality. You probably recommend these tactics to your own clients when you encourage them to take care of themselves! 

Engage in Relaxation Techniques: Stress is inherent in the therapy profession. Therapists can benefit from incorporating relaxation techniques such as mindfulness, meditation, or deep breathing exercises into you daily routine to manage stress effectively.

Maintain a Support System: Building and nurturing a support system is vital. Whether through professional supervision, peer groups, or personal connections, therapists need outlets to share their experiences, seek guidance, and receive emotional support.

As therapists in private practice, embracing both self-love and self-care is essential for sustained personal and professional fulfillment. By understanding the nuanced differences between these concepts and incorporating them into daily life, therapists can foster a resilient and compassionate relationship with themselves, ultimately enhancing their ability to provide quality care to their clients. Remember, taking care of oneself is not a luxury but a necessity on the path to becoming a more effective and fulfilled therapist. 

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Posted on by Author Kayla Quesnelin Categories Advice for Affiliates, Tips for Healthy Living, Wellness

The Importance of Initial Client Screening in Private Practice

Our series, Managing Your Private Practice, examines how to successfully run your private practice as a behavioral health clinician. Essential to any therapy practice is a clear process for screening new clients.

As clinicians, we know what happens in January…every January. We get inundated with new clients. Coming off the stress of the holidays, possible family drama, anxiety over the coming year, post-holiday blues. There is so much need this time of year.

Having worked with hundreds of private practice clinicians over the course of our agency’s 13-year history, we’re reminded (particularly at this time of year) of the importance of screening. With all the requests and referrals you’re likely receiving, it’s more important than ever to slow down and screen. Do you have a tried-and-true screening process? Do you know who your ideal client is? Have you identified your particular therapeutic skills so you can ensure your skills match the clients’ needs? Are you clear up front about your schedule, rates, and what insurances you do (and do not) accept?

As clinicians, one of the things we all dread is getting into a relationship with a client whose needs do not align with our therapeutic skill set or modality of treatment. And because most practitioners do this work because they are called to help, it can be challenging NOT to accept a new client. Client screening is is about creating the right match between therapist and client so that the client receives the highest quality of care. It’s also about ensuring ongoing satisfaction in your work.

Screening Strategies for Initial Client Call

Here are a few screening strategies we’ve seen our affiliated clinicians employ that have set them up for successful new client relationships.

Be True to Yourself, Your Values, and Your Brand

We suggest screening clients in a way that feels authentic to you. You should have the freedom to develop a process that makes you feel comfortable and confident. You may want to do short, structured calls or longer, more free-form calls. You may want to send a follow-up email after the call to reiterate what was said. Regardless of how you screen or what your process is, the process should be followed consistently so that both you and the client get the information needed to ensure a productive, lasting relationship and also to ensure the process and level of care are the same for all, regardless of age, disability, religion, cultural background and sexual identity.

Know Your Niche

We could write an entire blog about finding your niche (and we plan to!), but for the purposes of screening, it’s important to identify what your particular therapeutic style and specialties are. What presenting concerns are you most interested in? What are you really good at?

As you know, not every therapist is the right fit for every client, and not every client’s needs align with a therapist’s expertise. Client screening allows you to evaluate your own competencies and determine if you have the necessary skills and experience to address a potential client’s specific concerns. Treatment plan interventions denoting your specific therapeutic modalities ensures more effective and focused treatment, enhancing the overall quality of care.

Consider creating a checklist of items you need to ask to identify if you might be able to help a potential client. Are there certain presenting issues you stick to within your niche? 

By knowing your niche, you will also be able to determine at the time of screening if the client’s level of distress and presenting concern are appropriate for the type and level of care you provide.

Know Your “Target Market”

Who is your ideal client? Based on your specialties or niche, what types of clients do you most enjoy treating and working with? In our experience, we see practitioners gaining much more satisfaction from their work when they are working with a population that they have identified as people they wish to serve.

Can you identify certain criteria surrounding the clients you want to treat? Do you only work with adults? Families? Adolescents? Do you only work with clients who have MaineCare or private insurance?

It’s helpful to have a list ready of other therapists in your area so you can easily refer out if you are unable to serve the client within your specialty or scope of practice.

Don’t Forget the Logistics

It’s important to inform clients of your rate at your earliest convenience. Before you schedule an appointment, ask the client if they have any questions about schedules, insurance, or fees. If a client has a pressing question about logistics at the beginning of the call, consider answering it right away so you don’t waste their time. There’s always a chance that your fee is too high for their budget, you don’t accept their insurance, or your schedules don’t align.

Be sure to have a plan for sorting out logistics in the initial call regardless of whether the potential client inquires about them. Here are some key logistics to go over:

  • Scheduling
  • Fees/Insurance
  • Location accessibility
  • Initial paperwork requirements

We encourage you to think about your screening process not as a means to exclude clients, rather as a means to create the best conditions for a successful therapeutic relationship. In private practice, you take on so many roles – from clinician to business owner. We find it’s helpful for our affiliated clinicians to think about the client screening process as a strategic tool for managing various aspects of your private practice including the mitigation of your own burnout! By carefully evaluating potential clients, you can build strong therapeutic relationships, reduce risks, and ultimately enhance your client’s overall well-being. In doing so, you provide the highest standard of care while fostering a fulfilling and sustainable private practice.<

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Posted on by Author Kayla Quesnelin Categories Advice for Affiliates, Private Practice

Managing Your Private Practice: Establishing Professional Boundaries with Clients


Our blog series, Managing Your Private Practice, examines how to successfully run your private practice as a behavioral health clinician. Essential to any therapy practice is establishing clear, ethical boundaries with your clients, including how to set out-of-office practices, which subjects are OK to text and email a client, and how to terminate a patient-therapist relationship if need be. 

