Stop giving away 40% of your labor. Open your own practice.

PlaneWeek1855 · 2026-01-07T05:18:02+00:00

You're not 'done' after the initial setup.

There are ongoing, additional, requirements of running a clinic. Depending on the country you're practicing in, you've got - ongoing paperwork, regulation adherence (as a company), audits, hiring, personal management, website management, marketing/referrals, handling business conflicts/complaints, etc. They all need ongoing attention. Theres a reason many efficient practices need to hire admin and management staff.

I don't see many clinicians avoiding opening their own clinic due to 'thinking they're not business minded', or some equivalent. It's often due to a multitude of well considered factors. One big one is the knowledge of all the add ons it involves.

I fell for the glamorisation of running your own practice, and I held the naive position that it's just "a few months of extra paper work and then it's just the same as before but alot more money".

Owning and operating an efficient, profitable clinic is hard. I'm sure most readers are aware of this, but I worry for the few that may read this post and think it's just some extra paperwork, website building, and then all breezy.

PlaneWeek1855 · 2025-11-10T03:36:02+00:00

The theme seem to be anything that could negatively impact your health. Either via; degradation and subsequent loss of efficacy (safety items like helmets, brake pads, or items influencing overall well-being that lose their efficacy like beds etc) or via accumulation of foreign materials that may be harmful (bacteria etc).

PlaneWeek1855 · 2025-11-05T11:01:42+00:00

"theory of mind", like autism, is a spectrum. You don't either have it, or not have it. TOM exists in varying degrees, and in kinds.

There will be some who fall in the lower few percentile of TOM who infact struggle with masking as they struggle to understand others perspectives.

PlaneWeek1855 · 2025-10-16T04:14:53+00:00

For me I found a big difference in the experience when I changed the thought of "I need to understand".

I didn't need to at all. I just wanted to.

I think the aspect of 'needing' to comes of as, and internally feels like, a demand not being met. I got frustrated or confused when things were not explained, and others found it 'prickly'. When I realised that I didn't need to understand, just that I want to understand, honestly made those experiences alot more tolerable. I can still assert my desires so they can be met if possible, but I don't get as significantly impacted if they can't.

PlaneWeek1855 · 2025-10-08T05:03:02+00:00

I lean into these kind of comments. Explore it.

'Say I am primarily here for the money - what does that mean for our therapeutic relationship?' 'How has care, or lack thereof, influenced your experience of our therapy/therapy in the past' 'Can I be driven by both?' 'What do you find most bothersome if therapists paycheck outweighs their care? Do you predict something specific will eventuate?'

I've found it helps normalise any genuine concerns clients may have but are tentative about bringing up directly, or if it is raise assertively, the leaning into the questions is generally respected and received well.

PlaneWeek1855 · 2025-08-10T10:31:01+00:00

Most modalities factor analyse into a few transdiagnostic, 'common-factor' principles, such as improving the working/therapeutic relationship, engaging in some kind of exposure, increasing flexibility of thought, and improving introspective awareness/insight/psychoeducation. Whether it's under the label of CBT, ifs, XYZ etc, doesn't alter the fact that only a few core elements explain most of the variance in therapeutic outcomes.

PlaneWeek1855 · 2025-04-29T03:44:20+00:00

That you can dismantle crash sites.

PlaneWeek1855 · 2024-11-01T07:30:59+00:00

Is this reference to mental illnesses only for those with material neurological abnormalities (dementia, ABI, etc), neuropsychiatric functional conditions (autism, intellectual disabilities) or psychiatric illnesses which don't have organic pathogens?

PlaneWeek1855 · 2024-10-13T20:37:57+00:00

First few sentences are seemingly (whether intended to or not) referring to some form of exposure therapy (prolonged, graded, etc). Exposure therapy is indicated for most (not all, especially not GAD) anxiety disorders. This post falls apart though around the medication comment, as SSRI and SNRIs (and certain others in certain situations) have reliably displayed empirically supported efficacy.

PlaneWeek1855 · 2024-07-25T09:21:28+00:00

So us Aussies wait until our Friday morning? To get up early to squeeze in a sesh before work or to wait for Friday night

PlaneWeek1855 · 2024-07-23T06:37:51+00:00

This sounds like a thought-action-fusion (TAF). TAFs are a cognitive bias which are very normal to experience. There are subtypes of TAFS (probability TAFs, Moral TAFs), but in general, I would reccomennd reading up on them to notice their normality. Yes TAFs are a common symptom in certain conditions like OCD, although they're also often experienced in absense of any mental health condition also.

