Sliding Scale Fee in a Canadian Private Practice

Posted by: Julia Smith on January 29, 2020 12:31 pm

There are many reasons why Canadian counsellors opt for a sliding scale fee in private practice. Some counsellors may include a sliding scale because they:

  1. want to offer therapy to those who cannot afford their full fee
  2. want to have a full caseload of clients
  3. are not confident in their session fee price
  4. all or some of the above

Are Sliding Scale Fees Worth It?
Having a sliding scale can solve the above issues but may also create more! If anything, having a sliding scale opens the door for negotiation on your session fee price. That means more administration work of going back and forth trying to negotiate a session price for each client! You also risk not getting your ideal clientele (people who will pay your full fee). When you advertise that you have a sliding scale, people who are looking for a deal will be drawn to your practice. And those that pay the full fee may resent that they are not getting a deal. Sliding scale fees can cause so much hassle and potential harm to your business that I believe they are not worth !

Solution

Offering affordable counselling:
Instead of having a sliding scale … sign up for Open Path Collective. It is free for you to join and allows you to advertise a discounted price for counselling. You can decide how many sessions a month you want to have at the discounted rate and then once full, you can post on Open Path that you are full at your discounted rate. When a potential client inquires about a sliding scale you can just refer them to Open Path. No negation on your counselling fee price needed.

Wanting a Full Case Load:
First and foremost, don’t start a private practice until you have AT LEAST three months of savings and/or have another job to support yourself! It can be very easy to lower your rate and have a sliding scale out of worry that you will not be able to pay your bills. There are many ways to build your private practice caseload that does not include lowering your session fee. One tip is to offer a free 15 minute phone or in-person consultation where you can showcase your value to potential clients.

Not Confident in Your Price:
I get it. The ‘imposter syndrome’ is difficult to deal with. It makes us think we are not worthy. It makes us forget that we have graduate degrees in counselling, experience, and counselling skills that have helped people overcome issues. You are worthy of a fee that reflects that. Click here to learn more about how to set your fee!

Until next time,

Julia

About Julia
Julia Smith, MEd, RCT-C, CCC, is a Canadian private practice consultant who specializes in helping Canadian counsellors and therapists start private practice. She also owns a private practice in Halifax, Nova Scotia where she helps depressed teens build confidence, find happiness, and gain insight.
Click here to get more help with building your Canadian private practice!

 




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Nonconformity in Choosing Counselling as a Career

Posted by: Jeff Landine and John Stewart on January 9, 2020 2:02 pm

Typically blogs about career counselling address issues that relate to the delivery of career counselling, for example, the impact of Artificial Intelligence on future jobs and the need to prepare clients for that eventuality.  For the next few entries, however, we are going to shift our attention to the diverse perceptions that exist on the counselling profession and consider motivations to engage in counselling as a career.

We have, combined, over 50 years’ experience working as counsellor educators at the university level and have both been involved, throughout our careers, with national, provincial and local associations whose mandates are to further the profession of counselling. In these roles we have seen countless students through the process of preparation for a career in counselling and have first-hand experience in the processes of legitimizing these students’ positions as professionals by working with certification and licensing boards and committees.

Despite the recent increase in credentialing and professionalization of the counselling role, one constant we have seen is the frequent consideration by these students of their counselling education as preparation for a professional role somewhere down the road. On more than one occasion, I have heard counsellors-in-training refer to their intentions to have this graduate degree in their “back pocket” for use later in life, either when they no longer want to continue with their present work or as a transition into retirement and as a pension supplement. This approach to counselling as a career is surprising, as we don’t see the same approach employed in other professions. Nobody we know gets their Red Seal as a plumber so that they can open a side business in retirement. We don’t know of any B.Ed. graduates who choose not to teach after graduating, deciding instead to wait until later in their career to join the ranks of school teachers. This phenomenon begs the questions, “Why does counselling, more so than other professions, lend itself to be a career of convenience/second thought?” While people might pursue a law degree, for example, without the intention of practicing as a lawyer, the dynamic we are questioning is whether interest in the subject (in this case counselling) will be used as a support in the work being done or not. John completed a vocational Master of Theological Studies degree out of interest (during the latter parts of his career as a professor), with no intention to be employed as a pastor. Unlike these examples, counselling students appear to be intentional in using the counselling preparation they receive for employment purposes later in their career or after having retired from another job.

The history of counselling as a formal profession starts with the emergence of vocational counselling in the late 19th and early 20th centuries (Shepard & Mani, 2014).  The advent of large cities, built around manufacturing and industrialization, created the need for vocational guidance; however, the influx of people to these urban centers resulted in increases in unemployment, poverty, poor working and living conditions and crime. Corresponding to the increase in social problems, support systems typically declined as people moved away from their families and home communities. The development of counselling as a profession in Canada over the ensuing century was largely driven by a vocational focus but the resulting profession has adapted itself to the connection between career and personal difficulties and the increasing need for mental health support. Counselling and psychotherapy now make use of psychological theory and concepts and counsellors today are much better prepared to work with psychopathology in their clients.

In the next few blog entries we will explore the nature of Counselling education, credentialing and employment in an effort to decipher the motivations and career planning that have, in many instances, relegated counselling to a “sideline” or back-up profession.

Shepard, B., & Mani, P. (2014). Career development practice in Canada. Toronto, ON: CERIC Canadian Education and Research Institute for Counselling.