Office policies are an essential component for any successful business. When it comes to paperwork, therapists have an additional responsibility: ensuring all bases are covered in terms of legal, ethical, and HIPAA compliance. Fortunately, Health Affiliates Maine is here to help clinicians when it comes to compliance and current regulations. 

We previously addressed How to Write Office Policies, and now we’ll continue our discussion on private practices’ policy decisions as it relates to boundaries within the patient-clinician relationship. 

How a Therapist Can Take Time Away
Part of providing effective therapeutic treatment and avoiding burnout and compassion fatigue involves taking good care of yourself as a behavioral health professional. When you are ill, on vacation, or simply in need of a break, you may want to communicate your absence with clients and ensure they have continued therapeutic care if needed. 

As with other office policies, consider putting your vacation in writing. Setting clear policies in writing helps both parties know what to expect. It is also an extra step towards fulfilling an ethical obligation as a therapist to communicate in advance about plans to be away from the office. According to the ACA Code of Ethics, counselors are required to assist “in making appropriate arrangements for clients … during interruptions,” including vacations and illness. By following our suggested checklist below, you can ensure your client’s therapeutic needs are met while you recharge. 

  1. Let your clients know about your plans in advance. Give notice in both written and verbal formats, such as in an email or letter and then again in person at their session.
  2. Set up automated out-of-office messages for your voicemail and email for your time away. Include: 
    • Dates of absence and return date
    • Instructions that include how to manage emergencies or crises, such as local emergency room information or a crisis number

Likewise, if your client needs to cancel or reschedule an appointment, you may find it helpful to have standardized office policies in place to address those occasions. Here are some tips on how to write an effective missed-appointments policy 

Should You Share Clinical Information in a Text? 

While emails and text messages have become ubiquitous in our culture, questions around what type of information is professionally appropriate to share in this format arise. Behavioral health clinicians in particular have to be to be mindful of the confidentiality-related issues involved in sending information over the internet. To stay within HIPAA guidelines and the Transmission Security standard specifically, therapists often employ text or email solely for appointments and scheduling topics, leaving clinically related materials and information for in-person or other secured forms of communication. There are secure texting service providers and apps available, if you prefer to communicate through technology; however, keep in mind that licensed therapists are responsible for ensuring that the platforms are HIPAA compliant. 

An additional item to consider when texting and emailing your patients is the client record. You may need to retain and file some of the information they provide, and you will need client-informed consent regarding text messages and their documentation. If you are researching texting service providers and apps, you may want recordkeeping ability to be part of your search. 

Furthermore, when adding technology to your communication with clients, remember to be mindful of your own availability and work-life boundaries. Will introducing a new technology for communication blur the line between your time “on” and your time “off” as a therapist? This is a question you may first want to consider. 

How to Terminate a Patient-Clinician Relationship
In some instances, you may need to make the difficult decision as a therapist to terminate your professional relationship with a client. 

Can I Terminate the Client Relationship?
To avoid clients feeling abandoned and ensure your reasons for termination or referral are appropriate, consider why you are discharging the patient. 

Ideally, you will have already worked collaboratively with your client to create a care plan for their therapy. With a clear, written course of treatment, including benchmarks for goal progress, a review of the therapy plan may make it apparent that the client has either reached their goals and no longer needs assistance, or that the client needs a certain type of therapy that you may not provide.

How to Discharge a Client
If you have determined it best to discharge or refer a client, you may want to follow similar guidelines as shared below to work through the termination process in a professional manner. 

1. When you make a referral for where a client might seek treatment, give at least three options of other behavioral health providers located within a reasonable distance and who can help based on the client’s needs. This may mean making a referral to a therapist who practices with a different modality, has different training, or has more experience in a particular issue, for example. 

2. Assist your client in processing emotions related to ending the professional relationship with you. When the reason for discharge is your own career or location, consider providing as much advance notice as possible and developing a contingency plan for your clients to minimize interruptions to their therapeutic service. 

3. Finally, keep in mind that documentation throughout the patient-clinician relationship is not only required, but also a form of protection from any potential claims of abandonment by clients. Proper recordkeeping can demonstrate that you put your client’s needs first and acted ethically during each step of the process, including termination and referral. 

This Health Affiliates Maine blog post is another in our series on Managing Your Private Practice, where we explore how to successfully run your private practice as a mental health clinician. Previous articles covered how to market your private practice, create office policies, and billing and finances.

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Posted on by Author Kayla Quesnelin Categories Private Practice

Managing Your Private Practice: Finding the Right Office Space

As a therapist, you know that finding the right office space for your private practice is critically important. Your office location can be crucial to attracting and retaining clients and to your quality of life—after all, you will be spending a large part of your time there. Equally important, the interior environment you create in an office establishes the overall vibe for your practice—it needs to feel safe, secure, and welcoming for clients. 

