Enlightened Practice Podcast
Vacation and holidays. A pleasant topic for students and employees, and while self-employed private practice owners may enjoy time off, they also may feel the effects of not working in their bank accounts.The benefits of taking care of ourselves and finding balance in life are discussed in this captivating episode of the Enlightened Practice Podcast, which breaks through the boundaries of mental health and perfectly applies to other communities.
If you want your question featured and discussed on the show, send it to [email protected]. We’d love to hear from you.
Transcript of the podcast
Ken: Hi Kari. Welcome back to the podcast.
Kari: Hi Ken. Thanks for having me.
Ken: So, today we’re going to be talking about vacation and holidays. Maybe it’s not a coincidence that this came to my mind today given that we are approaching the trifecta of Halloween, Thanksgiving, and the end of the year holidays. But, even if it’s not a coincidence, I think it would be a good conversation for us to have about thinking through how much vacation time and holiday time therapists and clinicians should take and do take.
Ken: It’s not a topic that I talk a lot about with colleagues. I feel like there’s a little bit of, you’re supposed to just work all the time ethic in our field even though we are all mental health for our patients and clients. But, we’re also human too, and how we think through taking care of ourselves could be really useful in therapy, or even if you’re just doing med management and talking with patients about how they’re finding balance in their lives for their overall psychical or mental health, so I think it starts with us. So, I’m curious to hear from you. How much time do you typically take off? And then we can talk about how think through which time you’re going to take off.
Kari: Yeah. It’s such a great topic especially for therapists in private practice because you really do create your own schedule. And you can work 365 days a year if you want, though, it is important to figure out for yourself how much time do you want to take and when do you take it? And for me personally, it does fluctuate year to year just depending what I have going on that year, but I will say for the most part the most predictable time that I take off is a week for Thanksgiving, and then another week, sometimes two weeks around the end of the year, from like mid to the end of the December.
So, that’s a solid two to three weeks that I for sure take every single year. And the reason for that, I have kind of built that into my schedules because that’s the time for me to visit my family and that’s really important to me. And it’s also a time that actually a lot of the clients that I see also doing the same thing. So, it actually aligns really well for everyone. I learned that the first year I was in private practice and I was around the week of Thanksgiving for clients if they needed and I was around the week of the other holidays as well. I found myself feeling bored and I had a much slower schedule. So, I learned that I was going to protect those two weeks. And then I’ll take some other time off too, but I’ll just pause there because I want to hear if you have any regular vacation time scheduled every year or how you navigate it?
Ken: Yeah, it’s actually very similar. Also, at the beginning of my career too I remember having a lot of broken schedules around the holidays. It seemed that every other patient would cancel. So, I would be left, not quite twiddling my thumbs, but it was hard to get much other stuff done and that was in the days before people worked from home. Early in my career when my kids were young, I felt that it was especially important to get some time off, but it also felt to me with young kids that was not the most restful time off. So, I tried to do it in shorter blocks and take it a little bit more frequently.
I think, when you’re starting out your career it’s also important to think about the effect of income. If you start out your career thinking that every day you take off or every week you take off is lost income, that’s a really tough burden to overcome. So, even before we get into the logistics of it, I just wanted to call up the psychology of it that you have to think of it as time gained instead of revenue lost. Otherwise, like you said, you’ll always be second guessing if you should take a certain amount of time off and it’s just not fair to yourself.
You would never do that if you were an employee. Then of course you want as much time off as you can negotiate. So, when you’re in private practice, is it reasonable to treat yourself differently? I don’t think it is, but I understand the tendency when you first start out to want to maximize every hour that you could be seeing a client or a patient. So, I’m curious, the other days that you take off during the year, do you align those with the standard calendar with federal holidays or what’s your general approach?
Kari: Yeah, it shifted for me. Right now, my approach is that it’s mostly aligned with my kid’s school schedule. Usually, that does involve the federal holidays, there’s no school those day, for example, Labor Day. So, I do tend to take those days off, mostly for child care purposes. However, I will say, that before having children I was a bit more flexible, like if I could fill my schedule that day, as in my clients weren’t take that as vacation time then I probably would if I felt up for it and I didn’t feel like I needed the day off. But, there were other years where I actually felt like I can feel just from a burnout perspective that I wanted those kinds of breaks built into my schedule and I did follow the calendar a little bit more traditionally in that sense.
So, I’ve really changed my approach from year to year depending on my needs and what’s going on, but most recently I follow the school calendar. So, when my kids have days off, I usually will take those days off as well. I think, the other thing I was going to say about that is, well, I guess, I want to hear first if you’re aligned with the standard calendar?
