Yesterday I read a brief autobiography that said “Nearing sixty, still on rough draft.” That sounds like my career. Twelve years ago I went back to college to become a marriage and family therapist. It was my dream to go into private practice, earn enough to live comfortably, travel, and have some control over my life. I thought I would be in private practice within 2 or 3 years of getting my master’s degree.
It didn’t quite happen that way. After five years and a few internships, I passed the written exam. I expect to pass the second exam within a couple of months. In the meantime, I talk to other therapists about their practices; some aren’t doing so well. After working long and hard to get to this point, I want to know how to build a successful practice and I don't want to waste time "reinventing the wheel." I thought about getting a coach. Then Miranda Palmer made me an offer I couldn’t refuse.
I knew Miranda from the online support group she engineers for prelicensed MFTs and LCSWs. I admire her ability to nurture fledgling therapists and “walk the talk” of professional practice.
When Miranda asked if I would like to get together and discuss strategies to study for the exam and build a private practice, I agreed immediately. My husband is retiring soon and, although he will continue to work part time, my business will be our main financial support, so I feel some pressure to “hit the ground running.” In spite of my usual confident outlook,sometimes I feel anxious and unable to concentrate, whichaffects my studying and thus being able to pass the second exam, which is notorious for being difficult.
Before we met in person, I made a list of questions as Miranda suggested. Putting it on paperand out of my head quickly decreased my stress level. I wasn’t sure what to expect at our meeting and I was sort of nervous; I had high expectations.
We met after work; Miranda looked relaxed, typing on her laptop in a corner of a small, quiet restaurant. Right off the bat she asked me how I was studying for the exam. Not “if’ but “how.” Sigh.
You know that feeling you get when a doctor asks about symptoms that you were, until she asked,unaware of, but now make sense? I got that. I felt very comfortable with her. I confessed to having problems; she came up with concrete, doable strategies for studying, such as “seeing my clients’ faces in the vignettes.” I’m doing that now. It really works because I am a visual learner.
We didn’t spend too much time talking about the exam. I know I can pass the thing. What I really needed was to be around someone who is confident about the future.
“These are tough times for business” was all I seemed to hear. Some therapists had lost or were shutting down their practices; one colleague told me “I’ve never been this poor in my life.” But I know some therapists are so busy they turn clients away.
The best thing I learned in college was to hang out with A students if you want to be an A student. Guess what? It works. That’s why I was sitting with Miranda.
As we moved down the list of questions pertaining to building a practice, I felt prepared. I’ve “interviewed” many therapists, read Casey Truffo’s book,Be A Wealthy Therapist, and interned in a successful private practice for over two years. I am fortunate to work in the same city as Miranda so her business strategy for me was anything but generic. She suggested people to meet, meetings to attend (hint: all of them), how to network with people I know, and why I need to begin this part of practice building right now.
We got to the core task: finding my “niche.” I love the sound of that word; it sounds so intimate (probably because it is French). Is that not what a niche should be? I hoped to find a niche – work that I feel passionate about and love doing for the rest of my business life. If that’s not intimate, I don’t know what else to call it!
In private practice I worked with clients with chronic pain and trauma from work related injuries, both physical and psychological. In my current (and last!) internship I work with clients, including veterans, who are addicted to opiates: pain medication and heroin. Several therapies including CBT, guided imagery, trance, and pain management group work relieve trauma associated with chronic pain and PTSD. It has been very successful with my clients and I love doing this. So that is my niche.
We also talked about how to find clients and get income right away; start a website; networking through CAMFT meetings, other therapists and doctors, speaking engagements and teaching classes; how to do the daily business side of practice; and even how to use a cell phone to keep track of business and personal calls and save money.
Together we reframed my doubts into plans that I could visualize.
It was exhilarating to “see” myself in a new way. I’m not only a therapist, I am a resource for treating chronic pain and trauma in my community. When our meeting ended, I had a business plan, a sweet shot of confidence, and an amazingly resourceful friend and colleague.
Miranda is a gift that I hope you will give to yourself. When you meet her, think about bringing a tape recorder because you won’t be able to write fast enough!