As you prepare to search for office space for your practice, we recommend taking some time to ensure you have a good sense of your client base, location needs, monthly budget, and the type of lease you’re looking for. Here are four questions we’ve found it helpful to consider (or re-consider, as the case may be) as you prepare to start looking at properties. 

1. Who Are Your Target Clients?

Defining your client base will help bring your office location requirements into focus. Who are you looking to serve and where are they located? Do you specialize in practicing with a specific population group? For example, do you envision working middays with office professionals on their lunch breaks, or are you hoping to serve children for after-school counseling sessions? If you’re doing individual sessions with office workers during the day, you might look at properties in downtown areas that have a concentrated number of professionals, whereas therapists working with children or adolescents may consider locations close to schools or related health services to maximize cross-references and convenience for the child and guardian alike. 

Do your best to meet your clients where they are and when it’s convenient for them—but, obviously, within the parameters of your own work style and preferences—for example, you may or may not mind a longer commute. This is, after all, one of the advantages of running your own business. 

 

2. How Much Rent Can You Afford?

As you can imagine in this real estate market, for most private practice therapists, rent is one of the largest items on their monthly budgets—if not the largest. There’s no fixed number for what percentage of business income your rent should be. Most financial guidelines suggest spending anywhere from 2 to 20 percent of your total practice income on rent, with the majority falling in the 5 to 10 percent range. If you are new to owning a small business and don’t yet have at least a year’s worth of data to determine your annual revenue, we recommend being conservative with your projected figures. 

Five to ten percent of your revenue is still likely to be a large range. So how much rent can you truly afford? 

There are multiple factors that affect rent prices and some of these factors may be more or less important to you based on your target demographic and how you want to work. For example, if you’re conducting most of your therapy sessions online, geographical features might be less important than, say, noise control. Clinicians practicing somatic therapies or play therapy may need more space for equipment, for instance, while other therapists may value a window over more square footage. Some considerations include: 

  • Urban or rural location
  • Type and size of building
  • Square footage of office 
  • High-traffic area and/or easy to find
  • Easily accessible by public transportation
  • Ample parking
  • Services available nearby, including potential competition
  • Secure, reliable internet access (especially for those practicing telehealth) 
  • Noise/privacy levels 
  • Accessibility
  • Maintenance and repairs 
  • Windows and lighting

We have found that it’s helpful rank your priorities for office space from one to ten, with the top three or so being must-haves. 

From there, you can determine what your bare minimum requirements are for office space and what you would be willing to splurge on. Would the more expensive rent benefit your business in a tangible way? Whichever percentage you settle on within the suggested range, set it firmly in your mind before you start visiting properties, and stick to your budget.

 

3. What Type of Office Lease is Right For You?

There are three main types of lease contracts in commercial real estate: full service (landlord pays for all expenses); net (tenant pays the rent and a portion of taxes, insurance, and maintenance fees); and triple net (tenant pays the rent and all of the taxes, insurance, and maintenance of the property). 

If some of the fees are paid in a net contract, you’ll want to understand exactly which ones are included in the rental price, including expenses for common areas (such as the parking lot, building lighting, and property landscaping). Remember to adjust your budget accordingly if you have taxes, utilities, insurance, and cleaning/maintenance as separate expense categories.  

In addition to these types of office leases, you may also be able to find subletting options or flexible terms, such as a monthly, six-month, or yearly lease. Perhaps you can share an office with another professional whose work hours are different than yours. And your landlord may be willing to negotiate their asking price, especially if you are entering into an extended lease. If you can be creative within the lease contract, it may save you money in the long run. 

 

4. What Interior Factors Create the Right Environment?

Unlike some small businesses, the layout and interior design of an office rented for therapy use is critical. We all know that physical environment affects our emotions and behavior. When a client feels comfortable, relaxed, and safe in a therapy office, it builds therapeutic rapport and enhances self-disclosure. 

When scouting offices, occupy the space under consideration and imagine a therapy session taking place there. Is the space inviting as is? Are the walls thick and the doors solid to satisfy privacy concerns? Who controls the temperature? Is it quiet? Is the lighting warm and adjustable? 

Consider which elements in the office you are allowed to change and whether or not you want to spend the time and money to make those changes yourself. Can you paint the walls, hang artwork, and so forth to create a comfortable environment? Is the office semi-furnished? How much will furniture and other design elements add to your costs? What do you need to add to effectively soundproof the room? 

You can promote positive interaction with your clients through office modifications that follow healthcare design principles, such as clutter-free, light-filled spaces with greenery and soft seating. And don’t be shy about displaying your credentials: a study in the Journal of Environmental Psychology (Devlin, 2009) showed people rate mental health practitioners most favorably when they have more diplomas on the wall. 

Another thing we have found it useful to keep in mind is your client’s experience with the entire building location, from the first step of their visit to their last. Can they easily find a parking spot or bike rack? Is there a security system in place? Are accessibility aids incorporated throughout the building? Is the waiting room clean and well-maintained? Who are your neighbors? Is the bathroom centrally located? When you thoughtfully consider how your client will feel throughout each moment of their therapy session, your private practice is more likely to have positive therapist-client interactions and an advantageous retention rate, which will be reflected in your bottom line.  

