She Owns It

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We’re Green – Now What? by @HeidiDalzell

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Back to the Office or Continuing Online

Business owners in Pennsylvania have been more aware of traffic lights lately, at least those that signal we’re starting the process of reopening businesses. While therapy practices were considered “essential” during the pandemic, most of us have played it safe, entering the brave new world of online therapy. Now that many things are reopening, we have to decide whether to welcome clients back into our space, or to continue to offer virtual services. This decision is not confined to therapy practices of course.

A colleague of mine, Deb Owens, wrote a compelling blog about “holding space” for our clients during the pandemic. In it she affirmed that she would hold on to her office space with the intention of seeing clients in person when it is safe to do so. Many of my colleagues are still grappling with this decision. I’ve heard some state that they do not plan to return to a brick and mortar office, and others plan to do so only after a vaccine is widely available. While it’s important to err on the side of caution, especially for folks who have health concerns, have to consider whether people will continue to opt for services delivered on a 15-inch screen.

Information about precautions abound, and we’ve begun taking measures. Masks, plexiglass screens and ventilation can help reduce the possibility of transmission. So can practices like handwashing and temperature checks. Our waiting room currently looks more like a disaster zone than a comfy place to hang out, with blue tape criss-crossing chairs to keep people from sitting too closely.

I’ve started this conversation with most of my clients already, asking some questions about their own safeguards and risk factors. Informed consent is at the heart of any decision: assessing personal risks and benefits. There are also other things I need to look at both from the perspective of a business owner and therapist.

Are Your Services Effective?

The first consideration for any service provider is whether your services are as effective when offered online.

Online therapy services have been around for a while, and there has been some research into its effectiveness. The answer to “is it effective,” seems to remain it depends. What is the therapeutic approach? Who is the audience (age, concerns, individual comfort factors)? How much training and expertise does the therapist have? Does he/she/they have training specific to online therapy? Are there adjuncts to therapy such as online groups, written materials, etc.?

Most studies of online therapy were published in Cognitive Behavioral Therapy (CBT) journals, and CBT, more of an educational approach, has been shown to be effective. This is especially true for anxiety. In the beginning of the pandemic, CBT was by and large the approach I took, emphasizing concrete coping skills. While this has been beneficial for some clients, I have not found that to be the case across the board. Many of my clients with anxiety have gotten more isolative and restricted, anxiety has worsened, and they are rarely leaving their homes. Back in the day I could at least count on them coming in for sessions.

Online services of all kinds do increase access to specialty care, such treatment for eating disorders (my specialty), particularly in locations in which such services are hard to come by.

Looking at Your Niche and Audience

Another consideration is your niche and audience. Some questions to consider. Does your current clientele seem to like the online services? Does the age of your audience, or type of work you do, translate well to the online world? While I have maintained a busy practice, I have found that my client niche is generally better suited to live therapy. Many of my clients have privacy restrictions and are having their sessions in their cars. This does not make for comfort and ease. Ditto for kids at home, and other interruptions. And while their cats and dogs are adorable, I’m not being paid to coo. With eating disorders there’s a lot to be said for seeing the whole body. I also rely heavily on body language, and miss some things without these cues. People who work with children have repeated some of these same concerns.

Many clients I work with note other issues, such as slow Internet speed, technical glitches and general lack of comfort with technology (especially my older clients). There have been times when a good portion of a session is spent doing IT troubleshooting, rather than providing productive services. And privacy issues are a whole Pandora’s box I can’t begin to open.

Relationship-Building and Maintenance

My colleague who described “holding space” for clients by maintaining office space is clearly relationally-oriented, as am I. Thus, I see the therapy space, and the relationship that occurs within it, as sacred. I’ve been conducting online therapy from my office, so that clients see a familiar backdrop. This has been comforting, but not a cure all. But that direct touch is missing.

In relationships yet to be built, I’ve seen mixed reactions. One new client who I’ve only ever met online is doing very well. Several people have postponed sessions or delayed scheduling until they can meet with me in person.

A few other intrepid providers are also working from our office. We’ve built stronger relationships being in the trenches together. I can’t imagine what it would be like to be entirely isolated from professional colleagues.

The online world has challenged me to supplement my services in many ways to increase accessibility. This has included a specialized Facebook group, as well as blogging and learned more about video recording.          Thus I do “see” some of my clients most days, which we like. I’ve also had some great live sessions socially distanced outdoors with people supplying their own seating.

Downsides

While there have been some positives, there also also definite downsides. First, many people expect a “bargain” for online therapy, and will more readily attempt to secure services at the lowest cost they can. Professionals who negotiate in this way significantly reduce their own earning power. I have not.