*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Making and Achieving New Year’s Resolutions

Posted by: Coretta Rego, MA, RP, CCC on December 20, 2019 11:59 am

The hustle and bustle of the holiday season will soon give way to thoughts and plans for the new year. Many of these discussions will invariably touch upon the changes that people plan to make when January arrives. This might include lifestyle changes, like eating better and exercising more, learning how to better manage one’s money, or a desire to pick up a new hobby. Regardless of how we choose to do so, a new year often presents us with an opportunity to reinvent ourselves.

While any day of the year that we choose to make changes to help us live a happier and healthier life is a good day to start, the dawn of a new year is particularly promising. While many a joke has been made about the success (or lack thereof) of new year’s resolutions, many people do find success with making and sustaining changes at this time of year. What sets these people apart from those of us who may be less successful with our new year/new us plans? Much of it comes down to having a plan.

Step 1: Make a resolution

If you are considering overhauling an area of your life in the new year, I would encourage you to start by picking one area. We often overwhelm ourselves by picking too many things to do at one time and it becomes hard to sustain all changes simultaneously. Instead, start with one change. As you start to see success and have been able to maintain this, you can add on another change. The confidence and adrenaline that you experience as a result of succeeding with your first change will build momentum for the next one. Success builds success!

Step 2: Make a plan

Success in any area of life is rarely due to luck, and more due to planning and ongoing hard work. This holds true for whether you are learning to dance, losing weight or building an empire. The reason many of us are unsuccessful with our new year’s resolutions is because we often come up with well intentioned ideas but do not give much thought as to how we will implement them. When we then encounter a challenge with our idea, we do not know how to overcome it, and we often give up.

As an example, let’s look at a frequently cited new year’s resolution: losing weight. Despite how many people cite this as a resolution and the amount of services catered to helping people with this, many (not all) still struggle with accomplishing this goal. The difference between those who succeed and those who struggle is not simply a matter of will power. Having a plan for how to modify your life so it becomes more conducive to losing the weight is an important step towards achieving a positive outcome. Furthermore, the more detailed the plan, the greater the likelihood of success

Plan A: Lose weight. Eat heathier. Exercise more.

Plan B: Lose weight. Eat healthier. In lieu of buying lunch from a fast food place during the work week, pack a home-made lunch which includes fruit as snacks. Meal prep with a friend every Sunday evening to avoid it feeling like a chore. Exercise 3x during the work week. Join the gym at work so that exercising can be done before or after the workday to reduce the likelihood of a missed workout.

While the intended end result is the same, the person who made the second plan is more likely to be successful because they have given thought to how they will implement this plan in their life, including considering potential obstacles and coming up with ways to counter them. It is important to note that plans don’t need to be extravagant, they just need to be specific to how you live your life.

Additionally, when making your plan don’t overlook all the things that you might already be doing that can help you meet your goal. By doing more of these things (or doing them more frequently) change is less overwhelming. For example, perhaps you already bring a homemade lunch to work every day but buy snacks which is where you succumb to the unhealthy options. By packing additional items to your lunch which you already spend time making, it is easier to make a healthy choice when the 3pm craving hits.  Your plan should make you feel empowered and should build upon good things you are already doing.

Step 3: Pace yourself

You have 365 days (and not just until January 31st) to make it your new reality. Be kind to yourself when you stray from the plan. Be patient with yourself when you experience a setback. Celebrate when you achieve smaller milestones as you get closer to the goal.

Happy New year! Happy New(er) You!

Coretta Rego, MA, RP, CCC




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Appearing on Network Television: Are You Ready for Your 15 Minutes of Fame?

Posted by: Doc Warren on December 13, 2019 10:45 am

At some point in your career you will likely be contacted by the media. They may ask you to give a professional opinion on a topic they are covering or they may have an interest in the place that you work, the population you serve or even in you and your career. Whatever the reason, there are some considerations that should come into play before saying yes. What follows serves not as a comprehensive nor exhaustive look, but as more of a primer on preparing for what is often considered your “15 minutes of fame.”

Over my career, I have been honored to have been able to help promote our profession in several mediums ranging from television, radio, newspapers, magazines, text books and the internet. In some cases I was little more than filler, providing a few lines of professional opinion for a much broader topic. At others I was the main focus. No matter your role, it is important, even when the only reason the reporter is talking to you is because their focus cannot speak for themselves (like when they were covering a therapeutic animal in my office but alas, Helen, the dog could not talk so they asked me. If I remember correctly, it was my arm that made the front page, wrapped around Helen).

Some folks will decline any type of interviews for their entire careers, and there is nothing wrong with that at all. Who wouldn’t want to keep a low profile, do their job and go home? There is much to be said for that. For those who find themselves faced with the decision and are inclined to say yes, consider the following:

What’s your message?
Though the reporter will have their agenda and will serve as a guide for the interview, it is important to know what you want to say, how you want to be portrayed and the overall tone you would like the interview to have. This does not mean that you should stick dogmatically to your original agenda: a certain amount of give is often needed as the interview may take a surprise turn, but have a general idea of what you want your overall message to be.

What are your goals?
After saying yes, what is it that you hope will be accomplished in the interview? Is it realistic? Do they align with the goals of the reporter? Have you discussed them with the reporter? Doing what you can to make sure that there are shared goals can save one from awkward moments when the cameras are rolling. It’s very important to remember that no matter what you say, unless you are on live tv, the editor will decide what makes the final cut. This again underscores the need to mesh your goals and expectations with the reality of what the reporter is looking for. For the most part, put trust in the news-team to do a good job. If you do not trust that they will do so, decline the interview and move on.

