This week, I learned about the death of a colleague. We had worked in the same office suite for years. She rented an office from me. Yet in all that time, I only met her once in person.

This led me to think about what an isolating profession this is. While we talk to clients all day, in the end we are left on our own to hold their traumas, manage their problems, and keep their confidences. And we receive minimal support when addressing our own questions, doubts, and concerns related to the enormous challenge of running a small business.

And while many of us have gotten used to the “new normal” of working completely remotely with clients, there was a second change that happened simultaneously: Many of us now go months without interacting with another therapist.

I thought of this again when a veteran therapist told me she was creating a “Therapist Will,” but she didn’t know any therapists who might handle her files if she died. Many of us would struggle with this.

How did we get so disconnected?

When I started out over 30 years ago, I worked in an office suite with other therapists, who I saw regularly. We celebrated birthdays and holidays. I built a network of therapists in the community by attending workshops, conferences, and monthly luncheons sponsored by my local professional association. These therapists became my friends, my second family.

But since COVID, so many of us work from home and take trainings online. Getting to know other clinicians has become hard, so it’s difficult to refer clients when needed. And gone are those spontaneous breakroom discussions where we’d share about a difficult session, or your trip to Disneyland, or my mom’s recent visit. I never realized how much these mattered until they disappeared.

All of this is to say that there has been a huge shift in our field, one that for many of us crept up slowly and almost without notice, where therapist connections have fallen away. And now many of us don’t have a community of colleagues that we see often enough to support us. We are left alone to shoulder stress, leading to depression and burnout. And to do this VERY difficult job, we all need a LOT of support.

So, NOT ONLY is it important to ACKNOWLEDGE this shift, we must ALSO take ACTIVE STEPS to combat that isolation.

My one piece of advice to reduce isolation

Of course, there are hundreds of ways to fight isolation.

But if I could give only one piece of advice on how to combat isolation it would be this: To regularly consult with other clinicians.

Let me say this first: This article is NOT a plug for my consultation services – I no longer offer this service. But I truly believe consultation is essential to avoid burnout, and later in the article I’ll give you some free resources.

How can consultation help?

At the risk of stating the obvious, let’s review what makes consulting essential:

• To hear ourselves talk about cases. As in therapy, I often heard myself saying something aloud in consultation that I didn’t realize I felt. Sometimes by talking about the case with someone, I heard myself identify the problem, the solution, or a pattern I hadn’t seen.
• To get advice or a fresh approach, a new way to conceptualize the case, or strategies for handling the next session.
• To hear someone reflect what they are hearing you say, something you may not be hearing.
• To regain compassion you may have lost for challenging clients.
• To help you see progress or get praise for effective handling of difficult cases.
• To “cover your butt” and keep you from making legal or ethical missteps. Just having sought consultation on a case can reflect positively on you if a complaint is ever made.
• To let go of stress and avoid burnout.  Just sharing clients’ secrets can help us let go of the stress of carrying them. And hey, sometimes it just feels good to talk about cases, right?

7  tips to get the most out of consultation

1. Schedule regular clinical consultation, e.g. weekly or monthly. Don’t wait until you are struggling with a difficult case.
2. Choose a consultant whose ethics and advice you respect, and one that you can be honest with. Then be totally honest, and let go of defensiveness.
3. Trade time with a friend, join a consultation group, or pay a consultant. When I was seeing clients, consultation was the highlight of my week. If I had a difficult case during the week, I could relax, knowing that on Thursday at 2 pm over tea, my colleague and I would take turns discussing cases. I always left that meeting feeling lighter, calmer, and more sure of myself.
4. Start by telling your consultant where YOU are stuck, so they know what to listen for. Ex. “I’m feeling stuck because this client isn’t making much progress, and I feel incompetent.”
5. Schedule business consultations for that side of your practice (ex. fee setting, paperwork, policies, insurance billing, etc.). My free Practice Coach Referral List is available at theinsurancemaze.com/consultations.
6. Consultations with attorneys at your malpractice carrier and your professional association are often free. In addition to advice about ethical and legal issues, they sometimes can help with difficult cases and practice management issues.
7. Document your consultation in the client chart or in a separate consultation chart. Include the consultation date, the consultant name and credentials, the client you consulted about, advice the consultant gave, etc.

The strongest reason to get consultation?

The strongest reason to get consultation is to remind yourself that this is a difficult job – but you don’t have to do it alone.