Therapy for the Therapist: Therapy, Coaching, or Consultation

kh-pp-stick-figures-blue-therapy-couch-consultation-dollar-photoWho do you work with?

If you’re like most therapists, you “give” a lot in the course of your day or week.  We are healers; we are givers; we are providers of help, to so many different clients with so many different kinds of disorders, situations, or challenges.

You help with psychiatric challenges, relationship issues, workplace issues, drug/alcohol issues, and many other human challenges — but you might have some of the same human challenges yourself.

But who “heals the healer”?  In addition to being a therapist for clients from many different walks of life, I’m also a therapist, practice coach, and case consultant for other therapists.

For example, I work with graduate students who are enrolled in clinical training programs, but they want something beyond the academic training of their program, or beyond the clinical supervision or support they are receiving from their fellow students, at field placement, internship, or assistantship sites.  Students often need support for their own stress management, while learning how to help others.  There are classroom demands, papers and projects due, and an almost immeasurably high volume of reading.

I work with therapists who work in private practices, sometimes making that tough transition from working in other settings to being self-employed, and also therapists who work in social service agencies, community organizations, hospitals, correctional facilities, mental health clinics, and schools.  These jobs can be stressful, because the client populations served in these settings can be high-acuity clients and there can be dynamics of transference and counter-transference in addition to the bureaucracy that often accompanies public or private non-profit settings.  Self-care becomes paramount.

Therapists who are just starting in private practice is also a portion of who I work with, because private practice demands what therapist coach Casey Truffo, LMFT, calls “working IN your business, and working ON your business”, understanding that a private practice, while still about human interaction, is a business, just like any other service business a professional might run, like an attorney, physician, dentist, chiropractor, or accountant.

Just as important are the therapists who are not new to private practice at all, but might need support for sustaining their practices against a risk of “burnout”, or looking at balancing their personal interests (hobbies, relationships) with their practice, and balancing career satisfaction with self-care.  For very experienced therapists, sometimes they need support for an “exit strategy” toward retirement.

Still others might be retired or inactive, but enjoy their identity as a therapist and want to keep current with another therapist for clinical discussions, trends in the profession, and camaraderie and colleague consultation to validate the investment they have made over a long career.

What kinds of challenges and problems do you help therapists with?

While therapists can be trained in prestigious, accredited graduate programs, it is impossible for any Master’s or even Doctoral program to cover absolutely everything a therapist might face in a career of a lifetime.  Even after school, internship/associateship, exam preparation, and passing exams, a therapist might need help with conceptualizing client cases and planning treatment, which can include help and support for assessing, diagnosing, and implementing treatment models.  Discussing the nuances of a case with another therapist benefits both the therapist and the client, because the conceptualization comes about from discourse and open discussion of the influences and factors.

Some therapists need help with non-clinical issues (but, really, aren’t all issues clinical, at some point?). Perhaps it’s about managing your schedule, your office space, or setting/adjusting/collecting fees.  It’s not uncommon for therapists to need ongoing support on issues related to “the business of the business”, and issues of fees can be about feelings of self-worth, boundaries, and managing counter-transference.  Therapists need clinical skills, but also sound business management skills that would pertain to the other graduate-school level professionals — yet somehow therapists seem to have the least support for these aspects of running a practice compared to our colleagues who are physicians or attorneys, who are “helping professionals” as well.

Support for selecting, implementing, and evaluating clinical intervention models is also a common request from therapists who are also clients.  Our graduate school programs introduce us to many modalities and models, but often there isn’t time in those programs to learn the models in depth, or to fully evaluate the pros and cons of each model, including “evidence-based practice” ones — and some well-meaning therapists can be dragged into “trendy” interventions or models that are not evidence-based, or perhaps not even ethical, because apart from the California Board of Behavioral Sciences, usually for the most egregious or outrageous situations, no one is really holding the entire community of therapists accountable.  Sometimes consulting helps a therapist-client to learn where their own blind spots are, or to recognize their own strengths and weaknesses in matching the interventions to the their clients’ needs.

It’s not unusual for therapists to need support for setting (and keeping!) the “therapeutic frame” about office space, scheduling, fees, policies, and boundaries.  Having support for any or all of these helps to strengthen each of them individually, and your practice as a whole.  For therapists not in private practice, these issues can be about working in a system, such as a hospital group, federal/state/county bureaucracy, or very “corporate” private treatment settings, that carry their own pros and cons.

Support for managing client transference and countertransference is another common issue, as are issues related to unusual or awkward situations, or even dual relationships, where only the most confidential support will do.

What do you offer as solutions to all of these?

