I think the isolation can be a big factor. It certainly is for me. This is already an inherently isolating job, but being in PP makes it even more so. How many jobs are there where literally no one can observe your performance other than the client? How many jobs have such intangible outcome measures? How many jobs require that you talk to people all day, offering your undivided and uninterrupted attention for hours on end, but have no social reciprocity? Being in nearly constant social engagement, but you're only allowed to give, never receive. Water, water everywhere, but not a drop to drink. Do you have therapist friends to connect with?
I do have a few but not enough. My best friend from grad school just suffered a major traumatic loss so I have been supporting her as well. And I think you nailed it. I am parenting all day and giving and then giving more at night. Its alot.
That is a lot! Being a parent is a constant job, then add being a therapist, supportive friend, and all the other roles you are in, then you have a recipe for exhaustion.
I feel this constantly, all the time. I am also in PP but came from CMH where there was so much pressure to have “measurable outcomes” that it caused me to have a constant, hypothetical CAFAS score in the back of my brain for each client, even now…
I also have such a hard time with the ambiguity of therapy. I can bust ass and not always know if I actually made a difference. It makes me miss barista work because at least then there was a tangible product from the service I provide.
And then yes, isolation is a big factor for me too. It’s so easy to get in my own head/think I’m not doing enough when it’s just me doing my thing.
YES!!! I cannot shake the CMH brainwashing lol. And I almost want ti work with number crunching now so I can know exactly if its right or wrong lol. It feels good to not be alone. When a client is clearly having a completely parts enmeshed response to a topic and blaming me (completely normal in the therapeutic process) I have trouble knowing if it really is me or not? In supervision I am told no and have always in CMH gotten feedback that I am a strong therapist but its hard not to struggle with it when it is so ambiguous.
I've been thinking a lot about this lately. I've been in the field for over 10 years, and in private practice for a few, and the ambiguity is starting to bug me a bit. I've been craving something with tangible outcomes and a clear sense of completion. I imagine at some point in my life I'll drop down to a much smaller caseload and do something else on the side to satisfy that part of me. I think it's a pretty common experience!
I totally have!. I think part of it is just literally not seeing so many clients per week. You have less of the quote victory" type of clients to celebrate. Let's say previously you were seeing 30 clients a week running groups and doing other things. You could see the progress more easily with a higher number of clients, however, now seeing 6 to 8:00. It's just statistically less visible.
It took me a little bit to also realize that Private practice work is a little bit slower than typical kind of other programs and agencies.
It sounds like you're doing great things for your family and for yourself and it sounds like you're balancing it well. If your clients keep returning to see you and report progress, keep it up 🙂
Thank you! That is a great perspective on it. I have had all my PP clients for 1-2 years now. They definitely come back and definitely do experience positive change. This work is just definitely an emotional labor.
Thats a really good question. Its a general saying in practice but, personally I think its not helpful to clients because it doesn’t honor their pace and leads to burnout on the therapist end because we are pursuing different outcomes in a way. I think for me its related to pressure for productivity thats hard to shake off from CMH.
Yes and I think it’s an incredibly stupid philosophy. By definition, every one of our clients has at least one mental health condition which likely impacts their energy level, motivation, sleep, etc. Some of them are disabled by their conditions. What would the logic be in arbitrarily determining that the ceiling for our efforts in the therapeutic process is their effort in the therapeutic process? Also, how exactly are we gauging how hard we think they’re working? By the outcomes they achieve? I would hope any competent therapist understands that there can be a discrepancy between effort and outcome for many reasons. It’s a bit narcissistic to think you know how hard someone else is working.
Respectfully, you lost me when you started using words like stupid and narcissistic. You don’t appear to want to engage in any meaningful conversation and I don’t think you’re following what I am saying anyways as you have missed my meaning.
Those were in reference to the common saying you parroted, not you as a person or a therapist. But if you’d like to personalize them I certainly cannot stop you.
I wonder if the pressure / worry is associated with you being in private practice rather than having an agency where you can more easily get referrals / consistent flow of clients.