Preparing mentally
Most “bad” interviews that I’ve seen are often rooted in a lack of mental preparation or focus. Though there will be varying numbers of viewers depending on whether or not you are doing public, local, state, national or international programming, try to focus on the interviewer and not worry about the viewership. Obsessing about the ratings, number of views and related issues tend to mostly lead to undue stress and possible anxiety attacks. Many times when folks freeze on air it has so much to do with them being psyched out by the thoughts of all the people watching them. Try to clear that from your mind and focus only on those before you. Try to think of the camera as an old friend.

When preparing for the interview, remember your goals, desired message and the approximate time they have given you for the interview. Handle the interview with the same calmness that you would have when conducting a session with a new client.

Preparing the office
If your interview will be done in the studio, there is nothing that needs to be done in terms of office prep; but when the crew comes to you and your office, that changes things considerably. When doing an office-based interview it is advisable to clear the amount of time that the interviewer has estimated. On a recent interview, the producer estimated that the interview and B Roll (extra filming for filler or to do voice over work with) would take no more than 30 minutes. Once they got on scene and asked a few questions, they pleasantly discovered a much bigger story. Two hours later I needed to hold a session and they had not yet filmed their originally planned footage. Thankfully, what they needed to film was out of the office and in part of the 50 acres that surrounds it.

When a film crew is present it is best not to have clients around so as to avoid any potential privacy violations. Also be sure not to have any charts or other medical records in view.

Some folks will want to stage their offices prior to the interview, others will just make sure it has had a good cleaning, there really is no wrong answer.

How to dress
Depending on the type of interview, you would likely either dress much like you would for a typical work day, or perhaps dress more “corporate.” Dress according to how you want to be portrayed. It is not uncommon to see one dressed in a “smart” suit or similar fashion but many exceptions exist.

Setting boundaries
Don’t be afraid to say no to a reporter, producer or other member of the crew should they ask you to do something that you feel uncomfortable with. This includes saying no to the whole interview if the timing, location, topic or whatever feels wrong.

Protecting client privacy
Your clients deserve respect and the law and code of ethics demands that their privacy be protected at all costs. Be sure to read, understand and follow the laws and codes of ethics related to client\patient privacy. Avoid giving details of any actual client that could potentially lead to their identification. Do not have any identified clients with you as part of an interview and keep all notes, charts or other documents out of the area where the film crew may have access. This applies even when you have a high-profile client or clients that the news community would be very interested in. Do not risk your career for a chance at a few minutes of fame.

Getting over yourself
Ok, your segment has been filmed and edited and is about to go on the air, the teasers (promotional commercials) are in rotation on the network and folks are starting to notice and contact you. It is fine to acknowledge the upcoming interview and to share the promos and information but remember to keep things in perspective.

As the segment(s) air there will likely be an increase in calls, emails and social media response. There may be many messages of praise and some level of fanfare. There could also be a fair share of skeptics or naysayers as well. It is best not to tie your self-esteem to your public standing. There may be some hype surrounding the event but it will die down in short order. Remember who you are, what you do and stay grounded. You are no better than you were prior to the interview and soon enough, folks will have moved on to the next big thing. Acting superior now will likely just help kill any positive vibe the press gave you in the first place.

Case Study:
A short while ago I was contacted by the Today Show to offer an expert opinion on a story they were covering for their site. They found me after an internet search for professionals associated with the topic. After a brief exploration of the story, message, goals and related issues we agreed on a day and time to conduct the interview via telephonic means. The interview took place and a day or two later it went live internationally. NBC Universal cross-promoted the story and soon I found that several people who had seen the story but had not read it yet had forwarded it to me as they thought I may have found it of interest. I also shared it on social media and mentioned that I was in it. I then went to work doing my normal client load and farm chores.

A matter of days later NBC Connecticut contacted me about doing a story about the program that I founded and run in Connecticut. They had read the story and my part of it and thought it could be of interest to Connecticut viewers. We explored the items as described above and I set aside four chunks of time that they felt they would need for filming. I cleaned my office and made sure no clients would be scheduled at the office for any of our other clinicians as well during that time.

As our program was the focus, I decided to dress much like I normally do for work as I wanted to appear genuine. My wife did buy me a new Carhartt Tshirt because she felt some of my daily shirts would not look great on television, but otherwise I wore what I often do, right down to my New Balance sneakers and cowboy hat.

As the B Roll was being filmed and small talk between the news anchor and myself took place, there seemed to be a change in both scope and direction of the piece. Though I was prepared to discuss the programming and only a bit about myself, once the cameras were rolling for the formal interview I found that much of the interview focused directly on me and the program itself was second. As the news anchor remained in due bounds, we continued and I followed her lead as she had my full trust and respect.

Two hours into the process, they had not filmed the animal sanctuary that I thought was going to be the main focus of the spot. Having to get back to work, they filmed the animal spot without me (they were well aware of the fact that privacy was paramount and did not attempt to film any client that may have come to the property).

In the end, the minute or two segment that I had planned for turned into a day or so of teasers followed by in studio conversations by the entire news team and two segments in the morning. The evening news team had their own conversations and a single but expanded version of the interview was played. I had no idea what would be in it until I watched it on TV. My wife, also a clinician and member of our clinical team, was interviewed as well and my son Warren IV was shown and discussed. We could not have written a better PR piece if we had tried.

