Speaker A: Welcome to the Therapist Burnout podcast. Episode number 54. Hey, therapist. I am talking to you today about how to know if you should close your practice.
So I talk a lot with other therapists on console calls about if they should or shouldn’t close their practice. Sometimes they know like, this thing is shutting down, we’re done.
And then other times I, I find like, you know, there’s kind of waffling and really normal, really normal to not know if you should close your practice or not. But I just wanted to give you some, some tips and things to think through about whether or not you should close or leave.
Right. Maybe you’re in the position where you’re at a job and maybe you’re in agency work or you’re just like thinking of a departure from the field. So I wanted to give you some insights.
I this week, or last week rather, I was on the Selling the Couch podcast, which is a very large podcast. I was humbled to be asked to be a guest on that podcast.
And I just love Melvin Varghese. He is just awesome, just a wonderful human. Listen to that episode. If you want to hear a little bit of my story, you know, check that out.
I will include it today in my newsletter. And so if you’re not on my newsletter, by the way, I’ve included a link in there to my pen pal list and I write back.
So if you want tips on burnout or you’re thinking of closing your practice, then sign up because I’m right back, back. I’ll stop being weird. It’s January and a lot of you, if you’re in private practice, you are squarely in deductible season if you are insurance based.
And I didn’t realize that when I first started to practice that I needed to like check a deductible. So if you’re new in private practice and you don’t know to check a deductible, I hope you’re doing it because you might not get paid for like a month or two because you got to start collecting those.
I think last year on the podcast I had a whole series on its deductible season. And so I can. Yeah, so that was early on those episodes. 15. So navigating busy season as a therapist burnout concerns as we start the new year and a lot of therapists are seeing likely a surge in their practice in January, the holidays are over and people are kind of figuring out like, maybe I need to work on some stuff or I actually don’t have a lot going on in My life in January.
So let’s get some sessions in. Let’s work on the thing. And so I just remember January, February, March, really until the end of April here in Maine because it’s cold.
People were, you know, pretty steady in my therapy practice. So I just feel like we’re getting into that busy season. And if you need some tips for that, I have you.
Episode 15, check that out.
So I know a lot of you are probably, you know, looking at your caseload, and it’s just probably pretty heavy at this point. And also, you know, there’s seasonal stuff going on.
I struggle with seasonal depression. I don’t know if it’s diagnosable.
I just know in the past couple weeks I have not been feeling great and I’ve had little motivation, little energy. Maybe that’s just the natural nature of January in a cold climate, I don’t know.
But I had like an overwhelming just day where. And I was thankful it was just a day or two where I had an increase of depression symptoms. And I kind of fear when it happens.
You know, it looked like not really wanting to do much, staying in bed a lot.
And I struggled with that, like early on when I first went into menopause. I’ve talked a little bit about that on the podcast. Maybe not as much as I should, because I think there’s other female therapists that might be struggling with that.
Yeah, all the, all the life stage things. Things as a woman I went through as a practice owner. So having children and then dealing with my body being different, my mind being different, as a mother, and dealing with my own mental health concerns through that.
And then, you know, just in 2018, going through sudden menopause medically was a big shift to my mental health that also coincided in the winter. And so I know for a lot of therapists, they’re kind of bumping up against perimenopause in mid career.
And so I just encourage you, you know, if you need resources on that, I might just do a whole episode for therapists on if you’re struggling with this, here’s some resources.
So if you’d want to hear more about that, just let me know. I will do an episode.
But if you’re in practice, I think it’s important just to think about it. Okay. All right, let’s get to the crux of the episode. How to know if you should close your practice.
So the first point I want to talk to you about is, is it financially viable? I think a lot of times what therapists want to do is be like, I don’t know, I’m doing all the things and it’s just not making money.
I’m feeling like, not as great about it.
So we’re kind of vibing out how we’re feeling about the practice and maybe more about clinically what’s going on.
But I really want you to, like, look at the math.
Does it make sense for your needs? So that might mean you have to do some personal finance calculations, which I know is not our forte. I have a partner who, you know, pretty much manages our finances.
So, you know, I think we also went through a process in me leaving my practice where we sat down and came up with a number that I needed to replace income with.
And it wasn’t as much as I thought because my practice wasn’t bringing in as much as I thought. And maybe, and I knew because I looked at the taxes, you know, year in and year out, and maybe I was bringing home net revenue and I wasn’t always full time.
Just so I’ll just add that caveat. I was as full time as I could be in practice. Right. I, I think my top year I brought home K net, maybe it was 80k gross.
And so I needed to bring in 45k. And that number was very illuminating in many, many ways.
That, number one, I have a doctoral degree and I’ve been licensed for, at that point, nearly 10 years, so maybe eight years at that time when I was kind of considering this change.
And I’m making 45k net. That’s what I need to make. That’s what, that’s what I need to make. And that was a really big wake up call that I can do a lot of things for 45k, right.
I can be a librarian. I could probably wait tables and make that income. I don’t know if I’d like it. But like, there’s all kinds of work that I could be doing that I could feel great.
