Guest Post: Managing Expectations – Laura Anderson

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Editors note: This is a guest post from Laura Anderson. We occasionally have other practitioners share their story of building a private practice. Laura offers some excellent insights about starting a practice. If you have ideas you’d like to share with our readers, click here to contact us for more information.

March marked the three year anniversary of opening my private practice—and it’s been a glorious three years! Coming from community mental health to private practice has changed my life in every possible way, for the better—so much so that it can often times be difficult to remember what it was actually like to start a private practice. I don’t feel the pain of deciding to pay my electric bill or eat. If a client, or a few, cancels within a given week, my anxiety is maintained at a stable level. And when those phone calls come in telling me that some company is looking for a website to feature a local therapist (and they think I would be a perfect fit!), I can dismiss their offers without wondering if perhaps the cost might be worth the business.

Call it blocking out trauma or some supernatural ability to move past that situation mentally, it can be difficult to remember “the old days” with my practice. So, when my licensure supervisees and consultees come to me and ask why they aren’t getting clients and what I did to grow my practice so fast, I am sometimes at a loss!

I’ve spent a long time reflecting on what it was like to build a practice and have even gone back to my licensure supervisor, who walked with me through that time, to try and find some little nugget of information that I can pass on to my supervisees and to you. And what I am coming to find that it boils down to is this: managing expectations.

As long as humans keep being humans and relationships keep happening, there is job security in the therapy “market”. Despite how the economical structure of our country might rise or fall, there will be a need for therapists because it doesn’t look like people’s issues are going away anytime soon. In some ways, knowing this is a relief—at least we are in a market that will have a little longevity!

That being said, as excited as people are to be done with their graduate programs, start the licensure process and open their own practice, the mere hanging of the sign and opening your practice door does not automatically mean clients will flock to you! Opening a practice, getting clients and developing a business is just like any other job in the world in that you have to put your time in— networking, marketing, developing your skills and continuing your education—just like you would in any other area of work.

When I began contemplating opening my own practice, I talked to several other people who had opened practices to glean wisdom from them, avoid pitfalls and to gain an accurate picture of what I was getting into. Somewhere in these conversations the number 18-24 months stuck out in my mind as the time that it takes to get your practice to where you feel stable with client load, yourself as a therapist, finances and like you can float a little bit rather than struggling to keep your head above water.

Sure, there were moments when I got down on myself and wondered if I would have business come in the door—six long and painful weeks seemed like a very long time to wait before that first phone call came in—I legitimately celebrated after my first private practice session! There were definitely those moments of anxiety but there was also some sort of peace in knowing that having 4-6 consistent clients about three months in to my private practice was right on target. I absolutely wanted more and financially it would have felt a lot more secure, but I knew that I was, for lack of a better term, paying my dues.

In talking with my former licensure supervisor she reminded me that during this time where clients weren’t flocking in my door I took advantage of those spare moments and considered them “built in office hours” in order to develop myself professionally. I am an introvert by nature and networking to me is a terribly uncomfortable experience. But I made myself do it; every free opportunity that was in Nashville, I took advantage of. I handed cards out to people I met and asked people to grab coffee with me. I visited churches and community organizations just to get my name out. I e-mailed every single professional I had met while doing community mental health and let them know what I was doing.

I used spare money that I had to purchase books on topics and therapeutic models so that I could teach myself. I searched online for advice on business, accounting and marketing. I researched different search engines and how to build a website. I thought of creative marketing plans and started to build my clinical resources. I used every moment that I was supposed to be in my office as an office hour, regardless of what my client load for the day or week, to set up my business.

I invested in and connected myself to wonderful people who could help me along this journey. My licensure supervisors were my rock and encouragers during this time (having a great supervisor is a make or break deal!) I got involved with peer consultation groups and group supervision that connected me to other therapists who could, at the very least, empathize with my journey.
I got a part time job (at a gym) and took any odd job I could—babysitting, housesitting, working a yard sale, painting, moving, contract work—anything in order to make ends meet. I let my friends know that I was in the market for doing anything (well, ok, not ANYTHING…I had my limits!) for a few extra bucks, and they were gracious! They made me the first on their “call list” of babysitters, and offered me first preference in other opportunities where they needed help. I didn’t love doing this, it wasn’t ideal— certainly even seeing clients who paid the base rate of my sliding scale made me more money—but until I could guarantee that my schedule would be booked, I worked as many jobs as I needed to during my non- office hours to be able to pay my bills. I had to—I had no choice; I had no one else who was going to help me so I was going to make this work!

And in all of this, I managed my expectations. For me it was like losing weight—you have to work hard and consistently so that over time you see results. Sure, we all hope for that quick fix so that we can wake up tomorrow morning and be thin—or have booming businesses—but the fact of the matter is, like losing weight, building a practice takes a level of commitment, motivation, passion, reflection, awareness and dedication. It takes managing your expectations. It takes knowing that there will be good days and bad days, hard days and easy days, moments of frustration and moments of celebration, moments where you feel like you’re not going anywhere and moments where you can see improvement.

I can’t tell you for sure when it happened that I felt like I was able to really see the fruits of my labor, but I can tell you that it did happen. There came a point where calls were regularly coming in, clients were consistently showing up, where I could create a budget and know that each week I could meet it, where I had the opportunity to pick and choose which meetings and networking opportunities I wanted to go to and where I could truly design my schedule the way I wanted it to be. But it didn’t happen overnight. It didn’t even happen in a few months—it took many weeks and months of working hard and managing my expectations.

I tell my supervisees and those I consult with to be kind and patient to yourself in this process but to work hard—to dig your fingers in and get dirty. I fully believe that if you do the nitty gritty work on the front end there will come a day when you can take a day (or a week!) off, where you get to enjoy a snow day just as much as everyone else and when you can spend the majority of your time focusing on the things you love—helping clients walk through their own therapeutic journeys.

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