Ken: One hundred percent aligned with the kid’s school calendar. Although, when I started out before having kids, there was a certain joy that I took out of working on federal holidays because some of the patients didn’t cancel and it felt really good, like extra income in a way. When I was thinking from a dollars perspective, so psychologically I was thinking like, oh, this is me asserting my independence from authority and working on a holiday and then taking off other random days where it felt more selfish to do it. For example, if it was a particularly good time of the year to travel to a different country and there weren’t going to be hordes of tourists there and there was a really good airfare, those were four of the reasons that were more compelling at that time. However, now we are part of the masses that are the first day of winter break, we’re on break. The first day of spring break the same. And I imagine that once the kids are out of the house and on their own schedule then I’ll revert back to the way I used to be, at least to some degree.
Kari: Yeah, exactly. I think another thing to consider for people who are getting started in private practice and trying to figure out when to take time off and how to plan for that. It comes back to the finances a bit, but it’s just to kind of think of, what is your target or general, ideal income for a given year? And there is actually a way that you can figure, like you were saying, you’ll kind of drive yourself crazy if it’s just, make as much as possible, work as much as possible because we’re only human and we need breaks too.
So, I think if you have a general idea of some of your financial goals for whatever reason, then you can kind of just work your way backwards from there and you’ll probably see that there’s plenty of built in time for breaks and time off. It can be relieving to just know this is part of the plan as opposed to lost income or something like that. I think it is important to build in vacation time and time off into the plan for a sustainable career without burnout.
Ken: Sure. And also, snow days, or you’re sick, or there’s a family emergency and knowing that you have that buffer built in, in the first place just takes so much of the stress off. One of the ways I approach them, I’m curious how you did it. I thought about, what is my monthly typical income? And then I just multiplied that by eleven instead of twelve, to think about my annual income, thinking that about a month off per year gives me a good smattering of sick days, family emergency days, mental health days, vacation days, whatever you want to call them. I’m curious how you approached it.
Kari: That is a good idea. I did it a little bit more complicated. I did after like my first few years in private practice, then I got a sense of like, all right, what’s the average amount that I make in a given month or a given year? And then from there that gave me a sense of what I can expect to me earning or what I would like to be earning and then from there worked on, okay, how many hours do I literally need to work each week to hit that mark? But it took me a few years to figure that out because I needed a few years of data till I was pretty regular in terms of seeing clients all the days that I’m working and having a full schedule.
Ken: So, you took less vacation when you first started because you weren’t sure?
Kari: Yes. For sure when I first started I had more of the mindset, the unhealthy one that you were talking about that was more like, I should be working as much as possible. And I learned that is not natural and it’s just not sustainable. And then, I transitioned into really protecting vacation days, sick days, and all that kind of stuff because I realized that will actually help me earn more in the long run because I’m taking care of myself.
Ken: It’s a long term investment.
Kari: Yeah, exactly.
Ken: So, I’m curious, what do you think about taking a random day off here and there, like a birthday or some other kind of day, what’s your approach to that?
Kari: Yeah, this has also changed for me over the years and is still evolving as we speak. I used to actually have a lot of guilt about it, like I can never just take a day off for not a really, really good reason, like I’m sick or what I deemed a good reason. Like I’m sick or I have an appointment that absolutely can’t be scheduled any other day, or whatever it is. And just recently I learned how empowering it can feel and how rewarding it can feel to simply just decide to take a day off because it’s important to me, I don’t need a good reason or what I considered a good reason necessarily. And that has been really rewarding and from a responsibility perspective, of course I think you can take advantage of that quickly and it can have professional consequences, like if you become unreliable for some reason, but I think every once in a while if that’s advice that I would give to my own clients then that‘s something I’m trying to take for myself.
So, every now and again take a day off for a mental health day essentially or something maybe that I used to think was not a good enough reason, like a birthday or something. Now, I will actually take those days off. And I find that when I talk to clients about it they’re excited for me. Not that I tell them everything I’m doing, but they’re like, oh, great. I’m glad to hear you’re taking time off. So, my worries about how it will come off and being unprofessional or anything like that, have not come true. What about you?
Ken: How refreshing. That is a motto to follow. I don’t take as many random days off, but I’m also not practicing full time because of Luminello. I also don’t feel as much of a need to break the mold because I have really nice variety in my day to day schedule. That said, that’s probably just a bad excuse for not taking a day off, and yeah, it always seems like there’s never a good time. And it often seems like you get punished for taking a day off. Not on that day typically it feels good, but when you come back the next day and there’s 600 messages waiting for you.
So, trying to find times that are maybe more predictably or lower resource intensive, it could be useful. I think this also ties in with the conversation that we could have at another time if you want, we’ll add it to our list. What to do with your practice during certain seasonal changes. Like during the summers for example, there’s often a lull and that would be a time I’m more likely to take a day off and take my kids to a baseball game, for example.
Ken: Hopefully, their teachers aren’t listening to this podcast right now. That did happen earlier this year. But that’s nice to hear that your patients were supportive and really why shouldn’t they be? They want you to be on top of your game. They don’t want you to be burnt out.
