I just spend an hour reading a professional association list serve and now I feel like I need a stiff drink (or a large ice cream sundae–pick your poison).

I’ve talked about the reimbursement cuts we are facing here in Massachusetts. For some psychologists they are a  massive income slash. We’re looking at 12-28% cuts. This is very, very bad news. But that is not what has me feeling overwhelmed and anxious.

It’s the desperation of my colleagues. Understandably most are angry, many are scared. This is health care reform in real time. This is our future and it looks bad.

Worse, most are stuck. Stuck in one business model, stuck in one mindset and stuck in their negative affect.  To me, it feels like watching someone drown and you have no means to help them. Honestly, reading those posts made me feel ill. Because there is a wild-eyed panic about their reaction, not a calm, deliberate problem solving mindset. And when your livelihood is at stake, calm, logical problem solving will trump panic and desperation every time.

And make no mistake, many of us are seeing our very careers at stake. This health care reform is going to be life changing and is being referred to as a “generational shift.”

Are You Ready?

This is the question I pose here most often.

Are you ready for major change?

Are you ready to innovate?

Are you ready to do the work required to maintain your standard of living?

Are you ready to stop begging outsiders for a viable income stream?

Those who are ready to take on these challenges will come out on top,with solid careers and an income stream to be proud of. Those who sit back and wait for someone to fix the problem are in trouble. No matter how desperate, wild-eyed and panicked you become, you will not turn the tide of health care reform.

You Want Me to Sign a What?

Over the last few days, I’ve been asked to sign petitions, support political candidates (not even in my district) who psychologists feel have some power to change our situation.

I will not sign your political petition to reinstate reimbursement fees, nor will I spend money to support your candidate.  It won’t do any good. It’s like drug addiction. If you rely on managed care for your fix of income and managed care jacks up the ante for how you get paid and how much, you have no power. None. They can ask you to do a song and dance routine for your income fix and if you have no other options, you have to do the song and the dance.

[And if you want to disagree you can, but that political approach you're taking in August--realistically, how soon will you see a benefit? But I can take the $500 you want me to spend on your candidate's re-election, redesign my website and produce a product that I can sell and make $1500 in a weekend. And I have a plan to actually do that by end of August].

I’m putting my energy toward innovation. I literally want to change the way health care providers do business.

Amazon changed the way we bought books, now publishing companies are dying.

Bloggers changed the way we get news and now newspapers are dying.

The internet changed the way we market everything from cars to colleges and since ad money is flowing into the internet, now magazines are dying.

E-mail, Facebook, and Twitter are changing the way we communicate and now postal mail is dying.

You need to decide if you want to be on the side of Amazon, bloggers, the internet, email, Facebook and Twitter or hang on to the alternative. The writing is on the wall. You make the choice.

Now I need to ask a favor. If you agree with anything I say above, please share it with colleagues, friends, association executive directors, your networking groups, etc.

These really are potentially devastating times. Truly. I’m not saying this to be dramatic, it’s bad here in Massachusetts and we are the bell weather state. To share this you can forward the link, retweet, post it to your Facebook page, post it to LinkedIn, start a discussion about it on an online group. I don’t care how it’s shared, but please be  a part of the solution, not a passive consumer of ideas. We need to start a movement in mental health and I can’t do it alone. Here’s the shortlink to share: http://bizsavvytherapist.com/?p=1525

Don’t feel overwhelmed and stressed. You truly CAN do the work you love and make a good living!

photo credit: programwitch

Think of a time you wanted to purchase something that was important to you and instead of feeling good about buying it, you felt stressed and disappointed that you could not afford it financially.  Maybe it was a vacation with your family, or possibly it was a product or course to help you grow you practice.  Something you really wanted, but couldn’t have because you felt you didn’t have the money.

Do you remember that feeling of disappointment and frustration that your dreams could not become reality because the “money’s just not there?”

Let’s work on making that feeling go away.

If you come from a scarcity mindset, you focus on the idea that there is “not enough” of anything.

Not enough clients.

Not enough money.

Not enough time.

But the truth is there is more than enough. The reason why some people can generate all the money they need is because they have empowering beliefs about money.  The main difference between the ‘haves’ and ‘have-nots’ is not their talent, abilities, luck or opportunities, it’s their specific beliefs about the following 3 things:

• You offer something of value that people will pay for.
• There are enough people out there who will exchange money for what you offer.
• You have the ability to communicate your value to the people who need it.

