Review of Evening Talk January 15th 2020 – Managing risk in private practice – with Pam Gully

As someone in private practice for two decades, I was very keen to hear from someone who might speak ‘directly to me’ as it were.  I wasn’t disappointed.

Pam delivers her knowledge in a very easy gentle manner.  There were many anecdotes that showed that having your own private practice can lead to a very individual style of practice.  You can offer what you like, and decide what fits your work style, work ethic best.

Where to start – literally – 

Pam talks of how different counsellors will have opposing ideas of the ideal workplace.

• Working with other therapists in a shared space
• Working in an office block where there are other professions to mingle with
• Working from home
• Working in an isolated or quiet place

There is no right or wrong in any of this.  But what is important is considering the space.  What noise might be happening whilst you work with clients and how much of that sound will make it into the room.  Eg if your therapy room is above a commercial outlet, will they play music in the daytime, a hair salon – would the noise of hair dryers interfere, above a cafe – would the smell of food [good or bad] waft in?

What does private practice look like?

This too has a similar answer.  For some they will only have 1 workplace, others will have 2 or more locations.  Some combine home with an external workplace.

Some people will offer home visits as a regular option and others will offer adhoc home visits (eg an elderly client can physically make it to the office one day, or a postnatal visit).  Others may do this on a more regular basis.  A word of caution from Pam about doing home visits when you don’t know the client, nor their circumstances.   It’s always worth doing where possible a risk assessment beforehand.  Whilst there are the obvious realities of assessing one’s physical safety at all times [not just during a home visit] there may be situations that require significant adjustment of what one might expect from a ‘usual’ house visit.  Pam recalled a situation where a client had not left the house for a considerable period and it took a lot of cajoling [through a letter box] and negotiation for the client to allow her into the hallway of their home.

Pam adds a few extra ‘musts’ when doing home visits.  For example – if working with elderly people, always have a contact of a relative (who can answer the phone on the day) and the client’s GP details too.

A range of services can be offered too, Pam’s include

• Counselling
• Supervision
• Group Supervision
• Workplace support – psychological debrief after an incident or death
• Group support for foster parents

What to charge?

In a country where people are used to a free NHS I think this is an area of challenge for many counsellors.

Pam’s guidance is to match those around you.  Hampshire prices will differ to London prices.  If you undercut those around you, it may send a message that you are less experienced.

When to start?

To state the obvious, having a trusted supervisor is key to anyone in private practice.  When all hours are completed and your supervisor gives you ‘the green light’ Pam says you’re ready for off.  Many do ‘bolt-on’ courses to add to their confidence and experience, but it is also the doing that builds us as counsellors.

Taking care of you

Pam makes many suggestions and uses her own examples

• Set your maximum number of sessions and day and stick to it
• Put time between sessions and use to read something non therapeutic [others practice very differently to this]
• Have ‘end of day’ rituals – a dust off of the day as it were.
• Have other trusted professionals (eg experienced social worker) that you can pay to support you in any tricky situation and offer you best guidance.
• Learning something cognitive that is not related to mental health eg a new language

Note taking

Session notes – write as though a court was to subpoena them.

Personal musings – your own ‘thoughts’ on the session, not for court eyes.

In short, I think students attending and those just starting off will have gained some wonderful insight to the world of private practice to stand them in good stead.

Pam’s session was delightful whether you have 2 decades experience, or just about to dive in.  Thank you.