Episode Transcript
Speaker 0 00:00:00 Hey, hey Shauna, A here licensed clinical mental health counselor. You are listening to the Business of Therapizing podcast. This is episode three entitled Set Up to Fail. Now, here's the show. You know, the more that I examine and think about the mental health industry and even my experience in the industry, the more that I think that it reflects an assembly line. If you think about it, you have young energetic therapist, and when I say young, I mean young in the field with the desire to make change, and you put them in a high acuity, fast-paced environment, and you tell them to perform this one task over and over again. That environment says you have to practice in a certain way, i e evidence-based models, and then you have to make a quota i e productivity. And eventually that clinician becomes so engulfed that they lose sight of what they envisioned and the creativity that they had stops flowing, the curiosity simmers, they become tired, burned out, and overwhelmed, and they're chasing the last time they felt like a good therapist.
Speaker 0 00:01:04 Most of the clinicians I have conversations with around their ideal way of having a sustainable career are often riddled with overwhelm, fair and burnout. And it's not like these feelings come from nowhere. This is the result of being told to fake it until you make it. When you get into the field having to mask who you are in order to serve as a therapist and being pushed through a one size fits all model of therapy business with high productivity and low reimbursement. However, there are three concepts that I use to shape these emotions and build my private practice with confidence revived and refreshed mindset. So let me explain more. So now I'm not gonna talk about crystals and sage and start talking about manifestation, although that's something I do do regularly. I'm just here trying to break down the haze that has fallen over therapists in the mental health industry.
Speaker 0 00:01:53 It's the same haze that has you believing that you didn't get into the field to make money <laugh>, and that most clientele only have an interest in one kind of service at the lowest possible reimbursement rate ever. It's the haze that led you to believe that your skills are non-transferable and limited to do only one type of thing. It's this same haze that has clinicians in a chokehold thinking that in order for you to be successful in the field, you're gonna have to sacrifice your wellbeing and time. It's got me trying to figure out how we even got here in the first place. So I want you to float back with me. Remember back in grad school when you were an eager student, young in the field and ready to help you learned all of the theories and the modalities, the ethics were fresh in your mind. You had your favorite professors who were full of prestige. This was a time when you could clearly see your future. You imagine yourself with an autonomous career working in private practice. Those times moved so quick, you graduated and you came into the field and you're ready to get your job. And then maybe it was at that point you realized that you couldn't even start your practice as an associate professional because of board rules,
Speaker 1 00:02:59 Or perhaps you didn't feel ready to start yet to build that private practice independently. So you decided to get your feet wet and get some experience in the field, whether that was through community mental health or through a group practice, whatever may be you found yourself working in community mental health or the big practices and they had a corporate mindset. And what you found was that in those places, what mattered most was the bottom line. You found yourself with a quota and a high caseload. The reimbursement wasn't all that great to begin with, but you figured you'll do this until you can make your shift. But not only was your caseload high, so was the acuity of your clients. So soon you began to feel overwhelmed because high caseloads also comes with high admin time in which you don't even get paid for. Now, you're here working all times in the night and on the weekend you don't even feel prepared for this acuity because you just got your degree not too long ago.
Speaker 1 00:03:53 And while you learned about cognitive behavioral therapy, you didn't have that much practice in implementing cognitive behavioral therapy. So now you're learning on the fly. What happens when you start calling out for help and you express that you're drowning? What do they say? Fake it until you make it. Sure, yeah. You try faking a swim to the shore and a sea full of hopelessness. How long do you think that curiosity that you had, that spark and that drive, how long do you think that could survive? And in the grand scheme of things, it seems like you were set up to fail from grad school. They didn't teach you any of this. You heard about therapy, but not how to apply it to actually do it. And while you had some practice in your internship, and that's great to do it in the real world is different.
Speaker 1 00:04:40 And on top of that, grad school led you to believe that you didn't have transferrable skills, that you were a blank slate starting from scratch. But in fact, you've always had the skills to pay the bills. You were just taught to mask it and pretend it wasn't there. Or worse, that what you already had was harmful and needed to be unlearned and new skills needed to be relearned. So when you enter the field, you're in this place of feeling like a novice, like you don't have experience or expertise or the tools that you need when you may have had them all along. And let's be clear, clinicians do worry about harming the people they work with, especially the ones who are already in a complex vulnerable state. So much so that they would rather become a cookie cutter version of themselves to fit the ideal model of a therapist.