I can help you to:

  • Feel less isolated in working in your practice, in any setting; our working relationship is your sanctuary to “let your hair down”
  • Clarify and bring awareness of the nuances of a clinical assessment
  • Develop culturally-appropriate treatment plans
  • Manage countertransference on sensitive points in therapy
  • Process and interpret client transference – positive or negative
  • Troubleshoot tough clinical decisions and ethical issues
  • Clarify differential diagnosis
  • Identify the ways to increase work/life balance and reduce burnout risk
  • Find ways to make your practice more efficient, focused, and profitable
  • Sharpen your unique edge and narrow your niche so that you’re working with your ideal client most of the time
  • Implement treatment models from a variety of clinical interventions for best client outcomes

How do we do this?

We do this by using your time with me in a variety of ways.  It could be seen simply as “therapy for the therapist”, where your professional role is a part of discussions, and your personal issues are put in the context of your professional identity (this is also true when I work with clients in Los Angeles who are in the public eye, and are never really “away from work” the way others are).  Or, our time can mainly be about reviewing your cases, much like pre-licensure supervision, but after you’re licensed, it’s peer case consultation.  Or, our focus can mainly be on practice-building coaching.  Some therapists who work with me combine these, which is possible, as long as we are both clear on what you want the focus of your session to be.  This might be similar to a social worker who works with a client on clinical issues, but might also receive case-management-style help to receive community resource referrals.

We also do this by discussing cases from an academic/theoretical point of view, or from a clinical intervention perspective.  We can also discuss your practice marketing strategy and efforts, as well as your networking and peer relationships among the therapist community (and other referral sources).

But Maybe You Still Have Questions or Concerns…

What do you provide that my graduate training and licensure didn’t already give me?

The development of a therapist is a process, not an event.  I believe in the concept of lifelong learning and growing.  Work with me offers the opportunity for ongoing support and both personal and professional growth.  By continuously identifying, exploring, and discussing how you’re working and how your work has meaning for you, you are feeding the “energy” that sustains you in practice, in any setting, theoretically for many years between licensure and retirement.  Discussing what’s going on with you helps you to be more “present” with your clients, especially in that neurobiological way, right-brain-to-right-brain attunement that is getting more research and is more compelling about how therapy works (I teach about this in my course at USC School of Social Work, using the book, “Being a Brain-Wise Therapist”, by Bonnie Badenboch, Ph.D).  Having regular consultation “primes the instrument” of your professional sense of self, and is, in part, an “ethical insurance policy” that you’re doing your best work without possibly unconscious stressors running the background of your mind, which clients will pick up, even unconsciously, eventually.

But doesn’t spending money on consultation undermine what I’m earning with the client’s fees in the first place? 

I can see how you might think that!  Yes, you have to balance the income you’re receiving from all clients against the overhead of doing business, and your own therapy or consultation is a line item of overhead expense for any practitioner.  But I see it as an investment in your overall skill set as a therapist, making you more effective in a way that will help your treatment of the original client you want help with, and of course similar clients who come along in the future with similar issues.

Just like learning a new treatment model or earning an advanced training credential, your skill set as a therapist in private practice is ever-increasing.  By investing in consultation, you “protect” your work with clients, and preserve the treatment relationship effectively, ideally until its natural termination.  Without proper consultation, you might make errors that could even subtly undermine rapport and provoke premature termination of the client.

Why should I choose you over other local therapists in the community who do this work?

Because I am or I offer:

  • Maintained a full-time, six-figure, private-pay (no insurance) private practice for over 11 years.
  • Maintained a part-time private practice for six years before that.
  • Continuously studied practice coaching and practice management.
  • Adjunct Assistant Professor at USC School of Social Work, teaching advanced courses in Clinical Practice for four years.
  • Served as a field instructor for clinical internships with USC, UCLA, and Cal State Long Beach.
  • Over 18 years experience as a clinical supervisor for post-Master’s (MA or MSW) graduates, guiding them to successful licensure and their own private practices
  • Blog author with over 200 articles on GayTherapyLA.com, HaveTheLifeYouWant.com, MensLifeSkillsCenter.com, and EzineArticles.com
  • Author of the book, “Self-Empowerment: Have the Life You Want!” (Lulu, 2011)
  • Host of the podcast series, “Have the Life You Want with Ken Howard, LCSW”
  • Co-host of the podcast series, “Get Gayme”, with Wes McDowell

How do I benefit from seeing you?

Some of the benefits of doing this work with me can include:

    • Burnout risk reduction
    • Increased job satisfaction
    • Higher or refined clinical skills
    • More effective client outcomes
    • More successful business (time/income balance, time managment, profitability)
    • Increased work/life balance
    • Working in your “zone” of ideal days/hours/clientele

Next Steps

Feel free to call me for a free question-and-answer about therapy or consultation services. You can tell me about situation, and ask questions. Therapy sessions are reimbursable if you have a PPO plan, but consultation sessions are not, but they are tax-deductible as a business expense.  Both types of sessions runs for 45-50 minutes and are $175.  There are no minimums; you can have one session, periodic ones, or ongoing.

See how I can help. Call my office at 310-726-4357, or call/text 310-339-5778 to schedule a no-charge, 15-minute phone consultation.