Guest Post: Boundary Setting In Therapy
Surprise! This week I'm excited to share a guest post for the very first time. My colleague and friend, Lindsay Bryan-Podvin is popping in for a bit on boundaries for therapists.
If you've been following my blog this month, you might recognize a theme emerging here around how we stay true to ourSelves while also engaging with the world. This can be particularly challenging for those of us who have careers or identities that involve space-holding and care-giving.
I myself have learned so much from Lindsay about navigating fees and other boundaries with clients, and in turn I've been able to help my clients think much more strategically about their own financial health. So without further ado, I hope many of you - therapists, and maybe even some non-therapists - appreciate this knowledge drop as much as I do.
Boundary Setting In Therapy
by Lindsay Bryan-Podvin, Financial Therapist
Boundaries are the guidelines we create and communicate to others to preserve and protect ourselves. To paraphrase Cristien Storm, boundaries are about building relationships; not ending them. As therapists, we know the importance of helping our clients create and adhere to their personal boundaries. But what about how we, as private practice owners, set and communicate our financial boundaries?
As a financial therapist, I love helping other private practice owners get comfortable with strengthening their financial boundaries. This blog includes a list of different places where therapists tend to make mistakes and quick ways they can fix them in their practices. Doing so helps to protect their time and energy and models the importance of boundary-setting for their clients. When we set and uphold our financial boundaries, we show ourselves and our clients the importance of self-preservation.
Financial Boundaries in Therapy: Common Mistakes and Easy Solutions
There are five common financial boundaries I see therapists struggle with when it comes to setting boundaries in therapy practices. The good news is that there are quick solutions to setting and adhering to healthier money-related limits. There are two types of financial boundaries: literal and energetic. Literal financial boundaries include your fee, cancelation policy, and payment policies. Energetic financial boundaries include starting and ending your sessions on time, communication outside of sessions, and your availability. Therapists don't think of the value that their time provides, and they need to protect it as fiercely as they would other areas.
Mistake: A common fee-setting mistake is setting a fee based on feelings instead of facts. Many therapists base their prices on what they think they should charge, on what their colleagues are charging, and struggle to adhere to a sustainable fee structure. Many therapists slide their scale far too low to support their needs, leading to overworking, burnout, and resentment.
Solution: Instead of basing fees on arbitrary things, I recommend that all therapists figure out how much money they need to earn personally and professionals to thrive. Once they have that number, they can divide it by the number of weeks they want to work and the number of clients they want to see. For example, if a therapist finds they need to earn $110,000 per year (that'd be closer to $85,000 after taxes), want to take off 4 weeks, and see 18 clients per week, they'd take $110,000 / 48 weeks / 18 clients to get a number of $127/per session. From there, they could create a sliding scale where they see the majority of their clients at $130 per session, and offer a few spaces at $100 per session.
Adhering to the time container
Mistake: You struggle to start or end your sessions on time. Clients show up late, you struggle to set a boundary around your time, and your day is thrown off. You aren't practicing financial boundaries when you see a client for over an hour, but only bill them for a 45-minute session.
Solution: Let clients know your policy on showing up late, and let them know you end your sessions on time. If you have a client with a history of "doorknob moments," give them a warning about 10 minutes before the session ends that sounds like, "with our remaining time, is there anything we need to cover today?” or, “anything you'd like to be sure we address next time?" Get comfortable with firm signaling, such as saying "our time is up," and standing to open your office door if you are seeing clients in person.
Late cancelation fees
Mistake: Charging a cancellation fee feels like punishment. So to be a "good" therapist, you waive all late cancelation fees and no-show fees. But at the end of the month, you find gaps on your calendar from times when clients were supposed to attend sessions, less income than you predicted, and feeling resentful (at best) and financially anxious.
Solution: Create a late cancellation policy that feels good for you and your clients. Perhaps a 48-hour cancelation policy won't work if your caseload is mostly young parents. Instead, create a 24-hour policy. You can give your clients a "grace window" to show up a little late to your sessions if it feels good to you. Personally, I give my teletherapy clients 10 minutes before considering them a no-show. I find 10 minutes is generally enough to troubleshoot wireless issues or find the connection link.
Mistake: You've been taught you have to be available when the client is available and that leaves you working odd hours. This means you work most evenings, have a weird gap on your schedule mid-day, and Sundays somehow become a catch-all for clients who missed their sessions throughout the week. You can't plan for anything, or even take time to care for yourself.
Solution: Create a schedule that works best for your energy and needs. Answer these questions to help guide you. When is my energy best? What time of day do I do my best work? What days or times are most challenging for me to be present therapeutically? You may prefer to work Monday through Thursday and have 3-day weekends. You might like to do client-facing work earlier in the day and reserve afternoons for notes and other administrative tasks. Create a schedule that best suits your needs, and inform your clients of the upcoming schedule change.
Communication & Accessibility
Mistake: You forgot to set communication and accessibility boundaries when starting with a client, and now they think of you as their 24/7 on-call therapist. It's hard to enjoy your out-of-office time fully, and you fear you're creating a situation where clients can't lean on coping skills outside of your empathy and compassion.
Solution: Start by extending an apology for failing to set the expectation of when you will–and won't–be available. Let them know that their session time is when they'll have your undivided attention moving forward. Their communication with you should be for scheduling coordination outside of the session time. In the case of urgent or emergent situations, they should have other resources (of course, make sure you provide them with local mental health resources).
Financial Self-Care as Social Justice
Implementing and adhering to financial and energetic boundaries can feel a little strange. But as therapists, we are familiar with sitting in discomfort, and it's a good practice to practice our boundaries as we implement financial self-care. Upholding financial and energetic boundaries is an act of self-care.
To take it a step further, practicing financial self-care is an act of social justice. A part of social justice is economic justice, and therapists have to include themselves in that. Ensuring we have enough money to take care of our needs affords us the ability to practice spiritual, physical, and emotional self-care.
Lindsay Bryan-Podvin (she/her) is a biracial financial therapist, podcast host, speaker, and author of the book "The Financial Anxiety Solution." In her coaching practice, she helps therapists in social justice or of marginalized identities grow their profitable practices from the inside out; so they can stop feeling icky about money, and start setting and sticking to sustainable rates that allow them to grow their businesses in alignment with their values. She lives with her partner and their dog on the occupied land of the Fox, Peoria, Potawatomi, and Anishinabewaki peoples also known as Michigan. You can take her free Money Archetype quiz here to learn more about your money archetype.
Photo by Christina @ wocintechchat.com on Unsplash