The morning it aired I decided to watch it, something I rarely do as I view interviews as part of the job, something to do, move on and forget about. I was glad that I did. I was super impressed by the quality of the piece and how they treated our program. I then got out of bed, cleaned the drain in the tub, got ready for work as normal, meaning a full round of sessions intermixed with farm chores.

We shared the links on social media and gave them to our website tech to have them embedded as soon as we could. Otherwise, it was business as usual, with the exception of the increased requests for services that often come with media attention.

Days later a different network requested an interview but we declined. It was felt that the timing was wrong, the set up was too rushed and there was concern that the producer did not fully understand or respect the need for privacy for our clients. Though we respect the team, we could not in good conscience do the interview under their terms.

The experiences were good, the added attention for our program was better than an expensive ad campaign, but in the end, we remain the same people and the same program as before. No better, no worse. It is after all just part of the job…

So there you have it, sometimes you become the story. Do your best and move forward. I’m rooting for you!

Links to the original article and one of the interviews:

Other clips may be available at www.docwarren.org by the time this is published.

Be sage, do good

-Doc Warren

“Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, clinical & executive director of Community Counseling of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). He is internationally certified as a Counsellor and Counsellor Supervisor in the USA and Canada (C.C.C., C.C.C.-S, NCC, ACS). He can be contacted at [email protected]  His program has also been featured on NBC https://www.nbcconnecticut.com/news/local/A-Happy-Place-Wolcott-Therapeutic-Farm-Redefining-Mental-Health-Care-563389381.html



*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

How to Store Client Records in a Canadian Private Practice

Posted by: Julia Smith on November 28, 2019 9:31 am

Keeping client’s notes and personal information secure is a very important task that all Canadian counsellors must do. There are two main ways that Canadian counsellors store their client records:

  1. File Cabinet
    Many Canadian therapists, like myself, started their careers with writing paper-based notes and then storing the notes in a locked file cabinet. In private practice, this can be an affordable way to keep client records. However, as your caseload grows you will need more and more space to store the records! Plus, if you do not have your own office space yet or commute between offices… it can become a very big hassle to store paper-based records.
  1. Electronically
    Since starting my Canadian private practice, I have been using Electronic Medical Record systems, otherwise known as an EMR. Yes, it does cost money… but it is soooooo worth it! By using an EMR you can easily store client records securely on an Internet server. By storing client records online, you can easily access your notes at any location! Plus most EMR’s include other services in their packages that help to grow your Canadian private practice!

Privacy Laws in Canada for Storing Electronic Records

As Canadian counsellors, we have to follow the Personal Information Protection and Electronic Documents Act (PIPEDA) (a federal law) as well as any provincial Personal Information Acts. The main point in PIPEDA for Canadian Therapists is to make sure that you are storing electronic records correctly. Electronic records are stored on Internet servers that can be located anywhere in the world (depending on what EMR you are using).

Since some provinces have some type of provincial Personal Information Act, regulations can be different per province. This means that currently every province (except British Columbia and Nova Scotia) can store their records on US or Canadian servers. This is a good thing as it gives Canadian private practice owners more options when choosing an EMR (you can choose a US or Canadian EMR). Unfortunately, British Columbia and Nova Scotia MUST store their records on Canadian Internet servers (you can only choose Canadian EMRs).

For more information you can read: https://vsee.com/blog/hipaa-canada-health-information-privacy/

EMR Options

There are many EMRs that you can choose from. I recommend that you choose an EMR that includes:

  • Online booking: allows clients to easily book their sessions online without having to call to schedule a session. This feature has helped me build my caseload, as many people would prefer to book online rather than call. Plus, if you do not have online booking and a potential client calls to book an appointment and gets a voicemail… they may continue to search for a counsellor that they can get an appointment with right away.
  • Credit card technology (such as Stripe): being able to charge clients for sessions through your EMR and have their credit card information securely stored through the system, saves you money! It has been very useful for me to have client’s credit card information saved (through Stripe). Especially when a client does not show up for their appointment and I have to charge them. It is also useful if someone else is paying for the counselling sessions but is not attending them (such as a parent paying for their teen’s counselling).
  • Secure online video counselling technology: it can be useful to have the option to provide online counselling. I have found it helpful with client’s that have moved away but still want to have sessions with me.

Canadian EMR Options:

Jane (hyperlink to www.fearlesspractice.ca/Jane)

$74 CAD per month (plus provincial tax)

I LOVE and use Jane for my own private practice! Its platform is easy to use plus it provides you with online video counselling, Stripe, and online client booking! Jane also has an amazing support team 🙂 Let Jane know that Fearless Practice sent you.

Click here to try Jane  (hyperlink to www.fearlesspractice.ca/Jane)

OWL Practice 

$100 CAD per month (plus provincial tax)

OWL Practice is an awesome Canadian EMR that includes Stripe, online client booking, and video counselling if you choose their Premium Video EMR.

Click here to save 50% off your first moth with PROMO Code: FEARLESS

Remember to:
* make sure you have some type of cyber insurance (usually offered as an addition when purchasing private practice insurance)
*check with your organization/regulator to make sure that you are following their requirements for storing client records

About Julia
Julia Smith, MEd, RCT-C, CCC, is a Canadian private practice consultant who specializes in helping Canadian counsellors and therapists start private practice. She also owns a private practice in Halifax, Nova Scotia where she helps depressed teens build confidence, find happiness, and gain insight.
Click here to get more help with building your Canadian private practice!



