The (Potential) Loneliness of the Private Practice Therapist.

‘Epidemic of Loneliness’

There has been much mention in the media of late about an ‘epidemic of loneliness’ (Harris 2015, Killen 1998)  regarding the phenomenon of growing social isolation in modern society. Isolation and loneliness appears to be on the increase  in spite of, or some argue because of, the new opportunities for connection offered by digital technology and social media.

Often as therapists we will be engaged in helping our clients and patients to think about and manage their own experiences of loneliness, but recently I found myself reflecting on how working as a counsellor or therapist in private practice itself can sometimes feel like lonely work.

Working from home or from a rented consulting room without the company of other practitioners can mean that practitioners have little or no contact with other colleagues in the course of their working week. Even when the private practitioner does have other therapists working alongside them it is still not always easy or possible to share work experiences, or to seek support when things are difficult or overwhelming.

The Advantages of Private Practice

There are of course huge advantages to working in private practice for therapists, which is why many of us choose to spend at least some of our time working in this way. It may also be that some people find themselves more suited to it than others. The private practitioner is able, to a large extent, to have control over practical aspects of their schedule such as the number of patients they see, the days and hours that they work as well as more clinical aspects such as how long they are prepared to contract for, and the kind of work they undertake.

The pay-off

The pay-off for all this freedom, as compared to therapists working in an agency or other team setting, is that the practitioner themselves holds the responsibility for all aspects of their practice on a day to day basis. There is no manager to complain to or have a quiet word with after a difficult day; no colleagues to let off steam to about frustrations encountered in the work. The private practitioner must also find a way of generating enough referrals into their practice to ensure that it is a viable way of them meeting their financial needs, as well as maintaining admin systems and record keeping while having up to date policies on areas such as child protection and confidentiality. It is also vital to remember that working as a therapist is a demanding and challenging occupation and that it might be very important to have someone to share these aspects of the experience with when the work feels difficult or overwhelming on a personal level.

Importance of support

For the practitioner who works in a more isolated setting such as from home or in a rented consulting room, often the only colleagues or other professionals they are in contact with are their clinical supervisor and possibly their own therapist. Although clinical supervision can be an incredibly important and enriching part of practice, it is unlikely to meet all the needs a practitioner has for support with their work, and neither should it. Supervision certainly can be a great source of support for practitioners, but the focus there is still largely upon the needs of the client, and when we have a busy and demanding practice there is generally not a lot of space left for the needs of the therapist themselves to be met or considered. Therapists in private practice need therefore to give some thought to what their ongoing requirements for support might be and how best to meet them. Even with a solid training in place and personal therapy, there are still likely to be needs unmet for the private practitioner and not taking these seriously can contribute to difficulties maintaining a practice and potentially lead to illness and/or burnout.

Holding and containment

Donald Winnicott (1960) talked about the role of the father in providing holding or containment for the mother so that she might focus her attention on the needs of the new born infant; so completely dependent upon her for the meeting of all its needs. In the same way therapists need to make sure that they have a sufficient support structure around them so that they can meet the needs of their clients in the therapy session.

Peer support networkspartnership

There are a variety of ways in which it is possible for private practitioners to explore getting the support that they need. It is worth noting that it may be necessary to try out different ways of getting support in order to find what works for you as an individual. Our need for support is likely to change as careers develop and bring changes and the structures we have in place will need to be flexible in order to facilitate and support this development.

One of the key methods for meeting these needs is to create or take part in some kind of peer support network. By finding a way to be in close contact with other practitioners of a similar level of experience, it is possible for a practitioner in private practice to provide for themselves and their colleagues some of the benefits of working with a team. For some practitioners this might take the form of a reading group or formal peer supervision group with some time allowed for more informal discussion of the participants experiences at work. Others may choose to meet more informally with colleagues for support and to share experiences without there being another agenda for meeting. It is up to practitioners to be creative and courageous in terms of devising ways of reaching out and getting together with other practitioners.

110529-O-ZZ999-010 LAE, Papua New Guinea (May 29, 2011) The Pacific Partnership 2011 soccer team forms up during an exhibition soccer match. Pacific Partnership is a five-month humanitarian assistance initiative that completed its mission in Tonga and Vanuatu, is in Papua New Guinea, and will visit Timor Leste, and the Federated States of Micronesia. (U.S. Navy photo by Kristopher Radder/Released)
Create partnerships

Private practitioners might get together to create partnerships, either working together in the same premises or sharing a website and referrals. It is possible to maintain independence as a practitioner while working alongside others.
Practitioners based in towns or cities with large populations of therapists working privately may find it easier to connect with others, but for therapists in rural or more isolated areas this may be more difficult. In such situations practitioners may choose to use the internet to create a network; meetings could take place via tele-conferencing platforms such as skype or facetime. For some practitioners this may take some getting used to, but the benefits to be gained are likely to make this worth the trouble.

Professional bodies

Aside from peer support networks there are also the professional bodies. Nearly all counsellors and psychotherapists are now members of a professional body of some sort. Organisations such as the BACP and the UKCP offer various forms of support to their membership such as networking opportunities, conferences, journals and more. The BACP has a private practice division offering support to practitioners working independently in the field. Engaging with other professionals by going to the conferences, reading, or even contributing to, the journals published by the various divisions can help to make practitioners feel connected and supported in their work.
Attending CPD workshops and trainings locally or nationally and connecting with others there can be a great way of building bridges with other practitioners as well as being supportive and enriching for practice generally.

loneliness 2

 

As therapists we often hear our clients speaking about their own experiences of loneliness and isolation. It is important that as practitioners we are open to understanding our own experience in this respect as it relates to our professional as well as our personal lives and are willing to make sure our own needs are not neglected.

Feel free to comment on your own experience of professional loneliness or of ways of finding support and connection.

Harris, R. The loneliness Epidemic: We’re more connected than ever – but are we feeling more alone? The Independent, March 20th 2015T

Kileen, C. (1998) Loneliness: an epidemic in modern society. In: Journal of Advanced Nursing, 28(4): 762-70.

Winnicott, D.W (1960) The Theory of the parent-infant relationship. In The Maturational Processes and the Facilitating Environment ed. Winicott, D. W. (1965) Hogarth Press: London

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