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Practice Isolation: Why and How to Manage it

Opening up your private practice or “hanging your shingle” is a moment of real accomplishment in the life of a behavioral health professional.

You have completed your education, internships, licensure, and all the work required to strike out as an entrepreneur. You’ve achieved the freedom that a seasoned professional earns through experience and training. And just when you reach that pinnacle in your success, you find yourself having to manage something new and unexpected: isolation.

I so clearly remember the early days in my private practice. I had planned for many things, but I had not developed a plan to manage the isolation that so many solo practitioners face.

Like me, you may ask yourself, why am I feeling so isolated.’s why.

1. You’re making all the decisions on your own. If you are in a solo-practice, you will soon begin to realize that every decision to be made in your practice is made by you and you alone. If you have come from a team environment, and most of us have, it requires some adjustment. As the person at the top, there’s no one to run things by or team members to collaborate with. This can leave you feeling lonely.

2. Only conversations are with clients. Depending on how you structure your day, the only conversations you’ll have during business hours may be with your clients. Talking to clients is not the same as social interaction or support; in fact, it can feel like the exact opposite. It is almost as if you are there in the room, but only a part of you is welcome to the conversation.

3. There’s no one to talk to between clients. If you are in an office setting by yourself, think about how it feels after one client leaves and the next has yet to arrive. When no one else is physically present, it’s easy to feel alone. It makes sense to plan desk work and business calls during the lull between clients–therapists often benefit from a few quiet moments to gather their thoughts—but this may not always prove effectual.

4. You are your own supervisor. Having a supervisor to provide feedback, direction and encouragement is one of the invisible benefits of working in a larger environment. If you have ever had a wonderful supervisor, you know what a huge difference this can make in the development of one’s career. Click here to read Let the Ink Dry on more about how supervision helps to develop your career. Once you are in practice, it can feel like your work is being done in a vacuum. There is no supervisor to provide structure and accountability. You are on your own in managing your time and work flow.

5. Invisible success becomes your new normal. When you’ve had an awesome session—maybe your client experiences a transformational breakthrough or insight—who are you going to tell? Peer supervision is a great way to stay connected with your peers, but it is not as “in the moment” as working alongside a colleague. If you have back-to-back sessions, you may not even have time to allow the good feeling of validation to sink in before you are on to the next client and a brand new set of issues.

So what do you do about it?

1. Access peer supervision to discuss clinical cases. If you are reading this prior to “hanging your shingle,” start developing a network of clinicians now. When you give yourself a safe space to discuss your cases and receive good feedback, you are taking good care of yourself, and that is crucial in running a successful business. Even the most seasoned of clinicians can benefit from the perspective of others in the field. Use peer supervision not only as a way to think through your cases, but as a way of processing your thoughts and feelings about your work.

2. Work outside of the office when you are not with clients. Find a way to remove yourself from these four walls. Working in a coffee shop, at home, or in any environment other than a small office is important when you are a single practitioner. A change of scenery will do you good and refresh your perspective.

3. Network with other private practitioners who can relate to what you are experiencing. This is a bit different than supervision. These conversations are about what being in private practice is like, not so much about the actual work you are doing. This works beautifully when solo practitioners share a larger office space. You can use that shared environment to connect between sessions, pool resources, and work together to find creative solutions that benefit everyone’s practice.

4. Stay connected with online groups that discuss issues relevant to you. LinkedIn and Facebook groups, focused on the work that behavioral health professionals do, are a goldmine of support and interaction. Set up your online profile, and join groups that discuss issues that are relevant to the work you do. Be mindful to maintain rules of confidentiality in your interactions.

5. Connect with consultants. When it comes to making good choices for your business, you are not going to always know everything. Acknowledge that, and commit to being self-aware. Get familiar with the areas where you will need support. Once you have identified those areas, invest in working with consultants that offer the expertise you need. Doing so helps you to stay focused within your unique gift. In addition to hiring people like accountants, billers, and web designers, it is helpful to have a mentor or coach who has experience with what you are dealing with. This will not only combat isolation but help you develop a strategic approach to getting the results you want.

Managing isolation is one of the unexpected challenges of hanging your shingle. Once you know that isolation is a concern, you can be proactive in developing a plan for addressing it.

I would love to know what else has worked for you as you’ve fought off isolation. Connect with me on Facebook or LinkedIn, and let me know what other options you can think of? Perhaps an idea you have will inspire and support someone else.

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