*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

The Holiday Season and Why It’s Not Always the Best Time of the Year

Posted by: Coretta Rego, MA, RP, CCC on November 8, 2019 12:24 pm

It won’t be long before the fall leaves have been raked up, the trick or treaters have come and gone and the countdown to the end of the year will begin. In the midst of all of this revelry, there will be many opportunities for gatherings with loved (or not so loved) ones. Diwali, Hanukkah, Kwanzaa and Christmas are all celebrated closer to the end of the year. Even if one isn’t religiously inclined, the end of the year tends to bring with it multiple occasions for celebration. Unfortunately, along with the food, drinks and presents, there also tends to be a large serving of stress.

There are different reasons why people find the holidays so stressful. It can be busy with every evening or weekend committed to a celebration of some kind. It can be expensive with the list of people to buy gifts for getting longer each year. It can also involve social interactions that can be uncomfortable or downright unpleasant.

In some cases, holiday stress can often turn into distress.  As therapists, we are aware that holidays can be a difficult experience for people.  Family estrangement, grief and financial pressure are some of the reasons why people struggle at what is often promoted as the most wonderful time of year.

So how do we support our clients, loved ones and ourselves to remain emotionally healthy during the holiday season? Unlike other life events that may happen less frequently and are therefore a little easier to grin and bear, the holidays are inescapable. It can be beneficial if we take some time in advance to think about what we anticipate the challenges of the season will bring, and come up with a coping plan. While the hope is to create a plan that can help us thrive, in some cases, simply surviving and making it out to the other side is also a valid goal.

Here are some suggestions to help you plan for the upcoming holiday season:

  • When possible, try declining invitations to certain events. Regardless of how much fun an event is promoted as being (like an annual reunion with your high school friends) or how obligated you feel to attend (a family dinner), saying no to an event or two has multiple benefits. To start with, it gives you back some time in your schedule, spares you the expense of attending, as well as allows you to avoid any unpleasant social encounters. It also helps to build some comfort in saying no and not feeling guilty about it, which is an important life skill.

 

  • If there is a social event that you must attend, recruit a buddy to go with you. Think about what your biggest concern is about attending this event. Is it the small talk with colleagues you only see once a year? Turn to the person in your social circle who is skilled at banter. Is it seeing a family member who often berates you? Take a loved one who can calmly but firmly put an end to the conversation. If necessary, make an appearance and have a signal in case an early exit is required. The benefit here is twofold: you get credit for attending, while also allowing you to avoid some of the more challenging aspects of the social gathering.

 

  • If you feel that hosting a social gathering is an important though stressful element of the season, consider choosing an alternate venue. For example, in lieu of a potentially tense dinner with the entire extended family in your home, consider inviting family members to a public event in the community a few days before or after the holiday season (for example, ice skating at the local rink). This is an opportunity for the family to be together while removing some of the one on one interaction that is often the source of conflict and stress. It also gives an objective goal to focus upon…

 

  • If the holiday season is difficult due to grief, give yourself permission to not celebrate if you don’t feel capable, or to celebrate on a smaller scale. Carve out time and space to grieve. If possible, do something specific that addresses your loss so that it doesn’t feel minimized in the midst of the celebration occurring around you.

 

  • If the holiday season fills you with dread to the point that it is interfering with your well being, consider speaking to a therapist. A therapist can work with you to not only address the source of the struggle, but also to come with strategies for how to manage it. Holidays can have a negative impact on mental health and well being regardless of how well one has been throughout the year. Seeking the appropriate professional support can be very beneficial.

For some people, the holiday season is truly the most wonderful time of the year. For others, there is less joy and more strain. Regardless of how you feel about the season, remember to take care of yourself, as that is the best gift you can give yourself and others.

Coretta Rego, MA, RP, CCC




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

How to Rent a Canadian Counselling Office

Posted by: Julia Smith on November 1, 2019 10:07 am

One of the first things to do when starting a Canadian Private Practice is to find an office space to rent. Renting (or buying) your own office is ideal but for most Canadian counsellors, it is too expensive when beginning private practice.  Luckily, there are many professionals and clinics looking to rent out their offices when they are not using them! Here are two factors to consider in your search for the perfect space:

Location
When searching for office space it is important to consider where it will be located. The main thing to remember is that clients will travel to see a good therapist. However, the more convenient your office space is located… the better.

Many therapists feel that if there is a location with lots of counsellors that they should stay away from that area and find a location that doesn’t have any therapists. But usually, if an area has lots of counsellors, it means that there are lots of people willing to pay for therapy in that area! All of the office spaces that I have rented have been in a city where there are many therapists located. What I have found is that people are more willing to travel to a city to see a therapist than travel from a city to a rural counselling office.

Other things to consider:

Parking
One of the most important considerations is parking! In my first office, there was no parking and clients constantly complained about how difficult it was to find a parking space. This also meant that many clients were late for appointments as it took a long time for them to find parking. So, when searching for an office space… make sure there is parking available!!!!

Air Conditioning
In most provinces, spring/summer (and sometimes fall!) can get VERY HOT! Make sure that the office space you rent from has air conditioning. The last thing you want is to be counselling a client in July when it is 30 degrees Celsius! Clients will appreciate the cool office and the cool air will help you stay focused.

