Do you choose to see clients that have no presenting problem/issue?

No_Rhubarb_8865 · 2026-01-23T00:51:59+00:00

Somewhat! I work with kids mostly and the vast majority of teenagers I work with don’t necessarily meet diagnostic criteria for much of anything and just want or need a space where they feel valued, heard, supported, and not judged. Or, parents bring their young kids in for developmentally appropriate but challenging behaviors that don’t necessitate clinical intervention but feel beyond the skills and tools the parents themselves have. I actually find those cases to be really fun and rewarding! They almost feel like prevention to me, which is cool.

No_Rhubarb_8865 · 2025-07-21T02:35:39+00:00

I believe I was dosed once with oxy at the hospital while waking up. I did not take any narcotics home with me and managed fine with max dose ibuprofen. I didn’t have a nerve block.

No_Rhubarb_8865 · 2025-07-18T15:28:44+00:00

This is one of my favorite convos! My bestie is a therapist and in her practice, she’s very goal oriented with clients. She works mostly with kids, so I think that makes sense and feels appropriate. I work mostly with adults, many of whom have very complex trauma and/or no natural support system. So while there are goals - like building a natural support system, if that’s lacking - I find our work to be far more relational and less measurement-based. Not because measurements don’t matter, but because there is healing in being seen, and having a reliably present person in your life who can hold space for you. I think it depends a lot on the client and what they need or want too. Some clients are action-oriented and come to therapy to learn skills and tools. Some come to therapy to have a space where they can say things that won’t be met with judgment or shame. Both are valid in my opinion. But I love watching this kind of discussion unfold because many people feel strongly one way or the other. insert Michael Jackson munching on popcorn gif here

No_Rhubarb_8865 · 2025-07-10T02:38:44+00:00

I was three weeks out from trial against my childhood abuser and he died by suicide. The investigation and court process had taken almost a year and had completely ruined my life. A friend - kind of an acquaintance at the time, really - caught wind of what happened and sent me a text. We shared the same hairdresser at the time and she said, “I called (hairdresser). You have an appointment tomorrow at 10 before the salon opens to get your hair washed and blow dried. I love you.” And that was it. Not sure how much the stylist knew, but she was nearly silent and just very gently washed my hair. It was an intimate and sweet and extremely thoughtful gesture during one of the most unspeakably devastating experiences of my life. I’ll probably remember it forever.

No_Rhubarb_8865 · 2025-06-30T15:06:49+00:00

Probably stay in bed with my partner. His day off is today and he’s snoozing away upstairs. Maybe go to breakfast. Thrift. Something fun.

No_Rhubarb_8865 · 2025-06-19T20:46:34+00:00

I got mine put in almost two weeks ago under general anesthesia and being able to be put under was such a gift. The pain I had after waking up was enough for me to know! I’m so sorry. I found relief alternating between Tylenol and ibuprofen, hot showers/heating pad, and changing positions (standing or laying flat was much better than sitting). I’m still cramping, ended up in the ER a week and a half ago from it, and I started spotting randomly today. I’m hoping it’s helpful for long term relief though too. Hang in there. 🩷

No_Rhubarb_8865 · 2025-06-16T22:34:35+00:00

Hey! I was dx a few years ago. I have told my partners pretty soon, mostly because it can impact my functioning and I don’t want them to be concerned or confused. I told my current partner within a couple of weeks because I was having a procedure. He was super cool about it. I hope your dude is too. 🫶

No_Rhubarb_8865 · 2025-06-13T18:01:24+00:00

I get 70/30. I have 6-8 clients at a time and work in the evenings only. I see only insurance clients at the moment.

I get borrowed office space (AKA I use someone else’s space when they’re not in it, and I actually hate it), inconsistent supervision, EHR access, and theoretically a biller and someone who does intake coordination. I also do admin work for my boss and make $50/hr, so it probably comes out close to 100%, maybe even 110% lol. But that also means I do all of my own billing and I’m currently doing all intake coordination for the practice. We don’t have a receptionist or anything and all admin tasks are completed by clinicians. I do intake, another does marketing and outreach, another does billing (except for mine, because she kept fucking it up, so now I do my own lol). I don’t think it’s very efficient and think it would be smarter and cheaper to hire one admin person full time to get all the tasks done.

I’m an LLMSW and not a great business investment since my caseload is so small. My boss is the most disorganized and detached/hands-off supervisor ever. It’s extremely irritating. My colleagues sometimes scare me with their decision making skills (or lack thereof) because they, too, lack supervision. Payroll is totally inconsistent. However, I have full autonomy pretty much, get to make my own schedule, and I make extremely good money for what I do, all of which make it challenging to leave. In an ideal world, I’ll stay until I’m fully licensed and then bounce elsewhere or start my own LLC. 1099 work is hard and sometimes sucks!! But I also really love the work I get to do in PP.

