Buckets of Money

Most people are uncomfortable talking about money and I’m committed to helping my clients understand the psychology of money and the impact it has on our lives. I’ve read many books about money and I’m fascinated by the way our attitudes about money and worth influence our countertransference and the fee setting process. One of my favorite money books is Bari Tessler’s- The Art of Money. Tessler is a somatically trained financial therapist who teaches a yearlong online money course which I took several years ago. One of the many valuable practices I learned was to divide my money into separate “buckets”. These buckets help me organized my finances and avoid “surprises” at tax time.

My first bucket is a business savings accounts labelled “quarterlies”, I transfer money to this account every week so that when the end of the quarter comes, I have enough money to pay my taxes. My second business savings account is labelled Gray’s Bank which I use for my rainy-day fund to cover me during slower times and to save money for training and other “big ticket” expenses.

I use the same system to manage my personal finances, and the structure is based on my personal values and interests. I value fitness and I invest in yoga and Pilates classes (currently online) which I purchase in packs of 20. I’ve created an account called “Pilates and Property Tax” for my property taxes, yoga and Pilates, and an “Adventures” account that I use to save for vacations. In the past I’d charge my vacations on a credit card which resulted in having to pay off a large debt when I returned home. Now I have the money ready and I can pay for my vacations immediately without any pressure.  I have a main savings account where I’ve saved six months of living expenses. Most financial professionals recommend saving at least a year of expenses, so I’m working on building up that account. 

Maybe this sounds like too many accounts to you, perhaps you’d prefer just one or two. I’ve found that paying myself first and planning for emergencies, vacations, fitness expenses and taxes has created more ease in my financial life. It helps me manage the ebbs and flows of income that come with being self-employed.  What buckets might you use if you were organizing your money this way?

Rest: Why You Get More Done When You Work Less

I’m currently reading a book entitled “Rest: Why You Get More Done When You Work Less” by Alex Soojung-Kim Pang, which explores our relationship to rest and work. Pang is the author of four books and the founder of Strategy and Rest, a consultancy devoted to helping companies and individuals harness the power of rest to shorten our workdays, while staying focused and productive.

Pang believes that you can work better if you learn how to rest better, he challenges our culture’s “respect” for overwork, citing William James’s 1899 essay “Gospel of Relaxation” in which he argued that Americans had become accustomed to overwork and lived with an “inner panting and expectancy” bringing a spirit of “breathlessness and tension’ to work. James could have been describing my years working in the corporate world, prior to following my calling and changing careers.

I enjoy being a psychotherapist and have found that I am at my best when my days are shorter and include a long midday break. I see clients Monday through Thursday and use Fridays for administrative work, yoga/walks and Brainspotting consultation. In the early days of my practice, I was more interested in creating a sustainable business than focusing on work/life balance, so I worked on Saturdays and late into the evening; this was hard for me but it helped me grow my practice. Now that my practice is established, I can see clients during the hours that work better for me. I have more energy in the mornings, so I schedule more sessions early in the day, followed by a ninety-minute lunch break and two clients in the afternoon.

Pang states “If you want rest, you have to take it. You have to resist the lure of busyness, make time for rest, take it seriously, and protect it from a world that is intent on stealing it.”

I wrote this post shortly after returning home from five glorious days in Santa Barbara, the place where I go to hike, bike, eat delicious food and rest. Prior to the pandemic I scheduled time off every three months and this vacation was my first in six months. When I decided to plan a trip, I spoke to my primary care physician and she advised me about how to stay healthy during the trip. My five days felt blissful, with no access to email or voicemail and most of my time spent out in nature.

As a therapist, I sometimes experience a sense of “fullness” at the end of the day where I cannot imagine taking in any more information. It feels like my mind needs to be emptied and time away from work creates room in my brain and body; Pang’s book cites research explaining how rest can create space in our brains for creative thinking. Sometimes just a small amount of restful, quiet space is all I need after a busy day. I like to create a clear divide between my sessions and my evenings, sometimes I’ll take a short walk or sit outside on my patio. I notice that on the nights when I don’t have enough quiet time after work, I struggle to stay asleep. Pang explains “While you sleep, your brain is busy consolidating memories, repairing physical damage, and generating dreams. Most of the time you’re not aware of all this work, but it’s been going on your whole life. And your life depends on it.”

Are you allowing yourself enough time to rest?

Are We There Yet? Deciding When to Return to In-Person Sessions

Throughout the pandemic therapists have been engaged in social media debates about when/how to return to in-person sessions with their clients. I’m writing my article after watching a video where the Executive Director of CAMFT, Nabil El-Ghoroury, PhD, CAE weighed in about seeing clients in-person during the quarantine. He suggested we carefully consider the decision and cautioned his readers not to pressure themselves into making a hasty decision. El-Ghoroury stated that he planned to continue to see clients via telemedicine through Labor Day and would revisit his choice at that time. After watching his video, I took some time to reflect on the logistics of in-person sessions; my feelings about it deserve a separate blog post.

I knew I wasn’t ready to return yet, but I wanted to consider my options for the future and writing this post helped me gather my thoughts. The first question was masks. Right now, I wear a mask when I am out in public, except for my early morning runs when very few people are outside and the world seems almost normal. The thought of wearing a mask does not feel conducive to my work as a trauma therapist, where facial expressions help me attune to what’s happening inside of my clients and my face helps regulate their nervous systems. Some of my clients choose not to wear a mask, how would that work?

