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The Pros of Being Professional, Part IIBeing Professional Means Being Real… Really!!!

How we convey professionalism to our clients is a many-faceted and important topic. In the last issue of Therapy Marketing Monthly, I split that topic into two areas: passive and active professionalism. I referred to the passive components as the ways that we are being represented, even when we are not consciously aware of them in the moment. Those include web sites, outgoing voice mail messages, online profiles on various services, and others.

Active professionalism is, of course, about all of the direct ways that we present who we are to our clients. They are a real “tell” for the type of job we are likely to do for them. They let new clients know that they matter to us, and that the work we do matters to us. And clients pick up on those behaviors pretty quickly.

In that previous article, I wrote about the first contact we have with new clients. Those include our responses to voice mail or e-mail messages, meeting the client for the first time in our lobby, how we dress, and how our offices look.

I’d like to continue this discussion by addressing that important first session.

The First Session

Coming to a therapist’s office for the first time is anxiety provoking for most people. Our first job is to lessen that anxiety as much as possible. A warm, confident demeanor goes a long way toward accomplishing that.

I verbally appreciate that they are here to do some work on a difficult part of their lives. If I already know what the issue(s) are, I name them. Since I take notes for the first session, I explain why I do (that I usually get a lot of detailed information that I want to be sure and hold onto). I also let them know that if they decide to do ongoing therapy with me, they won’t see a notepad in the future.

And then I ask where they would like to start. If they aren’t sure or feel overwhelmed, I encourage them to take a couple of deep breaths and connect with themselves. In that way, I am already laying the ground for how I work. It’s about tuning into yourself, and being with you.

As a professional, you know that the work is about the client and not about you. Gentle probing works best to be sure that you understand their story correctly.

However, when their story includes some painful information, I typically can’t help but tear up with them. I often say that I flunked the grad course in being a “blank slate” with my clients. But lest they think that I’m overwhelmed by their story and can’t handle the emotion, I let them know that is not the case. My tears are just a real response to sad or hurtful information. And since they are in my office to learn how to be real, I will role model that for them.

But I let them know that they don’t have to take care of my emotional response in that case – since that is often what they had to do as children for their parents. I can and will handle that. Quite often, they will let me know – after I set those boundaries – that the validation of their pain in my eyes is helpful. But trust what is right for you during the sessions.

When the session is getting near to completion, I let the client know that – usually about 10 minutes before the end. And especially if they are in an emotional place.

But that extra time to close the first session is necessary because I want to check in with them about several things…

First, how did this initial session feel for them? While they’ve only known me for about 40 minutes at that point, they probably have a sense of connection or not. I ask directly: “Does this feel like a safe place for you to do the work you want to do?” I ask that question for a number of reasons.

I want them to know that the decision to do work with me is theirs. In order to determine that, they have to check in with themselves about how the session has felt. This approach also gets them to make a vocal commitment to doing the work with me. They basically agree to buy the service I am offering.

Secondly, I want to go over legal and ethical considerations – especially confidentiality and its limitations. I also want to explain my policies, which is basically about teaching boundaries. And naturally, I give them a chance to ask any questions.

Regarding boundaries, I make sure to tell them about my late-cancellation policy – that I will charge the full session fee if they don’t give me 24 hours’ notice that they need to miss a session. But that I also offer them a “make-up” session if I have an opening in that same week. Whatever your policies are, this is the time to go over them.

How you handle payments – methods of payment and when you collect, requests for phone “chats” between sessions (I limit those to 15 minutes), and weekend availability – all fall into this category of practice policies. Again, these are all about having good boundaries.

This information should be clear and conveyed in a direct way. They have enough ambiguity in their lives right now and need someone who is clear about their own structure.

As you know, many clients will test your boundaries early on – whether it’s asking “one more question” to extend the session time, or to challenge the 24-hour cancellation rule. You do no one a favor – yourself or the client – if you don’t adhere to your stated policies. In fact, a lack of trust is likely to ensue when you waffle.

Between Sessions

Returning calls promptly, maintaining your policies regarding the length of time you spend on the phone with them, and your weekend availability are all ways that you convey professionalism.

Regarding the latter, I let clients know that, while I pick up voice mail messages at the beginning and end of each weekend day, unless the calls are urgent, I save my call backs for Sunday evening. That allows me to have a non-work weekend as well.

Again, all about boundaries! I know, I know… I said that already.

Being professional includes interactions with colleagues. When you receive a referral, there is no excuse to not say “thank you.” The therapists I refer to over and over are the ones who of course do excellent work, but who also have the good business practice of acknowledging and appreciating when someone gives them something. Even if they can’t work with the client I referred to them.