Like, just clock in, clock out, like office space, job. Like, I’ll bring my own stapler. I love you if you know that reference. So I just want to talk to you.
Like if you are not making the money you want to make, need to make, there could be lots of ways that we can make money other ways. Right. And it’s a whole mindset shift to get around it, to be like, okay, I’m leaving therapy.
What does that even mean? That’s a whole nother episode. I’ve done identity focused episodes on transitioning out of the career as a therapist. But if we’re just looking at the numbers.
Sometimes the math doesn’t math.
Right. Our practice is not bringing what we need. And so if we just sit with that number and figure that piece out, it can be illuminating a lot of ways.
So if it’s. We’re going to stay in the practice, then all right, maybe I need to really get off insurance panels that are low paying. Maybe I need to consider.
Consider, you know, charging more, increasing my rates.
Because the amount of energy that I am outputting is not the exchange that I feel like is commensurate with my skill and my ability at this stage of my career.
Think through that. And also with money. What do you want your money to do for you? Because I think in. When we settle into our careers, we kind of get into, like the Groundhog Day of life.
You know, I’m a parent. It’s, you know, people are. What are you. What are you doing? I don’t even know what I did. I worked this week. I took my kids to activities.
I don’t know what was the weekend? I don’t know.
I don’t know what I did. I play tennis every weekend. I do X, Y and Z.
So it’s really important to think about. I’m working really hard. What do I want my money to do for me? Yeah. And for me, I think that centers around my home, changes I want to make to our home.
And so I have, you know, a big goal I’ve talked about on the podcast of working towards a bathroom renovation. I think I’ve been talking about it for a year and a half.
I’ll probably continue to talk about it for a year. Cause we put solar panels on the house because you don’t realize until you live in a cold climate, your energy needs.
All right, this is like adult stuff, right? So we used to have a generator and.
Because when it’s cold and you lose power, like, you need to have an alternate heat source. I’m. I grew up in Virginia, and so, you know, we had a wood stove and there was water, but, like, I’m on a well, so when the power goes out, there’s no water.
And then it gets really cold.
So anywho, we got solar, so we could have, like, bad. I have, like, it looks like I have a spaceship in my basement. So if the power goes out, we have batteries here that will power our house so we don’t freeze in a power outage.
So anyway, that was important not to freeze, I guess. You know, I didn’t really see the validity in maybe doing like, that. But.
And then our deck went out. You know, things happen in a house. What are you gonna do? Life is expensive.
So I’m motivated by that, and my partner’s more motivated by vacations and experiences, and I like that stuff, but I’m happy to let him plan that. It’s cool. It’s fine.
I’m also motivated by just health and wellness and fitness. Athleisure.
I love my athleisure, y’all. Athleta has my number. They don’t advertise. I don’t advertise Athleta on this podcast. But, yeah, they. They had. They’re in my inbox a lot. They’re like, did you look at this?
And I’m like, yeah, I did. All right. So anyway, so I’m. I’m motivated by, you know, kind of my tennis and athleisure and all that stuff. And so think about what you want.
You know, what do you want your money to do for you? And if it’s not working, then I think that’s the first stop. How much do you need to make from your practice or from your job?
Number two, you are constantly dreading the work. And that’s a hallmark burnout. That is a hallmark burnout symptom, rather so. According to the World Health Organization, burnout is defined as a syndrome conceptualized by resulting from chronic workplace stress that has not been successfully managed, and it’s characterized by three dimensions.
Feelings of energy depletion or exhaustion. My top post was, therapists just want to work at Target, and that’s what they talk to me a lot. I am just done. I am exhausted.
I have nothing left.
Two, increased mental distance from one’s job or feelings of negativism or cynicism related to one’s job.
So clinicians talk to me all the time about being salty like they are.
They have clients or sessions where they just feel like, I am not emotionally present here. I am not wanting to be in this space. And I care, actually care a little less internally about the client.
And I think part of that is normal, you know, for us as therapists as we go along, unfortunately, know, when we start school, it’s like we’re like, oh, my gosh, I’m so into therapy.
What does this client need from me? And so you’re holding this space in such, like, an intense way because we’re new and it’s cool. Like, therapy’s cool. After we go along, you know, we’re just like, yeah, I need to hold part of myself back, because if I have that level of intensity in the caring that I’m doing.
Number one, it’s hard to, it’s hard to sustain like an eight hour day and not feel just depleted. And also I think just the role of trauma, right? I think we have mental distance because our nervous system is kind of primed to protect us.
So that’s one thing. And then the last one is reduced professional efficacy. So we’re not as effective maybe as therapists because of all of that, because we’re tired, because we are kind of cynical, salty about the work.
And I think sometimes therapists are scared by that. You know, they’re scared that I don’t care as much as I used to care. And I’m worried about my ability to be effective as a therapist.
It’s just something I hear. I think it’s, it’s again that classic burnout symptom, those classic burnout symptoms that are coming up for you that are unsettling, but I think normal for the type of work that we do.
Lastly, the point. I could talk about so many points today, but maybe I’ll just talk about these three.
Three just sounds great. The last one is you’re lonely. And this is one I didn’t really realize until later. Like until I left my practice and I started having co workers again.