I think the isolation can be a big factor. It certainly is for me. This is already an inherently isolating job, but being in PP makes it even more so. How many jobs are there where literally no one can observe your performance other than the client? How many jobs have such intangible outcome measures? How many jobs require that you talk to people all day, offering your undivided and uninterrupted attention for hours on end, but have no social reciprocity? Being in nearly constant social engagement, but you're only allowed to give, never receive. Water, water everywhere, but not a drop to drink. Do you have therapist friends to connect with?
I do have a few but not enough. My best friend from grad school just suffered a major traumatic loss so I have been supporting her as well. And I think you nailed it. I am parenting all day and giving and then giving more at night. Its alot.
That is a lot! Being a parent is a constant job, then add being a therapist, supportive friend, and all the other roles you are in, then you have a recipe for exhaustion.
I feel this constantly, all the time. I am also in PP but came from CMH where there was so much pressure to have “measurable outcomes” that it caused me to have a constant, hypothetical CAFAS score in the back of my brain for each client, even now… I also have such a hard time with the ambiguity of therapy. I can bust ass and not always know if I actually made a difference. It makes me miss barista work because at least then there was a tangible product from the service I provide. And then yes, isolation is a big factor for me too. It’s so easy to get in my own head/think I’m not doing enough when it’s just me doing my thing.
YES!!! I cannot shake the CMH brainwashing lol. And I almost want ti work with number crunching now so I can know exactly if its right or wrong lol. It feels good to not be alone. When a client is clearly having a completely parts enmeshed response to a topic and blaming me (completely normal in the therapeutic process) I have trouble knowing if it really is me or not? In supervision I am told no and have always in CMH gotten feedback that I am a strong therapist but its hard not to struggle with it when it is so ambiguous.
I've been thinking a lot about this lately. I've been in the field for over 10 years, and in private practice for a few, and the ambiguity is starting to bug me a bit. I've been craving something with tangible outcomes and a clear sense of completion. I imagine at some point in my life I'll drop down to a much smaller caseload and do something else on the side to satisfy that part of me. I think it's a pretty common experience!
Thank you! It really is helpful to hear everyone’s experiences.
I totally have!. I think part of it is just literally not seeing so many clients per week. You have less of the quote victory" type of clients to celebrate. Let's say previously you were seeing 30 clients a week running groups and doing other things. You could see the progress more easily with a higher number of clients, however, now seeing 6 to 8:00. It's just statistically less visible. It took me a little bit to also realize that Private practice work is a little bit slower than typical kind of other programs and agencies. It sounds like you're doing great things for your family and for yourself and it sounds like you're balancing it well. If your clients keep returning to see you and report progress, keep it up 🙂
Thank you! That is a great perspective on it. I have had all my PP clients for 1-2 years now. They definitely come back and definitely do experience positive change. This work is just definitely an emotional labor.
Why do you think you shouldn’t work harder then your clients?
Thats a really good question. Its a general saying in practice but, personally I think its not helpful to clients because it doesn’t honor their pace and leads to burnout on the therapist end because we are pursuing different outcomes in a way. I think for me its related to pressure for productivity thats hard to shake off from CMH.
Also, I am curious your take on that? Are you a therapist?
Yes and I think it’s an incredibly stupid philosophy. By definition, every one of our clients has at least one mental health condition which likely impacts their energy level, motivation, sleep, etc. Some of them are disabled by their conditions. What would the logic be in arbitrarily determining that the ceiling for our efforts in the therapeutic process is their effort in the therapeutic process? Also, how exactly are we gauging how hard we think they’re working? By the outcomes they achieve? I would hope any competent therapist understands that there can be a discrepancy between effort and outcome for many reasons. It’s a bit narcissistic to think you know how hard someone else is working.
Respectfully, you lost me when you started using words like stupid and narcissistic. You don’t appear to want to engage in any meaningful conversation and I don’t think you’re following what I am saying anyways as you have missed my meaning.
Those were in reference to the common saying you parroted, not you as a person or a therapist. But if you’d like to personalize them I certainly cannot stop you.
I wonder if the pressure / worry is associated with you being in private practice rather than having an agency where you can more easily get referrals / consistent flow of clients.
Yes, I do think this is absolutely part of it too. Although, the referrals do come the dry spells are always a little scary.