5 things I wish I knew before Starting TikTok as a Therapist

Derrick Hoard, LMFT on Oct 17, 2021

My name is Derrick Hoard and I am a licensed marriage and family therapist. On TikTok, I am known as The Situational Therapist. As of this writing, I have around 800,000 followers and will hit one million before the end of the year. I have had several videos go viral, some with more than three million views, and began a conversation about spanking as abuse. You may not be familiar with the platform or you may dismiss it as yet another "social media fad," but by not utilizing TikTok as a platform to grow and market your business, you are missing out on a substantial boost to both your bottom line as well as your authority in the field. As a result of using this platform, I now have a fully cash-based private practice with most clients paying my premium rate. I also released an app called The Situational Practice on iOS and Android in June of 2021. Getting to this place was not without its difficulties, so I want to share five things I wish I knew before starting TikTok as a therapist.

How TikTok Worked

My first video to go viral on TikTok was a critique of cognitive behavioral therapy and how it can gaslight clients of color by reframing their societal induced anxiety, depression and other stress responses as problems that occur because of a fault in their thoughts instead of placing the blame at the feet of a structurally racist and imbalanced society. I had no idea the reach my statement would have, nor was I prepared for the rush of criticism that would come my way from therapists whose cultural competency class didn't cover conversations concerning classism in counseling. Not understanding the difference between a “duet” and a “stitch” nor knowing how to properly clip my responses led to many "Elder Millennial Screams at Phone" moments. An elder millennial is anyone born in what Gen Z would refer to as "the late 1900s." I wish I had taken more time to get to know the platform as a user before starting as a creator. It would have been helpful to observe other creators and how they each decide to handle responses to their point of view. It also would have been nice to understand the experience of someone who is just using the app to "pass the time" instead of a tool to grow their business.

How Close To Have My Face To The Phone

As I look back at some of my past videos on TikTok, I notice my face is extremely close to the camera. Now, I didn't think this was a problem until I saw a comment on one of my videos asking "Why is his face so close to the screen?" The truth is, there is no "correct" distance to have my face from my phone when recording a video, but considering how I wanted to present myself and my message before making a video would have saved me significant trouble at the beginning of my journey on TikTok. We all know that first impressions are everything, and due to the nature of the TikTok algorithm, sometimes they are the only thing. The Situational Therapist has gone through several iterations on TikTok and I know that for around 35,000 people, I will forever be the “I Can See Up His Nose” Therapist.

How To Embrace Being Canceled

I have been canceled on TikTok several times. Once, it was because I implied that therapists are also "The Police" due to the immense amount of power we wield in our ability to commit people into the system. I also got canceled for saying that "there is no reason to have children that isn't selfish.” Another time, I informed people of the fact that chemical imbalances are not the cause of mental illness, which was met with calls for my license and accusations of being unfit to perform professional duties. Really. I got three letters from my licensing board alleging "unprofessional conduct." I have been canceled several times since then, and I wish I knew at the time that "being canceled" is just another way of saying "being acknowledged by individuals who passionately do not share your viewpoint." The first time I read a comment calling for my license, I immediately went into a tailspin. I knew enough about TikTok to know that for every comment, there are 1,000 just like it. I was very sure that this would be the end of The Situational Therapist and I would have to become a life coach. I wish I had realized that "being canceled" as I understood it was defined by experiences of watching individuals receive criticism for racially or culturally insensitive remarks.

Some therapists have indeed been canceled as in "unable to post because people remind them of the insensitive thing they said and haven't apologized for." It is much less "being canceled" as it is "a reminder that you haven't taken responsibility." I have had to accept accountability for racially insensitive remarks and being able to be humble in public is a significant step toward building trustworthiness.

Being canceled by individuals who are simply reacting to or confronting an uncomfortable truth is not only something to celebrate but an excellent way to model internal boundaries and tolerate alternative points of view.

How To Maintain a Healthy Posting Schedule

In my early days of TikTok, I didn't have any consistent posting schedule. Whenever someone said something that frustrated me or if I saw a video I didn't like or something in popular culture upset me, I would post. This means a lot of my posting was reactionary, and being reactionary all the time is very exhausting. There were times where I would find myself posting well into the evening after I was done seeing clients for the day. This behavior was also fueled by just how addicting and accurate the "For You Page" can be, which is where the TikTok algorithm studies your likes and dislikes and presents you with a feed of videos you will want to watch and respond to. I wish I had set a boundary with myself when I began TikTok and limited my posting and responding to set hours of the day, but before I realized that posting on TikTok was work and should only be done during work hours, I brought "work" home. While I was always careful not to allow TikTok to interfere with my clinical persona, not setting this boundary resulted in me getting frustrated with the platform and dealing with months of lost time and revenue from burnout.

How to Be Less Objective

I did not go into TikTok believing I would be successful on the platform. I thought the app was probably already full of other therapists with more experience, knowledge, and expertise. I wondered why anyone would ever care what I had to say. I didn't know how to differentiate myself from what I assumed to be the sea of other therapists on the platform. I certainly didn't think it would be a safe place to get new clients, and I worried about the liability associated with the exposure.

At the same time, I spent so much time trying to say things in a way that didn't offend anyone that I ended up not saying anything at all. One day, I decided to step out of Derrick Hoard LMFT, the objective therapist, and step into The Situational Therapist, the extension and application of the knowledge I held, and said three words that I will forever be known for: “Spanking is abuse.” While making such a determination in the confines of a therapeutic space would trigger mandated reporting requirements, saying it under the banner of my persona, The Situational Therapist, allowed me to speak to an experience that hundreds of thousands of people across several countries and territories have resonated with. Objectivity is important in the context of therapeutic work. You do not want to allow your emotions to drive the interactions with your clients. On TikTok, your expression of emotion is your brand, and it is hard to express emotion while being so objective that you sound just like everyone else. Learning how to be less objective and finding my voice allowed me to stand out from the other therapists on TikTok.

There are many other lessons I had to learn during my time on TikTok: How to Handle Clinical Questions, How to Communicate with Current Clients About My Public Views, How to Establish Boundaries with Clients from Social Media, How to Deal With The Guilt Associated With The Substantial Increase in Revenue, and many other problems that were a direct result of not preparing for the success I had with this platform.

After only a year of "work," I have a steady referral stream for clients, I'm seen as an authority on topics related to family dysfunction, I have been invited to several speaking engagements, and I have an app with almost 10,000 members. If you are not using TikTok to grow your business, you are ignoring a wealth of free advertising potential. Other therapists are succeeding simply because the competition is non-existent unless you count life coaches.

Side-note, many therapists fail because they start their videos with "As a licensed therapist..." Step two of succeeding on TikTok as a therapist is that "no one cares that you have a license until it's time to book you for a podcast.” Betterhelp, Talkspace, and other "Online Therapy" providers may be able to outspend you in advertising, but they will never be able to compete with your personality. The era of the therapist who hides away in their office doing work in the background is over. Now is the age of the Therapist-Influencer, and this age rewards those who know the people with whom they were meant to work.

I help therapists grow their business on TikTok. Find out more.

Derrick Hoard is a Licensed Marriage & Family Therapist in Washington. He works with clients who are tired of knowing how to help other people, but feel absolutely powerless when it comes to helping themselves. Learn more about how he helps therapists grow their practice on TikTok.

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