Speaker 1 00:05:28 And it's this reason why outsiders are able to come in and profit offer the therapy industry. It's because clinicians have this idea that the traditional model is the only model. So it's no wonder why clinicians are exiting stage left on the therapy career altogether. And to be frank, some of us don't have the privilege to throw away all of the money that it took for them to become a clinician in the first place. We're not only talking about schooling, we're talking about licensure, we're talking about dues, we're talking about fees. We're talking about the extra classes, the extra courses that we took so that we could do the different modalities so that we could provide emdr, C B T, those quote unquote evidence-based practices. We had to pay for all of that. So it's hard to be like, oh, you know what? I'm done with this.
Speaker 1 00:06:15 We're gonna go get a new career. This is something that I see that's happening on a regular basis, and as I watch, I recognize that it's so hard to shake what the industry does to you as a clinician. And if you're lucky to start your own private practice, many people, many clinicians end up bringing what those corporations did to them into their own practice, and they either end up re-traumatizing themselves or they're traumatizing their employees. So I decided to break this mold and I decided to embody these three concepts because I knew that the way that it's being done is driving burnout and is causing harm by seeing more clinicians exit than more clinicians coming in. So here are my concepts. So one, we need to start seeing the industry for what it is and where it's heading. The mental health industry is a billion dollar industry.
Speaker 1 00:07:09 It's healthcare for profit, and the people at the top are often not clinicians. The service providers are being exploited, and there is a box cutter business model for mental health services. So they love talking about those evidence-based practices, but those are not the only practices. So this box cutter business model for mental health services tricks therapists into believing there's only one way to be a therapist, and that's trading fee for services. And in this model, people come in and they talk to a therapist and then they leave. They either pay their therapist through their insurance and pay a copay or they pay a private rate. This is a therapy based model and there's nothing wrong with it. It just drives productivity because in order to make a living off of this, you would have to see a certain amount of people and sometimes that amount may not match what you feel comfortable with doing.
Speaker 1 00:08:08 And here's the issue. There's currently a mental health crisis. There's not enough clinicians to people in need. So the more that you drive the demand and there's not enough people to cover that, the more you put clinicians in a position where they're juggling their wellbeing and their health to see more and more people. So where is the industry heading? There's a lot of talk about accessibility. People are having a very hard time accessing services either based on proximity or based on costs. So one thing that we can think about is that because so many need access to services, there's space to provide therapy in different ways. So some are exploring virtual reality, which is kind of cool, and others are deep diving into telehealth. And overall mental health services are growing beyond the traditional means and methods. So this tells us that we don't have to stick to what it is.
Speaker 1 00:08:58 As a matter of fact, we should be considering stepping out from what it is and offering other ways to provide care for the people that come to us. In order to do that, we have to think beyond where we are. We have to think beyond what it was. The traditional stuff worked traditionally, but now we are in modern times where things are moving faster than we could have ever imagined. So we have to catch up to the pace that is happening at this point, and we have to do it quickly. As clinicians, we have to understand that all of gi, all of this gives us the abil, the ability to recognize that there is more beyond what was taught to us and where we're stuck at. There are multiple ways of being a therapist, and once you step out of the box, you have many, many possibilities.
Speaker 1 00:09:46 Concept two is what I call focus in. So you're focusing in on what you're doing and what you've envisioned. So yes, you're a therapist, but are you doing what you desired? When you think about what it is that you wanted to do as a clinician, are you doing that? Let's go back to grad school for a minute. Were you truly a blank slate? I know I wasn't. When I started grad school, I had already been working for years at that point. When I graduated college, I took a year off before I went to grad school and I was working in childhood education. My degree was child and family development. I was a preschool educator. So when I look at the skills that I brought into grad school, I wasn't a blank slate at all. And many clinicians already had skills. Many clinicians had the desire that looks nothing like where they're at today, and that's not in a good way.
Speaker 1 00:10:42 You spent so much time faking it that you're starting to believe that the fake you is actually the true you. When the truth is closer to the idea that you probably need a smaller caseload or that you're not really a big fan of the evidence-based practices that you're performing, or perhaps you recognize you want to walk and talk during therapy or even work out and process, and you constantly play the idea of is that possible as a clinician, and I'm asking you who says that it isn't? Why do they say that? It's not. When you start to look around and you start to realize you were once a full of curiosity and ideas, and now they've fallen away so that you can practice this cookie cutter way of being a clinician all along, you begin to realize you were pretty connected to what you wanted to do, but you were shaped by a discouragement.
Speaker 1 00:11:34 They told you, let your niche find you. So now you don't know who you wanna help because you've been out here waiting and waiting and waiting for this concept to show up at your footsteps when really you probably knew they told you that you had to do therapy in a certain way. Even if you have a narrow divergent mind and see the world differently than the traditionalist, does that make you less of a therapist? No. Does it fit the traditional model? It doesn't. Does that mean that there's no room at the table? Does that mean that you can't be a clinician? No, it's actually quite the contrary. And this leads me right into the third concept. You have the skills to pay the bills. Perhaps the biggest disservice to clinicians is them forgetting that you already had skills when you entered grad school. You had knowledge, you had expertise, you had skills.
Speaker 1 00:12:21 You were just supposed to be fortifying it, which were grad school education. Those skills, those experiences, those knowledge, which you know is in fact what makes you a great clinician to begin with. But when you're recovering from bon, your confidence is shot. You believe that you need to learn more about what you already know how to do. You believe that your clientele is a monolith, or they'll only purchase therapy at a certain rate rather than seeing people in various stages of healing. You see them singularly. They're only in this one stage and it's, I need therapy stage versus a continuum of getting care. But if you're in various stages of healing, that means how you care and engage in mental health will vary. Not everybody will enter therapy. Some will buy books, some will journal, others will engage with products that help them maintain. Stepping out of the session only model and tapping into the various stages of your clientele is what gives you the ability to use your skills in various ways.
Speaker 1 00:13:19 No one has to teach you how to answer questions and find patterns and behavior. You already know how to do that. You've already been practicing that. As a matter of fact, you bought all the books and courses about this already. You, I bet you some of you out here looking at certifications, talking about how can I be a coach? You're a therapist. You know how to be a coach. And some people are not going to like that because it's two different business models. But the truth is, the skills are transferable. You have the skills. You are just led to believe that you cannot apply those skills. You're led to believe that there's only one way where there's multiples. And that healing is this one thing that you do in this one place versus a discipline and a continuum. When you tap into that, you tap into a world of possibilities.
Speaker 1 00:14:11 It's a setup. And maybe that wasn't the purpose of it. Maybe the purpose of it was to put more people in the field so that they could provide help. But along the way, they tried to push therapists so much into the field that they left out some lessons. They didn't teach therapists how to operate a business. They didn't teach therapists how to actually sit down and determine what modality would be a fit for their person. So they've taught us in a way to say, yeah, do what modality works for you. But they didn't say, Hey, by the way, some of these modalities are probably not going to work. They're not a one size fits all kind of thing. You have to find what jobs well for the people that you work with. You have to find the issues and then see how you can apply the modality to those issues.
Speaker 1 00:15:02 And hey, by the way, there's this whole concept of niche and getting focused and figuring out what you wanna do that you probably should learn, but we're gonna wait until you're burned out and you're like, I don't like this no more. I'm leaving. For us to be like, oh, you know what? You could find a need. None of it makes sense. It feels like a setup. And I wanna say like it feels like it's happening to us individually because a lot of us do, when we talk about therapy, we're talking about therapy from an individual standpoint or an unit, right? So like we have this one singular family, we have this one person coming to individual therapy. We are not talking about it in terms of community. So we often approach it from a individual standpoint. I'm burned out, so I'm leaving. I'm burned out, so I need to raise my prices so that I can see less people.
Speaker 1 00:15:54 And what I argue here is that the answer is a collective one. It's a group project. So it's not just let me fix my prices, it's let me refresh myself. Get revived, start networking and start getting focused. Because if one of you say, Hey, my area is parenting, and another one of you say, Hey, my area is infidelity, and you work together, guess who has another referral source? And let's say the parenting person works with the infidelity person and they both work with a person who is incorporating healthy eating habits and holistic therapy and nutrition into their things because they have the skills for that already. And all three of you work together. You have a network of referrals. So now you have people that are accessing a variety of services, not just mental health therapy. They're accessing the person with the book, they're accessing the person with their own parenting program.
Speaker 1 00:16:58 You have people accessing care on various levels from refreshed clinicians who are having a sustainable career, so they have longevity. If you are ready to make the shift, if you are ready to revive your career, if you are ready to have a clinician refresh, join me for the 10 Day Clinician Refresh Challenge. It is a email challenge. All you have to do is sign up. You can sign up by visiting www.thedelightfulclinician.com, or you can just type in the delightful clinician.com and click on the Clinician Refresh challenge. Let's get you revived refreshed so that you can start looking at your career differently than you have been looking at it up until now. I'll see you there. Until next time.