This Health Affiliates Maine blog post is another in our series on Managing Your Private Practice, where we explore how to successfully run your private practice as a mental health clinician. Previous articles covered how to market your private practice [link to https://www.healthaffiliatesmaine.com/how-to-market-a-private-practice/], create office policies [link to https://www.healthaffiliatesmaine.com/writing-policies/], and billing and finances [link to https://www.healthaffiliatesmaine.com/managing-your-private-practice-finances/].

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Posted on by Author Kayla Quesnelin Categories Advice for Affiliates, Private Practice

Health Affiliates Maine named 2023 Agency of the Year

By the National Association of Social Workers Maine Chapter

 

Health Affiliates Maine is proud to have been selected by the National Association of Social Workers (NASW) Maine Chapter as the 2023 agency of the year. The NASW awards are intended to foster excellence in social work by recognizing individuals and agencies who have gone above and beyond in showcasing dedication and expertise in the field.

Founded in 1955, the National Association of Social Workers (NASW) is the largest organization of professional social workers in the world, with over 150,000 members in fifty-six chapters nationwide and internationally. The NASW Maine Chapter, with over 1000 members, is the major professional social work organization in the state of Maine. 

A statement issued by the NASW noted that they had named HAM the Social Work Agency of the Year “in honor of over two decades of work dedicated to serving communities across Maine.” The statement goes on to say, “Health Affiliates Maine (HAM) has left an indelible mark in the behavioral health sphere of our state. HAM’s extensive advocacy, training, and direct practice support to countless numbers of clinicians and case managers over the years showcases a long-standing dedication and commitment to providing quality behavioral health supports to the citizens of Maine.” 

“This is an incredible honor for HAM,” said founder and executive director Andrea Landry Conley, LCSW. “We are both humbled and proud to be recognized among our distinguished peers (hats off to the other award recipients!) for the impact we are making on the state. It’s a testament to the talent and passion of our affiliates, our case managers, and the entire HAM team—and our collective commitment to living our mission and values every day.”

The NASW Maine annual awards ceremony will take place on Friday, October 20 at the NASW Maine Chapter Annual Conference, which will be held at the Samoset Resort in Rockport, Maine.

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Posted on by Author Kayla Quesnelin Categories News

The Smallest Steps Can Lead You to a Happier Life

Making a tiny change each day and seeing an improvement can help move us out of what psychologist Martin Seligman—University of Pennsylvania professor, past president of the American Psychological Association, and best-selling author—calls “learned helplessness” and into “learned optimism”—the idea that we can cultivate a positive perspective and a feeling of control over our lives. 

Research has demonstrated that small steps (and small successes) build healthy habits and are significantly more likely than setting big goals—which often trigger fear and procrastination—to lead to sustainable, long-lasting behavior changes that improve our well-being. 

Seligman’s Five Components of Human Flourishing

One of the founders of positive psychology, Seligman developed the PERMA™ theory of well-being to define human flourishing and help people to achieve it. PERMA is an acronym that represents what Seligman identified as the five components of well-being: Positive emotions, Engagement, positive Relationships, Meaning, and Accomplishment/Achievement. 

The PERMA model provides the perfect framework for thinking about the kinds of incremental, small steps that build good habits and help you to enhance your happiness and well-being over the long-term.

1. Positive Emotions
Strive to experience more positive emotions and to focus and reflect on them. Do more of whatever makes you feel happy, bring joy to the everyday, and focus on your personal strengths. 

Limit Distractions:
Turn off computer and phone notifications. Airplane mode is your friend! The more time you spend with your phone or on your computer, the more likely you are to experience depression, sleep problems, higher stress levels, and increased anxiety. 

Practice Self-Care:
Self-care has been clinically proven to increase happiness. A regular self-care routine contributes to your physical, emotional, and mental wellbeing.  

  • Stay hydrated. 
  • Get enough sleep. It improves memory, awareness, and creativity, among other benefits. 
  • Add steps to your day and stretch regularly.
  • Replace one processed snack with a healthy snack.
  • Take regular breaks, especially if you work on a screen. 
  • Get outside. Quality time in nature makes for lower cortisol levels and higher serotonin and dopamine levels.
  • Don’t slouch. Posture affects mood.
  • Breathe more deeply. Deep breaths trigger your parasympathetic nervous system, which naturally brings you into a calmer state.
  • Bring Joy to Your Daily Routine:
  • Upbeat, happy songs lift your mood. Binaural beats help you focus or relax.
  • Keep a gratitude journal and/or a joy list. 
  • Smile! Physically smiling reduces stress, even when it’s not caused by happiness.

2. Engagement
Increase your engagement with life. Get energized with work and hobbies that fit your passions and interests. Don’t be afraid try new things, as novelty has been shown to arouse the senses.  

  • Make art or music or engage in other creative pursuits.
  • Find inspiration in motivational quotes, by calling someone you admire, or watching a documentary on one of your heroes.
  • Engage in play. Board games, lawn games, and organized sports all work. 
  • Challenge yourself. Embrace humans’ love for novelty and learn something new.

3. Positive Relationships
A key factor in the quality of your life is your connections to your fellow humans. Strengthen existing relationships you enjoy and make new friends. 

  • Put your phone down, look up at the sales clerk, and make small talk.
  • Give consensual hugs. Hugs generate oxytocin, which may provoke greater trust, empathy, and morality in humans, boosting our overall wellbeing.
  • Practice random acts of kindness, which boost your serotonin and dopamine levels in addition to increasing peer acceptance.

