Give and Take
It finally happened, Basic Steps Mental Health now has a waiting list. All I can say is that I am honored by your testimonies and your recommending us to family and friends. Because of this, the way that we have been providing time during the sessions will need to change.
From the beginning, we have always used the full 60 minutes to treat people. The beauty of our approach has been to allow whatever needs to simply bubble up and naturally be dealt with. It wasn’t uncommon for sessions in the past to last 90 minutes – in trying to honor the natural process, then as we grew, time was at more of a premium and had to end at the 60-minute mark. Now, as we hit our limit, out of sheer necessity, we need to honor a 50-minute session.
One of my best friends is a dentist, who told me he envied my work. Dentists don’t have time to work a client through fear, doubt, and upset, so he uses more of a stepping-up process to help clients get through their feelings much quicker. He would love to naturally let the process happen, but just can’t.
Now, for current clients, I ask you for the following. Before you come in for your session, jot down what you want to address. This will help you get to the issue quickly so we can have the proper time to address it. Often times people will talk about things that are troubling them but wait till 10 minutes are left to talk about the real zinger that they have been chewing on for weeks.
I would also like to do something different in the individual and couples sessions by having people set intentions when the hour begins. We do this in the IOP program and it gives each person a direction to take. Setting intentions helps a person get right to the point, so why not with every other session we provide?
50-minute sessions? I never dreamed I’d have to conduct therapy this way. At times Basic Steps felt like a part-time job. I’d see a few people, have a nice break, go hiking, walk through the mall, and take long lunch breaks. Obviously, these days are now behind us.
Years before, I used to watch our Psychiatrist at the Mental Health Urgent Care Center dictate his notes after a shift. He worked fast while treating his 20 or so clients, but talked even faster as he dictated his notes to his personal assistant, who did the paperwork for him. 20 people and I am getting clogged with my 9. However, in my defense, he saw clients for 15 minutes tops. One thing about Dr. J was he made it a priority to goof around with staff throughout the shift, which kept him upbeat. It is time for me to take a page out of his book, and to start this practice I need to create a bit more time for myself in order to do so.
As I write this, I am recovering from a bit of vertigo. Yeah, I have a tendency to get that every once in a while. It shows me that I am not superhuman and need to set limits. I burrowed through my last day at work and completed most of my notes so I could get out of town and go camping. Yeah, the best-laid plans of mice and men. We make plans and God laughs. I guess it was just in the cards for me this weekend to do nothing, kick back, and let the spinning slow to a stop. I have to admit, it was nice watching football for a change and watching my Seahawks kick butt, as well as my Dodgers come from behind and win in the last inning!
I have learned that balance is key and self-care is a must, but unfortunately still have the tendency to make everyone more important than myself and I need to change this. “Physician heal thyself” keeps spinning through my brain and I need to heed that call.
50-minute hour, will that be enough? I think I really need to take a full hour for lunch each day as well. My dentist friend does it and now I see the importance of it.
It has been interesting having a full, and I mean a full schedule. Normally a person or two will cancel at the last minute, giving me time to practice self-care, which lately has been writing progress notes and filling out forms for the courts. To minimize the spins in the future and having to push myself for my needed time off, I need to practice like other therapists do and see people for 45 minutes, though 50 should be sufficient.
I am reminded of those crazy shifts at the Mental Health Urgent Care. From the moment I entered the facility, there would already be half a dozen people waiting to be treated. The sessions were short, out of necessity. A room full of psychotic, overwhelmed, and frustrated people didn’t allow me the freedom of 90-minute sessions. No, I needed to get into the trenches, discover what was going on, treat it, hand them over to the psychiatrist for medication, slap down a note, and then dive into the next patient. This was all day, every day, and on breaks, you wouldn’t see me eating at my desk, you would find me walking around the large grass field next to the parking lot trying to catch my breath. And I did this for 11 years! These memories are now coming to the surface as my schedule jumped from 3 or 4 people a day to 9 – soon to be 8, I do need to give myself a one-hour break each day.
I guess what happened is I got excited. Owning this business has been a grind and I have done a lot of juggling. With a full load it has allowed me to pay down debt, actually pay myself the money I withheld to keep the practice floating, and not worry about the financial burden that weighs on a small business person. Though over two months of this, well… it’s making my head spin.
So this is my current status. Cutting down my work hours is a great start and funneling work to my coworkers is another, but one has moved to Florida and the other has her schedule filled. I am interviewing college interns to help with the load and give them practical field experience, so that will also ease some of my tension – though it isn’t guaranteed. Having interns has its own challenges but I love teaching people new to the industry and will always want to pass on this knowledge.
Am I complaining? Absolutely not. With growth comes adjustments. My company was an adolescent for the past 7 years and now is a young adult. Clients grow, staff grow, and now I see the business is doing so too.
Then 50 minutes it is and in doing so I don’t have to excuse myself to go to the bathroom, worry about returning a call, or meet a deadline for a legal document. As you can read, you probably see that I am still trying to convince myself of this, but logically speaking I do need to take care of myself so I can help take care of others.
A final acknowledgment of my Vertigo. Okay, I got your message and yes I will slow down and take better care of myself. I ask you instead to not spin me around and just ask. I promise to listen to you, though I appreciate your spinning was on the mild side this time, which I really do appreciate.
Compassionate Care is Always Available
There are many more tools and strategies you can use in your pursuit of happiness. Here is where we come in. Contact us at Basic Steps Mental Health and let us support and educate you on this journey back to your loving heart center. Imagine living a heart-centered life, regardless of what is happening externally. We’d love to be of help.
For 25 years, Dr. Scott Alpert, the clinical director of Basic Steps Mental Health, has treated over 7,000 people with mental health and addiction problems, using a Psychological approach that mixes and matches ten of the top approaches used in the industry. We are here virtually and in-person to help you get through this COVID-19 pandemic and many other difficulties you may be experiencing.
May you have good mental health.
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