Episode 14: Scared To Leave Your CMH Job? ME TOO!! [featuring Victoria Rodriguez]

Show Notes

Scared about leaving your Community Mental Health Job?

I was too! I think we all are to some degree. It makes sense that when we feel comfortable and "secure," we struggle to embrace the fear of the unknown no matter how badly we want to.

Community Mental Health definitely has a role to play but unfortunately, the system is broken, which means you end up struggling with: Resources, $$, time,  and BURN OUT!

In this episode, I talk with Victoria Rodriguez, a Ph.D. student at the University of New Orleans and owner of "My Car Is My Office," about the problems with Community Mental Health (CMH), but more importantly, how clients and therapists both suffer because of the systemic injustice and lack of resources.
 
More about Victoria:

Victoria Rodriguez (she/her/hers) provides professional consulting and program development services for community mental health agencies and provides telehealth counseling for individuals with health anxiety throughout Louisiana. As a Ph.D. student at the University of New Orleans, she has published research on barriers to treatment in community mental health and the theory-application gap in nonclinical settings. She is passionate about making community mental health sustainable for clinicians and participants.

Find Victoria's research and other resources at mycarismyoffice.com and on social media at @my.car.is.my.office.

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A Thanks to Our Sponsor!

I would also like to thank Embark EMR for sponsoring this episode.

Embark EMR is a superb software solution for the solo practitioner, as well as group practices. Embark was designed by therapists to be simple and intuitive without all the extra stuff that you don't need so you don't feel like you're being nickel and dimed. Embark enables scheduling with automatic appointment reminders, a note organization system with multiple pre-built templates, and an automated invoice and superbill generation to make it easier on your clients.

There's even a patient portal where your clients can access notes, documents, and generate their own invoices and superbills. Embark EMR is setting a new precedent in EMR functionality and affordability. Embark’s simple one-tier system is $20 a month per therapist, and there are never any extra fees. Try Embark EMR today with a free trial at embarkemr.com.

You can also use code ATPP at checkout for 20% off an entire year of Embark.

Transcript

Season 2, Episode 4 – Scared to Leave Your CMH Job? Me too!! (Featuring Victoria Rodriguez.)

PATRICK CASALE: This episode of the All Things Private Practice Podcast is brought to you by Embark EMR. Embark is a superb software solution for the solo practitioner as well as group practices. Embark was designed by a therapist to be simple and intuitive without all the extra stuff that you don't need, so you don't feel like you're being nickel and dimed. Embark enables scheduling with automatic appointment reminders, a note organization system with multiple pre-built templates, and an automated invoice, and super bill generation to make it easier on your clients. There's even a patient portal where your clients can access notes, documents and generate their own invoices and super bills. Embark EMR is setting a new precedent in EMR functionality and affordability. Embark’s simple one-tier system is $20 a month per therapist, and are never any extra fees. Try Embark EMR today with a free trial at embarkemr.com. You can also use code ATPP for 20% off an entire year of Embark. 

Hey, everyone, this is Patrick with the All Things Private Practice Podcast talking about different topics and small business ownership, private practice, and mental health, joined today by Victoria Rodriguez. She is an LPC in New Orleans, which she refers to as the Chicago of the south and owns a company called My Car is My Office. We are going to talk today about imposter syndrome, leaving community mental health and starting your private practice. Victoria, thank you so much for coming on. I know it was short notice, but I'm really happy to have you here.

VICTORIA RODRIGUEZ:  Yeah, no, thank you, Patrick. I really feel like this is going to be a good conversation. And it's been leading up to this in your podcast, especially, when you talk about leaving community mental health, what imposter syndrome looks like in community mental health, and then, private practice. It's so different but so similar, right?

PATRICK CASALE: Totally, it is so different and so similar in the way it shows up. And one thing I hear so often from therapists who are taking the leap, so to speak, is that they are fearful, scared, anxious and insecure. And I think that's really normal when we don't know what we don't know, especially, when we didn't have any business training in grad school for the most part. So like, we're just taking this leap of faith, like, I really hope this works out, because I've got to get the hell out of community mental health. Can you tell us a little bit about your journey, what led you here and why this topic feels important for you?