4. Meaning
Purposefully seek meaning through work, volunteering, mentoring, or leisure. Meaning, which is the M in Seligman’s PERMA model, also relates to living an authentic life—only you know what truly gives your life meaning. 

  • Spend time with someone with whom you can be your true self.
  • Schedule a therapy session.
  • Write about what matters to you. 
  • Take time for large- and small-scale reflection: on your day and on life dreams.
  • Be awed. Get outside. Watch the sunrise or sunset.

5. Accomplishment/Achievement
By keeping your eye on your goals while simultaneously ensuring there is a healthy balance of priorities in your life, you can achieve eudaimonia. Positive psychologist Christopher Peterson asserts that eudaimonia, or the process of fulfilling one’s nature, is more important for the quality of your life than hedonism, which focuses on pleasure. 

To ensure you’re on your own authentic path, you can take small actions that revolve around self-knowledge checking in with yourself. Do you feel balanced? What matters to you? Do your goals need any adjustments? 

  • Enjoy time alone.
  • Practice expressive writing in your journal. 
  • Meditate. 
  • Maintain healthy boundaries. 
  • Perform progressive muscle relaxation and/or body scans from your resiliency toolkit.
  • Savor pleasures through mindful enjoyment.
  • Celebrate your accomplishments. A pat on the back or listening to your favorite victory song can go a long way.

“Flourishing”
Positive psychologist Dr. Lynn Soots calls the sum of what you get when you pursue all these aspects of wellbeing “flourishing.” “Flourishing is the product of the pursuit and engagement of an authentic life that brings inner joy and happiness through meeting goals, being connected with life passions, and relishing in accomplishments through the peaks and valleys of life.” And it all starts with a small step. 

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Posted on by Author Kayla Quesnelin Categories Tips for Healthy Living, Wellness

Managing Your Private Practice: Finances

In this blog series, Managing Your Private Practice, we explore how to successfully run your private practice as a mental health professional. We started the series by looking at how to market your private practice and how to create your office’s written policies. This month, we turn our attention to another critical aspect of owning your own business: billing and finances. 

As a business owner, you get to decide how to structure your therapy practice, including which hours you’re available, who your clients are, what your office policies are, and which insurance providers to work with—if any. While the autonomy can feel liberating, the sheer workload of managing both the therapy part of your practice and the business part of your practice can be daunting. Fortunately, Health Affiliates Maine can help clinicians in this area, by providing administrative support for credentialing and billing for MaineCare, Medicare, and private insurance companies, among other benefits.

Separate Your Business and Personal Finances

Whether you have structured your private practice as a sole proprietorship or as an LLC will determine your accounting and bookkeeping methods to some extent. In either case, treat your practice’s finances as separate from your personal finances. This delineation—separate checking accounts, separate debit or credit cards, separate accounting systems—will not only save you a headache come tax-filing season, but it will also make it easier for you to check in regularly and see quickly whether your business is achieving its financial goals.

Take Advantage of Accounting Software

While some business owners still do their books by hand or on a simple Excel spreadsheet, some in private practice prefer bookkeeping software such as QuickBooks or FreshBooks. Among many helpful features of tools like these is the ability to easily generate balance sheets and profit and loss statements, which gives you an “anytime” snapshot of your practice’s finances. This ongoing financial monitoring can help with decision-making, for example, whether you need to adjust your marketing in mid-stream in order to build the business you want to lead.

Establish Timely Billing and Documentation Habits

Billing your clients on a consistent, timely basis can help you avoid any cash-flow issues and helps to reinforce your practice’s financial safety net. Not only does maintaining a regular billing cycle help make your income stream more predictable, but consistency also communicates stability and reliability to your clients. Since billing at HAM is tied to session documentation, timely completion of notes is vital to receiving regular payments. In addition, collection of copays, deductibles, and coinsurance at the time of service is ideal to ensure receipt of payment, particularly if the client does not return for services thereafter.

Outsource Administrative Tasks  

When it comes to administrative tasks, it can be tempting to try wearing “every hat” for cost-saving purposes. But outsourcing can actually be cost-effective by freeing up more therapeutic hours for client work. Thus, you might consider hiring an office assistant, an accountant, or an IT person to assist with HIPAA compliance for your practice’s computer systems.

Invest in Education  

As a small business owner, you know there are many facets that go into how your business functions. Understandably, not all therapists are knowledgeable in accounting, IT, HR, or general business management. If this describes you, rest assured, you are in esteemed company, and you might consider making educational investments in areas where you are less skilled or knowledgeable. The good news is that brushing up on your business management skills—whether by attending financial training workshops or seminars, reading books and articles, joining networking groups, and so forth—is generally a tax-deductible expense.

Protect Your Future Self

To guard against any potential financial loss down the road, it’s important to be prepared for any eventuality or absence. For your business, this means ensuring that you have short- and long-term disability insurance, pre-planned savings for upcoming vacations, bereavement leave, or illness, and a healthy retirement account. It’s not uncommon for business owners to delay paying themselves at certain phases of their operations, but compounding interest generally makes Individual Retirement Accounts (IRAs) and the like more financially lucrative the earlier you begin. So, be sure to pay your future self! While spending more money, especially at the onset of opening your own private practice, may sound counterintuitive, it can be a beneficial long-term investment for your future.

