How to reduce overwhelm and prevent burnout as a Speech and Language Therapist running your own private practice
Do you ever find yourself feeling overwhelmed or on the verge of burnout as an independent Speech and Language Therapist running your own private practice?
As an independent healthcare practitioner, it can be difficult to strike a balance between running a business and delivering high quality, evidence-based, patient-centred care.
Most likely, you chose this profession in the first place because of your passion for working with clients.
Your transition into private work may have been motivated by a desire to focus more on client work.
What you maybe didn’t expect is the multitude of roles to be juggled as a small business owner - CEO, administrator, finance officer, HR director, accountant, bookkeeper, head of sales and marketing, customer service representative - to mention a few!
In my two years so far of working in private practice, I’ve regularly found myself taking on too much and questioning how to manage it all. I’ve noticed the same patterns arising for other independent Speech and Language Therapists during supervision sessions.
Whilst I definitely don’t have all the answers, I’ve learnt valuable lessons along the way that have helped reduce the feelings of overwhelm and allowed me to truly enjoy all the benefits that come with working for myself. By implementing the right systems and establishing clear priorities, private practice can be a really exciting and fulfilling way of working.
This blog post aims to provide practical insights from my experiences, which may be particularly beneficial if you’re new to private practice, considering taking the leap into independent work, or experiencing mounting pressure in your independent practice.
To effectively serve your clients, it’s crucial to take care of yourself and develop your business in a way that fits in with your life.
NB. I reference various systems and apps that I find useful, but please note that I am not affiliated with them in any way and I’m always very open to hearing about other suggestions and approaches!
STAY FOCUSED ON YOUR ‘WHY’
As a self-employed business owner, it’s so important to make sure your business is working for you – and not the other way round!
Be clear on your priorities and your values
What are the reason(s) that motivated you to move into private practice?
For me, the main driving force was the desire to have the flexibility to be present for my son when he started school, not tied into specific working patterns within the NHS that wouldn’t enable me to do school runs. I also wanted to be in control of my own career development, being able to focus my CPD and learning in the clinical areas I was most passionate about.
Staying focused on your priorities and personal values when making decisions or setting goals relating to your business helps to create a business that fits in with your life.
Set yourself business goals and review these regularly
Just as we set ‘SMART’ goals for our clients, it’s important to apply the same approach to our own business development goals.
In employed work, your goals at yearly appraisals likely focused around the clinical needs of the team and the business goals of the organisation. When working for yourself, whilst it’s still crucial to consider the clinical areas in which you want to develop your skills, it’s also important to consider your goals around how to develop your business.
This may be to develop working relationships with certain referrers to support a steady flow of referrals.
It may involve learning skills such as web design or content creation for social media marketing.
You’re likely to also benefit from setting finance goals to ensure you’re appropriately balancing your revenue against your expenses.
Working for yourself allows the freedom to set goals aligned with your passions and values. Regularly assess what's working, what needs improvement, and how your business can better serve you.
Recognise which tasks energise you and which drain you
After working independently for about a year, I found myself on the brink of burnout. I had been saying ‘yes’ to every opportunity out of fear of financial instability. I felt pulled in too many directions and didn’t feel I was working to my full potential.
I found it helpful to consider all aspects of my work – the different clinical caseloads I had been working with, the administrative tasks I was completing and the business-related tasks I was working on. I reflected on which tasks fulfilled me most and energised me, and which drained my energy.
This helped me to realign my goals and priorities.
I was then able to focus my professional development and my marketing efforts on the client caseloads I most enjoy working with.
I realised I didn’t enjoy spending a lot of my day driving long distances to visit clients, so found a clinic room I could use instead.
It meant I could consider how to reduce the amount of time spent on tasks I didn’t enjoy, such as automating and outsourcing admin tasks.
MASTER TIME MANAGEMENT
Effective time management is crucial, especially if all your income relies on one-to-one client work. It’s essential to make sure you’re not spending excessive time on all those crucial and unavoidable tasks that aren’t directly bringing in money.
Be realistic about how long things take
Is it just me, or do administrative tasks - like sending invoices, writing reports, writing up notes, creating therapy resources – always take so much longer than you allow yourself time for?!
Conducting a time audit for a week or two can be really beneficial to help you to determine how long tasks actually take, so you can ensure you allocate enough time for them, and to assess whether tasks really need the amount of time you’re currently spending on them.
Establish boundaries with your time
In the early days of working for myself, I had no specific structure to my week other than trying my best to cram everything in.
Structuring my week by allocating chunks of time for specific tasks has been a really useful method to reduce overwhelm and maximise productivity.
I now have time allocated for outpatients, home visits, online sessions, patient administration and planning and business tasks. It's important to ensure some flexibility is factored in for unexpected tasks that inevitably arise!
This has been the most helpful way to stop me from overbooking myself and being tempted to squeeze in ‘just one more thing’.
Use an effective task management system or to-do list
It probably goes without saying that to manage time effectively, you need an effective system to manage your tasks. Running a business, however small, inevitably involves a million tasks that you can’t keep inside your head.
