Speaker A: Welcome to the Therapist burnout podcast, episode 56. Hey, therapist, welcome back. I am talking to you again about my private practice closure guide. So, yeah, it’s taken me about a year to kind of figure out how should a therapist close their practice if that’s their.
Their decision?
So last week I talked about the timeline, but when I talked about the timeline, I thought I left out a step. I’m like, let’s get to, like, pre contemplation. So if we’re thinking of motivational interviewing, so let’s just bring up all the motivational interviewing steps.
Okay? Most of the time, when I work with therapists who are closing their practice, they are in preparation or action phase, right? So if our stages of change model for motivational interviewing is pre contemplation, contemplation preparation, action, and maintenance, I like to think of that because a lot of you guys come to me on consult calls when you’re in really either like, contemplation stage or sometimes pre contemplation stage of closing your practice.
All of the people I’ve worked with as therapists who have closed their practice have a level of burnout. So burnout is happening. And a lot of times, I think I had written this post this week, Squirrel Brain is happening.
I had a plan, and then I turned to Squirrel brain. Jen, I’m so sorry. Okay, so this week I posted so Melvin Varghese. I’ve been talking about being on that podcast early in the month, and he had posted a video of me on there.
And I wrote this little summary based on listening to another podcast about burnout Creep.
So for therapists, I think a lot of us, burnout just doesn’t happen, right? It just. It’s like one day we’re, like, happy in our little cozy practices or in our therapy jobs, if you’re still an agency or you’re working for a group practice, you know, for my folks across the pond, it can be the nhs.
So perhaps you are in that system, whatever system you’re in, and you’re doing pretty well. And maybe you’re like, I’m starting to be more tired. And I just don’t know if I can really keep going this way.
But I think we don’t really realize it until we literally burn. Like, we literally cannot do this work anymore. And that is typically most of the consult calls that I talk to therapists on, they cannot do this anymore, and they don’t know what it is they need to do.
They’re like, jen, please help me.
What is the job? I can do what is the thing I can do with my practice to kind of make it work? Actually they’re not asking that. They’re, they’re saying what jobs can other therapists do?
Or it’s mostly like escape hatch stuff. Right there. You guys are trying to this. I was the same way. So it’s not just you. It’s a common human thing. Our brains are telling, screaming, literally screaming.
I can’t do another day of therapy anymore. We’re done. But you keep making a show up to this office every day, sit here for eight hours and I’m picking my cuticles, my nails are bleeding.
That’s this, that was my body, that’s my story. And we need to get out. So your brain is constantly. I’m hitting my mic because I’m getting passionate constantly trying to figure out a way out of this.
And so we, it’s like we’re not in our logical brains. We’re not in a place where we can make these great rational long term decisions.
So I need you to get out of burnout before you make a long term decision about your life.
If I can tell you anything that it would be that please don’t make. I am going to start a new career decision. When you are burnout and you need to leave your job.
It is not the time for that. If I can say anything, it would be that I’m hand clapping because I think a lot of people are looking for simple solutions to years of chronic stroke stress.
And if we have years of chronic stress, it’s going to take some time to figure that **** out. It just will. And so for me to give you a simple solution like, oh well, I, you know what it is, you’re going to be a librarian.
I knew it. All the therapists are becoming librarians. That’s the job that’s going to work for you. I’m getting a little, I think I’m getting a little passionate about this because that’s the questions I get.
And I know why, I know why you’re asking those questions. I think it’s just because it’s. I was in fight or flight, literally, I needed to find something else. And when I found something else, which is what I’ve been doing for the past 2ish years, I’ve been working contract doing evaluations.
That’s how the majority of I make, that’s how I make my income right now. It’s not super like I’m not an employee, right? So they can not renew my contract.
That’s something I face every Single year. And I’m telling myself this year I’m not doing it again. Like either I don’t know, this business that I’m running for the burnout stuff gets bigger or I do something else.
So I’m kind of like right where you guys are, where I’m needing to make some decisions for my career. So like I said earlier, if we can’t make these long term decisions, then what do we need to do?
So if you’re in burnout, if you feel the way that I’m talking about right now, please get support for your burnout, for the chronic depletion you’re under. What does that look like?
That can look like therapy. That can look like going to see your doctor. That can look like, look like figuring out how to take the micro breaks you need throughout your day so your nervous system knows that you’re not in danger right now.
Your body, if you are feeling the way that I’ve talked about, if you were telling yourself like on a console call. This week someone told me, I hate my life, I cannot stand it anymore.
And this, it makes me emotional because number one, I’ve been there. But number two, I am just very passionate that work does not have to take our whole being anymore.
And that is like the line that I drew in the sand with my practice because a lot of it was my own making, right? I thought that to be a therapist I had to give all of myself.
I had to throw myself into the work when I needed to do less, I needed to take on less. But I didn’t see a way to do that without burning myself out to make the money I needed to make.
And that is right there is the crux of what we face as therapists. We want to do this work, we were drawn to do this work, yet we can’t do it in the way we want to do it.
Burnout recovery really looks like that deep self care. And I, I use, I’m using self care now, but it is the caretaking of ourselves and that is, it is different from simple self care.
So it’s know your body knowing basically that it’s safe when you’re working, that you’re going to take care of it, that you’re going to pee when you need to pee.
As Kate Donovan says on the, on the Fried the Burnout podcast.
But really thinking about one of my mantras is this year I’m working at a human pace, a normal human pace that humans were like designed to work at. I think in our digital world, anxious generation, I Think hit me so hard over last summer when I read it.
Just the impact of the media and just the digital nature of our lives now. We are constantly on. We’re constantly. Our brains are constantly working, so they’re looking for an escape because they’re not getting restricted.
And so this year, I’m really thinking about working at a normal human pace and allowing myself to rest more. So anyway, I. I don’t. Don’t have it all figured out by any stretch of the imagination, but I’m sharing what I’ve learned and what I’m learning because I’m still in burnout recovery.
As I sit here talking on this podcast to you, it is very much messy middle for me, and that’s what I’m realizing at the start of this year.
So I have been dealing with some depression, and ever since I, you know, I’ve talked about this on the podcast, but I have gone through medical menopause in my 30s, and so ever since then, I’ve dealt with depression.
I also dealt with panic attacks, which I talk about. I’m like, I don’t know. You can have my whole mental health history. I don’t care. But, you know, I live in a cold climate, and it does hit me hard.
And so I need to figure out how I can navigate this time of year in a way where I don’t feel like I hate my life either. So what I want for you, therapist, is that I know it’s possible because I’ve been in those places where I’ve hit that sweet spot again, where I’m like, I feel like I can leave work at work.
I feel like I can breathe easier, and there’s just adjustments we need to constantly make for different seasons or different times of year. For me, it’s like January in the state of Maine in the United States where it’s cold and we’ve had a pretty cold winter.
Maybe that means I need to leave and make sure I go every February down somewhere warm. Anybody who wanted to invite me in Australia for the Australian Open and host me, you want me to speak at a conference.
I’m coming because I’m a tennis player and I love the Australian Open. So please have me.
I’ll come.
Just buy me a flight. Anyway, I say it in jest, but maybe this podcast can make me go to Australia in January because I can’t stand it here when it’s so cold.
And I’ve always wanted to go to the Australian Open. So if there is some way this podcast can get me to the Australian Open.
I would die. I would just. It would be wonderful. Okay. Okay. So if we know most of you guys are at that place, I just feel like I just needed to back up the train and say, summer, you are here.
And that is why you’re spinning an indecision. Because your brain is constantly trying to figure out a way to feel safe. And so those simple things that we do very simply, like allowing yourself to take more time in the shower.
So simple.
So simple. But it’s those micro moments where our body’s like, oh, we’re actually safe right now. We’re not rushing. We’re not going from thing to thing. We’re taking time to have a slow morning.
So on Mondays, I’m going to schedule a slow morning for myself because I don’t have any other slow mornings any other day of my week.
And so that’s something I’m putting in place. Not necessarily this Monday, but it’s coming.
I’m also gonna stop doing consult calls and just I’m full for burnout clients for a while until I figure out this next chapter of my working life and how to get more of a break.
So for you, I really want you to think about what can I let go? Often need to think about what can we let go before we put something else in.
So if you’re asking that question about what’s next, I would say start to give yourself more space. So there you can start to think about the next thing. Because you can’t do it in depletion, and if you do it in depletion, sometimes it’s like survival.
You have to do it right. Like, I took a job initially and then I closed my practice. That’s what I did. I’m not saying you can’t do that. I’m just saying you have to think about those things.
You’ll need on the other side of it too. But it is so totally possible. So I just also want to instill so much hope. So last week I talked about step one of thinking about your timeline for closing your practice.
And I just want you to think about so backing up to that. So if you think about your timeline from step one, this could apply also to some job that you’re working.
So if you’re working for a group practice, if you’re working for some agency, wherever you’re working, you can just kind of apply those principles of looking at your contracts, of thinking about if there’s payers that dictate that you have to stay a certain amount of time.
Usually if it’s you’re, you’re contracted with the government or whatever, they have it right there about how long that you need to give notice, which is 60 days, 90 days, 30 days, I don’t know, whatever it is is however many days you do that right, and you make a plan, you set your date and then you start the process.
So if you’re working for an organization, they probably have some policies and procedures about how to terminate with clients. Now you can choose also to think about, do I want to take longer for my clients?
That might be sticky for some of the places you work because maybe they’d want to, like your clients might want to leave sooner. And the agency or the company you’re working for may not love that.
So I think you have to think ethically through. Do I want to do something differently based on my own personal ethics? Which is totally fine. You’re, you’re, you’re a professional, you can do that.
So for those who do have their own private practice, I’m just going to go over step two, which is informing your clients. And that’s based on my closure practice guide.
I will put the link to that in the show notes. So go ahead and grab that if you are in private practice or I think some of these things are actually going to apply if you’re thinking of leaving the field.
So think about this, especially for this particular part. So according to nearly every ethical code that I reviewed, I’m a psychologist, so I definitely go in depth over my own ethical code.
I always recommend you seek your own consultation with your liability company or a lawyer or in your area, because that might differ depending on your local laws and regulations. So do that.
But generally there’s no beset time for predetermination counseling.
Pre termination, not determination, determination counseling. But ethics dictate that we provide enough time to make referrals and provide a continuity of care. I’ve seen some things so the social worker website, so in see y’all, I don’t know social work, but anyway, their site says, I think I talked about that last time, says 60 Days.
For thinking of closing your practice, I recommend 90 Days.
And I think that’s for a couple of reasons because number one, there’s also like, there’s like a ton of things to do.
There’s a lot to do in 60 days to close down a practice, do all your termination sessions and close a business down. If that’s also what you’re doing, give yourself more time, give yourself 90 days.
If you’re able to, that would be great. Again, I’ve done. I’ve seen people do it shorter. So it’s not. It doesn’t mean that you can’t do it. It’s just what I’d recommend for your own mental wellness.
So step one, you’re going to inform any new potential clients of your closure date. And when you’re no longer accepting new clients, you can set that up on your website or where you market your services.
A lot of people use like, Psychology Today here or Therapy Den, I think people are using, like, I’m kind of out of the loop with that, y’all. But, like, Mental Health Match, I don’t know what people are using anymore.
People are saying bad things about Psychology Today lately. And just a sidebar. So Psychology Today, which we use in the US I don’t know what y’all use across the pond or down under.
That’s. That’s where they’re at. My international folks typically are for to like, market yourself, but Psychology Today is based in the Cayman Islands. And I remember my bank sending me an alert twice that my money was being sent to the Cayman Islands.
And they were like, that’s shady. So I don’t trust it. I don’t trust it. So I don’t know what you guys are doing. You know, this gets tricky. Like, if you’re working for a company and you decide to leave and you ethically don’t feel okay not informing a client that you’re going to be leaving, but you’ve informed your company and your company’s like, oh, but you can take on new clients until 30 days before your last day.
So maybe you told them, like, give them a 90 day notice. And then they’re saying, actually, you can still take on new clients until like a month before you leave.
And you don’t feel okay with that. I think it’s just important that you figure out what you feel comfortable with. And informing your own clients, like, your ethics trump their company.
So you can say, well, my personal ethics will dictate that I am going to inform my client and give a reasonable timeline for termination counseling. So I think you can definitely push back there if that’s what the company is telling you based on your own professional ethics.
All right, so step two. So back, back to step one. So informing any new clients. Some people just have, like, I’m not accepting new clients. So you can put a general like, I’m not accepting new clients on your webpage or on whatever.
And you don’t have to say, like, the practice is closing, effective date, you know, 90 days from now if you’re not prepared to do that. So just think through that.
Think how you want to advertise that way. Step two, Inform your current clients about your closure with a date and information about referrals or termination counseling.
So provide a written letter. I recommend a written letter and send that via mail. Or I’m seeing a typo, not a test alert on my form, but a text alert.
Dang it. All right, A text alert to check their portal for a portal message. So if you have a EHR that has a portal and they can log in confident you get confidentially, then you can pop that in your portal and do that that way.
Some clinicians opt to tell their clients in person and give that letter in person. That’s what I did when I closed. I had a pretty small private practice, so it could be very challenging for a medium to large practice.
So I think you have to consider your size and consider doing the letter or something of that nature. If you have a group practice or have a larger practice where someone in your town or in your area might get wind of your closure and then them feel like, well, why didn’t they tell me?
I mean, I didn’t know. That’s weird that you know, but I didn’t know. So I would just think through those decisions and that actually happened to me where I met with a client and then that client told another one of my clients that knew them through somebody that I was closing.
It can get tricky, get tricky. So just think through that. I also provide templates for my one to one clients and letter as well as scripts for closure with clients as it can be a very difficult conversation.
So I’m going to go over some scripts next week for how to inform clients that you are closing or you’re terminating. So I’m kind of go over like I’m leaving.
Here’s how to tell your clients in a way that you can feel good about it. All right, I’ll go over that more in depth next week. So I think as a clinician you need to think about your own countertransference reactions.
I felt like it was just, I think one of my clients recently said, my therapist client said this feels really liberating and also completely awful at the same time because you’re ready for that change, you’re ready to move on in your life at the same time you’re having to say goodbye, you’re having to grieve the thing that you built, your practice, your role as a therapist, all at the same time.
And that is really the most difficult part of the work that I do with my clients in burnout coaching and helping them close their practices is figuring out how can they manage that grief they feel.
I think just knowing that for me, instilling a lot of hope in them, that at the end of this, you have really thought about this decision. If you are wanting to get out of the field of therapy, if you are wanting to close your practice and do something a little bit different, you’re not going to regret it.
You are not going to regret it at all. You’re going to have so much less stress. I just tell them, like, imagine a situation at the end of your work day.
You get home and you’re not mentally fatigued and have brain fog because you were literally concentrating and listening and holding emotional space for someone all day. What would that even feel like?
And a lot of my clients can’t even imagine it. They’re like, I don’t even know. Like, it’s like a pipe dream. Who knows what that’s like? But it’s on the other side of this.
So I am there constantly reminding you that you don’t have to hate your life. You can build a life that you can be at least okay with. And let’s get crazy about enjoying some of your work days.
Crazy talk, right? Crazy talk. But it can happen.
All right, So I provide templates to my clients for these letters and scripts for closure. The things I want you to think about, and I put this in my guide, is the letter should contain the essentials of the closure date, the information about predetermination counseling.
So how they can access that with you. Like, I’m going to. I can offer sessions until this date, referral information and information about on a release of information to obtain their records and also provide an address for future, future record requests.
All right. And step three would be to inform previous clients. Again, check with your state board wherever you are internationally, not in the US Figure out what you guys do.
I don’t know what y’all do. Figure it out. Some states require notification of practice closure and where clients can access their records after your closure. Some require that in the newspaper because we’re all picking up newspapers, right?
In 2025, we’re decid picking up newspapers, looking for practice closure notices so I can get my records. But the law is still there, so we still got to do it.
Do you know what I figured out? I did not realize till just this week that I have to maintain a treatment summary in the my state on all of my clients for 15 years, my mind was blown.
So I just want you to make sure that you’re calling your board and making that part of your process so that you aren’t surprised, because I was. I thought I did my due diligence, but maybe I overlooked something in my craziness of trying to close my practice.
It was all a blur. So I’m mapping out these steps for you. So in your craziness of closing your practice, you can just go back and look at it and say like, okay, I need to go back and check this.
This could be like an after you close thing too, where you inform previous clients, by the way.
Well, no, I’m sorry, it shouldn’t be after. You should be doing this as you close, letting them know they can find you somewhere, right? If you’re going off offline, they have to be able to find you somewhere.
When I consulted with my liability insurance carrier, they recommended that you are easily findable for the whole length of time you are required to store your records. And for me again, that’s 15 years with my treatment summaries.
So I have 13 more years of record storage to do and then write a letter to previous clients about where they can access their records or have them transferred and how they can contact you moving forward to access their records.
I recommend that clients you’ve seen in the last two years from the guidance I’ve read through the APA and various ethical resources that you inform them via letter. And it’s fine if you want to do so for any long term client.
So if you had a long term client but you haven’t seen them for a few years, maybe you do want to issue that letter just so they are aware of your practice closure.
So this would apply again for folks going through retirement as well. So I find that this could be helpful to you. All right, that is all I have for you today.
Again, I am going to put the link in the show notes to your guide. I’m going to talk a little bit more about how to say goodbye to clients. I might start out more general.
I might post on LinkedIn this week. So find me on LinkedIn. Jennifer Blanchette, two T’s and an E host of the therapist Burnout podcast. That’s me if you find me.
And I’m going to post about, you know, what were your favorite ways to termination. So maybe we’ll talk a little bit generally about what are some of your favorite ways.
I went back to this. My one of my favorite terminations was as a intern and I was co facilitating a process group with another clinician. And it was just this beautiful termination process.
And we gave each other little cards. We wrote cards for every group member, and then we read that to each person who was there in the group. So I. With most of my clients, I wrote them a card and I read the card to them and then gave the card to them when they left.
And it was just so beautiful and meaningful. But there’s so many ways that other therapists might have. So I’m going to put a post on LinkedIn about your favorite ways to end therapy with a client and give us some ideas, because this closure process, while it feels really overwhelming, I don’t want you to miss out on some of the beauty that I found in those last sessions with.
With being able to really end well with clients. And I felt really good about a lot of those sessions.
I really did. There were a couple that felt icky. They just did. They just.
Yeah, and that’s just gonna be. That’s just gonna be that way. Some sessions just won’t feel good. We can’t expect that. So that’s what we’ll do next week. And then I’ll probably just have.
There’s one part in this guide about closing down your business. I don’t know if I’ll podcast on that, but I’ll just have that in the show notes for you. And I’m going to reference back this guide.
And I think also as part of this series, I’m going to talk about the emotions of closure, the emotions of termination for the therapist, because I do not see enough guidance anywhere on this on how we’re reacting to the work, if you’re going to leave therapy or not.
I think it’s really important if you’re staying as a therapist to think about the reactions you’re having about keeping clients who you struggle with in therapy when you feel like you cannot make any more progress.
You’ve consulted, you’ve done all the things you’ve tried, the different modalities. You’ve thrown the therapeutic kitchen. Chicken. Chicken soup, kitchen sink. Oh, my goodness. I’m gonna keep that in because you guys are probably laughing at me.
That’s good. Keeping you entertained. All right, have a good one. Bye.