Accessibility
If you want to have the option to counsel all populations it is important to make sure that your office space is wheel chair accessible. Being accessible can also be helpful for clients who are injured (i.e. broken leg). The last thing you want are clients cancelling appointments because your office is not accessible.

Counselling At Your House and/or Online Therapy
Renting an office space will not be an issue if you want to build a private practice at your home or online. There are many legal and ethical considerations for these types of private practices so be sure to check with CCPA and your insurance provider before developing your Canadian private practice.

Starting a Canadian private practice at home or online will save you money but you also might lose clients who only want in-person therapy. I offer both online and in-person counselling and also find it healthy to have an office space that is separate from my personal space.

Rent Price
The price to rent an office depends on what city, province, or town you are located in.  You do not want to be ‘house poor’ when renting space so make sure that you rent is no more than 20% of your income. The three ways that most Canadian offices rent out space are either:

  1. Rent per hour: When a practitioner is not using their office at certain times of the day/night and is looking to rent their office when they are not there.
  2. Rent per day: When a practitioner is not using their office on certain days and is looking to rent their office on those days.
  3. Percentage: Instead of paying rent, a practitioner will take a percentage of your counselling fee. This can be useful at the beginning because you will not have to worry about paying rent. BUT as your business grows… more and more of your money will go towards the practitioner/clinic. For example, if you charge $100 per session and the practitioner takes 30%… every time you see a client you will be paying the practitioner/clinic $30… so the more clients you see… the more money the practitioner/clinic will take. Whereas, if you have a set rental fee, you have the ability to make a lot more money in the long run! The busier your Canadian private practice becomes, the more money YOU will make. Plus, when you raise your prices it will not affect how much rent you are paying.

How to find a space:
The best way to find office space is to start sending out emails to other private practice counsellors in your area and/or health clinics (online advertising services like Kijiji.ca can also be helpful). When starting off, it can be best to just rent a day or couple evenings per week as you build your cliental. A simple sample email could look like:

Hi,

My name is Julia and I am a counsellor that is starting a private practice. I am looking to rent office space and am curious if there are any times during the week or on the weekend when you are not using your office?

Thank you,

Julia

Depending on where you rent, you can then choose to rent more time at the place you are renting from OR find another office space that meets your needs. Start small and grow big!

Happy searching,
Julia

About Julia
Julia Smith, MEd, RCT-C, CCC, is a Canadian private practice consultant who specializes in helping Canadian counsellors and therapists start private practice. She also owns a private practice in Halifax, Nova Scotia where she helps depressed teens build confidence, find happiness, and gain insight.
Click here to get more help with building your Canadian private practice!



*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Reflections of the Future of AI Technology and its Implementation

Posted by: Jeff Landine and John Stewart on October 25, 2019 2:26 pm

In our last three blogs, we provided a brief overview of the field of Artificial Intelligence and its impact on the world of work along with suggestions to help career counsellors respond to these innovations with their clients.  While predictions suggest a massive immediate impact on the workforce, in this blog, we will discuss some issues that we think need to be addressed before implementation and that may even delay the use of some deep learning technology.

Predictions are that within five years, deep learning machines with the ability to mimic human cognitive functions will take over many thousands of jobs (1). Currently, these new innovations are being used in law enforcement, health care, scientific research and even determining what information we see on Facebook.  Before these deep learning machines are deployed, there are several social policy and legal issues that need to be clarified (2). One issue focuses on the lack of transparency in the development of algorithms (3). Due to the layering of deep learning algorithms, as the machine processes larger volumes of data, the algorithms make connections between layers that help to make more refined decisions. Some developers have voiced concerns over whether the decisions made by these machines can be trusted due to the changes in the algorithms.

This issue of trust raises legal issues that have yet to be resolved by the courts (4). For example, if these machines make biased decisions resulting in a human rights discrimination against a candidate for not being short-listed for a job, the issue of who is responsible is raised. Is it the developer, the owner of the machines, or the machines? We suggest that before implementing such technology, policies and legal statutes need to be in place. For example, “can a machine be a legal entity much like a corporation?” Or, “what standards of security need to be demonstrated by the machines to ensure user privacy of information before they are deployed?” Such decisions and policies will help to prevent unnecessary legal disputes.

Additionally, there are indicators to suggest the public is already leery about robotic-made decisions, and we think this attitude will have a negative impact on bringing newer innovations online until testing demonstrates no biases or weaknesses in deploying them. For example, autonomous cars have been in the media for over a decade. Current research suggests that 94 % of US citizens know about these cars; however, 56% of them indicated they are not ready to ride in such vehicles citing a lack of confidence and trust in robotic decision-making and a mistrust in the general safety of the technology (5).  To change these attitudes, industry has more development and promotional work to do before the public will use this technology.

With smart machines, there is the possibility of collecting large amounts of personal data from users that could be used for nefarious purposes.  For example, one has only to look to Facebook as a social media platform and how foreign agents were able to use it to influence voters in the 2016 US federal election. There was a public outcry concerning the use of information obtained by Cambridge Analytica from millions of Facebook users by political parties to build US voter profiles (6).  At this point, policies are in short supply to protect consumer information and to regulate accountability should breaches be made. With the use of deep learning machines and the possibility of personal data being collected, safeguards are needed to ensure confidentiality and protection.