The other downside to online therapy and other therapy services is time and administration. While some articles I’ve read say it takes less administrative time, I find it takes far more time to administer and deliver services. From sending Zoom links to confirming and reconfirming appointment times, it just feels more cumbersome at times.

Is an Online Business Sustainable?

While there are pros and cons, I just have not found that the online therapy world to be sustainable. Large providers, such as Better Help, have large advertising budgets and take a cut of what their contactors earn. While their services may be sustainable, they are well-established for people who want to meet virtually.

By and large, I my want to fully return to my office in for sessions when it’s safe. I suspect that a few clients will want to continue online, which is fine, but if I do not put my shingle up on a real building others are likely to find someone who has.

Taking A Stand in Your Business by @HeidiDalzell

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by Heidi Dalzell

“I write for those women who do not speak, for those who do not have a voice because they were so terrified, because we are taught to respect fear more than ourselves. We’ve been taught that silence would save us, but it won’t.”

— Shirley Chisolm, first Black woman in Congress

Change has been a constant over the past weeks. I can’t believe it’s been almost two weeks since the death of George Floyd, and longer since the passing of Breonna Taylor, Ahmaud Aubrey and Tony McDade. This has been a time of personal reflection and change for me as well. As a business owner — and a therapist — I’ve asked myself some difficult questions about how to address racism within my business and my practice. I have considered what I am communicating to others, including clients and colleagues. My hope is that sharing these thoughts may jumpstart your thinking processes. I write this from the perspective of a White, Jewish, educated woman. Some of those statuses afford opportunities that I would not have otherwise.

When I shared my first blog for She Owns It, the topic was about embracing the changing world of Teletherapy and reinventing my business. I was thrilled to have my guest post published, and am now even more excited to be featured as a contributor on this site. None of us could have anticipate the recent examples of racism and injustice affecting our nation.

These events represent generations of violence against Black and Brown people. I stand in solidarity with the Black Community and state emphatically that Black Lives Matter. Sadness, anger and outrage are just a few of my emotions connected to the deaths of these innocent men and women. What can I do with these emotions.

Businesswoman and Advocate

Core values of my psychology practice include compassion, acceptance, tolerance and love. These values are the literal foundation on which my business is built. I have seen other women owned businesses speak out and some remain silent. Not speaking out and walking the walk would feel incongruent and inauthentic with of my mission.

I know that sharing my views may affect my business, and after a recent newsletter and blog post in which I advocated for change and racial justice, some people unsubscribed from my email list. That was ok. I do not want to be complicit in the racism that lies behind ignoring the voices of Black people.

I can use my privilege to speak out. Imagine if all people did this. When Martin Luther King led civil rights protests only 25% of Whites supported these ideals. Gloria Steinem encountered similar opposition. While many of us know Steinem, others are not as familiar feminists like Shirley Chisolm, Dorothy Pittman Hughes and Flo Kennedy. These women taught us that women should speak out.

Examining Privilege and Bias

Racism is “prejudice, discrimination, or antagonism directed against someone of a different race based on the belief that one’s own race is superior.” Privilege refers to unearned advantage or entitlement that benefits White people over non-white people.

As business owners, it’s important to be aware of our privilege. It aids our communication with others. And systematic privilege hurts everyone, especially women in the business world. Many of us would not be reading this blog had we not dismantled the systems of patriarchy during the Women’s Right’s movement. And while it’s still an uphill battle for women, Black women face bigger challenges in the workplace.

While conscious examination of privilege is a start, it is equally important to thoroughly examine our biases.

There are three main components of bias: stereotyping, prejudice, and discrimination. Stereotypes are beliefs about a group, such as the false belief that Black men are violent. Prejudice is a preconceived opinion that isn’t based on reason or actual experience. Discrimination often begins with prejudice, and involves unequal treatment of people due to the various groups they belong to (racial, ethnic, etc.). Discrimination can range from inequities in opportunity to hate crimes and violence.

We form biases at an early age based on things we see in the media and learn from parents and peers. It can be helpful to sit down and create a list of adjectives that describe your feelings about a group. Are they factual, or do they reflect stereotyping or beliefs that may not be true? If you used these adjectives in your everyday communication, would the language be seen as neutral or dehumanizing?

Be honest—this list is for you.

Don’t Allow Invisibility

How do you promote diversity and allow Blacks within your organization to be seen? This includes being sure to actively provide depictions in artwork and other items within your work setting. For example, one of our waiting room magazines is Essence. Within workplace settings, provide ways for Black men and women to take up space and to be visible. It’s also helpful to consider the additional challenges faced by those with intersectional identities, such as Black transgender women. They are a group who face significant violence, discrimination, and many kinds of disparities.