Those three beliefs are what drive people who make money to success.  They believe that it’s possible.

How the Red Sox changed my life

When I was just starting out in private practice, I had a scarcity mindset.  It was hard for me to imagine that 20 people a week would want to pay me for my services.

Then I went to a Red Sox game.  If you don’t know, the Red Sox are something of an obsession in New England and they sell out every single game every summer, and have done this for over a decade.  That’s 37,000 people who schlep into Boston (no easy task) 80 times a summer to see baseball.  And not only do they buy a ticket (which costs anywhere from $40 – $300), they buy all the overpriced food, hats, shirts, and programs that are hawked through Fenway Park.

I sat in that crowded park where people were spending money left and right and said to myself,

“If the Red Sox can do this, so can I.  If 37,000 people will go through all the steps required to spend hundreds of dollars to take their family to a baseball game, I can find 20 families to pay me $100 an hour to help them function better. Hell, there are 20 families in my ROW right here!

There is enough.”

That evening changed my life.  I knew I had something of value and after that baseball game I knew there were enough people who would pay me. I just needed to figure out how to communicate that value and I’d be all set.

That mindset shift from scarcity to abundance was the key to my success.  It suddenly made total sense to spend some money on learning about business and marketing because I knew that once I could tell people about my services, there would be a line out my door as long as the beer line at Fenway. I just knew it. How did I know?

When in doubt, research your ass off

I had done my research on my specialty.  I knew that 1 in 150 kids were diagnosed with an autism spectrum disorder. I knew that ADHD is a struggle for millions of families and  a problem for schools to manage.  I did my due diligence looking for statistics, talking to school administrators and teachers, questioning the families I worked with in my group practice.

You can do the research.  Take some time to find out how many people need your services.  How many people will be willing to pay you for your valuable expertise?  It’s not hard to find out.

My guess is most of you are severely underestimating the demand for your services. Look around.  Do you see others making good money offering similar services?  That is a good sign because it means there is demand.  Remember, each of us can only serve a limited number of clients, so even if there are a few people in your community who work within a similar specialty, chances are good there are enough clients to support you , too.

Now Communicate!

Once you believe in your value and that there are enough people who will pay you, the next step is to start communicating with them.  Many health care professionals get stuck here.

No one will call you if they don’t know you exist.

Marketing is communication. So is talking to colleagues, sending out newsletters, using Twitter and other social media.

You would think that therapists would be good commuicators. It’s what we do for a living. Yet, we seem to save all that good communication mojo for our clients and don’t share too much in the greater community.

This is the disconnect

When you don’t commuicate, no one can find you.  Then YOU become frustrated because you feel, “there are not enough clients,” and the public is frustrated because they feel, “there are not enough therapists.”

See how the scarcity mindset holds you back from success?  And notice how it leaves the public confused, underserved and ready to find help anywhere they can (even from unlicensed providers)?

The evidence people use to support scarcity is flawed. “No one wants therapy.”  “The doctors don’t even consider referring to me.”  All that can be changed with a good communication strategy.  When you are top-of-mind because you touch base with people frequently, clients are referred and show up in large numbers.

Abundance is the way to go.

I can tell you “there is enough,” until I am breathless, but it won’t help you until YOU believe it, too.

My request to you is to assess your beliefs about your abilities, value of your services and abundance vs scarcity.  Do you think there is enough? Do you believe in your value?  Do you want to communicate with those who are ready to pay you?

If you want to help more people AND make more money, sign up for email updates to get these  articles  sent directly to you. Or register for my free e-course: 7 Ways to Grow Your Practice this Spring!

Fear is underrated.  All the great business gurus tell us to blast through fear. Sure, we need to figure out how to manage it and keep going, but sometimes you’re just scared sh**less and you  get stopped in your tracks. And I think that is perfectly OK. When I started my private practice I was scared. Scared I wouldn’t be able to find any clients. Scared I wouldn’t do a good job. Scared I’d make no money, go broke, have to sell my house.  Really so scared I would FAIL. So for a long time I avoided the scared and worked for others. It was safe, I had a paycheck, there were no administrative demands. I didn’t need to learn anything new. It was safe but I was bored and annoyed that someone else was profiting from my hard work.

It is so easy to get stuck in that place..bored, frustrated, angry that things aren’t different. But that darn fear gets in the way. Stuck.