Those “Real” Moments

Hopefully, each of you has been in therapy yourself. I’ll bet you can remember vividly the moments that your therapist was caught off guard. You no doubt watched his or her response in a laser-like way.

For example, I typically work into the evening and when we first moved into our current office suite, we hadn’t yet trained the janitorial staff to not clean our offices until after 9:00pm. So, naturally, one evening one of the cleaners burst my door open and was startled to see the room occupied. I was startled by the invasion of privacy, even though it was unintentional. I could feel my clients’ eyes on me.

I got up quickly to keep the cleaner from coming into the office any further and seeing my client. I asked if she could come back after 9:00pm, while I held my door partially closed behind me – trying my best to maintain confidentiality. The cleaner was very apologetic, of course. The event gave us (my client and I) an opportunity to talk about how that kind of invasion felt for her – and whether it brought up any echoes from the past.

If I had yelled at the cleaner (I can’t imagine doing that!) or done something else inappropriate, that would have affected the therapist/client relationship.

Seeing clients outside the office when we are shopping, going to church, at restaurants or other public places, is another opportunity to be “real.” You will be, of course, caught off guard and your automatic response is who you really are. The decision to speak to you is the client’s and I’ve had it go both ways. Sometimes a client will purposely turn away, and other times they’ll come up and introduce me to whomever they are with. Accepting either response with graciousness works best.

The times when you make a mistake are also opportunities for being real. Ever double book? If you’ve been in this profession for any length of time that will happen. Sometimes, it’s the client’s error; sometimes it’s the therapist’s. How you then handle the consequences – two people in the waiting room at the same hour to see you – makes a huge difference going forward.

I take the time to rebook the client whom I don’t think is supposed to be there at that time. That helps that client know that I do want to see them and aren’t just pushing them out the door to deal with the “rejection” alone. If it’s my error, of course, I apologize and then we look at that in session. We all make mistakes. How we handle those and repair the relational rift is what matters.

In the “Real” World…

I ran across my dentist once in a Starbucks that wasn’t anywhere near his office. We were both surprised. He acknowledged me, spoke to me warmly for a few moments, and then made a polite exit. I was impressed. The exchange didn’t feel any differently than what it was like to receive his services in his office. He felt very “professional.”

I use that example, because I think it indicates the difference between someone who works in a “profession” vs. those who don’t. It’s like having a coat or cloak that is always ready to be worn.

There are times when that cloak of professionalism is obviously required outside your office.

Such as when you are giving workshops, doing presentations, attending a professional conference, consulting about a case with colleagues, taking a CEU class, etc. You take the work seriously and you convey that in your demeanor, the words you use, how you speak, etc. That doesn’t mean that you can’t be lighthearted at times. You wouldn’t be real otherwise. But the people you are with grok that you respect the work that you do and you expect them to do likewise.

But there are times when the opportunity to be professional sneaks up on you.

My favorite example happened only last year. I was pumping gas into my older Audi. A woman pulled up behind me at the station to do the same. She had a “hot off the presses” new Audi. “I like your car,” I said to her. She looked at me, then at my car, and smiled. And we were off having a conversation – first about cars, but then about her license plate which indicated a company name. So the conversation morphed into what we did for a living.

When she heard that I was an MFT, she said, “OMG, my husband and I could use your services!”

I could feel the professional cloak come on.

I pulled out a business card and gave it to her. She talked briefly about their situation. I never heard from her again, but I’m still aware of the shift in my demeanor that took place when she talked about couples’ counseling.

“Real” Professional

Being a psychotherapist changes you in fundamental ways. As a grad school professor once said, you don’t put it down at the end of the day like a carpet layer does. You can’t separate it from who you are. The change happens, of course, when you do your own healing therapy, but it continues through grad school when you understand human relationships and the brain in ways that most people never will.

This fundamental change continues as you work with clients over the years, as you watch and deal with your counter-transferences, as you heal your personal relationships, and create a healthier one with yourself.

Being professional requires you to honor the work you do. Being real requires you to honor you. They go together.

I’ve always loved the child’s story The Velveteen Rabbit by Margery Williams, which is subtitled “…or How Toys Become Real.” In it there is a discussion between the Rabbit and the Skin Horse on how one becomes real.

The Skin Horse tells the rabbit:

“You become. It takes a long time. That’s why it doesn’t often happen to people who break easily, or have sharp edges, or who have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are Real you can’t be ugly, except to people who don’t understand.”

It takes time to become a professional too. And awareness. And intention.

We’d love to hear about your professional journey. Please share your thoughts and experiences by leaving a comment below. We look forward to hearing from you!

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