I find it useful to categorise my to-list:
Urgent tasks - to complete today
Quick tasks – just get them done
Less urgent - tasks to complete by the end of the week
Don’t forget - things to remember/follow up at a later date
I love the free app ‘Todoist’ that I can access on my laptop and phone. You can organise your tasks into different sections and move tasks between sections.
Avoid multi-tasking
As tempting as it can be to juggle multiple tasks simultaneously, remember research suggests that multi-tasking is not an effective strategy for time management!
We’ve probably all been there… you’re writing up some client notes, when your phone rings and you respond to a client’s enquiry. You’re just adding details of this phone call to the client’s record, when an email pops in that you quickly respond to, which leads to more emails bouncing to and fro… and before you know it, an hour has passed, you need to leave for a home visit, and you still haven’t written up the original client’s notes.
Focusing on one task at a time and dedicating uninterrupted time can lead to heightened concentration, efficiency and productivity. I find the ‘Pomodoro technique’ really helpful for this. It involves breaking work into focused intervals of 25 minutes, followed by 5 minute breaks. You can use the online timer here.
STREAMLINE AND SIMPLIFY YOUR PROCESSES
In order to manage your time effectively, it’s important to ensure the systems and processes used within your business are as smooth and efficient as possible. I’ve always been a sucker for efficiency and I love new tools, technologies and systems that help me to streamline and simplify my workload.
Map out your client’s journey and consider what could be simplified
Consider the process your clients go through when booking and attending sessions.
At each stage of their journey, consider whether any changes could be made to simplify the process for both you and the client.
For example:
Where do clients find you and how do they first make contact? Are there certain questions you’re always receiving from new enquiries, that you could make more readily available online, so you don’t need to respond to every enquiry?
How do clients book an initial appointment? Are you currently going back and forth by email or phone calls to arrange a session? Could you make use of automated scheduling systems or even use a virtual assistant?
How are you collecting information from clients ahead of initial sessions? Are you taking time taking details over the phone or sending out word documents for case histories and consent?
How are you arranging payment? Are you creating invoices and sending out before/after each session? Is this working effectively or are you spending lots of time chasing up late payments?
Don’t forget - asking your clients for feedback can be a really helpful way to identify whether any parts of their journey with you could run more smoothly!
Consider which tasks could be automated or outsourced
Using an online appointment scheduling system (I use Calendly) takes the hassle out of scheduling appointments. I can send clients a link where certain appointment types (online, clinic, home visit) are linked to different days and times in my diary. It syncs with my Google calendar, where I put all my personal and work appointments, so it only shows the times I have available. If I know I need to spend a morning catching up on admin tasks, I can block this out so that no one books an appointment. I also take payment via this system where possible, to save me creating and sending invoices. The system also automatically generates and sends Zoom links for online appointments.
There may also be tasks you can outsource to a virtual assistant (VA). This can be particularly helpful for administrative tasks that eat up your time and drain your energy.
Whilst there are additional costs to factor in when using a VA or automated systems, you’re likely to save costs overall with the time it frees you to spend on income-generating tasks.
Make use of templates
Another time-saving/productivity hack is to create templates for patient forms, case-notes, reports - any paperwork that takes up your precious time.
For example, using the practice management system ‘WriteUpp’, I have created:
various forms to send to patients ahead of appointments, for example consent and information gathering forms as well as standardised and informal patient-reported outcome measures for different conditions
more in-depth case history forms for certain patient populations (i.e. a neuro case history form and a nursing home dysphagia questionnaire)
casenote and report templates
feedback forms
appointment reminders including details of clinic location
Not only do these look professional, but they save a lot of time!
KNOW YOUR WORTH
Charging people for our services can be the most challenging aspect of running a private practice, especially in the current context of a cost-of-living crisis and long NHS waiting lists. Whilst you want to ensure your services are accessible for anyone that needs them, remember that ultimately your business won’t be sustainable if it’s not allowing you to pay the bills.
Set your charges appropriately
If you’re anything like me, the single most difficulty thing about working privately is having to charge clients for your services. This is particularly difficult when you’re used to working in the NHS and never before had to ask clients for a penny for the services you were providing.
But undercharging is a fast track to burnout, if you’re needing to cram your diary to bursting point in order to make ends meet, leaving yourself limited time for all the essential non-clinical tasks.
Make sure you’re being fairly compensated for your time and expertise. Consider the actual amount of work you’re putting in – not just the time spent with a client, but also the time spent booking the session, planning the session, travelling, writing casenotes and reports and any associated admin such as sending (and chasing!) invoices. Consider also additional expenses such as fuel, clinic room fees and resources.
Of course you also want to avoid pricing yourself out of the market, and it’s important to be comfortable with the price you charge. I find it helpful to offer discounted blocks of sessions. The client benefits from a reduced price on block bookings whilst I can manage my diary more easily. I also offer a certain number of free/pro bono sessions each month, to patients who otherwise wouldn’t be able to afford my services.