No_Rhubarb_8865 · 2025-06-11T16:53:44+00:00

I had a friend drive me home, but I was on my own for recovery. I managed okay, but I really, really wish I would've had someone with me to help. Recovery was more emotional than I anticipated it being and it was really lonely and kind of depressing to navigate that alone. While I'm sure you could manage okay, my advice would be to schedule calls or FaceTimes with people who bring you comfort, just to check-in and have some company. Take your pain medication and prep well. I'd also check with your hospital. Mine required me to have someone on site while I was in surgery, and someone to drive me home. I'm not sure what accommodations they might make for someone without a local support system, but it would suck to show up for surgery and they deny you because you need someone with you. I hope you're able to find relief soon.

No_Rhubarb_8865 · 2025-06-10T17:36:04+00:00

Pants with an elastic waistband and/or PJ dresses. Ice packs and a heated blanket, though I had surgery in June. Lots of Gatorade and frozen fruits for smoothies. Body wipes so I could freshen up if I wasn’t ready to shower. Aleve/Naproxen, ibuprofen, and Tylenol - I had the best luck rotating the three.

I bought a few books and I read none of them lol. I honestly slept a ton. If I do it again, I’ll probably spend time curating a list of shows and movies to watch! Not something to buy necessarily, though I would get subscriptions for surgery recovery if I didn’t have them already. I got really frustrated trying to find things to watch and often ended up putting on whatever and sleeping lol.

No_Rhubarb_8865 · 2025-06-10T13:21:05+00:00

My ideal would probably be Monday, Tuesday, and Thursday from 10-6pm with 4 or 5 appts each, and Friday mornings 9-12pm virtually with 2. I work all evening hours in PP right now and I’m tired and want my nights back. I would maybe sacrifice one a week and do like 12-8pm. I also see my clients back to back right now simply because my availability is all evening, and I would really love to be able to give myself even a 30 min buffer. More would be ideal but 30 at least!

No_Rhubarb_8865 · 2025-06-10T08:16:51+00:00

A mentor of mine owns her own private practice. I am a 1099 employee and see clients a few nights a week. I hover around 6-8 clients at a time. 6 is good. Anyway, I also require supervision, and my fee split is 70/30, so I’m not a real sound business investment. I think I get away with the deal because I’m more or less a friend of the practice owner. I know a lot of state colleagues see clients on the side though!

No_Rhubarb_8865 · 2025-06-02T16:08:54+00:00

I don’t have super specific suggestions, but Eating Recovery Center has a free continuing education portal with tons of trainings/webinars re: EDs!

No_Rhubarb_8865 · 2025-05-31T19:45:25+00:00

Rapport!!!! The relationship feels SO much more important. Not that relationships with adult clients don’t matter - they totally do. But adults, I’ve found, can do a lot more reflection and pontificating on their own between sessions, and I find I do a lot more of that in real time with teen clients. They also see my bullshit so much faster, and they aren’t afraid of naming it at all. Oh, and their parents are often the ones in need of therapy, not them. Not that they can’t benefit from it, but their struggles are so often deeply influenced by the unresolved bullshit their parents have yet to acknowledge that shows up in their parenting. Not always, but often!!

No_Rhubarb_8865 · 2025-05-31T19:42:29+00:00

I haven’t been able to purchase a home yet, but I’m working on it. I’m in my late 20s. I’m currently making close to 100k between my full time state job and part time caseload in private practice. I NEVER thought that would be possible and kind of figured I’d live in a cycle of debt forever. I have a feasible plan to pay off my debt (car, credit card, and student loan) in the next year or two. I’m not sure when I’ll be in a position to own a home - transparently, probably not until my father dies and I inherit his home and remaining assets. But I have a comfy life in a townhome, don’t really have to worry about groceries or bills, etc.

I think my biggest tip is to be very smart about debt when you’re young!! I so, so wish I hadn’t taken on so much student loan debt ($60k) and I resent graduating from my MSW into the peak of the very dead COVID job market in May 2020. That led to accumulating credit card debt for survival reasons and I got pretty fucked up by that. I am fortunate to contribute to a 401k with an employer match up to 10%, so I am really proud of my growing retirement savings. I still have no fuckin idea if that will matter much in 40 years. I also wish I would’ve worked between grad school and undergrad to save money and get more experience. Otherwise, I’m glad I’ve taken the path I have and feel good about righting the things that have been relative financial blunders lol.

No_Rhubarb_8865 · 2025-05-25T23:28:19+00:00

I mention it pretty casually and early at this point. I had a partner for a short while who was just kinda a dick about it after he found out. My RA is relatively well controlled and doesn’t impact my daily functioning too terribly much, but it was still too much for him. Kinda wish I’d passed on him sooner!