Did I not realize? Maybe I did a little bit, but I just realized that I missed having coworkers. I didn’t have anybody to talk to at work.
I worked in solo practice and I had like an office mate for a while and that was good.
In 2020, I had someone join like my, my little office suite. I had two offices there and they actually launched in 2020 and closed like six months later. So I just think, I just feel awful for therapists who actually started in the pandemic.
And I’ve heard from a number of you who actually started your practice in 2020, 2021 and are just kind of now realizing that you want to close. So I, I just personally saw that from another colleague who I worked with.
It was just, it was just so intense and so quick to be licensed and then start a practice in 2020, 2021. So tough. But you’re lonely, right? You need co workers.
And I tried to do all the things too, right. I had a peer supervision group. We only met monthly.
Honestly, you know, I could have like, I could have called one of them up and had more consultation, but there was a piece of me not wanting to share everything related to how I was feeling either.
So to be vulnerable with really where you are as a clinician is also pretty tricky because I think we also want to be viewed as competent, that we still have skill and we’re not struggling to the degree where we’re questioning our ability to do the work.
So maybe some recommendations for you. So for the first point of being able to figure out if this is financially viable for you is doing some personal finance calculations. And so I love Ramit Saiti.
And so he has a podcast is. I think it’s. He changed it. It’s like Money for couples now. Whether however his website is I will teach you to be rich.
And he has calculators on there and that’s a more conscious spending plan. Anyway, it’s in his book I will teach you to be rich. I’ll find it and I’ll link it because it’s good.
Basically what it has you do is it looks at your expenses and your income and what you want your money to do for you. And also thinking about crazy things like retirement investments that maybe we don’t always think about.
So I would recommend his tool for your own personal finance. Yeah, I found it. So he calls it his conscious spending plan. And I’ll link that in my show notes so you can download that.
And it’s a really nice spreadsheet.
It is a time investment. But I recommend it place your spending in four categories. So fixed cost, so that’s monthly expenses. So just anything that’s kind of that you have on an ongoing basis, your rent, your mortgage and consider like a 15% buffer there.
And also your investments. So savings, your Roth ira, those types of things.
Savings is third and then fourth is guilt free spending. So things that you can spend on whatever you want, like your lattes, ordering takeout, my nails, all that stuff you can just spend and not think about it.
So when you allocate it, you can do that. So I really like his work and what he talks about. And so that’s kind of the system that my partner and I use.
So I will link that in the show notes. Also what I link often is the MIT living wage calculator. So a lot of therapists are not at that living wage calculator or not at a living wage.
So it’s kind of interesting to look at. So it will. You can look up exactly where you live and be able to see how much is a living wage in your town or in your state.
I’m doing it right now, so I’m kind of like giving you some numbers. So interestingly so, in my state of Maine, in my county with two children, which I have, they are saying that my living wage would be 3140, my hourly wage, and I guess that’s 40 hours a week.
And so maybe some therapists are making that, I don’t know. But then, right, if we are one adult and you have kids, like a single parent, that would be 58, 13 is your living wage.
And that’s probably like a W2 wage. And then it has typical expenses. And some of these are, you know, they’re low.
Right. So food costs, childcare, medical, those things. And so that’s kind of looking at a general, like fixed cost and what you can kind of expect for yourself. Okay, so my second point, you’re constantly dreading the work, and that’s your kind of hallmark burnout symptoms.
What I went over, I would have you really look at your week. What is depleting you? Where are those sticky points in your schedule where you need to maybe put some intervention in play?
I would recommend a break to figure this out. Whatever break you can take. Some people have the luxury of taking, you know, a month off, a week off. Maybe you say, I’m gonna take off a day and let myself kind of think through some of this stuff, really think about what is depleting me, how much money do I really need?
And start to make some decisions about your next steps. Three is you’re lonely and you want co workers. You are tired of doing this, doing this alone. You’re tired of being alone in your practice.
And there’s some ways to do that. I think that you could do that in community with other therapists. So there’s some. You.
I was part of a peer supervision group. Again, I don’t think that was enough. I think I really needed that touch point of seeing people every day, talking about vacations, talking about our lives, talking about our kids, those types of things.
So I really want you to think through this loneliness piece as a clinician and think through, does this meet your needs socially? Maybe it doesn’t. Maybe you are kind of an introvert and you have a really great ability to be alone at work and that works for you.
Or you are extroverted and you get your needs met socially in other ways. Right. So it doesn’t mean it like private practice does not work. You start over. It really is person dependent on what your needs are.
So how do you think I’d have you think through that? All right, that is your episode for today. I am going to be putting together a guide for private practice clinicians and giving them like a timeline of if they do want to close, how to look through that, how to think through, like, what is the notice I should give clients?
What are the things that I should be thinking about with termination, with closing everything down? I’m just not sure when I’m going to get it all the way together.
So I might talk next week a little bit about the timeline of when you should inform clients. And that’s going to be dependent on if you’re cash pay or insurance based.
But I’m going to give you some of my ideas about that. Okay. Have a good one. Take care therapist.