Career counsellors can play a significant role in dealing with these concerns. They can be advocates for their clients by working on policy development committees concerning the deployment of smart machines in the economy. Career counsellors have ethical guidelines, which regulate the use and storage of their clients’ personal information. These guidelines would help in developing policies around the storage, use and dissemination of information collected by deep learning machines. Career counsellors, through their professional associations, can send briefs to major banks, food retail companies, insurance companies, medical corporations, professional associations, and politicians to express their concerns over the lack of parameters surrounding the use of deep learning machines.  We think these endeavors will help to raise public awareness and develop policies and laws before deep learning machines become.

By Jeff Landine and John Stewart

Sources Used
  1. AI, automation, and the future of work: Ten things to solve for (June 2018). Retrieved on August 26, 2019 at www.mckinsey.com/featured-insights/future-of-work/ai-automation-and-the-future-of-work-ten-things-to-solve-for.
  2. Artificial intelligence and machine learning: Policy paper. Retrieved on August 1, 2019 at www.internetsociety.org/resources/doc/2017.
  3. Gershgorn, D. (2017) AI is now so complex its creators can’t trust why it makes decisions. Retrieved on August 1, 2019 at www.qz.com/1146753.
  4. Beauchemin, H. (2018). Key legal issues in AI. Retrieved on September 19 at https://www.stradigi.ai/blog/the-key-legal-issues-in-ai/#pll_switcher
  5. Smith, A and M. Anderson. Americans’ attitudes toward driverless vehicles. Retrieved on August 1, 2019 at www.pewinternet.org/2017/10/04/americans-attitudes-toward- driverless-vehicles.
  6. Cambridge Analytica and Facebook: The scandal and the fallout so far. Retrieved on August 1, 2019 at www.nytimes.com/2018/04/04/us/politics/cambridge-analytica-scandal fallout.html.



*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

When a Client Dies

Posted by: Doc Warren on October 15, 2019 11:39 am

I’ll never forget the first time that I received notice that a client had died. I’ll never forget any of them actually. No training truly prepared me and I’ve had far more training than the average thanks to an intense drive on my part and having had some of the best mentors in the field. I can only imagine how folks with minimal training and a lack of good supervision fare.

The longer we are in the field, the more likely we are to have experienced the death of a client. The death may have been through accident or natural causes or by their own or someone else’s hands.  Few, if any, clinical training programs spend any great deal of time exploring this issue unless you are specializing in hospice settings. When a death happens, there are many things that tend to be the focus of supervision and consultation sessions. Below are some of the more common issues that I find in my supervision and consulting work when a client has passed.

Processing the loss yourself
Once receiving notice of the death, many clinical professionals attempt to “work through the pain” by continuing their day as they normally would. Though this may work for some, many, if not most, will require time to process the loss either immediately or in the very near future. Be sure to allow yourself to be human, acknowledge the loss, explore the emotions associated with it and whenever possible, do this with the help of a colleague. You do not have to keep everything bottled in. Remember what you would do for and with friends, loved ones and clients who have suffered a loss and allow yourself to be present with your emotions so that you may heal. While there are times when you may need to continue to work to help aid others who are affected, processing it yourself as soon as possible can be a key factor in moving forward healthily.

Could I be liable?
One of the first fears shared by clinicians when a client has died of anything other than natural causes is that they may be sued or otherwise investigated. In most cases, there has been nothing to indicate that this could happen assuming that  the clinical professional has given nothing but the best level of care to the client that has passed. This fear is sometimes grounded in the grief process itself: the clinician is blaming themselves for not having been able to prevent the death. Other times it can be a simple fear of being sued by a next of kin that is “just looking for someone to blame” regardless of any real malpractice having occurred. A small fraction of the time (I have personally never encountered anyone in this situation) the clinician has indeed made mistakes that could be considered malpractice. In this case, the fear may indeed be founded. Whether or not you feel you did anything wrong, when in doubt, contact your malpractice/liability insurance provider and discuss the matter with them. It shouldn’t cost you anything more than your time and just may help ease your worries.

Protecting the client’s right to privacy
Today more than ever we find ourselves with the ability to emote freely via venues that were unthinkable just a few short years ago. Many find themselves posting to social media for just about everything. Public grieving is considered the norm to many folks but as clinical professionals we need to remember that the client’s right to privacy does not end with their death, therefore we as clinical professionals should refrain from public expressions of grief that either name or share any information that could potentially identify a client that has passed. I’ve seen very good clinicians make this mistake. Comments such as “I lost a client recently to a drunk driver” or “Cancer took a client today” may seem harmless enough but can lead to ethical issues especially if more information is also shared.

I’ve also seen clinical professionals that have made generic statements on personal or professional pages that would appear to be fine. Comments such as “thinking of those lost to cancer” or drunk drivers, suicide etc. may help the clinician process without potentially identifying a recently deceased client.

Should you get a request from a next of kin to provide copies of the deceased treatment records, be sure to consult with an attorney to learn exactly what the next of kin is allowed to access and what they will need to provide your office in order to allow you to release copies. Here again, your liability insurance provider can be a key resource as well as your supervisor.

To go or not to go to services
Going to the services of a client that has passed can be a controversial decision. One side of the coin says that by your very presence you are saying that the deceased was a client unless they were a known friend, coworker or relative of ours. The other side of the coin says that if the service is open to the public then you are free to go with no need to explain. Many a heated conversation has come from posing this question in a group supervision encounter. One quick way to handle this would be to contact your liability insurance provider for guidance. Please note however that the answer may differ from provider to provider.