VICTORIA RODRIGUEZ:  Sure, so I am still in community mental health, but I will be leaving next week. This is a really appropriate time to talk about why I chose to leave and start my own private practice right out of community mental health versus maybe working for a group practice or working in another setting. And yet, while I'm still leaving community mental health, my PhD is in counseling, and I study community mental health, I work in training on community mental health. And something that you had said in your last podcast or in the first one that you had recorded was that, community mental health is still needed, and I 100% agree with that. And also, think that that's a large part of where my imposter syndrome comes in. 

If I know I'm doing the important work here, I know I'm doing important work in community mental health, but at what point is it just no longer sustainable for me both emotionally, financially, sure, why not spiritually. To the soul, you worked on it for years, it just gets exhausting and not financially sustainable anymore. I think I finally reached that point in my own agency work. Even though I work for an agency that is relatively supportive in comparison to a lot of other agencies, both in our area, and throughout the United States, it just no longer became financially viable to continue to work in that system. When I could see half the amount of clients that I would see in a day, not have any travel, and just have more opportunities to do podcasts like this or to just grow my own practice and my own income.

PATRICK CASALE: Yeah, that's really well said. And I almost get the sense that there's some sadness that comes up when you start talking about leaving and that almost polarizing feeling of, “I love the mission, I love the clients, but I just can't do this anymore. Like, this is not sustainable. This is not viable for me financially, if I want to move on to different goals.” And having a PhD, I imagine, you accrued some student loan debt throughout the process. And that doesn't work well when we're in community mental health settings. Some of us hold on for like the, “I hope I get acceptance into the student loan repayment process.” But I think the odds are so fucking slim. It's like 10% of applicants. Yeah, I guess your transition out is a powerful one, because it sounds like you did good work, you're ready to leave. And what was the tipping point for you? Everyone has their breaking point moment. I definitely remember what mine was.

VICTORIA RODRIGUEZ:  Yeah. For me, it was sitting down and just doing the math. I have an amazing supportive supervisor. I'm not finished with my PhD yet. I start my dissertation next semester, and I thought I'll just do community mental health throughout the rest of my education so that there doesn't have to be this disruption. And it goes back to that comfort. It's almost more comfortable to stay than it is to step into something new, to step into something that is fear-provoking, then it might just be easier to stay in community mental health. But for me, really just sitting down and doing the math, and saying, I literally cannot afford what I need to survive at this point. And I'm talking about getting a new car when my car breaks down. I'm talking about,   making a reasonable mortgage, just all of these expenses that were adding up to where I said, “I don't know how much more I could sacrifice financially to make it worth it. 

And even when you bring up student loan forgiveness, what comes up for me is almost being in this financially abusive relationship where one day it's going to pay out, one day, 10 years later, three years later, whatever it is, I'm going to buy me a farm, and settle down on some land, but like you said, it is just not happening A, fast enough, and B, not at all. And there's been a lot of reporting on that recently, that I'm sure people can just Google, because it's been all over the news, how they're trying to revamp it. But I could not afford to wait around for that to happen.

PATRICK CASALE: That's really well said. I talk about emotionally abusive relationship comparison sometimes to community mental health, because it does such a good job of keeping us there, right? It's secure, it's consistent, I know what I'm going to get. But it really breaks me down. It really makes me feel bad about myself. At the end of the day, I have no capacity left to even think straight. I'm burnt out, I'm miserable, I’m underpaid, I’m undervalued, all the things that comes with the territory. And systemically, it sucks, because it's pretty broken. But we bear the brunt of that. And yeah, if you're holding on for 10 years to potentially get loan forgiveness, what do those 10 years look like if you're just counting down the days until year10 hits? And then, how burnt out are you at the end of that time? Do you transition to a different career?

 I just feel for people who are holding on like that, and I give them credit. But that's not something that feels sustainable for me. Also, what are we working towards? Life is short and unpredictable if I'm holding on for 10 years. What if I never get to do the things that I want to do with my career, with my personal life? So yeah, it's an interesting thing. Tell us about how imposter syndrome’s showing up for you as you're leaving community mental health to start your business?

VICTORIA RODRIGUEZ:  Yes, let's talk about that.  I thought I had gotten over all of this original imposter syndrome out of grad school, going into my PhD. I had a lot of, how do I want to put that? Like affirmations from what I had accomplished academically. But the problem when you go from community mental health to private practice is really that you're working with clients that really want to be there for the first time. I started asking myself, how can I charge people X amount for a session when I am already so lucky to be in private practice, when I am already so lucky to be in community mental health?