I’m concerned that my clients’ journey from their cars to my therapy room could be activating. We have seven offices in our suite and approximately twenty other suites in our large, three-story building. As I considered the entrance to the building, keypad, and elevators, I realized that on the way to my office my clients could encounter people who might not be wearing masks or practicing social distancing; I wondered how these encounters might impact their sessions, there would certainly be “grist for the mill.”

Antibacterial wipes would be available at the entrance to the suite. Once they made it to my office, clients could text me to bypass the waiting room and I could meet them in the outer hall. How would we handle it if another person’s client was walking out when I was escorting my client in? There is no way to stagger the schedules of seven clinicians, even if we all started and ended our sessions precisely on time, which is never going to happen.

Once we made it to my office, I imagined my chair being six feet away from my client, which feels way too far. To handle the credit card payment I’d have to roll my chair over to my client, and once they handed me the card I could swipe it, show them the amount on the screen and sign for them. Once I gave the card back, we could have another round of hand sanitizer. I realize I can keep a credit card on file, however, the fees are significantly more expensive, and it eliminates the chance to explore any potential financial transference as the client pays for their session.

I decided to ask my doctor for some recommendations, and she strongly recommended that I wear a mask at all times and require my clients to wear a mask. She advised me to wash my hands frequently and use antibacterial hand disinfectant with 70% alcohol. She told me to avoid touching my face and to wash my hands after touching any door handles.

Writing this article has helped me see that there is no magic business process that will allow me to feel perfectly comfortable returning to in-person sessions. We all have different opinions about this issue, and it can feel adversarial when colleagues communicate their judgment on social media. Writing this article has led me to decide to continue to practice telemedicine (via ZOOM) for now. Although it presents some challenges, I have been able to do important, clinical work during this time. Two weeks ago, I returned to the comfort of my air conditioned, quiet office, away from the many distractions at home and the noise of my neighbor’s bathroom remodel. I’m wearing my mask, washing my hands and using antibacterial wipes on the door handles. My doctor’s suggestions proved to be helpful as I navigated the reentry process, sharing a restroom and elevators with other people.

I will continue to reevaluate my decision as I learn more about the Covid-19 virus. I know there is no perfect solution, but it’s clear to me that I don’t want to do therapy with a mask on and I am not willing to risk my health or the health of my clients in order to see them in person. I’m interested in your ideas about this and would welcome a discussion.

Creating Your Professional Will

Last year, I decided to update my professional and choose new members for my Emergency Response Team, these are the people who would manage my business affairs if I became seriously ill or in the event of my death. When the coronavirus hit, I wanted my will to be current in case I got sick and could no longer care for my clients. Both people I contacted readily agreed and said they felt honored to be asked.

Creating a professional will is not difficult, the challenging part for me was calling my friends and requesting their help because I know it’s a big responsibility. Before you create your will, think about who you’d like to coordinate care for your clients in your absence. The colleagues I chose both specialize in addiction and trauma as I do.

I suggest you find at least two people. One of their main responsibilities would be calling your clients to inform them of the situation and providing them with referrals if needed. In the event of your death, your team would access to your office and any paper records. I maintain electronic records and my brother is my delegate for my password management software; he’ll be in charge of providing my friends with access to my records and managing any outstanding financial issues. If you use paper files, I recommend creating a list of your active clients and filing it with your professional will.

As therapists we have an ethical responsibility to our clients and our colleagues to keep our business affairs organized. I know it’s not pleasant to think about the possibility of getting seriously ill or our inevitable death, it’s comforting for me to know my affairs are in order during these uncertain times.

You can find professional will templates online and I’ve included the link to CAMFT’s template below https://www.camft.org/LinkClick.aspx?fileticket=8V-aZFCfl7s%3d&portalid=0

Choosing the Right Telemedicine Software

Choosing the Right Telemedicine Software
Due to the Coronavirus (COVID-19), many of us have moved our practices online to protect our health and the health of our clients. I have always offered online sessions to clients who travel or simply prefer not to drive in LA traffic. When I started doing video sessions I inquired with CAMFT about HIPAA privacy rules and video conferencing software for telemedicine. The first step in choosing the right software is determining whether you are a HIPAA-covered entity.

Here are three questions you need to ask yourself; you must answer yes to all three to qualify.

1. Are you a healthcare provider? The answer is yes for psychotherapists.

2. Do you transmit health information electronically?

3. Do you conduct covered transactions? According to CAMFT- “A covered transaction for HIPAA's purposes involves transmitting information between covered entities to carry out certain financial or administrative activities related to health care.” From David Jensen JD’s 2010 Article- “Are You A Covered Entity”CAMFT’s website and verified by phone

Since I am not on any insurance panels and do not transmit health information electronically, I answered no to questions 2 and 3.  I chose to use ZOOM, which is not HIPAA compliant.

When researching software choices, be sure to ask about the software’s privacy protocols.  Ask if the sessions are recorded and who has access to that server. If you are a HIPAA covered entity, check out VSee, one of the more popular HIPAA compliant platforms.

California law says we must maintain confidentiality and reasonable security when we conduct telemedicine sessions.  If you need more information about telemedicine, you can find it on CAMFT’s website www.camft.org.