Setting Boundaries as a Therapist

Lisa Marie Bobby:   Hello and welcome back to Love, happiness, and Success for Therapists. Today we’re talking about something that is very important to all of us, possibly the most important thing for all of us, which is how to set healthy boundaries as a therapist. As therapists, we’re pouring our hearts and souls into our work often in very personal ways.

And if we’re not careful, it’s very easy to become energetically emotionally depleted through our work. It’s vital that we are very deliberately setting and maintaining healthy boundaries so that we can stay nourished. Stay strong, stay energized for our clients, but also for ourselves because we matter too, right?

And we’re not robots. We’re not, in fact our empathy and our compassion our humanness is what makes us so good at what we do. And it’s these exact same qualities. Caring a lot, being empathetically in tune with other people, having a desire to help others, it’s that’s what makes, the personality of a counselor so beautiful.

But it’s also exactly the same thing that can leave us so vulnerable to burnout if we don’t have healthy, strong boundaries. So to dive right in, I really, I wanted to put together this podcast episode for you because in my role I’m the founder of growing self counseling and coaching. I’m a therapist.

I’ve served as the clinical director of our organization. I do clinical supervision with early career clinicians and invariably I think for every single one of us, at some point in our career, we need to confront this and. The time we often are confronted with this is when we are tipping over into burnout.

We are feeling I. Tired, sometimes exhausted. Apathetic, honestly can be part of it. We are even checked out or feeling activated by clients, maybe our personal lives are suffering, and when we become aware of this is the key to say, okay, what do I need to be doing a little bit differently here?

And it’s okay. That’s, I think, part of this, we have to tip over too far in the other direction in order to help ourselves be like, okay, what do I need? But these moments are also, I think, a really great opportunity to be thinking about who you are, your own needs, rights, and feelings, but also, the context of your life in a way that can be incredibly growth promoting and change the trajectory of your career even.

It’s a very positive thing. And I’ll start by saying, we often think of boundaries as being very much about our own internal processes, our own ability to set limits or to say no or to, figure out where we stop and other people start in terms of interpersonal boundaries.

And that is absolutely a big part of this. And something that we need to be thinking about keeping our eyes on and. What I think we don’t often acknowledge to the degree that we should is the impact of the environment around us and how that environment can place different kinds of pressures on us.

That makes it extremely difficult to have healthy boundaries. E, even if we’re trying really hard to have healthy internal boundaries, and I know that I am letting my marriage and family therapist flag fly right now, but I think that these systemic factors are incredibly important, something that needs to be part of the conversation, and I don’t think it is frequently part of the conversation.

So that’s why we’re having it here today. But, so what I’ve seen from this is that it’s not just our internal work of, okay, how do I say no as a helper and how do I practice healthy self-care? But it’s also recognizing that getting into the right environment, either changing our system or changing the system that we’re in, that can really make the biggest long-term impact on our well-being and I’ll give you an example.

So I know many of you probably listening right now are in very demanding environments like a mental health agency community-based mental health, and some flavor of social services perhaps working with very high-need clients and in these environments. The workload itself and the emotional toll can just be overwhelming.

I have personal friends working in community mental health who’ve been managing a caseload. A hundred, 120, 150 high need clients. And that is no small feat because there’s just so much, the volume of it. And then, because you really don’t have the time and the energy that, that all of these people really do require, it sets you up to fail a little bit.

It feels stressful because there’s just no way of doing all of the things and helping people in the way that they really need to be helped just because of the system. But it can also make it extraordinarily difficult to set boundaries in that kind of environment because of the demands of the workload and the very serious and sometimes, crisis situations, life-threatening needs that some of these clients have.

So this requires a very delicate balance to ensure that you don’t lose yourself in the process. Because, if you do, when those boundaries start to blur, you’re staying there till six o’clock, finishing your notes, you’re squeezing in one more client. Now you’re there till seven 30, right?

Burnout can set in and one of the first signs is that we start to lose our empathy. We start to care less, and that’s a clear sign that we need to reevaluate our situation for the well-being of our clients, but also for ourselves, unfortunately. Because these systems can be so difficult to work in. Many therapists at some point decide to leave agencies in pursuit of a more balanced work-life experience, which they think they’ll find in private practice.

And I think some do. And private practice also has extremely real structural burdens that aren’t. Often discussed or acknowledged. Transitioning into private practice brings its own set of challenges. The freedom of running your own business and setting up your own shop. It can be very invigorating, particularly if you’re coming out of a toxic work environment that has really not been good for you.

