30+ Things I Learned in the First 10 Years of my Therapy Practice

Jeff Guenther on Apr 01, 2018

I’d like to think that I have grown a lot in the ten years I’ve been in private practice. When I first started out, I was kind of all over the place. It took a couple years to really settle in and find my therapist voice. Looking back, I feel like I have become more wise so I decided to jot down 37 things I have learned. Some of them are silly and some of them are serious. But all of them are important to me and have shaped who I’ve become as a counselor. One of the great things about being a therapist is how there is always something new to learn and I look forward to seeing what the next ten years have in store!

1. You’re going to say the wrong thing and it’s not the end of the world

No matter how hard you try or how careful you are, you’re going to say something that you shouldn’t have said. Sometimes, the client will notice and sometimes it slips by. But try not to be too hard on yourself. You’ll probably feel horrible at first. But if it’s perfectly healthy for your client to be imperfect, then it’s just fine for you to be a little flawed as well. 

2. It’s almost impossible to cover up a yawn

Sometimes you feel bored in session. And sometimes you just didn’t get enough sleep last night. Or maybe your body just needs a bit more oxygen. No big deal. Even though it feels like one of the biggest sins to yawn in front of your clients, it’s probably a better idea to just let it rip. Covering up a yawn is super obvious and will just make your client feel weird. But if you feel confident in your cover up skills, by all means, give it a go. 

3. Always have something to fidget with in your hand

Is it just me or does it feel incredibly awkward to sit there and not do anything with your hands? Where should they go?! In your lap? On your knees? Cradling your face? No. You should be discreetly playing with a pen while listening intently. Just make sure to not put it in your mouth. That’s gross. 

4. It’s fun to have a cliche therapist catch phrase

“How does that make you feel?” “And how’s that working for you?” “You can be right or you can be in a relationship.” The list goes on and on when it comes to cliche therapist sayings. But they’re cliche because they work. And you know clients want to hear it. It’s like seeing your favorite band and hoping they’ll play all the hits. My personal favorite that I use outside of therapy just as much as in is, “I support that.” It puts a nice little stamp of approval on what the client is saying. 

If you are a therapist, listen to the new podcast Say More About That. A podcast created specifically for therapists to learn more about what clients really want in a counselor. In this episode Jill, a woman in her 30's who never thought therapy was for her, talks about how difficult it was to find a therapist that was truly a good match. Click play below or listen on Apple Podcast or Spotify.

5. Get an office space with other therapists

It’s lonely being a therapist. Especially if you work in an office with non-therapists. And even if there’s an acupuncturist or a naturopath, there’s nothing like being on the same level with another counselor. You can be there for each other in between sessions and you can share the burden of shushing people in the waiting room. 

6. Sign up for a therapist directory you can feel good about

The Psychology Today directory and magazine is problematic. Very problematic. Here are two articles that explain why: article 1 and article 2. There are a ton of online therapist directories that can actually match your values as a clinician. And signing up for a directory that resonates with you will also enhance your brand as a counselor. TherapyDen has a mandate to challenge racism, homophobia, transphobia and other forms of discrimination. You can sign up for FREE and learn more about TherapyDen here. But don't stop with TherapyDen. Here are another couple lists of directories you should check out. list 1 and list 2.

7. Attend networking events even when you don’t want to

It’s such a pain to have to leave your house and go to a networking event and not even know if it’s going to be a bust. For some reason, I never feel like going. It always seems like it’ll be a drag and a waste of time. But (almost) every time I leave an event, I am always happy I went. As cheesy and awkward as they can be, it always feels nice to connect with other therapists. 

8. Create an alternative stream of income

You probably know I’m a big fan of creating alternative and passive streams of income. In fact I have come up with 24 passive income ideas for therapists. Check it out here! Not only can you create more money, but you also get to mix up your week a little bit which makes things more interesting at work. I think it’s fun to use different parts of your brain at work. And I think I’m a better therapist because of it. 

9. Your clients are paying you to be honest with them. So be honest. 

There was a time when I felt like I shouldn’t be very direct or honest with clients. I thought maybe they might be offended, caught off guard or put off in some way. But I eventually realized that clients are paying me to tell them things that other people won’t. When you can be honest and direct, while also being caring and compassionate, it’s a real shame to waste that opportunity. And besides, you’re getting paid the big bucks to be honest. So go for it!

10. Keep learning 

Don’t be one of those therapists that gets stuck in old ways of thinking. Keep pushing yourself and learning about new ways to grow and be a more effective therapist. Clients assume that it’s our job to be on top of the latest trends in counseling. And they’re right. It is. 

11. Sometimes you only see progress if you’ve seen a client for a year. (Or more).

I like to see progress happen fast and right before my eyes. But that’s pretty unrealistic. It takes a long time to make big changes in your life. Remember that you’ll set yourself up for disappointment if you think that you’ll see forward movement in the early weeks.