Ken: And maybe there’s some concern about if you’re working with really low functioning patients or clients, can they tolerate your absence, especially if it’s more than one session? I think the old rule of thumb was for each week you’re going to be out or each session you’re going to miss, you give that many weeks heads up notice. So, if you’re going to take off two weeks, you let them know two weeks before the first session is going to be missed, that way you have time to process it in session if they want.
Ken: I’m curious, how do you handle that?
Kari: I like to give at the minimum a week’s notice and sometimes I’ll give a month’s notice. I keep reminding people as we get closer to the time. And depending on the client and depending on the reason that I’m taking time off, I will potentially offer a session at a later point in the week or offer some kind of alternative like sometimes the alternative can even be communicating about a therapy homework assignment or something like that, but it really depends. It depends like if I have a high need client, ten there’s a good chance I’m going to try to make up the session at some point in the week.
If the reason for the time off is mental health for me, then I probably won’t do that. And if I have a high need client I’ll either make an exception or I will offer them some other resource like meeting with a different therapist if there’s an emergency or something like that. But it really depends how I approach it, just depending on the reason that I’m leaving and also the need of the client. And based on those two things I make decisions. I’m curious, when you decide to take time off whether it’s a one off day or a vacation, do you try to make up those sessions or do you just cancel?
Ken: Well, early in my career I did because I wasn’t following my own rules about income and being able to just be at peace with the fact that even though I had this nifty formula of take your monthly income and multiply it by eleven instead of twelve, when those months came around where there was a week or two off and I ran the numbers, I saw, oh! That’s terrible. Well, of course it’s terrible because you didn’t work. But, the point is that you’re supposed to enjoy that time off and not double back and go make it up some other time, because then it’s not really time off, you just traded one set of time for another set of time.
So yes, the numbers looked better when I did that early on, but I don’t know how over a long career of the kind of work we do, you wouldn’t get burnt out if you didn’t take breaks. And yes, it means less revenue, but even as I’m thinking now, I’m saying less revenue it’s kind of an implication where you’re supposed to make a certain amount and anytime or way means you’re not meeting what you could be meeting. As opposed to, who else in the world works like that? Nobody.
Ken: They talk about the US as a no vacation nation. So our standards are so different to much of the world. Vacation is the best part of the job. It’s not a bug, it’s a feature. And they have a much different connection to it in terms of their identity. And they don’t look at it as you’re trading one for the other, it’s built in. How could you even think about working without taking vacations? It isn’t even a thought to them. So, now I don’t make up the time. If it’s a patient who I’m concerned about, could be especially vulnerable, I’ll definitely process it with them before hand and think about what skills or strategies they can use. We try and do some visualization or make predictions about what might come up and I of course offer coverage, but they never call the coverage because it’s about the relationship with the therapist, in a case of therapy.
It makes sense to me why they don’t call. But in the kind of therapy I do, I want them to see that I’m a real person and that I have my vulnerabilities, and my limitations, and my needs. I try to model that for them, just a smudge at least, so that they can see that a life well lived takes all of these factors into account.
Ken: And that you don’t have to live some kind of idealized version of a life.
Kari: Yeah. And there’s some benefits to time off whether planned or unexpected. Clinically, I think a lot of times we both, myself and a client can start to feel like in mostly a good way, that therapy is really necessary. But it slides into like, if we skip a week, I won’t be able to handle it, or I can start to worry, is my client going to be okay if I’m not there every single week? And every single time I’ve ever been worried, is this okay, is my client going to be okay without me? Whatever it is, it’s been so important for both me and the client to see they end up using their skills without me present and I feel like, every single time it’s been a really important clinical experience for them.
And an important learning lesson for me like, I’m not that important. My clients are going to be okay without me. And that’s been so helpful for me to learn. Apparently, I need to learn this a lot. Every time I’m going to take time off I get a little bit nervous, is everything going to be okay without me and every single time, I can’t learn it enough how important it is for everyone for me to leave the situation every once in a while.
Ken: That’s a really good point. And it feels really good to come back and hear how patients or clients used the time. That they can take in and internalize the work that we do and actually go live it over a more extended bases, and I would say, maybe once or twice I’ve actually had a patient say to me, that was great. Why don’t you do that more often? Actually, why don’t we cut back on our work because now I realize, I don’t need to see you quite as much as I thought I did, which leads to a whole other conversation. So, there’s a lot of good that can come out of it clinically for the patient or the client, as well as for us. I would keep that in mind that everybody gets something out of it.
Kari: Yeah, exactly.
Ken: Okay. Well, I think we covered this one. Any other thoughts?
Kari: No. I would just encourage people to talk to their colleagues and get a sense of how different people plan for vacations. There really are so many different ways to do it and it’s going to look different for each person. So, I think, if you’re just starting out or you’ve been struggling to take a vacation, the more people you talk to about it the better it is to get an idea what options are out there and how to make it work for you.
Ken: Sounds great. All right Kari thanks. This was very relaxing talking about this. I feel like I need to take a day off now.
Kari: Me too.
Ken: I’ll go take a look at my schedule. All right, take care, bye.
Kari: You too. Bye.