The Five Most Important Boundaries For Your Private Practice
Boundaries can be tough for all of us. When you are starting your private practice it’s a vulnerable time. You are excited and you want your practice to grow. It can be easy to let some boundaries slip in the middle of it all.
The most common areas I see therapists bending their boundaries are:
#1 Scheduling Clients.
This is a huge one, especially for new therapists. It’s hard to say no when you get a call from a potential new client and the temptation is to schedule them WHENEVER you can get them in the door. Even if it does not work for your life.
This is a huge mistake and a good way to end up frustrated, exhausted, and burned out. I remember when I was brand new to private practice, I moved my ENTIRE schedule around to accommodate an intake call. It was a major hassle to move things, but I really wanted to get them in. Of course, they didn’t show for the intake appointment. I was so angry with them and so frustrated with myself. Not a great way to start things. But I learned an important lesson.
Before you see your first client, you need to decide what you want your practice to look like and this includes your schedule. Your schedule should be based on what works for you, not driven by what you think your clients want. Part of what makes a client a good fit for you is whether they can come when you have available times. If you are twisting your life into pretzels to accommodate everyone but you, you are going to end up frustrated with yourself and resentful of your clients. This is not going to be your dream practice. It’s going to become your nightmare.
Figure out what you would like your schedule to look like and stick to it.
#2 Not Maintaining Boundaries When You Are Off Work
One of the mistakes therapists make is feeling like they always need to be available to respond to incoming messages – voicemails, texts, emails. The truth is this is a recipe for burnout. Our work is hard and exhausting. We need downtime to be able to give our clients our best energy during sessions. You need to have a life that is not constantly interrupted by work.
From the very first interaction with a client, you are letting them know when you are available. If you don’t want to work on the weekends, don’t return calls, texts, or emails on the weekends. If you do, you have let your client know you are available during that time.
Make it clear in your paperwork and your voicemail message when you are, and are not, available and stick to that. Provide crisis resources so that people reaching out know who they need to call if you are not available. This can be as simple as leaving the crisis hotline number on your voicemail.
Help your clients decide who the people in their life are who can support them when they are struggling.
Believing you are the ONLY one who can help a client is not healthy for the client or for you. It’s also not good therapy, it’s breeding dependance.
#3 Taking on Clients Who Are Not a Good Fit.
See #1. When you are new to private practice you are going to be feeling the pressure to build your caseload. You will be tempted to take on every person who contacts you because you are excited to get new clients. It’s a wonderful feeling on so many levels and hard to say no to.
The empathy factor complicates this further. When someone calls in a lot of distress, we want to help, and it can be incredibly hard to say no. We end up taking on clients our gut is telling are a bad fit. I’ve certainly been guilty of this and always regret it. It is easy to slide into things we shouldn’t because of our empathy.
We also don’t want to disappoint referral sources. If a good referral source sends someone your way, the temptation will be to make it work, even if it’s not a good fit. You are better off touching base with your referral source to let them know why the client was not a good fit.
Be clear about who you are as a therapist and which clients are a good fit for the work you do.
Do not take on clients who are out of your scope of practice. If you don’t have training in working with eating disorders, it’s not ethical to take on a client who needs treatment for an eating disorder.
If you are not comfortable working with certain issues, honor yourself on this rather than pushing yourself to take on something you don’t want to do. Trust me, you will regret it.
I’ve devoted an entire chapter in the Master Course and a Mini Course, Establishing Your Professional Identity to helping you build a private practice that brings in your ideal clients. Don’t miss this crucial information.
Lean into listening to what you gut is telling you (sometimes screaming at you) about an intake that you know isn’t right for you.
What if you could successfully set up your practice without the mistakes most therapists make?
What if you could do it without feeling stressed out and overwhelmed?
My Private Practice Builder Master Course and Mini Courses are here to make that happen. Check them out now!
#4 Doing Things That Are Out of Our Scope of Practice.
This seems like it should be clear, but there are a lot of things clients or other professionals ask us to do that can feel murky. Again, our empathy can often get us into trouble here. When people ask us for help, we want to respond. But this can get you into real trouble.
A great example is writing letters for clients. It’s not that we can never write a letter for a client, but we often don’t stop to think whether the letter we are being asked to write is within our scope.
Can you complete a disability form?
Is that letter you’re writing actually a custody recommendation?
How is the letter going to be used?
If you are writing a letter for an emotional support animal, are you incurring liability if the animal hurts someone?
Is a client, or another professional, asking you to make an opinion about something out of your scope?
A good rule of thumb for client requests, or requests from other professionals, is to STOP, consult, and listen to your gut. It is often a good idea to get legal consult if a client is asking you to provide something for court or an official proceeding.
Learn to take a breath before saying ‘yes’ to requests and make a practice of running things by a colleague or legal for consultation before agreeing to them. Just because someone asks does not mean you have to provide.
#5 Talking About Clients on Social Media.
DO NOT USE SOCIAL MEDIA GROUPS AS A PLACE FOR CASE CONSULTATION. EVER.
Hard stop.
It is so tempting to use therapist boards for case consultation. You have an entire group of experienced therapists with wonderful advice. They are available 24/7. What’s not to love?
A lot.
Even when a group is private, it is NEVER TRULY PRIVATE. It is on a public platform and things get compromised all the time. I have seen people who have copied posts and comments from a private group interaction and posted them on a public facing post. You have zero control over what happens to information once you post it.
Even if you think you are not exposing identifying information, the minute you start talking about your case, you just did. No one else may be able to identify the person but chances are, if your client saw the post, they would identify themselves. It is NOT worth the risk to them or to you. It is also disrespectful to our clients and the safe space we hold for them.
Ethical practice requires us to consult but doing this on a public forum is a disaster waiting to happen. Instead, find a good consultation group or a colleague you can talk to cases about.
Keep your consultations private.
Here are some good rules to follow to help you maintain healthy boundaries:
When you are tempted to break your boundaries take a few moments to identify what anxiety is leading you to think you need to bend your rules.
When you start talking yourself into why it’s OK to break your boundaries, stop, breathe, and consult.
Have a referral list ready so you can give an intake call some names and numbers if they are not a good fit for you or your schedule is full.
As much as possible avoid making decisions on the fly, especially regarding client requests. It’s always OK to say, “I need to think about that, let me get back to you.” Take time to think it through and consult! Use your legal resources as needed. This is exactly what they are there for.
Have a plan for self-care in place from Day One. Be purposeful with your schedule, the pacing of sessions, what your max caseload is, how many sessions you can handle in a day. Don’t worry about what everyone else is doing. You need to maintain what works for you. Then stick to it!
To find out more crucial information about the steps you need to take when starting your private practice check out The Master Course, Everything You Need To Know About Private Practice But Didn’t Know To Ask. To get the same information in more affordable, bite size pieces, don’t miss the Mini Courses!
I love helping therapists build successful private practices! For more great information like this to help you build yours, make sure to check out the Master Course and the Mini Courses. I’m here to support you and I want to help you reach your dream!
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