12. Being a therapist can be incredibly rewarding

It may not happen often enough but once in a while a client will tell you how much you’ve helped them and it will feel wonderful. But it doesn’t have to be verbal validation from a client. It can be a slight change in awareness or the relief of anxiety in a client that makes you feel good about the work you’re doing. It’s important to keep an eye out for the subtle changes.  

13. Being a therapist can be incredibly scary

Sometimes I freak out when I have no idea how to respond to a client. Sometimes a client is totally hijacked by their trauma. Sometimes a client makes a life altering decision based on something I said. All these things make me scared. I don’t expect the fear to every fully go away. But I can handle it. At least I can handle it better than I used to when I was just a baby therapist.

14. Telling a client that you don’t remember something they said is okay

I tried for as long as I could to avoid telling clients I couldn’t quite remember what they had said in the past. I thought it would instantly make me the worst therapist on the planet. But once I allowed myself to ask clients to remind me of something, it turned out that they didn’t ever hold it against me. It might not seem like a big deal to you. But this was in incredibly liberating moment in my counseling career. 

If you are a therapist, listen to the new podcast Say More About That. A podcast created specifically for therapists to learn more about what clients really want in a counselor. In this episode Jolyn, a woman in her 40's saw her therapist for 10 years and grew in ways she never expected. To hear about her journey click play below or listen on Apple Podcast or Spotify.

15. I’m not a good fit for some clients and that’s fine

Actually that’s great. I don’t want to treat issues that I am not trained for. I don’t want to cause harm to a client by pretending I can help them. At the beginning of my therapy career, I thought I should be able to treat anyone who walked into my office and that I was incompetent if I didn’t. Now I only treat folks that I feel confident about and things are working out much better for me (and them). 

16. Having a friend crush on a client is perfectly normal

I am pretty sure that I could be really good friends with many of my clients. I felt a little awkward about that in the past because I thought it wasn’t very professional to have these feelings. But now I know it’s perfectly normal. I just have to make sure that I don’t treat them like my pals in session. Which is actually kinda tricky sometimes. 

17. Set boundaries at the start of every new client

“Please don’t text me late at night. I can’t do therapy over email. If I see you out in the world, I’m going to ignore you. Don’t be offended. Ask me anything you want! But I might not answer if it’s too personal.” I make sure to state all this at the start. If I don’t, then it can get weird. 

18. Go to the bathroom between every client

Okay, this might not be a thing for you but I feel incredibly distracted when I have to pee in the middle of a session. And it’s also my biggest fear to pee my pants when talking to a client. I know it’s unrealistic, but it’s a completely real fear for me. If you’d like to learn more about my pee pants fear, read this blog I wrote

19. I shouldn’t hold back tears if I feel like crying

Possibly one of the best ways to connect with a client is crying with them. Or crying for them. So don’t feel like you have to hold back when your eyes well up. It’s okay to cry. 

20. Saying goodbye to client can be super hard

I hate saying goodbye to clients. It’s something I’m working on and will probably always be working on. Although a good way to avoid this is to provide therapy that is good but not quite good enough so that the client feels like they just gotta be in therapy forever because they haven’t quite worked out all their issues. Kidding! 

21. You don’t have to go deep every session

We are paid to dive deep into the unconscious or have big emotional breakthroughs or connect past hurt to current pain. But if you have a bunch of heavy sessions in a row, feel free to keep it light. You don’t have to do heavy lifting every time. It can be exhausting for you and the client.

22. Chit chatting should only last so long

You know how some clients come in and are chatting away about nothing really? Maybe the weather. Maybe the local sports team. It’s not a bad way to start out a session. It’s weird to just dive in to the deep stuff right when the client hits the couch. But there have been times where I let the chit chat take up half the session. And then it feels really tricky to transition into therapy topics. It’s always better to keep small talk at a minimum.  

23. Check your privilege 

I’m a white heterosexual dude that comes from a well off family. I need to check my privilege when I’m talking to a client that has a different background or a different skin color. The way I see and experience the world needs to be taken into consideration when I’m giving feedback and analyzing my clients. I wrote a whole blog about it if you want to learn more about how white therapists can check their privilege. 

24. Don’t be scared to talk about what’s going on in the room

I should honestly do this more often but it just slips my mind sometimes. I remember feeling really weird about talking about what I was experiencing in the room. But trust me, clients typically find what I have to say very intriguing when I comment on the feelings that I am experiencing. It’s hard to bring up though because sometimes it creates awkwardness. I usually say something like, “can I tell you about the feelings that you’re invoking in me right now?” I know. I know. Sounds like cliche therapy lingo. But it works.

25. Developing trust is everything

We all know this. But it doesn’t really crystalize until you try to challenge a client or confront a client before you have developed a good amount of trust, it can be painfully obvious that you moved too fast and you made shit weird and uncomfortable. 

