What happened when I stopped seeing clients for therapy? How to evolve a business in adversity

Welcome to the Business of Psychology podcast. Today is a bit of a different episode for me because I wanted to be honest with you about some decisions that I've made recently that are really personal, but that resonate a lot with decisions that I help some of my coaching clients to make, because it's rare that we go into private practice without some complicating factors happening in our lives.

Full show notes for this episode are available at The Business of Psychology

Episode Links:

Episode 19: How psychologists and therapists can use an ideal client avatar to co create and market their services

Episode 103: Why you should specialise – old gold that is still important

Episode 128: Who are you helping? Three ways to specialise your psychology or therapy practice

Episode 152: Thinking differently about your practice: A tool to put the client first

Links for Rosie:

Substack: substack.com/@drrosie

Rosie on Instagram:

@rosiegilderthorp

@thepregnancypsychologist

Evolve and Thrive Mastermind

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Shownotes

What happened when I stopped seeing clients for therapy? How to evolve a business in adversity

I've spoken a bit here, and a lot more on my substack, about how I originally went into independent practice really because my children have additional needs. I wasn't aware of that at the time; all I knew was that nursery didn't work and that we didn't have other childcare options available to us. But looking back, nursery didn't work for the same reasons that school is very challenging now. And that was the beginning of me having to learn to evolve and adapt and be a clinical psychologist in a different way, and that's been very much the purpose of my business and what I love to help other people do too. So it felt only right that I should share with you about some of the recent evolutions that have had to be made in my business, my thinking behind it and the kind of strategy that I use every time I have to make a big change in my business. Because it has happened so often that I have developed a bit of a framework for thinking about it and helping my clients through it when it happens to them too. So, I thought it might be useful to share what's happened, but also my framework for thinking through and strategizing my way through those difficult moments that often lead to a change or an evolution in the business.

Firstly, I want to acknowledge that there's a lot that I love about independent practice, and I am so grateful that I have this profession that enabled me to set up independently when the NHS wasn't going to work anymore. But it's a paradox because I also felt extremely sad about leaving the NHS. It was 2018, I was very young, I didn't feel anywhere near experienced enough to go into independent practice at that time. So, to an extent, my first journey into independent practice involved a big evolution of identity in and of itself, and I guess that's a context for many of us. Many of us feel a big wrench when we leave the NHS or when we even start to think about potentially leaving our public sector roles. So, I guess independent practice starts from that place for me, and for me it's always held this kind of paradox of opportunity and excitement alongside sadness and loss. I know that that's the case for very many of us in independent practice, and I suppose what I hope is that what I'm going to share today helps me and you, if you find yourself in this kind of situation, to use an actionable framework to find the opportunities and the excitement, even when maybe you wouldn't have chosen the situation that you find yourself in.

What's been going on in my business

I'll let you behind the curtain a little bit in what's been going on over the past few years in my business, the harder bits perhaps. As I mentioned, I have children with additional needs and sometimes it's difficult to get those needs met by anybody other than me. I think if you've navigated the SEND system in the UK, then you'll know exactly what I mean by that. A few years ago, my children really couldn't cope with school, so suddenly I found myself needing to go back into the role of being the primary carer all of the time, and there was no space for my independent practice. It was very sudden, I hadn't anticipated that my children would struggle to that extent, that they couldn't be in the school environment. I'd never in my life met anybody that had a child that didn't go to school. I knew it happened for teenagers, I did not know that it could happen for five- and six-year-olds, but it really did. And in fact, it was a problem that lasted for more than a year as we tried to find flexibility and find ways of making school accessible and suitable for them. I should say that compared to a lot of families, we were very lucky. We’re in a lovely school with an amazing SENCO and a really compassionate and strong head teacher who have been flexible in ways that I do not think are normal in mainstream primary schools. They've bent over backwards to support us and that is not the story that I hear from a great many families that I work with. So, just to check my privilege on that one, I know how lucky we've been. But it still took a really long time to help the children recover and to find the adaptations that we could make to make some sort of school more accessible to them. We did get there, but it took all of me to do it. And so in a real hurry, and I'm not proud of how I handled it, because I don't think that I handled it in an optimal way whatsoever, I had to close down my clinical practice. It wasn't the first time it had happened, it happened to many of us in COVID as well, but it felt much more rushed, much more traumatic than that, because I went from expecting that I would be seeing my clients for years to come. I was really excited about the premises that I had, really excited about establishing a service in my local area, and all of that just ended really abruptly when I had this realisation that I'd had to cancel more clients than I'd seen in a week. And I can't overstate how painful it is to know that you're not being the psychologist or therapist that your clients need. As soon as I had that realisation, I knew the only ethical thing to do was complete closure and to hand people over in the best way that I could to other professionals in the area. But it was brutally painful and I still feel waves of trauma thinking about it and talking about it, so that's all I'm going to say about that. It was forced, it was hurried, it was crisis driven, it was not what anyone would hope for.

So the practice stayed closed for probably at least 18 months, if not two years, while I just focused on recovering my children. I kept Psychology Business School going, because although there were parts of me that thought let's just retreat from professional life entirely, financially I didn't really have that option, or it would've been extremely difficult for us if I had chosen to do that. But I think more for me, I needed to feel that connection to my profession and to my colleagues and hopefully as anyone who's done coaching with me will know, I really enjoy immersing myself in somebody else's practice and somebody else's struggles, and solving the problems that come up in other people's businesses was the kind of relief from the rest of my life that I needed, and it also meant that I didn't lose contact with the mission that we have as mental health professionals and my professional values. So it was important for me to keep that going during that really difficult period, even though it was also extremely difficult, and I would find myself snatching hours of work at un...