** Full Disclosure: This post may be a bit of a rant or vent as I use my blog as a therapeutic outlet for personal/professional life stress.**
Many of you already know that I have worked in community mental health for almost three years. It was my stepping stone immediately after graduate school and now serves as supplemental income while I build my practice and the center. I had never wanted to work in community mental health but saw it like living in a dorm: doing it for a year is good experience and a rite of passage. But just like a dorm, 3 years is too long. I have learned a lot about clinical mental health, the bureaucracies surrounding healthcare, and low income people… heck, people in general. I also don’t think I would have embraced DBT, a very marketable tool, so fully had I not been in community mental health.
However, I’m tired. I am burnt out. It is too stressful to build a career in this field (for me). The work is stressful, yes, but there is also the never-ending gotta-keep-my-lights-on kinda stress. If my clients don’t come to session, I don’t get paid. And there is no penalty to them for not showing up. So I am relying on individuals experiencing inhibited motivation or exaggerated fears (common symptoms of depression, anxiety or the like) to show up in order to get paid. Swell. Now we have to look at the governing body that supplies the money from which I get paid. The government. Double Swell. 15 months ago, Medicaid cut provider reimbursement rates by 8%. Ouch. And news has surfaced that they have just made an additional 3% cut. So, I am relying on people that may or may not be motivated for treatment (through no intentional fault) to attend their sessions (with no penalty if they don’t) in order to get paid less than I was making when I just finished school, and hope that cuts don’t go lower, all with the same eagerness, integrity and optimism.
So, maybe needless to say, I am losing motivation for working in community mental health. Correction: I have lost motivation for work in community mental health. I have many clients whom I love. However, the worries about paperwork, no shows, insurance, unsanitary work environments, and bureaucratic nightmares are worries I am ready to live without. I plan to serve those that may not have the financial resources, but not like this.
But what are my options?
That has become the distressing question of the millennium! I have considered it all. I applied for and got a full-time, cube job as a wellness counselor. Decent pay, good benefits, bad commute, no flexibility… no private practice. Nope. That wouldn’t work. I could go back to personal training as supplemental income. Flexibility, fun environment, lots of time and energy spent building another clientele… Nope. Not a good option when you are already building one business. Get a part-time job working a register. Hmmm… interesting but might make me nauseous when I get a paycheck that is 1/10 of my hourly rate that I have earned through tens of thousands of dollars that I owe on student loans. Keep coping with community mental health. That has seemed to be the best option. I have tons of flexibility in my schedule to jump if I need to sign some papers or check out a potential space for the center. I can continue to build my practice in the meantime which is giving me joy and pride.
So this is how I cope: Blog and vent with other therapists that are frustrated. Take a break from work and plan my wedding. Focus my energy on building the dream. Yoga. Coffee and/or wine hiatus mid/end of day respectively. The most helpful skill is reminding myself that it is temporary. I have gotten through worse. It is almost over. I am SO close to a dream profession. And not just a dream profession but my dream that will accommodate my life as a therapist, wellness junkie, wife, and one-day mom.
So, I will keep on keepin’ on… for now.