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Posted on by Author Kayla Quesnelin Categories Private Practice

How to Navigate Parenting and Your Career as a Therapist

Back-to-school time is a time of transition. Schedules shift, kids are returning to classrooms, and as a working parent, you may be pivoting from more caregiving to more professional time. How can you navigate that shift effectively, with grace and compassion?

Transitions are one of the five “core challenges” of working parenthood, according to Daisy Dowling, author of Workparent. Dowling’s solution to the problem is to rehearse. This sort of practice, several days before an expected big transition occurs, helps parents identify potential snags ahead of time and brainstorm ways to fix them. It can be as simple as play-acting the first day of school with your children. By rehearsing the change to come, you and your child can feel prepared for a new routine, which can affect everyone’s attitudes and mindsets.

Reflecting and Setting Intentions for Your Family and Job

The transition to a new season and school year provides a ripe opportunity to set your intentions for the school year. With the fresh start autumn provides, you might consider pausing to look at the big picture. You can begin by reflecting on your life goals and all the things that are—and aren’t—working.

As you reflect on your career and family, you might ask yourself:

How satisfying is my current life?
Are my values reflected in the life I’m leading?
What are my priorities right now, in this phase of parenting and at this phase of my career?
What do I want to hold on to?
What do I need to let go of to make life easier?
What do I need to ask for at work and at home to make my goals achievable?
In which direction do I wish to go?

Caring for Yourself as a Parent and Professional

You might find it hard to make time for that kind of deep reflection. After all, life is so busy right now. Although the knee-jerk reaction to this hectic stage of life might be to just slug through it, reflection and self-care are arguably even more essential for mental health clinicians who are parents than it might be for parents in other professions—particularly non-caregiving occupations.

At heart, behavioral and mental health professionals and parents have similar mandates: they support and encourage others’ unique growth and development. When you’re both a therapist and a parent, there are special challenges to integrating work and parenthood. “Work-life balance” may not speak accurately to the conflicts that arise between your professional and personal choices, as both roles require you to draw from the same well of compassion. A better description might be the one put forth by therapist Robin B. Thomas, Ph.D.: existing in a “constant state of adaptation to meet the many demands of family, career, and social obligations.”

In order to flow within that “constant state of adaptation,” you need to put your (figurative) oxygen mask on first. It’s worth repeating: self-care is vital, particularly for parents who are therapists. Left unaddressed, burnout and compassion fatigue can amount to a personal and professional crisis. The antidote is self-care.

Regard self-care like you would any other appointment on your calendar: your needs are equally important to others’. While it may seem like you’re taking time away from other obligations to focus on yourself, what you’re actually doing is enabling yourself to care for others well while modeling healthy behavior for your children. This article contains specific advice on self-care techniques for handling therapists’—and arguably parents’—occupational hazard of secondary stress.

Strategies for Navigating Your Career and Family Demands

While challenges such as secondary stress may be unique to parent-therapists, there are some more-universal methods for working parents seeking to flex and adapt to the dual demands of both roles.

1. Make value-driven choices. Reflection on your own unique life has to be the first step. Once you decide what you value, you can arrange everything accordingly. Maybe at this stage of life you value convenience over wealth, so you buy precut vegetables to save minutes in the kitchen. Getting clear on your values can guide decisions both big and small to ensure they’re consistent with the life you seek to lead—and that’s a natural recipe for satisfaction. See the reflection questions above as a starting place.

2. Change your strategies as needed. What works when your baby’s in diapers is not necessarily going to work when they’re a teenager. Your need may be the same (e.g., focused work time), but your strategy for meeting that need (e.g., childcare you pay for) can change. But your needs can change, too—especially if your values have changed! As a general rule of thumb, you can expect to reevaluate your values, needs, and strategies every two years as you and your family grow and evolve.

If you find you’re in need of new solutions, take note of other working parents’ strategies. What seems to work and what doesn’t? What do you like and not like? Can you imagine that method working for your family? It’s fine to experiment with changes in your own life to find what works for you. Strategies are not set in stone. By employing flexible thinking, we can accommodate new needs. And remember, reducing your commitments is a legitimate strategy, too. Do you want to reduce your contribution to your field at certain stages of your child’s life? Dowling calls this “auditing your commitments.” Which leads us to setting boundaries.

3. Set boundaries. This is work; this is home. With clearly delineated boundaries between what’s personal and what’s professional, you are in a position to push back on overwork culture and increase your happiness. In practice, boundaries look like not answering work communication after hours, for instance. Not only does this sort of boundary setting establish guardrails for yourself and contribute to life satisfaction, it also helps head off a whole host of secondary problems that thrive in the neglectful shade of burnout culture, according to Anne Helen Petersen, a journalist who has written two popular books on the difficulty of maintaining work-life balance. “Turns out,” she writes, “it’s incredibly hard to build community, to forge social safety-nets, to agitate for larger social change, [and even to] give and receive care when you’re dedicated, willingly or not, to the culture of overwork.”

4. Establish an egalitarian home if you have a partner. This can be one of the most important factors for partnered parents thriving at work and at home, according to Danna Greenberg, author of Maternal Optimism. Consider how well your current home management routines and organizational systems (shared calendars, to-do lists, digital versus paper, etc.) are working as well as who is carrying the mental load.
Embrace flexible gender roles to balance work and family and contribute to your happiness, advises Jeremy Adam Smith, author of The Daddy Shift. There’s that flexible mindset again!