Look out for the trap of people pleasing!
Speech and Language Therapists, like many others working in other ‘helping’ professions, can have a natural inclination to go above and beyond to help clients achieve their goals.
We strive to provide an exceptional service whilst offering value for money.
However, it’s crucial to establish and maintain boundaries to prevent falling into the trap of ‘people pleasing’. People pleasing can lead to undervaluing ourselves, increasing overwhelm and ultimately result in burnout.
This is a work in progress for me! Kindness, generosity and helping others are important personal values of mine. But taken too far, I can find myself doing too much work for free and going too far to prove my value, leaving me feeling overwhelmed and resentful.
People pleasing behaviours, or a lack of personal boundaries, may look like:
Spending excessive time talking to potential clients, offering free advice that devalues your expertise and time.
Regularly running over the allocated time for client sessions in an attempt to provide maximum value. This can be disruptive to your schedule and drain your energy.
Spending hours on client-related tasks without charging for this time, for example, writing reports, liaising with other professionals and creating lengthy personalised resources. If additional work is required beyond the time you spend face-to-face with a client, it’s important to discuss associated costs with the client. Remember your time and expertise deserve fair compensation.
Boundaries are crucial!
Your Terms and Conditions are important for communicating your professional boundaries and the fees involved for additional tasks. Ensure you value yourself by sticking to these! If you offer free calls for initial enquiries, ensure you set a limit on the time allocated to these, keeping more in-depth clinical discussions for your paid consultations.
The most important boundary to establish may be within yourself. Developing self-awareness can help you to recognise when you’re slipping into people pleasing tendencies and where you may need to put some boundaries in place.
Engaging in regular supervision and/or coaching can be invaluable in understanding the underlying reasons behind your people pleasing behaviours, helping you to set healthy boundaries and find a sustainable balance between serving others and valuing yourself.
ACCESS THE SUPPORT YOU NEED
Having access to support is crucial for maintaining your well-being as a private Speech and Language Therapist. It’s can be particularly helpful to have people to talk to that understand the challenges involved in running a business and being self-employed.
Prioritise regular supervision/coaching
RCSLT recommends that certified Speech and Language Therapists receive at least one hour of professional supervision every four to six weeks.
But engaging in regular supervision shouldn’t be a box-ticking exercise. Supervision provides a safe, open space for you to reflect on all areas of your work and discuss any areas of private practice that you’re finding challenging.
Engaging in effective and regular supervision can be the difference between feeling overwhelmed by your business vs. looking forward to every day at work.
Coaching is also invaluable for small business owners. Coaching helps you to create a business that’s aligned with your values and fits in with your life. If there are areas of private practice that feel particularly overwhelming, coaching can be a great way to open up new perspectives and provide a deeper understanding of what’s holding you back, by building self-awareness and uncovering any limiting beliefs (such as imposter syndrome). Coaching supports you to set action plans, step out of your comfort zone and grow your business in a way that works for you.
Now please forgive me while I take the opportunity for some self-promotion…! 🫣
As a qualified Life Coach, I bring my coaching skills into my supervision practice. As a result, clients experience the benefits of coaching alongside the support and understanding of a small business owner who understands the challenges of running a private Speech and Language Therapy practice! I’m particularly passionate about supporting private Speech and Language Therapists that promotes their wellbeing, taking a holistic view that can involve working through tricky client cases as well as barriers that might hold you back from growing a business that you love.
My background is within Adult Speech and Language Therapy, but I also work with several paediatric SLTs. I’ve also coached various small business owners outside of the profession altogether, including a make up artist and personal trainer!
You can read more about my supervision here.
Access a support network
Ensure you have people you can offload to about your work – whether it’s friends, family members, other Speech and Language Therapists or even other small business owners. It’s important to be able to discuss challenges, share experiences and seek emotional support from people who have your back.
Prioritise self-care
It goes without saying that self-care is important for preventing burnout.
Learn to recognise the triggers that indicate you need a break. Prioritise activities that support your physical and mental wellbeing.
And remember… self-care is not selfish!
Self-care should be considered non-negotiable – you can’t serve your clients and keep your business running if you aren’t taking care of yourself.
Remember the importance of taking breaks!
We all know the importance of taking a break, but in reality, it’s not always easy when self-employed.
It can be hard to mentally switch off from work when you’re a business owner.
Holidays can feel like a double expense when considering the missed income alongside the holiday costs.
The flexibility of being self-employed can be great to fit around family commitments, but you may find yourself catching up on work every night when the children are in bed, leaving no time for yourself.
Taking time away from work is not only essential for your wellbeing but also increases your productivity and overall satisfaction in your work, so that your business is sustainable in the long-term.
Conclusion
Setting up an independent practice can be a really exciting journey, but it’s important to be intentional about taking steps to protect yourself from burnout.
Ensuring your business fits in with your priorities and values within the wider context of your life means you will have the energy and capacity to provide the best possible care to your clients.
If you’d like to find out more about my supervision and coaching services, you are very welcome to book a free 15 minute introductory call.
