Working on the business, working in the business

Mar 16, 2016 by Ann

The title of this post is about working in a new private practice, but don’t let that fool you.  The same principles apply to your post-graduate internship, if that’s where you are in your journey.

Building a practice or starting a clinical internship is like walking a tightrope.  Both require thoughtful balance of working on and working in.

If you’re just starting out internship hunting or hanging out your shingle, it’s easy to get swallowed up by all the job-hunting or business-building to-do’s you keep reading about online.

You’re working on the business, getting it up and running.

You’re working on the job search, tailoring cover letters and resumes.

You aren’t seeing many (or any) clients, and you miss that terribly.

If you’re in established practice or in the thick of internship, the opposite problem is true. 

Your appointment book is so full, you’re having a hard time finding time to do anything other than see clients.

You’re working in the business, seeing clients back to back for days at a time.

You’re working in your agency job, trying to figure out when you’ll see the 3 new people your boss just added to your caseload without warning.

Let’s talk more about working on and working in.

Working on– waiting for the phone to ring…

If you’ve ever set out to build a private practice, you’ve had the problem most of us face—loads of things to do but no clients to see.  This is so hard.

You’re doing a lot of work that feels thankless at the beginning—

choosing a business structure,

finding office space,

ordering business cards,

cultivating referral sources,

getting on insurance panels.

And doing the work you most love—sitting with clients—can feel very, very far away some days.

In those cases, you can’t pull clients or appointments out of thin air.

So, how do you feed that need?  Two things—

• Turn the attention and compassion you’d offer your clients toward yourself. 

Set aside some time for good self-care practices.

Journal, meditate, get outside.

Do all the homework-y sort of things you’d encourage your clients to do, if you’re a homework-y type therapist.

Take a little time to reflect honestly and openly on your feelings each week.

Hang out with people who are emotionally nurturing and supportive.

Give yourself permission to fail, to feel uncertain, to not know the answers.

Added bonus—all this stuff will make you a better therapist.  If you’re struggling to justify this practice, think of this as an investment in your future clinical work, to be able to practice what you preach.  And also consider talking to a therapist about why you struggle to “justify” being nice to yourself and setting good boundaries.

• Give yourself permission to step away from the business/job hunt, etc.

I cheated a bit.  This is #1, but being really specific about limit-setting as a crucial form of compassion and self-care.

In building a practice, the work is never done. 

This limit-setting is especially crucial if you grew up in a household that taught you that you could play once all the chores were done.  There’s only so much work you can do at a time before your brain goes fuzzy.

This is true of clinical work, administrative tasks, and certainly applies to new skills you’ll be learning as you go about setting up a new business.  If you’re working yourself harder than you’d work an employee under your own supervision, you’re doing it wrong.

So, if you’re spending hours and hours working ON the business—setting up all that infrastructure is exhausting work!!—really make sure you’re stretching that “working in” energy by taking good care of yourself, limiting the scope of your to do list (and your work week), and being a good boss to yourself.

Working in–booked into a corner…

If you’re waiting for the phone to ring, getting booked into a corner with appointments sounds like a great problem to have.  But it does present its own set of challenges.

When I see clients, I think of it like picking fruit from the tree.  I enjoy those hours—it’s why I became a therapist.  But if all you do is harvest those hours, you’ll eventually end up with a bare tree.

If you’re doing really excellent work, you may continue to get referrals via word of mouth from satisfied clients.  But there’s all the other, less glamorous work that needs to happen to keep your business running.

There’s billing and advertising.  Those blog posts you’re supposed to write.

And continuing education requirements, let’s not forget those.

This is true if you’re building a practice, completing your clinical internship, or working towards your master’s degree. 

I know of many people who are so busy working on getting direct hours during internship that they haven’t taken time to plan their next steps.  It’s a very, very easy mistake to make.

So, how to find time to work on the business?

• Consider outsourcing. 

It’s totally justifiable (and smart) to hire someone to do some of your work if there’s overflow.  While it will take additional time and effort to get the right person on your team and teach them the ropes, once you’ve done it, you’ll get to enjoy the flexibility that comes with not being the only person who knows how to do all the things (aka, the burden of competence).

This is why people pay to attend my workshops on internship.  They are outsourcing the effort and time and energy it takes to learn the hoops you have to jump through to get your license, find a job, and secure a supervisor for internship.

• Schedule it.

Schedule certain work that tends to get pushed off your plate.  Put the time in your planner and treat it with the same respect you’d treat a paying client.

If you’re already booked into a corner, this step won’t be of much help in the short-term.  But, the only way to get where you want to go is to know where your destination is.

How many clients do you want to have a week in your practice?  What is full, and what’s too full?  Be really clear and specific about how many hours a week of billable time that is.

Be really honest about how many hours the other parts of your practice or internship require, and account for those when you’re looking at your weekly schedule.

Otherwise, you’ll constantly be feeling the pinch of too much to do, not enough time, because you weren’t honest with yourself about all that needs to happen and how much time you have.

Working on, working in.  Both are important! 

Are you an intern or new business owner coping well with the stress of new beginnings? Share your tips in the comments!  Are you overbooked in private practice but still managing to get it all done?  Let us in on your secrets.