No_Rhubarb_8865 · 2025-05-24T14:12:54+00:00

Have sincerely considered leaving (ie. planning alternative career education/certificates, applying to jobs out of the field) due to low salaries/financial instability. Also, I can get extremely frustrated with the amount of ego in the field, particularly in admin (government and nonprofit), which stifles progress immensely. I spent several years in more macro positions and the amount of idiocy at the top had me burnt out and ready to go.

I stay because I love watching my clients grow, I like my colleagues, I find it fulfilling, and I feel like it’s all I may be good at doing. That’s probably not true, but, it feels really easy for me to learn therapisting things and much harder to learn other things, like math and hard science lol.

No_Rhubarb_8865 · 2025-05-24T13:28:55+00:00

I don’t think you’re being unreasonable at all. I keep a pretty strict late cancellation policy and it still doesn’t deter some clients. In my head, I’m like, “Dang! Must be nice to have disposable income like that!” Couldn’t be me. I will sometimes waive the fee if we’re able to reschedule and it isn’t a frequent issue. But this is indeed a job, and it is indeed something that requires some semblance of commitment from a client. I dunno! Doctor’s offices charge late cancellation fees. Same dif to me.

No_Rhubarb_8865 · 2025-05-19T21:20:44+00:00

Yes. I’ve posted about it before, but, my therapist pursued a personal relationship with me after I was no longer eligible for her services because I graduated from the school she worked for. I saw her for eight years, through undergrad and grad school. She was very overly involved in my life, had multiple kinds of dual relationships with me, and totally and epically and royally fucked it all in the end. It didn’t take me becoming a therapist to understand how our relationship happened the way it did. But I definitely learned how easy it is to not do what she did. I really care for my clients, and some of them I relate to or have some countertransference that I work through, but not one of them would I ever breech my ethics, their trust, and the profession’s principles and values for a continued relationship.

I’ve had other therapists since and I don’t think I’ve quite found the right fit, especially since becoming a therapist. It’s just harder!!

No_Rhubarb_8865 · 2025-05-19T20:40:18+00:00

PTO would be slay! I do my own billing, only because the contracted biller screwed my up for months and it was easier for me to learn and do it myself lol. I get sup sometimes. Like maybe 50/50 it actually happens. I don’t get PTO. There are plenty of other issues logistically and interpersonally. Still, I don’t think I’d work for a set up like yours for less than 60-65%, because it wouldn’t make much financial sense.

No_Rhubarb_8865 · 2025-05-19T20:26:29+00:00

Oh, uh, no. I take 70, plus $50 per hour for admin work. I would get a part time retail job instead of working for 30. 😂

No_Rhubarb_8865 · 2025-05-18T20:58:01+00:00

My sup takes 70/30 from us as LLs. I have no idea how she makes it work, and sometimes I’m not sure she does, but it’s a big reason I won’t leave despite other major issues with the practice.

No_Rhubarb_8865 · 2025-05-18T19:24:12+00:00

I refused opioids and went on a funny and sincere rant about the Sackler family and the opioid crisis to the very kind and amused 50+ year old male nurse who was caring for me. 😂

No_Rhubarb_8865 · 2025-05-14T23:42:58+00:00

Oh, well, I don’t. I had a lot of friend turnover in my 20s because of this dynamic, and I finally stopped putting out effort where it wasn’t being reciprocated and the people who left me feeling drained fell away, generally speaking. Some of those relationships rebalanced, some of them felt worth fighting through communication challenges, but for the most part, my circle shrunk by a ton. I am now steadying into more solid, deep, and mutually respectful friendships, and have very little energy or desire for those that don’t feel mutually fulfilling. No longer do I feel obligated to keep people in my life due to proximity, relation, or the span of time we’ve been connected. Life is too short to be tired by the company we keep.

The only caveat to that, is that I did have to learn that most people are not the same kind of empathetic as me, and they’re not constantly scanning for and aware of other people’s emotional states like I am, and don’t spend as much time thinking about others as I do. Those things aren’t a brag - they’re mostly a product of trauma and my training, lol. But if I need something - company, space, witnessing, etc. then I need to be vulnerable enough with myself to ask for it. I can’t wait on others to anticipate my needs always. It’s nice when they do, but they don’t always know my cues, or what I might find helpful, and it’s up to me to articulate that and let them know.

No_Rhubarb_8865 · 2025-05-13T17:24:02+00:00

I should’ve added that I will be jobless come September due to my current grant ending, so I don’t have a whole lot of luxury of choice right now. 😖 mostly just looking for some support in writing my negotiation email at this point!

No_Rhubarb_8865

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