So I’ll tell you how I side stepped my fear. I didn’t jump over it, victorious like Superman, or plow through it like the Incredible Hulk. I greeted it, said “hello,” walked with it for awhile and then tiptoed around it so I could move on with my life.

I greeted fear

The first step in maneuvering around fear is to acknowledge it. For me this meant sitting in my office saying to myself, “I am stuck here because I’m afraid to take a risk.” I repeated that phrase to myself for many weeks. Hello, fear.

Next, I walked with fear for awhile. Had a metaphorical chat with it, if you will.

Me: “So, yeah, fear. What’s up? I’m stuck in a job I hate and here you are.  What do you want?”

Fear: “I want to let you know that you’re safe now and change is hard. Why change when things are safe?”

Me: “Because I’m bored and I want to do more with my life. Actually, I want to build something that’s mine, and do things my way.”

Fear: “OK, but that is hard work.”

Me: “That I am not afraid of. Hard work I can do.”

Fear: “So what are you afraid of?”

Me: “Not knowing what to do…I don’t know how to run a business!”

Fear: “Can you learn how to run a business?”

Me: “Yeah. I’m good at learning. I’ve been in school my whole life, for goodness sakes!”

Fear: “Ok..so you’ll learn about business. What about getting clients?”

Me: “I am wicked afraid that I won’t get clients! Freaked out! With no clients I’d doomed!”

Fear: “Can you learn how to get clients?”

Me: “I guess so, you can do that…learn how to get clients?”

Fear: “Do you have clients now?”

Me: “Yes.”

Fear: “Do they like working with you?”

Me: “They keep coming back, so I guess they do like working with me.”

Fear: “Will some of them follow you to a new location?”

Me: “Yes, but is that right to do?”

Fear: “You want to know if you can get clients….Don’t overanalyze.”

Me: “Right…so clients, yes, I can get clients. Because if I have some now and I can learn how to find more, I’ll be ok.”

Fear: “You could fail.”

Me: “I know. I could fail.”

Fear: “What’s more important–always being safe and maybe regretting not trying this new thing, or taking a risk, doing your best and figuring out how to NOT fail?”

Me: ” Uh, taking a risk and trying the new thing?”

Fear: “Not convincing…”

Me: “OK, ok!  I need  to try the new thing because I don’t like where I am now.  Anything is better than this. And if I am an UTTER FAILURE I can always return to this job, or another one that I might like better…..So, I guess I have nothing much to lose, do I?  Now, please get out of my way so I can do something and make some changes!”

Fear: “Alright, I will step aside but I will always be here.”

Me: “Good to know because I wouldn’t want to go all rogue and really throw all caution to the wind.”

Fear: “I think we’re done talking…Move along.”

The chat with fear was useful. It took a long time. But I was no longer in a panic, I was sleeping relatively well at night.  So my next step was to do all I could to learn about business and attracting clients.  The awareness that I could learn about the very thing that provoked my biggest fears was what allowed fear to move aside.  Learning is a comfortable action for me. When in doubt, confused or overwhelmed I always default to trying to learn more. But that’s  me.

Each of us has to have our own conversation with fear. We need to figure out why it is there and what we need to do to tiptoe past.  Maybe it’s finding a mentor, reading a book, running 10 miles, having a chat with a friend, meditating, taking a vacation. You need to chat with your fear and ask.

The Doing

Ultimately, you will need to do something to move beyond your fear. And I mean anything. Ordering a book, calling a consultant, reading a blog, registering for a course, jotting down notes.  The trick is you need to move beyond “stuck” and into “do.”

Fear will still be there, but he’s hanging around to keep you cautious and informed, not to stop you from achieving your goals.

Do you know if fear holds you back?  If so, how do you manage it? Are you stuck in “stuck?” How can we help?

Hey, have you seen the most recent Newsweek article by Sharon Begley?  It seems antidepressants don’t work. Apparently, 82% of the improvement people feel is placebo effect.  If you are a mental health professional, you know this, whether or not we want to admit it.

Let’s face facts, folks. When it comes to curing mental illness, we are in the dark ages.  We have NO IDEA what we are doing. It’s not our fault. The brain is just so stinking complex!  But we have this need to say we know stuff that we don’t.  I know we get pressure from our clients/patients, other professionals for an easy answer, a quick fix, the little sad blue pill that turns yellow and happy after taking Prozac (remember those commercials?).  It seems good marketing trumped good science but we all wanted to believe it was that simple.  And yet, in the face of the evidence,people treat the researchers like criminals and they are labeled as anti-science.