5. Lean on the village. It takes a village to raise a child—even more so if you are a single parent. Outsource help where your budget allows: dog-walking, housework, cooking, even lice combing are all subject to outsourcing. If your budget is tight, you might find creative solutions for childcare, such as forming a cooperative for daycare. By leaning on your friends and extended family, you strengthen social ties and develop community. It requires time and planning to ask for their help, but the benefits are tenfold.
A professional peer group is also crucial for social support. Mother-therapist Maggie Benedict-Montgomery, Ph.D. speaks of the need to find “allies” within your professional network. These professional peers can assist you in navigating your specific field as a parent, and might have experience in areas that are new to you. It’s good to know that others have your back—and that you can have their backs, as well—and that you are not alone in navigating these challenges. Which finally leads us to:

6. Speak up. You know that trying to navigating parenting and your career isn’t just your private, personal struggle when you Google “parenthood and career” and the first options that come up are survival guides! Fifty million Americans are surviving as both parents and professionals, but they aren’t necessarily thriving. Our workplace policies could do more to curb overwork culture and help working parents and families thrive. For example, only one out of ten American men have access to paid paternity leave, according to the Greater Good Science Center at UC Berkeley.

Statistics such as these showcase how important it is to advocate for social change. We can all do our part to advocate for family-friendly workplace policies. In fact, activism can make you a happier parent, because volunteering and advocacy offer considerable mental and physical health benefits. When industries and institutions in the United States become more supportive of parents in the workforce, we all benefit.

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Posted on by Author Rachael Severancein Categories Tips for Healthy LivingTagged , , ,

Dr. Paul Foxman

Treating the Anxiety Epidemic in Children and Adolescents

In this webinar, participants will learn how anxiety develops and acquire practical treatment strategies that can be applied immediately.

Friday, September 22, 2023
8:30 AM – 4:00 PM EDT

About the Training

Anxiety disorders are now recognized as the most common emotional disorder in the U.S. as well as in 16 out of 17 countries surveyed by the World Health Organization. The soaring trend towards anxiety has been accelerated by stress and threats, such as terrorism, natural disasters, economic recession, school shootings, pandemic illness, and divisive politics. These threats to children’s security, which also include divorce, bullying, and violence in the media has produced a “shell shocked” generation suffering from anxiety in many cases. Our challenge is to recognize anxiety in children and help them cope.

In this webinar, participants will grasp how anxiety develops in children and adolescents, and acquire practical treatment strategies that can be applied immediately in their professional work. Seven key anxiety disorders will be addressed: separation anxiety disorder, panic disorder, overanxious disorder, obsessive-compulsive disorder, social anxiety disorder, phobias, and post-traumatic stress disorder. Emphasis will be on integrative psychotherapeutic interventions involving insight-oriented, cognitive-behavioral, mind-body, solution-oriented and family systems approaches.

This training is worth six (6) continuing education hours.

An application for 6 continuing education hours has been made to the Maine Board of Alcohol and Drug Counselors.

Objectives of the Training:

  • Explain how anxiety develops in children and adolescents using the “three ingredients” blueprint
  • Distinguish between “normal” and “abnormal” anxiety
  • Identify the personality traits and cognitive style of anxious children
  • Describe the key features of six child/adolescent anxiety disorders
  • Apply effective interventions for each of six child/adolescent anxiety disorders

Agenda for the Day:

Morning I: Nature and Causes of Anxiety 8:30-10:15

  • Why, how and when anxiety develops in children
  • Three ingredients in all anxiety disorders (temperament, personality style, stress)
  • The “anxiety personality”—assets and liabilities
  • Foundation skills for managing stress and anxiety

Break 10:15-10:30

Morning II: Treatment Strategies 10:30-12:00

  • Separation Anxiety Disorder: graduated exposure, helping parents let go
  • Panic Disorder/Agoraphobia: “Floating Technique”

Lunch 12:00-1:00

Afternoon I: Treatment Strategies 1:00-2:15

  • Generalized Anxiety Disorder: interventions for replacing worry with positive cognition
  • Obsessive-Compulsive and Related Disorders: types of obsessions, purpose of compulsions, exposure and response prevention (ERP)

Break 2:15-2:30

  • Afternoon II: Treatment Strategies 2:30-4:00
  • Social Phobia: self-esteem causes and interventions, group therapy
  • Specific Phobias: Using virtual reality in exposure therapy
  • Trauma- and Stressor-related Disorder: ACE studies, treatment goals and methodologies

About the presenter:

Dr. Paul Foxman is Founder and Director of the Vermont Center for Anxiety Care, a private outpatient practice in Burlington, Vermont. He has over 40 years of professional experience in a variety of settings, including hospitals, community mental health centers, graduate schools in psychology, and private practice. Dr. Foxman is the author of Dancing With Fear (1996) and The Worried Child (2004), the Clinician’s Guide to Anxiety Disorders in Kids and Teens (2017), as well as other publications on the topic of anxiety including a co-authored casebook, Conquering Panic and Anxiety Disorders (2003). His most recent book is Traumas and Triumphs (2022).

Dr. Foxman’s education includes Yale University (B.A. in Psychology), Vanderbilt University (Ph.D. in Clinical Psychology), pre-doctoral internships at the Department of Psychiatry at Mt. Zion Hospital in San Francisco and the Kennedy Child Study Center in Nashville, and training seminars at the San Francisco Psychoanalytic Institute.

In 1985 Dr. Foxman co-founded the Lake Champlain Waldorf School in Shelburne, Vermont, now flourishing from kindergarten through high school. As a frequent workshop presenter as well as expert on radio and television shows, Dr. Foxman is known for his knowledge and clarity of thought, sense of humor, and engaging speaking style.

Register here

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Posted on by Author Randy Runnelsin Categories Events

Managing Your Private Practice: Writing Policies

In this blog series, “Managing Your Private Practice,” we look at how to successfully run your private practice as a mental health professional. We started the series with a dive into how to market your private practice. Now, let’s look at a critical yet sometimes overlooked element in owning a business: policy writing.

Written policy forms are an essential component for any successful business. Therapists have an additional responsibility when it comes to paperwork: you need to ensure your bases are covered when it comes to legal, ethical, and HIPAA compliance. Fortunately, Health Affiliates Maine is here to help clinicians when it comes to compliance and current regulations.

How to Write Effective Office Policies

How a counselor runs their private practice varies from person to person. Regardless of your office size or structure, there are several office policies we advise all practices to put in writing. While some behavioral health practitioners with staff develop internal policies specific to issues such as dress code and social media, we’ll focus on advice for external office policies here—the policies your clients will see and review. Here are some guidelines for how to write effective office policies.

Office Policies Reflect Your Practice’s Core Values

When you give clients forms to fill out, it’s not only important to ensure they are clearly written in simple, easy-to-understand language, it’s also essential to make sure the forms reflect your private practice’s core values. For example, if you value inclusion and diversity, you might want to create or modify an existing form or template to include options for preferred pronouns. Remember, while filling out paperwork such as an authorization to release information, intake, insurance, and informed consent forms, as well as signing office policies, your client is getting an impression of your business.

Get Feedback

Whether you consult a colleague, a mentor, or a trusted office assistant, getting feedback from others is invaluable. Outside perspectives allow others to see things you may be too “inside” your own practice to notice, and others may also have more experience around which areas of the practice need or could use written policies to make the office run more smoothly.

So, by all means, ask a friend or colleague to review the packet of forms you’ve created and get their impression. Ask:

  • Was there enough space to write your answers?
  • Is it easy to follow?
  • Are there areas of unnecessary repetition?
  • Did you find any typos?
  • How could this be simplified?
  • Which changes or additions would you make, if any?
  • Am I missing something obvious and important? (We all do this!)

While involving others in policy writing and reviewing takes more time, the final outcome of a collaborative process ultimately makes for smoother operations and happier clients. If that’s hard to add to your to-do list, consider reframing the time investment as optimizing your client’s care.

Strive for Clarity

Setting clear policies in writing is a bit like setting clear boundaries: it helps everyone know what to expect. Clear is kind.
Make it part of your therapy practice to include office policies in a new client’s paperwork and reshare annually or when policies change. Successful practitioners have standardized forms and make use of a secure, organized paper filing and recordkeeping system.

At the same time, don’t assume clients will read through all the forms. During your first session, discuss your office policies briefly. This helps ensure that expectations are clear and understood, and it contributes to building trust in the professional relationship you’re developing.

Which Office Policies Do I Need in Private Practice?

Which office policies you include in client packets are somewhat unique to the practice you run. In general, we advise therapists to develop written office policies around cancellations, fees, social media, and—important in Maine—weather. (Keep in mind office policies are separate from other paperwork you should require from clients, including intake, insurance or billing, authorization to release information, and informed consent forms.)

Cancellations and missed appointments: Life’s little mix-ups happen. But as a counselor in private practice, missed appointments can disrupt the treatment process and therefore adversely affect your income and business—particularly if they are a chronic, recurring issue. Craft a clear understanding with your clients in writing about what happens when you or they need to cancel, in addition to missed appointments.

Fees: Practitioners may accept all or some insurance, self-pay, and/or having slide scale fees. However you structure payment, be clear and upfront with clients about how (and when) you charge and collect fees in your practice. Include your fee structure with a written policy on payment and collections in every client package, regardless of whether they currently have insurance; and, of course, all practitioners should be up to date on the new GFE (Good Faith Estimate) law, which requires providers to give patients who either do not have or are not using insurance a written estimate for non-emergency procedures. (Find more information on GFE requirements here.)

Social media: Use of social media is prevalent in our country, so therapy practices in particular need policies on the use of Facebook, Instagram, TikTok, and the like. Set clear boundaries on how you or anyone in your practice orbit may communicate with prospective and current clients online, keeping in mind that some clients may have differing preferences around privacy. And, while we’re focusing this blog on external office policies, if you have an office assistant or other staff, we strongly encourage you to set an internal social-media policy for staff. And, finally, check with your licensing board and code of ethics to see what is required regarding confidentiality and social media use.

Weather: Maine knows snow days! Develop a written office policy on what happens in the event of inclement weather, letting clients know how you will get ahold of them or how they can check in with your office to see if it is open. Will you call them or text them? Should they check your practice’s website if the weather forecast looks questionable? While it may seem a small matter, this office policy will help eliminate confusion and smooth operations in the long term.

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Posted on by Author Rachael Severancein Categories Advice for Affiliates, Private PracticeTagged , ,

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