by Kimberly Sandstrom, LMFT

Well, first, I wish I’d known that private practice would challenge every “I’m not good enough” crack in my “I’ve got it all together” veneer. Yep, people think I’ve got it all together. I don’t. Every time I called a client and they asked if I took insurance or how long I’d been in practice, or what my fees were…the hesitation took over. “The ruse is over. They will know I’m a poser.” If they find out, they are going to run for the hills…or the therapist next door!”

These are things I wish I could tell you as you begin your journey in private practice as an intern.

No one will EVER ask you what your GPA was in grad school. (Well, one client did, but his son was in my practice for anxiety…hmmm.) So, don’t stress it while you are studying. Just learn what you are supposed to and enjoy the journey—you will miss the opportunities to learn and discuss (but not the papers and exams).

I would feel like a poser for a while. Sometimes I would catch myself in the middle of a session thinking, “Wow, look at me! I’m a therapist!”

I know more than my clients do. Telling clients I was an “intern under supervision” was one of the scariest things in the beginning. I was sure they would say, “I’m outta here. I want someone who can actually help me!” No one did run or tell me that. In fact, once they were in the office, they stayed—I’m good at connecting with people. My life experience couples with my clinical training and awesome supervision gave me the edge I needed.

I can charge what I’m worth. I thought I would have to charge $25 per session because that’s what all the interns before me did. I sat down and made a list of what I knew and what I need to learn. Surprisingly, all the extra training and interests, books I’ve read over the years, and my life experience being married 20+ years, raising 3 daughters, actually gave me a competitive edge. I started out lower than I am now, but worked my way up. I’m worth it. You are too. You have unique experiences no matter how old you are. You have a reason you pursued this career. Capitalize on that and think about all the work you’ve done in that area for yourself.

Helping people heal is like taking ecstasy! Well, I’ve never taken ecstasy but I hear it’s like the love drug. That’s exactly how I feel when a couple I’m working with begins to heal, lowers their escalation and begins to fall in love again. All the dopamine centers in my brain begin firing. It motivates me while working with the tougher couples I work with. There is hope and I’m a vessel for healing in their lives (not the only one, but one vessel they can access).

Transparency is okay in the therapy room. Remember #2? I thought I had to pretend I knew everything. I don’t. When I’m stuck with a couple, it’s okay to share that. “Hey guys, I’m feeling like we are getting stuck in this same place, are you feeling that too?” Usually this opens up conversation for where they are getting stuck and I don’t have to do all the work.

Opportunities don’t “present themselves” you have to go find them! During my practicum, the site I was at had to send me clients and there was no shortage—they took on students to provide for their clients and I needed the hours to graduate. Private practice, no one hands you clients (my supervisor was very generous with referrals). You have to go out and get them. This meant asking people to meet for coffee, asking people if I could blog for them (like here) and emailing audiences I wanted to speak to and asking them if they needed me. My name was unknown and I had to make myself known to others. While you may not like to speak, you can certainly put yourself out there in other ways. I networked with key people in my area and the referrals begin to trickle in. Now licensed, I have a steady stream of clients and community referral sources that I can rely on to keep my practice full. Oh, and about “full”…

I don’t have to see 45 clients a week. I’m exaggerating, of course, but I found a good number of clients that I feel comfortable with each week. They get the best of me when I stay within that client-hour range. There was one month during my internship that I saw 25+ clients a week. I was exhausted, irritable with my family, and not doing my best work. I got sick the moment I slowed down. I made a decision that this was not in my best interest. So, I raised my fees a bit with new clients and see less.

The BBS does eventually approve your hours. The past few years it has been a long seemingly endless wait for hours to get approved, but it meant I got an extra year of supervision and experience. Silver lining.