Creating Life-Enriching, Sustainable, and Financially Thriving Private Practices

In November 2022, I presented on the topic "Creating Life-Enriching, Sustainable, and Financially Thriving Private Practices" at the National Art Therapy Conference. I'm sharing here the abstract I submitted to the conference prior to being accepted as a speaker. This abstract is not my traditional writing style, but I think the information is relevant for therapists wanting a better way.

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Art therapy jobs with mental health organizations and agencies frequently require therapists to carry high client caseloads and accept an income that is not commensurate with the responsibilities, demands, or educational requirements of the job. Carlozzi, Stein, & Vredenburgh (2007) found a positive relationship between hours of client contact and therapist burnout. Therapists under high caseload demands are likely to end-up frustrated, exhausted, and burnt out (Berjot, Altintas, Grenot, & Lesage, 2017).

This acrylic painting I made was not submitted with my abstract, but it reflects the unknown possibilities of private practice

Art therapists often see private practice as a lifeline - a chance for more autonomy, less stress, and a better income. When art therapists start their private practices, they frequently structure their businesses based on the norms of the mental health field. The field teaches therapists to center clients above all else. This inadvertently fosters a culture of martyrdom mentality that suggests therapists must sacrifice their well-being for the sake of others (Schuld, 2022). Simpson et. al (2019) found “self-sacrifice” to be one of the leading causes of burnout in therapists.

With this mentality, therapists make business decisions based on how they can best “serve” clients. They set their fees, hours, and policies on what works best for their clients. This results in therapists who need large caseloads and long hours to make the income they need. Therapists soon find themselves stressed, worried, and unsure if they will have enough income from month to month. Without realizing it, self-sacrificing private practice therapists recreate the systems of oppression they sought to escape. In a study of therapists in private practice, Finan, McMahon, & Russell (2022) noted that the stress of private practice led some practitioners to question if they wanted to continue in the field.

There is a way for therapists to have private practices that are life-enriching, sustainable, and financially thriving. It begins with therapists stepping out of martyrdom mentality and honoring their own needs by structuring their practices based on their emotional, mental, energetic, and financial needs.

Therapists can decide what population and niche they enjoy working with the most (DiAngelis, 2011). They can determine the caseload they would like to have (Bryan-Podvid, 2021), how many days a week to work, and their ideal daily schedule. They can then set their fee based on the number of hours they want to work and the amount of income needed. They can be realistic about their financial needs (DiAngelis, 2011), budgeting for health insurance, vacations, sick days, and retirement. They can then put policies in place that protect them, such as a cancellation policy, consistency policy, or phone consultations.

These steps can fill a therapist with fear and bring up old wounds (“Am I good enough?” “Will I be able to find enough clients at this rate?). Therapists can use this rich time to engage in their own therapy to heal limiting beliefs and old narratives that no longer serve them. They can also invest time weekly in marketing efforts that will help them find ideal clients, such as creating a website, referral network, and SEO optimization (Myers, 2019).

A therapist with an ideal private practice can show up rested, ready, and in their power. They will have more time to reflect on therapy sessions, self-educate, prepare for upcoming clients, and reground. This not only increases the quality of therapy provided, it also models what therapists teach their own clients: to honor and meet their own needs. These changes also ensure that therapists can happily remain in the field, have energy for their personal lives, and have the financial resources to meet their needs and weather unexpected events.

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References

Berjot, S., Altintas, E., Grebot, E., & Lesage, F. (2017). Burnout risk profiles among French psychologists. Burnout Research, 7, 10-20.

Bryan-Podvid, L. (2021). How to start a private practice. Mind Money Balance. https://www.mindmoneybalance.com/blogandvideos/how-to-start-a-therapy-private-practice

Carlozzi, A., & Stein, L. & Vredenburgh, D. (2007). Burnout in counseling psychologists: type of practice setting and pertinent demographics. Counseling Psychology Quarterly. 12(3), 293-302. DOI: 10.1080/09515079908254099

DeAngelis, T. (2011). Are you really ready for private practice? gradPsycg Magazine, 11. https://www.apa.org/gradpsych/2011/11/private-practice

Finan, S., McMahon, A., & Russell, S. (2022). “At what cost am I doing this?” an interpretative phenomenological analysis of the experience of burnout among private practitioner psychotherapists. Counseling and Psychotherapy Research, 22(1), 43-54.

Myers, S. (2019). Establishing a private practice. Counseling Today, https://ct.counseling.org/2019/03/establishing-a-private-practice

Schuld, J. (2022). Stepping out of martyred therapist mentality. Jackie Schuld Art Therapy Blog, https://www.jackieschuld.com/post/stepping-out-of-martyred-therapist-mentality

Scruton, R. (1996). The eclipse of listening. The New Criterion, 15(3), 5–13.

Simpson, S., Simionato, G., Smout, M., van Vreeswijk, M., Hayes, C., Sougleris, C., & Reid, C. (2019) Burnout amongst clinical and counseling psychologist: the role of early maladaptive schemas and coping modes as vulnerability factors. Clinical Psychology & Psychotherapy, 26(1), 35-46.