Bring It Home

Another way to work on racial justice is to bring it home —literally. Seek out places where you can genuinely and authentically interact with people of different races and ethnicities. This may include in social settings or religious settings—places where you are interacting as peers. This does not include settings where there is an imbalance of power, such as interacting with someone who is providing a service. If you have children in your life, it’s also nice to be able to volunteer. If you choose a setting in which that imbalance of power exists, such as a soup kitchen, be sure that you augment the activity with a discussion of the disparities and injustices which led to economic disadvantage.

 

 

As we continue to witness the nationwide trauma unfolding, I encourage She Owns It readers to be kind, be sensitive, be compassionate, and be part of the solution. Please use your anger and grief to work for systemic change, and dismantling institutional racism and inequality in our communities.

 

Reinventing Yourself: Healthcare Professionals in a Virtual World by @HeidiDalzell

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by Heidi Dalzell

Full disclosure. I began this journey of reinvention prior to our current reality of working from home. And I failed. Well, not failed exactly, more like hit a wall. As a psychologist with a busy, often too busy, private practice I knew that I had to find a way to get my clients off my couch, and into the virtual world. For healthcare professionals this is the realm of Facebook, online coaching and virtual tools that leverage our skills. I needed to extend my practice to a new audience beyond the lovely but small Bucks County town that was currently my home base. Like many of you, perhaps, as I reached my twenty fifth year in healthcare I found that I was getting tired. Tired is not a good thing for most of health professionals, since it can lead to burnout and compassion fatigue.

Luckily I found a course that taught me some great strategies to market myself, and to leverage other people’s audiences and create a new niche developing online courses. I’m a CS (Steady/Conscientious) on the DISC profile (take it if you have not already) and while those traits of steadiness and conscientiousness have served me well, they are not a classic entrepreneur profile. I watched as those more Dominant/Influential members (DISC terms) of my group leapt into the already familiar territory of marketing, and sold courses. Without a current audience, I was essentially stuck at week four of eight, building that for myself, and that has been a bumpy but worthwhile ride. I also got to turn my psychological skills on myself and ask what was holding me back. It’s a question I continue to ask. If I can surpass these things, Ms. Steady/Conscientious may just be able to make it in the brave new world of technology. With the current pandemic and necessity of Teletherapy most of us in the healthcare field have already been catapulted into this realm, and many are lukewarm about it.

While I am admittedly mid-journey, I am learning new things every day about marketing and extending my influence beyond my small sphere. I hope that what I’ve learned, and am still learning, will be valuable to She Owns It readers.

  1. Are you struggling from imposter syndrome? Begin by considering what’s holding you back. Despite my many years in the field, it was a form of imposter syndrome that many women struggle with. The advice I was given was to find your role model, and emulate her (yes, her, not him). The finding part was easy – who doesn’t love Brene Brown – but the emulating part a bit more challenging. I could never be as articulate, accomplished and draw an audience like Brene, right? Well, I built a practice from the ground up, have a niche that sells, and stay busy unlike some of my colleagues. I needed to start looking at these strengths and own them.
  2. Know your strengths and limitations. Some small examples here. Limitations are always easy. I hate video, and don’t know all the platforms like Instagram. I can learn these. I’ve recently discovered that there are ways I can venture into video. For instance, while improv is not my thing (Facebook Lives may need to wait), interviewing works. A colleague asked if I could do a Zoom broadcast for local clinicians, and I in turn agreed to if she acts as interviewer. I’m also sticking with a topic I know backwards and forwards, binge eating disorder.
  3. Investing in my business is investing in me. Yes, I spent a ton on the course I mentioned and have yet to see results but unless I am willing to invest in my business this new direction I want to go will never happen. In psychology there is a term we call “acting as if.” It means that when we embody the person we want to become, the process itself creates this change.

And yes, I am doing a video course starting just this week. Looking forward to learning from all of you and to sharing the reinventing process on She Owns It.

 

 

Heidi J. Dalzell, PsyD, is a Clinical Psychologist, specializing in eating disorders and trauma. Dr. Dalzell has a busy private practice focusing on treating midlife eating disorders of all kinds, with a special interest in helping midlife women to stop binge. Dr. Dalzell also offers courses/eating disorder online coaching and is a prolific author on topics related to eating disorders, body image and spirituality. She is starting the journey of reinventing herself to extend her influence beyond the small Bucks County town where she grew up and currently practices. Visit her website at talktogrow.com or join her Binge Eating at Midlife Facebook group