So just the freedom, the autonomy of that can feel really good. And in order to make a private practice work, there’s a lot of work involved that is. Not seeing clients and having billable hours solo private practitioners. For every one client hour we have, we may be working 2, 3, 4 other hours unpaid in order to make the operation run.

Marketing, billing, administrative work, insurance submissions like this. It’s a juggling act and it can very quickly become overwhelming, which also makes it difficult to establish and maintain healthy boundaries, particularly when financial concerns become part of the picture. It always sounds good.

So yeah, we should say no more. And if you’re in a solo private practice, you only have a few clients, you’re worried about money, yeah. You’re. Probably gonna be working on a Saturday to spend the hours to, submit the insurance claims or stay late to accommodate a client who might not otherwise see you that week.

And so that can add a lot of pressure that gets in the way of our ability to set boundaries. It’s tough to turn away paying clients. When you’re worried about making ends meet, how do you say no? So understanding the realities of these different systems I think is one thing that we have to consider.

But also let’s talk about what some of the strategies are to. Set healthy boundaries and feel like your life is more balanced and that you’re more energetically nourished. Because then with these strategies in mind and talking about what this really should look like, then you can make choices around changes that you can make to the system or changes you make to your environment.

That will support the things that you really need to be doing. And step one here is simply getting clear about what your boundaries should be, just defining your boundaries. I think it’s crucial for all of us periodically to be taking a step back and thinking from a distance. Not what our boundaries are right now, but what you would like them to be and actually writing it down, even if it’s not the way it is right now.

Just journaling of questions like, what would I like my working hours to be? What do I need to be doing in order to step back and recharge? It could be I need at least two consecutive days every week when I’m not seeing clients. And it just those things, I need space, I need time.

I need to have time and space to be building exercise into my life, friendships into my life, things that nourish and recharge me. Also, on that note, if you have been working way too much for way too long, very easy to get disconnected about. What does actually fill my cup and nourish me? Like we can get disconnected from these things.

So just to be reminded like, oh yeah, yoga, I forgot about how much I liked yoga. You start doing that again, whatever it’s, but so first is just acknowledging to ourselves what the boundaries should be, what we should be doing. And I’m using the word should in the best possible way as an, this is what I aspire to, right?

And then to think about are there any changes that I can make in order to create this outcome that I want? Taking the realities of the system into consideration. But for example when you are clear about this. Then potentially you could have conversations with your employer. You could look into getting different help.

Could you afford to hire an assistant in your private practice to help manage the workload of the day to day of what it takes to run a private practice. When you’re clear about what you would like to have, then you can start thinking about, okay what would help me create this?

And a piece of this too, is when you’re clear about what it is that you want, you also have more direction that will help you establish some structural fixes. So you can define protocols for phone calls that come in after hours. Say, or if you get a text or a message from a client after hours or your work time availability this is what I want it to be, and so here is how I am going to handle these situations when they come up.

One just pro tip is if, particularly if you’re in a private practice environment, making sure that your personal contact information remains. Private, I would not give your personal text or cell phone number to clients unless you know them very well and know that they won’t be pushing at your boundaries otherwise.

I’ve gotten texts from clients at three o’clock in the morning before, before I learned this lesson the hard way, who were in trouble, who I needed to get out of bed, and. Talk off a ledge, like literally. So you know, to be thinking about some of those structural boundaries. But also I think too, when you’re clear about what you want that to be, then you can also start setting expectations with clients, right?

So here’s how we’re gonna handle, if you get in touch with me between our sessions, if you need something, here’s when I’m available, here’s when I’m not. And again, if you’re in an agency environment. To consider having a courageous conversation with an employer to help them understand, I signed up to do this from eight to six, or whatever it is.

And so if there are things that are not possible to get done between these times. I need you to know that these aren’t going to get done. So why don’t you and I sit down and take a look at everything on this list, how much time it’s all going to take so that you can help direct me as to what of these are the highest value and most important things to be doing and, have an understanding of what things probably won’t happen, or at least not on the timeline that is currently being requested of me because it’s not.

Possible and just to see how that goes. But it’s important that your system is cooperating with your needs because if you have needs and are in a system that is directly opposed to making those things happen, you have intrusive stuff coming at you. You have these expectations that make it impossible.

You’re setting yourself up to fail when it comes to healthy boundaries. So again, it’s just, it’s really important to have clarity for yourself first. And then of course, you know through this we’re talking about clear communication and to the degree that you can, when you enter into new relationships with clients, either private practice clients or even with an agency, be really upfront with people about your boundaries.