26. Learn to manage your own anxiety during session

In my first year of being a therapist I had multiple fantom pee attacks, almost passed out three times, got blurry vision twice and one time pretended to excuse myself because of a bad tummy but really I just had to get some air before passing out. I was kind of a mess. But now I know how to manage my anxiety during a session so if I ever feel weird again, I do not lose my shit. Thankfully, I don’t have anxiety attacks anymore. But if I did. I’m prepared!

27. Dress nice(ish)

When I first started as a therapist I wore hoodies and jeans. Then I ditched the hoodie for a nice button up shirt. I eventually got some nice shoes. And then I started wearing hip ties and nice pants. Every time I upgraded my style, I became a better therapist. Was it because I was getting older and more experienced? No. It was probably the clothes.

28. Don’t forget to be the client sometimes

I go to a therapist off and on. I like to switch it up and see different therapists based on my current needs. Every time I sit on the couch and experience what it’s like to be a client, I grow as a therapist more than I was expecting. You should try it. 

If you are a therapist, listen to the new podcast Say More About That. A podcast created specifically for therapists to learn more about what clients really want in a counselor. In this episode Jake, a gay man in his 30's recounts his epic tale of finding a good therapist. To hear about his journey that is filled with funny and moving moments click play below or listen on Apple Podcast or Spotify.

29. Ask for payment at the beginning of the session

Maybe it’s just me, but I like to get payment out of the way. It feels weird to ask for payment after a heavy session. And I just don’t like switching gears abruptly at the end. I just want to say bye and do a little wrap up at the end. If you don’t ask for payment at the start maybe you should try it.

30. Holding in a sneeze is always a bad idea

Just like with a yawn, I feel like a therapist should never sneeze during a session. Why I think this I have no idea. It’s bizarre that I don’t like to sneeze during a session. But what’s worse is when I hold my sneeze in. My eyes water and my nose runs. Which is ten times worse. 

31. Spacing out happens but you should try not to

I like to think that I’m laser focused when talking to a client. And most of the time, I am. But every now and then I’ll zone out and not hear the last couple things a client said. It’s a horrible feeling. But don’t be too hard on yourself. It happens to all therapists. Just hope that you didn’t miss anything important. If you think you did, it’s ok to ask them to repeat themselves. It’s not the end of the world. You’re probably judging yourself a lot more then they are judging you. 

32. If you can’t stand repeating yourself, being a therapist might not be for you.

Honestly, I think repeating yourself in slightly different ways week after week in order to create positive change in a client is an art as much as a science. And every year I get better and better at it. 

33. Just because you can’t help a certain client, it doesn’t mean you’re a bad therapist

This needs to be a course in grad school, am I right? There have been clients that have come to see me for depression and there is just nothing I can do to provide them relief. I know it might not be my fault. But it also could be my fault. Maybe I’m just not good enough. Or maybe I’m the wrong fit. But just because I can’t help them it doesn’t mean I should quit being a therapist. I had to learn this on my own. As a side note: I’d much rather treat anxiety than depression. Ugh. Depression is just so difficult sometimes. 

34. Don’t see too many clients in a row. Or in a week. 

I used to see eight clients in a row. I was a young therapist that didn’t have much going on in life. I saw clients one right after the other the same way I binged my favorite TV show. That didn’t last very long though. I was so totally wiped by the end of the day that it was hard to feel fresh the next morning. Also, stories started to blend together and I got scared that I was confusing the boyfriend from last session with the boyfriend from the current session. It’s a horrible feeling when you can’t remember the boyfriend’s name. So remember to take breaks during the day. Or at the very least, accept clients that have boyfriends with distinctly different sounding names. 

35. If a client won’t let you influence them, ask them why

Sometimes clients are really resistant to my amazing influencing skills. And I wonder why they won’t allow me to help them create positive change. When I run into road block after road block, I eventually ask them why they won’t let me influence them. They usually always have a great answer. It’s become my favorite question. 

36. Pay attention to how you end your sessions

If you end a session abruptly or on a weird note, then say something about it. But if it’s possible to end it gently with a nice little wrap up speech at the end, do it. I like to try and stick the landing every time. It’s unrealistic to put a bow on the end of every session, but it sure feels good when you can.

37. Sometimes clients hear what they want to hear

Have you ever had a client come in and tell you that they broke up with their partner because of the advice you gave last week even though you said nothing like that. Isn’t it bizarre what clients take away from session sometimes? Sometimes what you say gets lost in translation and there’s just nothing you can do about it. But almost every time that happens it can turn into a pretty great check in with your client.

38. Go to as many consultation groups as possible

Consultation is key. It keeps you sane. And it also keeps you out of trouble. Building community wherever you can is super important. I love my consultation group and I hope it never ends. Sometimes we don’t even talk about clients and it still feels incredibly replenishing.

Jeff Guenther, LPC, is a therapist in Portland, OR. He has been in private practice since 2005. Jeff is the creator and owner of Portland Therapy Center, a highly ranked therapist directory. Jeff, and his team, have launched a new progressive therapist directory, TherapyDen.

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