Therapists: This One’s For You…
Are you a therapist who is hoping or trying to build a private practice?
Therapists tend to be people who deeply want to help others. It’s literally called a “helping profession.” It’s a way to make a living while making a difference. And while most of us choose this line of work for primarily idealistic reasons, it’s not easy work. It’s gratifying, but often draining. And many of the jobs don’t compensate as well financially as they do personally. Eventually, some clinicians begin to crave the freedom to work for ourselves, set our own rates, and build our own reputations. For many practitioners, going into private practice is like the “holy grail” of making a living as a therapist.
But the idea of being essentially a freelance service provider can be scary. We can feel like we’re at the mercy of “luck,” competition, and the unpredictable flow of clients. If you’re moving from a steady, salaried position to self-employment, it can be a daunting step to take. Working for an organization may be limiting, but it’s more stable and reliable. There is more training and preparation in graduate programs for that sort of work. I don’t remember any classes teaching us how to tackle the business of starting or running a practice; despite the fact that some of the professors did so while teaching.
Some brave souls may quit their day job and go all in. Others will open for hours on the side until they fill up. Still others may start working under a more established therapist or practice and then segue out. There is a lot of skill that can be learned at clinics, hospitals, schools and agencies where most practitioners begin working. But when it comes to building your own practice, some questions arise in different ways:
How do you generate referrals?
How do you set and raise your rates?
How do you conduct the first point of contact- the phone call or message from a potential client?
How do you determine if you can be of help to this client?
How do you formulate and communicate your policies, confidentiality, and boundaries?
How do you determine what information you want to gather at the intake?
How can you establish rapport with your clients so that they feel safe and confident to continue working with you?
How can you empower them to continue therapeutic work and healing between sessions?
I learned much of this (and continue to do so) from trial and error, and a nice amount of supervision, over the years. So I know how challenging it can be, and the self-doubt that precedes and even coincides with competence. Every clinician’s journey is unique in some ways, but as I’ve been comparing notes with colleagues and coaching new therapists, I’ve learned that there are some suggestions and practices that tend to stand most of us in good stead. Mostly relating to ethics and empathy.
I was thinking that instead of continuing to give over much of this basic information repeatedly, to different individuals who come for consultation or supervision, it might be useful to create a simple guide- a collection of private practice building knowledge. This could serve as a more time-efficient, cost-effective way for more new therapists to learn these ropes, and avoid losing time, money, and clients, the way many of us began and struggled. This could help them establish their own strong and thriving practices, building on the lessons learned from others’ empirical experience.
So, if you're thinking of opening a practice, or you have one, but are looking to gain tips and confidence, this might be the course for you. Investing in the business end of your helping career is not only good for you, but your clients benefit too. Click the link below to see:
https://elisheva-s-school.thinkific.com/courses/private-practice-pro-tips
Have you ever wondered how often people engage in sexual activity?
Or how often is optimal for healthy, happily married couples to aim for?
(I purposely used the euphemism “be intimate” in the title because often, people who ask this question in the framework of “supposed to” are uncomfortable with the more direct language of “have sex.” They may prefer to say things like : “be together, do it, make love, have relations, etc.” Whatever works:)
Couples therapists get this question a lot, especially from people who feel like they didn't or don't have enough information in the area of sexuality education.
It’s a legitimate curiosity, but the answer may be unsatsifying.
Firstly: “supposed to” is not a great framework for healthy sex. It works better when the focus is on mutual pleasure, not obligation or comparison.
Second: Frequency is not something that is mandated. Not psychologically, not legally, not Biblically.
It’s determined by and customized to each couple.
There is a Medrash that describes this, and is quoted by Rashi in this week’s Torah portion (I’m writing this the week of VaYishlach, but you can read it any week:)
When Yaakov sent gifts of livestock to his brother Esav, the Torah lists in great detail, the numbers and species of all the animals in the caravan.
Why do we care how many he-goats and she-goats there were?
The answer offered is that the ratio of male to female animals was determined by how often they needed to mate, which was determined by how strenuously they worked. The Medrash extrapolates an analogy to human mating schedules. (The paradigm used by the Talmudic literature is phrased in terms of a husband’s requirement to be available for his wife, not the reverse, but sex should always be consensual both ways.)
The Medrash says that men of leisure might be available daily, laborers twice weekly, donkey drivers once a week, camel drivers ones a month, and sailors/ those who travel for work, every six months.
Of course these are just some examples but Rashi goes on to explain:
“From here we learn that this need is not equal to every person [or couple.]” It depends on the couple’s individual schedules, emotional, and physical limitations and needs.
I’ve heard many people say that they were initially under the impression that couples only have sex when they want to conceive a baby. They were genuinely shocked to learn otherwise. This is not so ludicrous, when you consider the fact that many young people are taught about sex only in the framework of “how babies are made” if that much. Of course, most couples have far more sexual activity than they do children or attempts to conceive them.
It’s a legitimate query to ask how often couples have sex, but there isn’t a one size fits all answer.
Naturally there are some broad, cultural averages, and data. The most commonly quoted one is approximately once a week, but the numbers range significantly, and fluctuate within each couple based on many variables, such as stages of life like pregnancies, having babies and young children, medical or situational factors, and other variables that often make it challenging or more feasible. So please do not use that average to shame yourself or your partner for wanting more or less than that!
The healthiest answer to "how often should a couple be intimate is “as often as works well for both of them at each stage and season of life.”
Desire discrepancies and changes in libido over time are normal, but if you're finding that yours or your partner's are feeling disruptive to your relationship, please take the time to have a loving, strategizing conversation about it with your spouse, read up on the subject, and if necessary reach out for help.
Check out my course!
A Religious Families Guide to Healthy Holy Sex Education: Sacred Not Secret
Elisheva Liss, LMFT is a psychotherapist in private practice. Her book, Find Your Horizon of Healthy Thinking, is available on Amazon.com. She can be reached for sessions or speaking engagements at speaktosomeone@gmail.com More of her content can be found at ElishevaLiss.com