Spring cleaning for my practice

2024 Update

Whelp this reminds me of all the things I need to do now that it’s almost spring. Thanks, self from 2022.

The Original Article

I used to write all about the secret lives of therapists and the parts of owning a therapy practice that clients don’t see. As I was reflecting today on all of the maintenance stuff that needed doing for my own business, I realized that I hadn’t written about this directly.

Let’s set the stage

I just finished Annie Schuessler’s Create Your Program course which was eight weeks of intensely focusing on my OCD Together Pilot Program for therapists and I’m now taking a couple of weeks to recover and make up all of the administrative work I fell behind on during those weeks.

At a larger level, I’m coming off of two years of navigating COVID with my three kids. There have been a lot of schedule changes, schooling challenges, sicknesses, and trying to support as many people, as best I can, during a global crisis. While I’m really good at never getting behind on clinical documentation and billing (those are ethical concerns), I let myself get way behind on administrative tasks that don’t directly face clients or impact their care. What does that list include?

Office maintenence

My home office in its natural, messy state.

One year ago, we moved house, about 30 minutes up Interstate 5 and I rented an office with a friend of mine who moved around the same time. We picked an office that was halfway between her house and mine and it was great except that it was a 20-30 minute commute each way. This doesn’t sound like much but the time when my kids are at school is precious client time and my commute was taking up at least an hour. So, I found an office for one day a week closer to home that’s beautifully decorated.

I moved out of the previous office this weekend and had to figure out what to do with the furniture. I ended up cramming it into my tiny home office (photo attached). It’s a bit crowded but it’s looking better and better with a maximalist style that is nothing like the rest of my house.

Never ending website maintenance

I’m never happy with my website. I’m always tweaking it, deciding I hate what I did, and re-designing. I’ve recently had to redesign navigation to accommodate more consultation services for professionals and the eventual OCD training I’ll be doing.

EHR Maintenance

I have an electronic health record system that manages client charts, my schedule, and various other necessary documentation. I recently added a workflow for other therapists I’m doing professional consultation or supervision with. I’m constantly looking at ways to improve how I’m running my business for the benefit of my clients and myself. At lest quarterly, I read through all of my clients documents and try to consolidate, clarify, and make things more user friendly.

Fees and payment policies

Ugh no one gets into therapy to talk about money. That said, we have to think about it because therapists do this as a living and we have to go to the grocery store too. I revisit my fees once a year, announcing in June and implementing in September, typically. This year, I ended up doing a larger fee increase due to my increasing specialization in OCD and the high costs of inflation for everybody. I hope that future increases will be more cost of living adjustments as I really dislike raising fees. But if you build it into your schedule to revisit them once per year, you get used to having the conversation and clients get used to you bringing up fees as a regular part of business.

Hours and schedules

My baby-children have helped me become WAY more comfortable with changing my hours around because their school schedules demand it of me. I used to have a major anxiety attack every time I had to shift my schedule but now, I have to do it at minimum in June and September, if not more often. Still - the school year shuffle takes up HOURS of time and spring is the biggest shift.

Automation and optimization

My next project is to begin recording videos and audio to orient folks to my practice. I hope that these videos can help some folks from feeling like we’re taking any of their session time to explain things like confidentiality in therapy and my mandatory reporting requirements. I thought I could just do this in a day but it’s going to be a bigger projects.

Clinical documentation

I’ve recently begun taking notes in session and sharing those notes with my clients so they can track our work together and remember what to work on between sessions. This has led to a phenomenon where I’m sometimes “pre-charting” for clients or copying over relevant things into the client-facing note prior to session. This can be a nice reminder to clients about what we’re about to talk about! I hope no one thinks I just copy forward notes every week because they look the same prior me customizing them.

Homework and between-session support

Especially as I move towards charging specialist-rates, I’ve been putting more pressure on myself to offer more between session help in the form of highly customized homework. I haven’t figured out how to do this in a really well styled way but my hope is to come up with a system that looks really slick and is easy to engage with. So far, it’s a bit clunky but I’m working on it!

That’s it for the moment

Of course, this doesn’t include any of the work I’m continuing to do for OCD Together but I have to remind myself that I can only do so much in a given week, since I’m also seeing clients each day!.

Did any of this surprise you in terms of what therapists do in addition to seeing clients?