What can they expect from you? What are the limits? Of your availability, what are you not going to do? And having this kind of clear communication is the key to establishing a healthy therapeutic relationship. It gives your clients. Some guardrails and it also creates a expectation of mutual respect, and it gives you a basis for having a courageous conversation.

If people are pushing your boundaries, you can go back, remember when we talked about our very first session? So again, having that clarity for yourself, but communicating it clearly to your system and getting clear about that, but also to your clients so that they can help you. Be healthy and can go both ways a little bit here.

Another piece of this, if you do. All of the above. You’re getting clear with yourself, with your system, with clients, and it is still not working. This could be a really important personal growth opportunity and professional growth opportunity to. Really reflect on a bigger picture level about what you really need in order to maintain your wellness and, have this be a sustainable career path for you.

If you’re trying to make changes with your leadership with your management and your organization, with your clients, and it’s not working. To have that honest question with yourself. Can I establish and maintain healthy empoundries in this environment? And if not, it might be time to explore other options.

Or if you know you’re reflecting on the experience of a solo private practice and say, in order to make this work, I either need to. Spend twenty-five hours a week above and beyond what I’m doing with my clients in order to do marketing and billing and all the management stuff that needs to happen here.

Or, if I decide to sign up for insurance panels, my, my rates automatically go down. And now I have this big administrative workload when it comes to spending insurance claims and chasing all that down. So if you’re looking at these and being like. I, these do not sound good to me. You might even consider other options that you hadn’t before that would really be more supportive of your long-term.

Well-being, and I think the personal growth moment here is to. Legitimize your own feelings, legitimize your own needs and desires in a way that I think we as helpers are not always socialized to do. I think that we are by definition I. Selfless people or generous people, and the act of turning your attention back to yourself can sometimes feel radical and new.

And here’s a moment though to consider. Can I get my needs met in these situations and to get creative with other options? For example, there are different things that you could do. I never wanna counsel anybody out of this profession, but I know, a lot of people have been like, I don’t wanna do this anymore.

And they go take a job in hr, right? So that could certainly be an option but I think a more long-term sustainable option for many therapists who want to remain as therapists. In this profession is considering a group private practice, which has a lot of advantages over either a, an agency model or an insurance-based model, or a certainly solo private practice model because.

It really supports healthy boundaries in a very active way. For example, even just administrative support. If there is a team around you whose job it is to handle things like marketing, billing, insurance stuff, administrative tasks, then you are free to focus solely on your clients. And that the work you are doing is going to be a billable hour and like maybe a couple notes, and then you’re done.

So just not having to do the rest of it can be incredibly liberating and a lot of support for being balanced that you’re getting paid for what you do and then somebody else’s problem to handle The rest of it can really be a huge advantage. Additionally. I think another huge benefit of being part of a solid group private practice means that you’re not alone.

You can get feedback or share experiences, get encouragement from other people to say, I wonder if you need to take a break or if you need to set different boundaries with this client. That because our profession can be so inherently isolating. We might not even recognize when we’re failing to take care of ourselves in the way that we should be, or set boundaries in the way they should be.

And so sometimes, just having a colleague who cares about you to say, you could say no right now. You know that right? No, I actually didn’t think of that. Thanks for saying that out loud. You know what I mean? That can really be invaluable and I think you know, that sense of belonging and support for our own, well-being and self-care can really be essential in feeling empowered.

Not guilty for setting healthy limits. So that is something that’s really important. But even, above and beyond that encouraging us just to set limits, there’s built-in backup. You know when life happens and you need or want or deserve to take time off, whether it’s for a vacation or a personal situation.

A group practice has systems in place to provide coverage for you. You can go to Thailand for six weeks and turn off your phone if you have somebody and a team there to keep an eye on clients and provide bridge sessions if you need to. And this continuity this I don’t know, collective effort.

Allows you to really unplug and have peace of mind while also having confidence that your clients are being cared for in your absence. ’cause you’re not alone in this. So that can be something really important as well. And Additionally. I think being part of a solid, clinician-centered group, private practice can create flexibility, autonomy, and independence that can be quite liberating and can help you set healthy boundaries in a way that’s difficult to do in an agency environment or in a solo, private practice because.

You have control over your schedule. You have control over the types of clients that you work with. You can say, no, I don’t wanna work with that person, or that kind of, presenting issue. And you’ll have a team who’s there to tailor your practice experience to suit your strengths and your interests.

