ACA Blog

Maureen Werrbach
Dec 13, 2011

Confessions of the Transition into Private Practice

When I started blogging for the ACA I was working in a hospital providing assessments for children, adolescents, and adults suffering with an array of symptoms and disorders. My primary objective was to provide a level of care assessment based on symptoms, presenting issues, and information that the family provided. Based on this assessment, I’d give a referral for treatment. There was a lot of paperwork. Petitions. Pages of notes. Calling the on-call psychiatrist. Calling other hospitals for beds. Talking with the ER doctor. Talking with the ER nursing staff. No counseling.

I left this life for a new one. Finally having been eligible to sit for the LCPC exam, I was eager for my next endeavor. Private practice. I had been waiting to practice what I had spent $65,000 to learn in school. Counseling. But I found myself struggling with my new role.

I had become so used to attempting to establish whatever rapport I could in the first 5 minutes of meeting patients in order to acquire as much information as possible to provide an accurate level of care. Where I normally had very little time to get information, I could now allow clients to express themselves at their rate. Although this is obvious information, it took me a while to learn to go at my clients’ pace. I had to learn not to make each session an assessment of sorts. I had become accustomed to understanding the difficulty in getting symptoms, emotions, feelings, and the inner thoughts most were afraid to divulge for fear of hospitalization. I needed to take a different approach in working with the clients that were coming in for counseling. “SLOW DOWN!” I’ve told myself several times since starting. It’s been hard to slow down. Doing assessments gave me one hour to meet, assess, and either hospitalize or refer out. It was an unspoken (but sometimes spoken by the ER doctors) rule that the speed of doing an assessment was correlated to one’s success as an assessment specialist. Getting info, and getting it quickly was my job. But not anymore. I don’t need to know everything right this moment, it’s not about me. Just be.

It’s been several months now since starting at the practice, and each day I notice myself a little less uncertain, a little more at home. Slower. Listening and not just hearing. Understanding. Working together.

Have you had to transition in terms of your role as a counselor? Maybe going from case manager or assessment specialist to therapist? How was your experience?



Maureen Werrbach is a counselor providing counseling in a group practice setting and volunteers counseling services for returning military men and women.

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