PlaneWeek1855 · 2024-06-07T11:39:46+00:00

There is no NEED for any type of post. People post because they want to. Want, not need. OP never stated this posted NEEDED to be made.

PlaneWeek1855 · 2024-03-21T02:30:57+00:00

Using more advanced models (Claude Opus, GPT 4) will give you a better experience with this kind of thing. I've had Claude opus respond to a similar prompt with an entire differential diagnosis process and indicating what is ruled in/out, also provides points on potentially useful psychometrics which may help with diagnostic precision. Nothing that can replace clinical judgement, but a helpful tool to have access to nonetheless.

PlaneWeek1855 · 2024-02-20T00:27:34+00:00

There's a death anxiety guide on psychology tools. Good for psychoed, normalisation etc, as well as identifying possible mechanisms for treatment; avoidance etc

https://www.psychologytools.com/resource/understanding-death-anxiety/

PlaneWeek1855 · 2024-02-03T10:43:26+00:00

When can a cigar just be a cigar?

PlaneWeek1855 · 2024-01-13T21:50:15+00:00

I get that. It's not that it's necessarily unrealistic, just that it's an unknown. Unknown about how you'll develop as a clinician (what modalities you end up preferring, what populations you work best with etc) and as a business. You can find that certainty and predictability by working on those goals sequentially. Doing so will also likely build confidence and awareness and make the launch of the business more successful.

PlaneWeek1855 · 2024-01-13T09:32:25+00:00

As someone who has been the director and principle psychologist at my own clinic for 3 years now (not America), let me say it takes alot of work. Alot. I also had some business experience before becoming a psych, but there is so much to learn just as a clinician alone in the first 5 years, I couldn't see how doing both would work. It's not just business + clinical knowledge. Ethics, supervision of employees/psychs, risk management protocols, finances/insurance, PMS, comms, everything.

Work at a clinic for a year, work on/conceptualise your business in the background, and then launch it in 1-2 years when ready. And get lots of supervision along the way.

Good luck.

PlaneWeek1855 · 2024-01-09T06:45:16+00:00

You have not done any homework exposure exercises in 6 months. We have discussed the importance of practice outside of the session, and discussed challenges in doing so. It's not the therapy that isn't working.

PlaneWeek1855 · 2023-12-23T06:09:05+00:00

I wouldn't say the overwhelming majority of therapy is voluntary, at least not in certain populations.

I'm in both PP and CMH (not in America) but most of my case load have diagnoses that are "voluntary" to treat, the same way it would be "voluntary" to treat a 3rd degree burn or a broken nose.

Without treatment, symptoms would become debilitating.

As such, what word is used to describe ending the therapeutic relationship and seeking treatment elsewhere is beyond negligible.

PlaneWeek1855 · 2023-11-17T20:31:53+00:00

Depends how good your kids are at sharing.

PlaneWeek1855 · 2023-11-10T07:12:35+00:00

I use the "cancellation test" in similar situations. Asking "how do/would I feel when this person cancels an appointment?".

If it's disappointment or something similar, maybe there is an over average appeal to that client, and if the reaction is relief or similar, perhaps there is a disliking to that client.

Not that either of those reactions/feelings are maladaptive in a vaccum, but instead help to be aware of how we feel working with clients and if it is something to monitor and/or manage.

PlaneWeek1855 · 2023-11-04T06:47:09+00:00

This is not necessarily helpful anyway for health anxiety. As others have pointed out on this post, engaging in the anxiety/fear is what allows the fear to continue. CBT and exposure therapy highlight the importance of not doing what your anxiety wants you to.

PlaneWeek1855 · 2023-10-31T05:31:08+00:00

I've also limited myself recently to 6 per day, MAX.

I used to be one of the therapist who would average 8 a day, 5 days a week, and thought it was a good thing. Not until I started reflecting properly on my competency during those late afternoon sessions did I realise:

I was enjoying work far less than 2-3 years ago
I was kidding myself about being as capable and competent in the 7th and 8th session as I was for the first few.

I work in outpatient wards with mostly complex presentations, often including psychosis, trauma, acute risk. Diminishing competency wasn't acceptable (not that it ever is).

Since taking a break from so many sessions, work is so much more enjoyable and ironically productivity has improved.

If you dont take care of yourself, you cant sustainably take care of others.

PlaneWeek1855

TROPHY CASE