Again I ask: How does this help people? How does it improve lives?  If we KNOW something is not working, why hold on to the fallacy that we are “doing good” by perpetuating a non-effective intervention?  I’m sure money is a motivator, so is laziness and fear. But I don’t want to talk about that, because looking for a scapegoat or a cause of the issue doesn’t solve the problem we have in front of us.

How do we help people with depression?

Let’s start thinking about  collaborating vs. going solo. If psychiatrists, therapists, and researchers all got together and worked together on how to address the complexities of depression we could come to a better answer.  But now, we have therapists saying therapy is the answer (and they seem to be right, but can’t agree on what approach is most effective-CBT or psychodyanamic), psychiatrists saying medication is the answer (and this is a weaker argument by the day), and researchers saying they don’t have an answer, but know what doesn’t work (but will tell the public it does because  a placebo effect, is better than just doing nothing.)

What a mess.

And the truth is, we are failing people who need our support. The more the evidence surfaces that we are at a loss on how the brain works and how to improve people’s mental health, the more the public sees us like the man behind the curtain in the Wizard of Oz. Because we claim to have answers we don’t have.

We are failing alone, publicly.

What if someone put a grant together to pull researchers, physicians and psychotherapists to tackle these issues? What if part of the grant was to bring in a good PR person (who understands social media) and opened the doors to the progress being made? And what if participants in the studies were recruited via social media, doctors’ and therapsits’ offices?  Do you think we’d be able to find enough volunteers to help solve this really big problem?  Do you think we could get an article in Newsweek talking about the collaboration and the progress? Do you think working together we’d learn more and generate knowledge faster than we are working alone and in isolation?

What do you think?

I’m frustrated with mental health as a profession. There have been a few articles and info bites I have seen in the last few weeks that lead me to believe we seem to be stuck in at the developmental level of middle schoolers trying to navigate separation-individuation (Though I’m not sure what or who we are trying to separate from.)

Our Middle School  Mentality

Let’s first start with the  the CBT vs Psychodynamic therapy debate, highlighted in this recent article published by APA.  This age-old argument is tired.  There is more than enough evidence on both sides that each approach has its merits and drawbacks.  One approach is effective for certain conditions and the other more effective for different people.  Yet, we still get articles that say things like,

“The consistent trend toward larger effect sizes at follow-up suggests that psychodynamic psychotherapy sets in motion psychological processes that lead to ongoing change, even after therapy has ended,” Shedler said. “In contrast, the benefits of other ‘empirically supported’ therapies tend to diminish over time for the most common conditions, like depression and generalized anxiety.”

“Pharmaceutical companies and health insurance companies have a financial incentive to promote the view that mental suffering can be reduced to lists of symptoms, and that treatment means managing those symptoms and little else. For some specific psychiatric conditions, this makes sense,” he added. “But more often, emotional suffering is woven into the fabric of the person’s life and rooted in relationship patterns, inner contradictions and emotional blind spots. This is what psychodynamic therapy is designed to address.” Jonathan Shedler, PhD

What’s with ‘empirically supported’ in quotes? Like it’s not real?  And where is the evidence that other therapies don’t have long term effects?  How about the “more often emotional suffering is…rooted in relationship patterns”? Who says? Define “more often,” please.  Middle schoolers look for a “right” way and dismiss others who have different, yet just as effective options.

My response: whatever. Both work. Let’s move on and help some people with the best symptom-intervention match, shall we?  And, APA, we are looking at you to develop those treatment guidelines, ok? It”s not like we don’t have any evidence that there are effective ways to treat mental illness.

Next up, the ongoing middle school clique of whose training is “better” and “more effective.”  PhD psychologists vs. PsyD psychologists, Doctoral level therapists vs master’s level therapists, MFTs vs LMHCs, Coaches vs Therapists.  Exhausting.  Oh, and my new found favorite, academics vs practitioners.  Why must we posture so?  Can’t we all get along?  Seems that the answer to that is “no,” as all sorts of new “associations” seem to be popping up to address the needs of academics, or practitioners, which is fine. Where my problem lies is the founders of many of these groups seem to need to lob pot shots at one another to prove their worth. Need an example?

