I know this conversation will create some controversy, but it's one that needs to happen based on the impact on we as therapists.
The issue? It's absolutely acceptable to say no to initiating a treatment plan with a client.
Let me frame it a bit....
I want to be clear. Notice my language is directed toward a treatment plan. I absolutely believe our scope allows us to evaluate a client and determine if their needs fit within our skill sets. BUT that skill set also includes the attributes of both the therapist and the client to have a successful therapeutic alliance. Yes, that includes personalities, change behavior strategies as well as belief systems about health.
We cannot be everything for everyone!
Both from personal experience as well as countless conversations with therapists have demonstrated that we are not empowered to say 'no thank you' to a client and refer them to a provider that may be better suited to that client's particular way of addressing their health OR expertise.
We are unlike other businesses. We are service-based and the extraordinary dedication toward helping another human being exceed what they create on their own is a powerful dynamic that requires alignment. And the frequency of care demands an alliance, not simply a prescription for care.
Yes, this is a huge part of 'burnout'. I commonly ask my coaching clients if they could imagine treating 'energy vampires' 80% of their schedule. I know that is extreme, but not being empowered to find another solution and be a resource rather than a depleted driver of a treatment plan will only strengthen who we are as therapists and as businesses.
Every day we hear about how frustrated people are with the medical system and the quality of care. That changes when they sit in front of the right person and are heard from a lens that can meet them where they are and guide them.
If we truly believe we are client-centric, then we need to accept that we are not everything for everyone. It doesn't make us inadequate, but rather emotionally intelligent and compassionate toward differences. Something we can all show a little more of.
In 15 years of practice as an employee I only 'fired' one client, and they created tremendous stress. You can imagine how I felt each day I saw their name on my schedule. It was well beyond the 80/20 rule. In my nearly 6 years of being a business owner of a clinical practice, I have said 'no thank you, there is someone better suited to serve you at the highest level' dozens of times. And when you see the client in this manner and as the priority, it feels exactly the same as when you refer to someone for a clinical skill you may not have. Because in fact, it's exactly the same.
Be truly client-centric.
Live from abundance rather than scarcity.
Recognize you a among a community of beautifully talented therapists.
You are not everything for everyone. Enjoy the exhale of releasing that expectation.
Embrace the opportunity to be a resource rather than a direct provider. Place yourself in the middle of the wheel as a cog and create the movement forward for a client with their health journey.