Survival Hacks for Your Private Practice

Keep a Spare Set Keys

An extra set of keys is a make or break item for when you forget your keys, leave them in a different coat, drop them down the rain drain (really happened to me). The bottom line: no Supervisor is coming to open the door. Fat chance a landlord is even available. Get a spare set of keys.

Invest in a Water Cooler

You know you will be working long hours. You need a quick hydration break and so do your clients. Plus you get to make tea, cocoa, soup, and vitamin shakes. Well worth the investment.

Wear Comfy Clothes

Believe me, clients are not paying attention to what you are wearing. I have worn my yoga clothes for sessions because I forgot my gym bag. Clients do not care. They need you 100% focused on the work, so don't be distracted by your adorable shoes.

Always Have an Emergency Stash

Always keep extra notepads, toilet paper, printer ink, and pens. Much like the keys, the buck stops with you. It would be terrible if you get ready to take notes for that new intake that waited 2 ½ weeks to get in with you, but your pen runs out of ink!

Subscribe to an Electronic Medical Record

I use Simple Practice and I can give you a discount code! For the money you spend, it is the best investment for organizing your charts, collecting payments, reconciling insurance payments, and speaking with your clients.

Karen Peabody, LICSW is a therapist and business consultant for social workers and therapists interested in starting their private practice. She founded Forgewell Solutions in East Bridgewater, MA. Her office is a great place to start a private practice. Visit her FOR THERAPISTS page to learn more.

Quiz: Are you Ready for Private Practice?

1. Do you love working with your clients?

2. Are you willing to work harder than you have ever worked to develop your business?

3. Are you ready to take personal responsibility for your success?

4. Are you bold enough to make decisions?

5. Are you humble enough to ask for help and usually PAY for the service?

6. Do you acknowledge you need time to run a business, which is different than seeing clients?

7. Are you able to stay accountable for your successes and/or losses?

If you answered YES to all of these questions you are well on your way to a private practice mindset!

Are you ready to take the step into private practice?

If you want to work in a strong clinical environment, participate in monthly supervision and earn the money that you deserve, we have a spot for you. You must have 5-7 years of experience in a clinical setting, strong documentation skills, highly organized and independent. We are offering 1-2 days a week for a licensed professional to develop a clinical caseload. The office provides referrals for all therapists. Forgewell Solutions is a co-op private mental health office. If you are interested in this opportunity, please call 774-222-3196 or email info@forgewellsolution.com.

Karen Peabody, LICSW is a therapist and business consultant for social workers and therapists interested in starting their private practice. She founded Forgewell Solutions in East Bridgewater, MA. Her office is a great place to start a private practice. Visit her FOR THERAPISTS page to learn more.

EMDR: Eye Movement Desensitization Reprocessing

I remember learning about EMDR (Eye Movement Desensitization Reprocessing) in Graduate School. It was 2004, Simmons College when I watched a video of Francine Shaprio, Ph.D. demonstrating her technique of holding two fingers in front of a client’s eyes moving her fingers from side to side. I can remember thinking, “This is crazy”. It was not until 8 years later that I decided to revisit this concept. It took me that long to learn she was on to something.

We have come to learn trauma is a whole different animal in the world of psychology. Big traumas and little traumas are stored in our brains, creating pathways that affect the way we think about ourselves and the world. Traumas and the emotions that develop from trauma change the way we navigate this world. This is because trauma is stored in your amygdala, which is a central part of the midbrain, not easily accessed. This is a central force of decision making, emotional reactions, and memory. This is part of our “instinctual” brain. The part where logic doesn’t live. This traumatic experience becomes a vulnerability, around which a story is then created. This story usually ends with some sort of self-criticizing thought, “I am weak”. It is a big concept. A client remembers being bitten by a dog at 4 years old however he had no idea it would lead to a pervasive feeling that he is weak. The neuropathway is created linking “fear” and “I am weak”. Because this is shocking and significant, it is something that becomes hypersensitive, therefore every time he is confronted with the feeling of “fear” or “I am weak”, the pathway becomes stronger. Either variable can trigger this pathway, making this vulnerability more susceptible to growth. So, 15 years later he is still very sensitive to any message he interprets as “I am weak”, or an experience which results in fear. His emotional response is that of a four-year-old child because this is where the vulnerability started.

When clients experience these hypertensive emotions, they feel very out of control because their reactions are usually disproportionate to their regular feelings. The emotional vulnerability is there, however, the long distant memory if being bitten by the dog is fleeting and thus the emotional turmoil is a mystery. Most of the time these memories of our painful events are not “repressed” as some might think. The event is stored in a different part of the brain. The client might know he was bitten by a dog at 4 years old, however, he had no idea it would lead to this pervasive concept that he is weak. Which is precisely why EMDR is so powerful. Clients can go to therapy and talk about their feelings for a long time. But if they can’t change the neuropathways that developed through the painful event to change the emotional connection, they are never going to resolve the negative emotions that govern their life.

So, how does EMDR work? It is easy, bilateral stimulation. Using bilateral stimulation, meaning that stimulating both hemispheres of a person’s brain, will trigger other parts of the brain to work. In everyday interaction, most people are utilizing their frontal cortex, which is executive functioning such as planning, working memory, and task completion. Moving a hand in front of someone’s face, forcing their eyes to move from side to side, both hemispheres are stimulated, thus activating other parts of the brain which store some of these complex neuropathways. We have advanced from 1987. Today bilateral situations can be created through touch and sound also. Tappers are a popular method of creating stimulation and a lot less work for the therapist. This allows the client to hold a small device in each hand as it alternates vibrations, or allowing a client to wear headphones that play soft music alternating in each ear. The results can be profound.

Is EMDR an amazing tool, yes. Is it for everyone? No. First, it is a learned skill, so the client must be ready to do it and the therapist must be EMDR certified. They must also be prepared for the painful emotion that results from EMDR, which can be difficult for people to tolerate. Through the treatment the client becomes able to control their memory, thus deactivating the intense vulnerable emotions. People suffering from acute substance abuse issues, acute psychosis, suicidal thoughts, dissociative disorders, or some neurological issues need to be stabilized before proceeding with this treatment. Also, people with pending legal cases should consult with their lawyers before having this treatment because it could affect their testimony.

EMDR opened the doorway to treating trauma in a multicomplex disciplinary way. Through this method, other forms of reprocessing have developed, such as, Gentle Reprocessing (which is my go-to), Brain Spotting and Tapping have become powerful tools to help clients heal from difficult situations. Some might even call it life-changing.

Karen Peabody, LICSW is a therapist and business consultant for social workers and therapists interested in starting their private practice. She founded Forgewell Solutions in East Bridgewater, MA. Her office is a great place to start a private practice. Visit her FOR THERAPISTS page to learn more.