In a newsletter I received from this organization (I am not a member):

XXXX (name of organization hidden) built a new type of organizational structure. One with no high paid executives, no slush funds for officers , no big parties disguised as workshops or conventions paid out of
member’s dues, no liaison travel vacations for board members and leadership, no
divisions among genders or races or other fractionating elements, no domination by our
colleagues who have been better organized and effective than practitioners at controlling
organizations (academics and scientists) [SG: thanks for clearing that up. I had no idea what you were talking about], no selling out of practitioners with Government or other entities, no sequestered slush funds that will not be spent on practitioner advocacy issues during times of need, no state RxP initiative funding that are allowed to be hijacked by academics, no state associations allowed to be hijacked by academics, no $30,000 President’s parties, no support for state licensure committees that take
contemptuous rather than supportive and rehabilitative approaches to practitioners, no
massive organizational bureaucracies to fund and maintain, no practice specialty board
affiliates dominated by academics, no hostility toward and undermining of other
practitioner organizations [SG: um, what is this rant? Feels hostile to me] , no training of masters therapists to compete with our members [SG:  hm, also not feeling the love here], no accreditation entities that do more to protect faculty and research interests than the interests of the practitioners they are training, no support for in-adequate practitioner reimbursement or deployment in first line interventions and institutions, and most importantly no tendency to get our energy and resources tied up in the petty and peripheral rather than “that which helps practitioners”.

Huh?   How does any of this help me as a practitioner? How does it  help my clients?  Can you smell the middle school lockers yet?

Big Questions

My questions about our behavior are these:

How does acting as middle schoolers  help someone with a mental illness?

How do our  antics of minimizing and mocking each others’ work, contributions, degrees and good work benefit our communities?

If everyone else doing the same work you are  doing is a potential threat, jerk, know-nothing what does that say about your world view, perception of other helping professionals?

And what does our in-fighting communicate to the public at large?  If I put down a master’s level therapist will that make my clients appreciate me even more?  Or maybe they may worry that I will ridicule their education or profession?

Let’s Grow Up

We need to grow up as a profession and move on to innovate, integrate and work as one to help more people with mental illness and mental health issues.  There is more than enough work for all of us to take on.  Instead of focusing our energy on who’s “right” and who’s “wrong,” why don’t we join together and build communities of therapists, academics and administrators with common goals to bring effective treatment to as many people as we can?

Let’s act like the intelligent adults that we are who understand that broad strokes don’t serve our clients or communities best.

We KNOW the research that says sometimes medication is effective. And sometimes CBT is the best treatment approach, and sometimes psychodynamic interventions work best.  And we also know that a person’s degree does not define how effective they are as a therapist.  Let’s do the hard work we need to do to parse out which situation warrants which treatment and who the best person might be to provide the intervention.

Oh, I know that is hard work and it is much easier to paint the other approach or person as incorrect. But the public is getting wise to this game and tuning us out.

Collaboration brings the greater good to all endeavors. Let’s do what we profess to believe in.  Helping others to manage complex illnesses and life demands requires all of us looking forward, respecting each others’ contributions, asking question when we don’t know, referring to those more expert than ourselves and keeping the best interest of the client in mind.

Is that too much to ask?

Thanks to this lovely post by my friend, Philippa Kenneally of the EntrepreneurialMD, I’m going to wax eloquent (semi-coherently) about how our emotions guide our business success.  This comes at a time when we are all talking about specialty practices and the fear, anxiety and trepidation that arise when we think that we must specialize. (And you still do, I’m not letting you off the hook  here!)

If you don’t know by now, you should be aware I work from a cognitive-behavioral model when I engage in therapeutic work with clients. Overall, I’m a rather cognitive person by nature, meaning my thoughts guide my actions more than my feelings.  (Please don’t judge. )  But I know many therapists are more emotional than I.  They are experts at understaning, sitting with and immersing themselves in the world feelings, theirs and others.  That is part of what makes them wonderful therapists.

Only, what works as a therapist,  might not work so well as a business person.  Building a business is a risk-taking, anxiety provoking experience. It’s all new ideas and tools and terminology. Money is invested, leaps of faith are made.  Oh yeah, building a business is not for the faint of heart.

How you feel about risk, trying new things, and exposing yourself to criticism all play a role in how successful you will be.  If you feel anxious and fearful, how do you manage these feelings? Do you find a way to cope? Or do you retreat from your dreams because it all feels too uncomfortable?

Feelings will affect how you think about starting your business, too.  If you feel confused about starting your practice, what do you think?  Do you think, “I need a way to sort this out,” and get to work?  Or do you think, “This is horrible, difficult, too much work for me. Forget it. I’ll just work for someone else”?

While there is always the age-old debate of what comes first: thoughts or feelings, the truth is they are intertwined and influence each other.

My opinion is that, for therapists, feelings are very influential in how successful we are as business people.  Sometimes we just give them too much power in our business building which leads to giving up (or never getting started).

Being a person with strong feelings is neither good nor bad. However, we need to assess how our feelings influence our decisions when it comes to the business-side of our careers.

Just as we guide our clients to manage their emotions in healthy ways, so too must we learn to manage ours as we look to add “business person” to our resumes.

When I was in grad school, a classmate of mine once said,

“Trust the process.”

I have no recollection of the specifics of what we were talking about, but that phrase still guides me in my work.

Building a practice, or any business, is a process. It doesn’t happen over night and there are no miracle success stories.

But before we trust the process, we need to have a process.    You will know that you have a one when you determine a goal, a purpose for your business.  When you can articulate the goals and purpose, you can take steps to achieve these.  This is the process.  One step at a time.

But sometimes things go wrong.  Which leaves us feeling unsure, insecure, and ready to head back to working for someone else.

These are the times when we need to trust the process.  When we are trying something new, mistakes happen. We stumble. Sometimes we try something and fail.  All part of the process.

To trust the process is to acknowledge all steps along the way: the good and the bad.  Accepting that setbacks are part of what propell us forward is trusting the process.

Learning from what doesn’t work, sitting with uncertainty are both part of trusting the process.

At a deeper level, trusting the process means we must trust ourselves, our choices, ideas and actions.  We need to know that for every bad day, there are more good.

Trust in yourself, trust the process.  Everything comes when it’s time.

Does your practice have a specialty niche? If not, don’t worry, most therapists do not specialize and its a darn shame.

However, this is one of the biggest fears I hear when I talk to coaching clients about building their practice. The fear sounds like this…

“I’ll be bored if I specialize.”

“What if I’m not good enough in the specialty area?”

“How many people have this problem?”

“What if I don’t want to work with that group forever?”

“But I’m able to help lots of different people with different presenting concerns. Shouldn’t I help as many people as I can?”

I hear you. It is scary to be forced to choose one path and stick with it. When confronted with the idea that specialization builds your practice and actually allows you to help more people, you understand this intellectually, but there is fear and the emotion stops you from making a decision.

What is the fear about? I think it is related to a mindset of scarcity.  We fear there are just not enough clients to go around, so we want to be open to anyone and everyone who might be interested in therapy.

But, using logic again, is that true?  How many people out there need help managing ADHD, divorce, grief, postpartum depression, OCD, phobias of flying? LOTS, right? Just pick one of those specialty areas and you will have more business than you can handle.

But we also have fear of boredom or lack of flexibility.  Many people I talk to pursue a mental health career, and private practice, because they heard it allows for a great deal of flexibility and career freedom. Yes, it does. But no successful business can fling open their doors and say, “We sell everything, do everything and are open when it is convenient for us! Come on in and stay awhile!”  It sounds silly, but that is what you will be doing if you hang on to a generalist model.

There is also a fear of limiting our future options. What if we specialize in working with women coping with an empty  nest at home and after a few years we don’t want to work with them anymore?

These questions are all legitimate and choosing a specialty requires careful consideration.  And the truth is there are boring days. This is a job, after all.  It is not all going to be exciting and dramatic, fulfilling and meaningful.  But there is no job like that, is there?

And those fears about being good enough or limiting your options? Luckily, we are all trained to be good students and we know how to find and learn new information so we can improve our skills or change paths later on if need be.

The mindset that allows you to make choices is that none of this is static. It can be fluid and change over time. After 5 years of working with people in substance abuse recovery, maybe you want to work wtih their spouses or children.  Maybe you decide to write a book about treating those in recovery, or start an online support group.

Fear can stop your career growth or inform it. Make a list of your worries and hesitations and try to decern what is really holding you back.  Try to bridge the gap between your heart (where you are anxious and unsure) to your head (that knows a speciality is necessary to build a great practice.) Be patient with yourself, but don’t ponder this forever. At some point you need to take a path and see where it takes you.

I have this cool, new blog. It has lots of features I know how to use.

It has lots of features I don’t know how to use.

There are features I want that aren’t installed yet. And I have a vague idea how to track them down and install them. Hazy. It will require some time and study.

OK–in all honesty, I have very little idea of what I am doing with my new and shiny blog! [At least I know how to post!]

And this makes me frustrated a a wee bit anxious (maybe more than a wee bit, if I am still being honest).

The frustration and anxiety, right before Christmas and all that comes with that, lead me to feel tired (maybe exhausted is the better word).

[Deep breath.] I’m ok with all of this.  It is part of the process of growing, learning, expanding my world.  But I’m not sure I like it. No, I don’t like it at all.

This is what growth is, I suppose. We have to push ourselves beyond the known and into a space of new, shiny, exiting, frustrating, exhausting.

This is how babies learn to walk and talk.  The meltdowns 18 month old children bless us with–frustration and exhaustion after the joy of learning all day long.

Growing up is hard work, whether we are a child, adolescent, young adult or mature adult striking out to build something new.

When you think about innovation in your career, or building that blog I keep begging you to build, know that I understand the feelings of discomfort. That riding a bicycle for the first time thrill and fear.

I’ll master this blog–I’ve asked some smart people a few questions. They’ll help me out.

You’ll master your next step, too. At some point, when the time is right.

What you are working on that’s new, exciting, frustrating and/or exhausting. Or maybe you know how to work my blog….?

I hear from a lot of people who want to build a private practice.  So many have great ideas, lots of desire. Some are ready to get started right now. But then there is the fear.

Is it just therapists that are this fearful of starting a business?  Any entrepreneur should be careful, cautious  before starting a new business. But fear will hold you back and make the whole process scary and yucky.

Fear also means that, even those of us who manage to begin a practice and find moderate success just don’t go bigger, or start anything new, innovate or grow.  We settle for safe and adequate, good enough businesses that pay the bills.

That kind of a practice is fine if that is all you want, but I know you guys harbor bigger goals and are curious how you can do your part to change the world (or at least a small corner of it).  Am I wrong?

But that dang fear just gets in the way!

So I declare, on the Biz Savvy Blog we are going to address this issue on No Fear Fridays!

Let’s just get that scary stuff right out into the open, examine it from all angles, take the power right out of it and free up our hearts and minds to get beyond our self-imposed limitations.

And let’s start today talking a bit about Fear of Change.

As humans we dislike change. What we are doing now is comfortable, known, predictable. Even if what we are doing now feels stressful or unproductive, we’d rather live with an unpleasant known, than risk changing to do something that might be even worse (even though we cognitively acknowledge it could make life better).

But what if we think of change this way–change is going to come whether we acknowledge, own and direct it ourselves, or not.  Change is around you every day. You don’t drive the same car you did when you were 20, nor do you use the same phone.  Our kids don’t learn math the way we were taught a million years ago and it is a rare thing to see a camera with actual film.

There is change in the mental health profession as well.  You know this.  New research, new treatment techniques, health care reform. Oh yeah. Lots of change.

But when we think about consciously changing our little world, tweaking our practice, adding a service or (deep breath) putting up a we site, we panic. Or we deny panic, but defend with declarations of lack of time, money, energy. “No need to change,” we think. “My practice is good enough as is”.

But deep down we know it might not be as up-to-date as it needs to be to sustain the dizzying pace of change.  But we get paralyzed by fear. Or we have a day or two where we make a few steps toward a positive shift, but hit a set back, or someone criticizes our idea and this reignites that anxiety that lurks behind change.

We know how to help others through their fear. We’re therapists! What advice would you give a client who desires a better way or a  new direction?

Acknowledging the issue is the first step, so put the mirror up and say, “Things need to change in my practice and I fear that.”

Own your discomfort, acknowledge the yuck. Then figure out how to manage the feelings.  You can sit with all this for awhile, but you cannot get stuck there!  [But if you do get stuck, I highly recommend, Havi Brooks blog.]

Nope, you need to start making a change.  OK, one little step toward change. Then another and another. One step a day will soon get you to one whole change sooner or later.

It takes time but as you put one step in front of the other you are changing and not panicked. The fear may rear up once in awhile, but by acknowledging it, you take away its power.

Change isn’t good or bad, it just IS. The sooner we learn to work with it and direct its course, the better. Does that make sense?