And additionally, I think having the autonomy to operate in the way that you want to operate. So not as an employee like working from an agency, but being able to manage your caseload and the number of clients that you wanna have, the hours that you want to be there. Like I only work. Monday, Tuesdays and Wednesdays.

Okay, great. Do that. Like you get to define it, which creates a lot of space and margin in your life to take care of yourself, to unplug, to turn off because you don’t have to sweat it, you don’t have this an agency environment with very high expectations. And you also don’t have that financial burden of oh, if I say no to this client, and.

I don’t have that many clients. How am I gonna get more clients? I have to say yes to this person. So it really helps with a lot of that. And then additionally, I think a good, positive, strong, collective private practice is going to have a strong focus on your wellness. I know that is the. One of the main missions of my practice growing self is that the well-being of our therapists is the number one priority.

Because of this understanding that a supported therapist who’s growing, who is happy, who feels successful, who is prospering, who is taken care of, is not only going to. Be happier and healthier, but to have a, I think a more sustainable, long-term career as a therapist and not abandon the profession first of all, but also a happy, healthy therapist is gonna really be able to do a better job with their clients.

I think this focus on wellness helps prevent burnout, and I think it ensures that we can bring our best selves to our sessions with our clients. We have more to give. Establishing and maintaining healthy boundaries is a crucial part of being a therapist. That is the experience of being a therapist is having a lot of people depend on you and what you, I want you to help them and having to figure out where that needs to stop for your own benefit.

Because if you don’t it, it never ends. And doing this ensures that we can provide the best possible care to our clients while also taking care of ourselves. And we talked about a lot of strategies to achieve this. Getting very clear about what those boundaries need to be developing protocols for.

Okay, here is how I am willing to operate in service of my needs. It involves communication, very clear communication, letting other people know what to expect from you. And. If you are in a difficult system, at least trying to have courageous conversations so that the system can support your well-being as opposed to feeling like it’s always a war.

And. This work may lead you con to consider doing something different than considering something like a group private practice where you get the support and the structure that you need to maintain boundaries with ease. Where you get the advantages, the freedom of a private practice more freedom than having a solo private practice.

Because you have a support team, which means you can thrive as a private practice clinician. Maintain the compassionate care that your clients need, but also be valuing your own time, your own energy, your own needs. So it starts by acknowledging the fact that you have needs and remembering that you are worth it and that ensuring your well-being is the best thing that you can do for yourself and for your clients.

So I hope that this overview of some of the struggles and, the reasons why it can be so hard to set boundaries is helpful for you. I hope you felt seen and validated because we have all been there. But I also hope that it helped provide you just with some encouragement and some guidance and some of the, strategic and actual things that you can do.

Like just writing down what should my boundaries be and how might I create those? But also, if you’re not. Familiar yet with a group practice model if you haven’t operated in that kind of environment. Just to float that as an idea because when I’ve seen this go really well for clinicians who are truly able to flourish and thrive, it’s often in that kind of community that they find the most satisfaction.

And not always. I also know people who are in agency environments who love it. That was why they are on this earth and they have been able to create internal and structural boundaries that make this very sustainable and satisfying for them, and that is fantastic. I’ve also met solo private practitioners who really enjoy doing all of the other things and are willing to accept all of that ’cause it’s what they want to do.

It feels. Good for them. But it always starts with having that self-awareness around who am I? What do I want my life to be like? How am I gonna make that happen? And then understanding what your opportunities are, I think, in a realistic way. So again, I hope that this conversation has been helpful for you.

And if you would like more on this topic, I have more for you. If you come to my website, growingself.com Forward slash. Therapists. I have a whole section of resources just for you, so you’ll see other podcasts that I’ve recorded on various topics to support your well-being articles that we’ve written to, just.

Dive more deeply into different things to think about, things to do on professional growth, personal well-being healthy boundaries, common client, concerns to support your success. And in addition, I put together a free assessment. It’s my how to Flourish and Thrive as a therapist, Quiz. And if you take it, it will give you insight and visibility into the things that are currently.

Getting in the way of your joy and satisfaction as a therapist. So if you take it, you’ll get insight into, how you’re doing in different areas that we all need to be thinking about. Professional development, community, solve a therapist stuff, but it’ll also provides you with direction around where to focus first and what to do.

So that you can reclaim your joy in our shared profession. So thank you so much for joining me today, and I’ll be back in touch next week with another episode of Love, happiness, and Success for Therapists. Talk to you later. I.