For me, I have only attended services if a surviving relative has requested me to attend. Even with such a request I will neither confirm nor deny that I ever had a professional relationship and will instead simply say that we live in a small town and that we all seem to know one another.

Erasing” the client from your practice
Many a consult has been spent processing feelings of guilt from clinicians who were feeling conflicted about how “easy” it was to “simply remove a person from my schedule.” The actual act of erasing a client from a schedule may indeed only take a moment. For me, in my office I have opted not to use the electronic scheduler that others use and instead use a pencil and paper system. I have literally erased people after a death and can remember the lump in my throat the first time I did so. I also remember hesitating to “give their time” away to a new client. It required some processing and grief work before I was able to truly move forward. Now, I remember that it was not the time slot nor the written name that made a difference, it instead, was the relationship that we had and that cannot be removed with a number two pencil.

Telling a staff member that their client has passed.
If you are a supervisor you likely will be one of the first people to learn of a death of any client. In my practice I have instructed the reception folks to notify me should there be any calls notifying us of a loss of life. They also will keep up to date on local obituaries as well as in some cases there is no next of kin that knows that the deceased was receiving services.  While there is no one correct way, I would avoid the use of texting, email, private messenger or other electronic means to advise your staff member of the loss. To me, a phone call is a last resort for notification and instead will call and ask the clinician to come see me the first thing when they come in. Once in, I try not to have it be too formal as in having a large desk between the two of us. Although I would never stage the encounter, I have shared the information while walking on one of the dirt roads on our therapeutic farm, sitting by the brook, walking some of our trails or spending time with our therapeutic animals. How I did it had more to do with the clinician and their normal preferences than it did with mine. Ensuring the privacy of the clinician is paramount as well. Should they need to cry, talk it out, yell a bit or whatever, the ability to do so without an audience is key. Many times, we process not just the passing but the process that the therapy took on, the good work that they provided and what they themselves will cherish from the encounter.

Moving forward
After the basic processing has taken place, it is good to remember that there may indeed be a need for further reflection and moments of pause in the future. Allow yourself to not only be a clinical professional but also a human being. We are not machines. Process as needed.

Be safe, do good

-Doc Warren

”Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, clinical & executive director of Community Counseling of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). He is internationally certified as a Counsellor and Counsellor Supervisor in the USA and Canada (C.C.C., C.C.C.-S, NCC, ACS). He can be contacted at [email protected]




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA

Coping with Political Fatigue

Posted by: Coretta Rego, MA, RP, CCC on October 7, 2019 2:14 pm

I was channel surfing recently and came across a commercial for the upcoming federal election. I changed the channel and came across another commercial. After having watched bits of each I thought to myself that I was ready for this election to be over and wasn’t particularly concerned about the outcome. That thought caught me by surprise as I am a political aficionado. I follow what goes on in government both nationally and internationally and I also love to discuss various hot button issues at length. It occurred to me that if someone like me can be so tired of the political cycle, many people must not only be fatigued but quite possibly overwhelmed by it.

Politics no longer lives in a realm outside of us. Instead, politics are now deeply personal, which means that there is a lot at stake in any given election. Recent elections have focused on issues that are deeply personal and inextricably linked to the type of world we want to live in and build for the next generation. However, with the promise of change and betterment that an election might bring, also comes the possibility that the outcome might be the polar opposite of what we wanted. The consequences of which can feel dire.

Additionally, discussions about politics have become inescapable. With the upcoming federal election in Canada and what seems like an ongoing election cycle for our American neighbours, politics remain constant even when the seasons change. Whether it is the onslaught of 24 hours news channels that are constantly dissecting every piece of information, or online message boards where people openly share antagonizing opinions without any responsibility to fact check, it is easy to get caught up in the negativity.

So how do we not just survive but thrive in this increasingly politically charged atmosphere? How do we remain engaged in political dialogue without becoming disillusioned about the world we live in? How do we support our clients as they navigate relationships with family members, friends and colleagues that quickly become hostile due to divergent political and personal views?

It is important to begin by recognizing that how we approach these issues will determine the outcome we achieve. Responding angrily to a tweet or getting into a heated argument with a family member over dinner is unlikely to produce civil discourse. Recognizing that what we talk about has an impact on the daily life of the other person can help build empathy. The point of a discussion cannot be to change the other person’s opinion. Discussion is about planting seeds and exposing people to things they may not have considered. We cannot go into conversations expecting to change someone’s opinion. If we do, we are bound to be disappointed.

Let’s also give ourselves permission to tune out or disconnect as needed. While smart phones and app notifications make it easy to constantly be plugged in, periodic breaks can help us avoid becoming overwhelmed by the information. Unless it is your profession, political engagement doesn’t have to happen 24/7. Taking a break from the deluge of information can help us process the information better and also provides an opportunity to focus on other equally important things.

Lastly, when it all seems too much, let’s take a moment to reflect on how far we have come. Let’s celebrate all that we have accomplished, the battles that were won by previous generations that have had positive impacts on our lives. History books are filled with stories of human triumph. Let’s use this to energize us for what lies ahead.

Political engagement is important; our democracy depends on it. However, political engagement should not compromise our mental health or well being. Maintaining optimism in the current political climate is not easy, but it is possible.

Coretta Rego MA, RP, CCC




*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA