Author: Kayla Quesnel

Over the years, telehealth has emerged as a crucial service model, transforming the way we think about and deliver mental health and substance use services. It offers unparalleled access, privacy, and convenience to clients who need it or may otherwise go without care. Its rise in popularity and necessity, especially highlighted during the pandemic, has made clear its value in our healthcare system.

For these reasons and more, Health Affiliates Maine (HAM) is committed to supporting private practice clinicians in all settings—including those who serve clients virtually. We fully embrace telehealth as a vital and effective mode of service delivery.

Supporting Quality Care in Virtual Settings

As clinicians’ support network, we’re not just here to embrace telehealth, but to make it feasible! Our services are designed to meet your needs and enable you to provide quality care to those you serve.

Here are a few tips to ensure your telehealth services remain effective and impactful, as well as how we play a role:

  • Ensure Privacy and Confidentiality: Use secure, HIPAA-compliant platforms for your sessions and seek out a trusted, robust EHR system. Knowing just how crucial EHR systems are in your daily work, the team at HAM has performed extensive research so that we can offer a state-of-the-art EHR system that leaves affiliate’s feeling comfortable and confident. Remember, privacy and confidentially also apply to your physical environment. When providing telehealth services, you should be in a private space and be cognizant of your surroundings. Check your background and consider what clients will be able to see. You want to ensure that they feel safe and protected—just as they would if they were in an office with you. We also encourage you to provide clients with guidance on how to set up a private space for their appointments.
  • Build a Strong Therapeutic Relationship: While telehealth can feel different than in-person sessions, the core of effective therapy remains the same. Spend time building rapport with your clients and employ strategies to make each session feel personal and engaging.
  • Stay Informed on Best Practices: Telehealth is an area of rapid growth and change. Stay updated on the latest in telehealth delivery, including advancements in technology and shifts in ethical guidelines. We stay connected with industry leaders to bring you news and timely trainings. Just last month, we held an Ethics training titled, “Who’s in the Room: You, Your Client, and AI in 2024.”
  • Understand the Differences in Billing and Credentialing: Telehealth services often have specific billing codes and credentialing requirements. Rather than bog yourself down in these nuances, we stay on top billing and credentialing for you. This means less time spent on administrative tasks and more time doing what you love—helping clients.

The integration of telehealth into mental health and substance use services represents a significant step forward in creating more accessible, convenient, and effective care. It’s a privilege to work alongside clinicians in Maine, and those licensed to serve in Maine, to build healthier communities.

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Running a private practice in 2024 demands leveraging cutting-edge technology to enhance efficiency, organization, and client care. Embracing the latest tech tools ensures your practice stays ahead of the curve, providing seamless and modern services. Here are some essential tech items to consider for your private practice:

A Reliable Laptop

A dependable laptop is indispensable for any private practice. It serves multiple functions, from scheduling appointments to managing patient records. By acting as a central hub, a laptop helps keep your practice organized without the clutter of physical paperwork. Additionally, cloud storage solutions enable you to securely store and access data from anywhere, ensuring your information is safe and easily retrievable even if something happens to your computer.

Key Features to Look For:

  • High processing power for multitasking
  • Long battery life for uninterrupted use
  • Robust security features to protect sensitive information
  • Ample storage space, complemented by cloud storage options

A Smartphone

A smartphone is a versatile companion to your laptop, streamlining various aspects of running a practice. For example, texting appointment reminders can be an excellent tool to encourage fewer no-shows. There are now many HIPAA-compliant text applications available to ensure privacy and anonymity. Additionally, telehealth capabilities on your phone allow you to conduct virtual sessions, offering flexibility for both you and your clients. The built-in timer function can help you manage session durations effectively.

Benefits:

  • Facilitates immediate communication with clients
  • Enables telehealth consultations on the go
  • Helps manage appointments and reminders
  • Provides a portable alternative to your laptop

Teletherapy Platforms

Incorporating teletherapy platforms into your practice allows you to expand your reach and provide care to clients who cannot visit the office. These platforms offer secure video calling, ensuring privacy and compliance with healthcare regulations. They are especially useful in maintaining continuity of care during unforeseen circumstances that prevent in-person visits.

Advantages:

  • Extends your service reach beyond geographical limitations
  • Ensures client privacy with encrypted communication
  • Supports flexible scheduling and remote care

White Noise Machine

Enhancing the confidentiality of client sessions is crucial, and a white noise machine can help achieve this. By masking conversations, it prevents those in the waiting area or passing by from overhearing sensitive discussions. This fosters a more relaxed and secure environment, reassuring clients that their privacy is protected.

Key Points:

  • Provides auditory privacy in your office
  • Creates a calm and soothing atmosphere
  • Available in various models to suit your office decor

Secure Communication Tools

Maintaining the confidentiality of sensitive client information is paramount. Employing HIPAA-compliant secure communication tools ensures that all messages and data exchanged are encrypted, protecting against unauthorized access and data breaches. These tools help you adhere to regulatory requirements and uphold the highest standards of privacy.

Features to Consider:

  • End-to-end encryption for all communications
  • User-friendly interfaces for easy adoption
  • Regular updates and support for ongoing security

Integrating these tech tools into your private practice can revolutionize how you manage and deliver care. By staying organized, maintaining flexibility, and prioritizing client confidentiality, you can provide a superior service that meets the demands of modern-day behavioral health care.

Remember that with all technologies, there are risks and benefits, including ethical dilemmas that might arise. For more information on navigating these dilemmas, Health Affiliates Maine is offering an ethics training titled, “Who’s in the Room? You, Your Client, and AI in 2024.“ To learn more about this training taking place on September 13, 2024, click here. 

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When thinking about starting your own private practice, moments of excitement and eagerness may quickly be followed by clouds of doubt. You’re not alone in feeling a bit confused or on edge about this big move! Transitioning from a structured work environment to the freedom (and responsibility) of your own practice is no small decision. However, with the right preparation and a fair amount of reflection, it could turn into the most fulfilling venture of your career.

As you prepare for the transition, or even just ponder what life would be like as a private practice clinician, here are a few things to consider.

Embrace Your Inner Entrepreneur

Stepping into private practice means you’re not just a clinician anymore; you’re a business owner too! Think of it as learning a new skill set. From managing finances to marketing your services, these are all aspects that, with time and experience, you can master just as well as any therapy technique.

Check Your Financial Pulse

Shifting from a regular salary to what might initially be an unpredictable income is scary. However, with some careful planning, like setting up a budget, understanding start-up costs, and saving for initial lean times, you can set yourself up for success. If you are not quite ready to jump all the way in, keep in mind that many of our affiliates hold part-time or full-time employment while engaging in private practice on the side. This can be a good way to ease into the transition and see if private practice is the right choice for you.

And though it’s important to market your own practice and grow your clientele, affiliates can breathe a little easier knowing our well-established referral network also draws in new clients to help grow affiliates’ caseloads and contribute towards a steadier stream of income. We also offer advanced payment for MaineCare and Medicare/MaineCare so you can receive timely and weekly payments for your services.

Create Your Unique Brand

What makes your practice special? Building a personal brand and establishing an online presence can help attract the kind of clients who will benefit most from your unique approach. Choosing a catchy name and designing a welcoming website are just the beginnings of creating your professional identity. You can learn more about marketing your private practice here .

Get the Legal Ducks in a Row

It’s crucial to tackle legal requirements head-on. From sorting out insurance to staying in compliance with ever-changing healthcare laws, make sure everything is buttoned up and you are following all guidelines. A chat with a legal expert is a great investment. We also provide affiliates with updates on the latest healthcare policies and regulations so you can stay in the know.

Though some clinicians choose to become incorporated or an LLC based on their business needs, this is not a requirement to affiliate with Health Affiliates Maine. Before making this decision, we highly encourage you to consult a legal or tax advisor. (We also encourage affiliates to speak to an expert in liability insurance!)

Surround Yourself with Supporters

Starting out on your own might feel lonely at times, especially if you’re accustomed to a bustling team environment. Cultivate a supportive circle of fellow clinicians, mentors, and advisors. Whether it’s bouncing off ideas, venting on tough days, or just sharing a coffee, having people you can rely on makes all the difference. If you’re looking for community, our network of affiliated clinicians provides a ready-made group of like-minded professionals.

Remember that as a business owner, you’ll need support beyond the clinical world. Having a network of business professionals, such as an accountant, lawyer, or expert on liability insurance is a great place to start.

With Freedom Comes Responsibility

You’re about to step into a world with more freedom and autonomy—but that comes with a great deal of responsibility. Without the frame of a 9-to-5 job or a boss to direct the show, are you prepared to steer your own ship? Managing your time effectively, holding yourself accountable, and embracing the full spectrum of running your practice can be empowering yet challenging. Think about how you’ll approach self-discipline, setting your schedule, and shouldering the exciting responsibility that comes with calling the shots.

Reconnect with Your “Why”

In the midst of all this planning and deliberating, take a moment to remember why you considered private practice in the first place. Whether it’s the desire for autonomy, the flexibility to balance work and life, or the passion to create a therapeutic environment that aligns with your philosophy, keeping your motivation in sight can guide you through
challenges and towards success. Would engaging in private practice get you closer to your “Why”?

Feeling nervous about stepping into this new role is completely normal, but it’s also an exciting opportunity to deliver care on your own terms. And remember, though you’re working alone, you don’t have to do it alone.

Learn how Health Affiliates Maine supports clinicians in building strong, independent and autonomous practices.

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As a behavioral health professional, just the idea of taking time off may elevate your heart rate. Whether it’s concerns about client care continuity or ensuring the administrative aspects remain in order, it can be hard to press pause on your private practice. However, prioritizing your well-being is crucial—not just for your own health but for the quality of care you provide. 

Preparation and communication are key to enjoying a guilt-free break. Here are a few things to consider as you prepare for your out-of-office time, ensuring peace of mind for both you and your clients.

Communicating Your Absence

Start Early. As soon as you have your vacation dates settled, begin to let your clients know. This gives them time to process the information and plan accordingly. It’s also a respectful way to acknowledge the importance of their treatment process.

Be Clear and Concise. Whether it’s verbally in session, through a written notice, or both, ensure your message about being out of the office is clear. Provide the exact dates you’ll be unavailable and mention when you’ll be returning. Keep the tone professional yet empathetic, recognizing that this break might impact them.

Set Boundaries. Make it clear if you will be completely inaccessible or if there will be limited circumstances under which you can be reached. Setting these expectations early helps manage any potential anxieties your clients might have about your absence.

Prepare Your Clients. Discuss with your clients what they can do if they find themselves struggling during your absence. This might involve creating a plan that includes coping strategies you’ve worked on together. For some clients, it might be beneficial to increase sessions leading up to your departure or schedule a check-in immediately upon your return.

Preparing Your Practice

Plan for Coverage. If possible, arrange for a trusted colleague to be available to your clients in case of emergencies. This is particularly important for clients who are at a higher risk or in the midst of a more intense phase of treatment. Ensure you have a clear agreement on what constitutes an emergency and the process for contact. We have a network of statewide clinicians and case managers to help form those trusted connections.

Administrative Duties. Ensure all paperwork, billing, and communication with third parties (including with us if you’re a HAM affiliate!) are up to date. This way, we can continue serving you even while you’re away. Set up an automated email response that reiterates your absence and provides information on who to contact in case of an emergency. If you have a practice website or online booking system, update your availability there as well.

Secure Client Information. Ensure all client files and information are securely stored and that only authorized personnel have access to them. 

Returning to Work

Upon your return, take the time to reconnect with clients and catch up on their progress or challenges during your time away. 

Taking time off is not just a luxury, it’s a necessity for your mental and physical health, reducing the risk of burnout and ensuring you can provide the best care for your clients. With thoughtful preparation and clear communication, you can create a system that supports both you and your clients, making your time away from the office a restorative pause that benefits everyone involved. Remember, stepping away doesn’t mean stepping back from your commitment to your clients—it means stepping back stronger, recharged, and ready to engage fully in the therapeutic process.

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Many behavioral health professionals are so focused on caring for their clients that they don’t even consider creating a professional profile. They often don’t realize that it’s an important tool for growing their practice. We get it. After all, you have deep experience and expertise in behavioral health, not necessarily in marketing yourself or your practice online. At Health Affiliates Maine (HAM), we encourage affiliates to consider their professional profiles not as a superficial sales and marketing tactic or a job resume but as a space to build connections with best fit clients, foster understanding, and inspire confidence. That is why we feature affiliates’ professional profiles on our website free of charge (just one of the many perks of affiliating with us!)

When it comes time to create these professional profiles, our affiliated clinicians often ask us for advice on how best to craft their professional profiles. They want to know what’s important to include and how it should be written. 

This might seem challenging, but by answering a set of key questions, behavioral health professionals can create an engaging and empowering profile. In this blog, we explore what these questions are and why they’re important for shaping your online narrative.

Who are you beyond your qualifications?

Of course, a brief introduction with your qualifications and professional background is necessary. Yet, remember, therapy is built on human connections. So, delve a little further. Talk about your beliefs, your passions, perhaps even mention how you find solace in the calm of nature or find inspiration in the strokes of a paintbrush. Show that you, too, are human.

What are your areas of expertise, and what is your approach to treatment?

Share your areas of proficiency–whether it is cognitive behavioral therapy, Family Systems Therapy, child and adolescent psychology or anything else. Yet, remember to also discuss your approach to these treatments. Your philosophy and methodology provide a glimpse into your practice and its uniqueness.

What are some of your experiences?

Share experiences that shaped you as a therapist. Talk about the resilience you have seen, the journeys you’ve borne witness to. This is about normalizing the ups and downs of behavioral health care and portraying yourself as a compassionate companion on this journey.

Why have you chosen this path?

State why you decided to delve into this field. Perhaps, a personal encounter sparked your journey, or maybe you’ve always felt an innate calling to help others navigate their mental and emotional landscapes. These insights make you relatable and trustworthy.

How do you nurture resilience and empowerment in your clients?

Including empowering language in your profile portrays positive outcomes and encourages those seeking help. So, as an advocate, supporter, and guide, how do you encourage individual growth and resilience? What specific strategies and interventions do you use to help clients discover and bolster their strengths?

How can someone reach out to you?

Make it clear how individuals can contact you for a consultation or further queries. Normalize this process by encouraging individuals to take this step, reassuring them courageously and compassionately.

Getting Started

Once you have written your profile, put it out to the online world! We encourage all affiliated clinicians to start by crafting their professional profiles with us at HAM. Affiliates can have their professional profiles featured on the HAM website free of charge one of the many benefits of affiliating with HAM!  Other organizations, such as psychologytoday.com, will also post online profiles for a fee. 

Creating an online professional profile is about breaking down the walls and extending a hand to those seeking help. Let your profile reflect that, let it echo your dedication, let it speak in a voice that grounds, heals, and believes.

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In our digital-first society, behavioral health professionals should not overlook the importance of their online identities. At Health Affiliates Maine (HAM), we encourage our affiliated clinicians to use the web as a platform to reflect their expertise, competencies, compassion, and dedication. Doing so will not only help you connect with clients that are the best fit, but it will also help you to market your practice. This all can be achieved by crafting engaging and well-articulated online profiles that accurately represent who you are and what you do.

You might think, “Why does my online profile matter? Isn’t my real-life work enough?” The online world isn’t detached from our physical lives, it’s a natural extension. An optimized profile bridges the two by introducing your “real life” self to those seeking services or professional connection online.

Let’s break down how to build an engaging professional profile that offers that important human touch.

Prioritize Authenticity

Crafting your online profile is about being true to who you are and the values you hold dear. Your profile should undeniably reflect your authenticity. We encourage you to list your qualifications, but don’t stop there. Humanize yourself by mentioning your passions, your approach towards treatment, and your commitment towards empowering individuals. You’re more than just your degree(s).

Frame Your Experience, Not Just Your Expertise

Of course, listing your areas of expertise is essential, but it is equally powerful to narrate your experiences. People connect with stories. They inspire, they console, they empower. So, talk about the resilience you’ve seen and nurtured, share how you’ve stood as an ally. This relatability helps build an emotional connection that often goes beyond professional levels.

Use Accessible and Empowering Language

A profile filled with medical jargon may showcase your knowledge, but it often fails to connect with patients and clients. Use accessible language that anyone can understand. Emphasize the power of individuals to enhance their own quality of life.

A Gateway to Genuine Connection

At a time when screens often precede handshakes, your online profile serves as the initial handshake, smile, and conversational opener. It’s your chance to say, “I see you, I hear you, and I’m here to walk through this with you.” For individuals seeking help, making that first step can be daunting. By including your picture and a warm introduction, your profile can help break down this barrier. It offers a sense of comfort and understanding right from the start.

Because, remember, as prospective clients search for a therapist, they will search online. And they will want to see and get to know you before ever picking up the phone or sending an email inquiry. They will want to read your professional profile and see your face to help them begin to determine if they want to work with you, and if they will be able to trust you.

The Essence of Your Practice Distilled

Think of your online profile as a distilled essence of your practice’s values, philosophies, and approaches. It’s not just about attracting clients—it’s about attracting the right clients. Those whose needs align with your skillset, who seek the specific support you offer, and who you can most effectively help. This alignment is the cornerstone of meaningful therapy.

The power of a well-crafted, authentic online profile in marketing your private therapy practice cannot be overstated. It’s a testament to your dedication and a bridge to those in need. As behavioral health professionals dedicated to nurturing resilience and advocating for accessible care, use every tool at your disposal to connect, uplift, and empower. Your online profile is not just a part of your marketing strategy—it’s an extension of your mission, your values, and your unwavering commitment to making a difference.

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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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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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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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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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