I didn't realize that that's like a socialized message that I've received, that other people have received, and our types of programs that are very helper-based. We receive those messages of you are a helper, you are self-sacrificing, and that's what makes you a good therapist. For me, the imposter syndrome comes in, in kind of that incongruence of, I view myself as a helper, but how can I live up to these expectations of people paying me literal cash to help their problems? Can I really help them? And then, that's when I use my own skills and my own therapy to explore, okay, but my job isn't to fix this problem for them. That's their responsibility. 

And another issue too, is just niching. I found out an incredibly difficult transition. I'm not sure if you experienced the same, but just moving to a point where I was seeing generally everything,   all sorts of trauma, domestic violence, substance use, and really figuring out, okay, now that I have a choice, I have a say in what I want to specialize in, how do I even begin to explore what's important to me, or what's a passion of mine when I have been trying to learn everything in community mental health when I have been seen every type of problem in community mental health? I would say that was one of the major challenges for me, was just figuring out a niche, and who specifically I wanted to work with.

PATRICK CASALE: Those are great points. And I think it's such a common experience. For the niche piece, I think that can elicit and evoke a lot of shamefulness around, I’m I excluding people? I've gotten so comfortable working with such a diverse set of problems, acuity levels, and struggles, then all of a sudden I'm honing in on people I really like to work with. And that combats that narrative of like, aren't I supposed to like to work with everybody? But in reality, we're not. We are just not set up as human beings to be able to work with everybody that comes in the door, especially, on an outpatient setting. I know that brings up a lot for people, and I talk about that a lot in my coaching, because it feels like we're like not really casting a wide net, we're going to exclude population A, B and C, and that's why good content creation, and good understanding of your client’s problem areas comes into play, and having good referral list that's really crucial. So that if someone comes in I'm like, “Okay, I'll refer client A to Cindy, because she specializes in A, B and C. 

And as for the incongruence there, are people going to pay me? Do I have enough experience to help people who want to be helped? Do I have enough letters behind my name? Do I offer intervention A, B, and C?  That really starts to ramp up. And then, it's like, “Oh, shit, I am not competent enough to do this. I'm fraudulent. I've just lucked by in my success. And now I'm here and people are going to find me out, and tell me, ‘You suck as a therapist, go do something else.’” And I think you're so right about doing your own therapy, that's crucial. And also, circling back to basics of, our job is not to fix. I think we get that message, and we think our job is to fix. My mentality has always been, my job is to work myself out of a job by helping people learn coping skills to use them on their own. 

And I think that grad school does not set us up well to separate ourselves from the work that we do. It's almost conditioned to believe we have to be supportive of everybody, we have to give all of our selves away. And then, there's that running joke of, “You don't get into this profession to make money.” And it's like, yeah, we buy into that shit, and that becomes our reality.

VICTORIA RODRIGUEZ:  Yeah, absolutely. And just speaking of that bullshit message of,   you didn't get into this field to make money. I want us to take a look at other fields who that is told to. It's told to teachers, it's told to child care, it's told to people that, oh, my gosh, the nonprofit culture. And if you are a leader, or a supervisor, or you’re a professor, and you're passing that down, I would really encourage you to look at maybe your own countertransference there or your own, why do I feel the need to tell this message? Do I feel like it's my personal responsibility? Like it's an obligation? It's really something to explore. Of course, like you said, it becomes the self-affirming message where, you're right, I didn't get into this field to make money. So of course, I'm never going to make money, because I'm never going to take those opportunities that would lead to that.

PATRICK CASALE: Yeah, absolutely. Good advice. I did just record a podcast on money, mindset, anxiety, and trauma that I'll be releasing. And I believe wholeheartedly that those of us who got into this profession to heal ourselves through our work struggle more with the concept of charging for our services. Because if we're believing that our job is to give ourselves away to heal other people, that's really problematic. And that's where codependency gets fostered to in the therapeutic relationship. That's why I see so many people have a hard time stepping away and take vacations. Like, “I can't step away, because my clients need me.” And I'm like, “Ooh, that's a red flag to me.” Like, your clients should not need you to get by. I get there's different acuity levels, but that's problematic, in my view. 

But anyway, back to imposter syndrome. Yeah, this is so common, and for newer therapists, especially, I think even my clinical director, who is a phenomenal therapist at my group practice, she was struggling with this at first when she went into private practice, because she was like, “These people are functional. They are doing really well. I don't think I know how to help them.” And I was like, “Jen, you're fantastic. Just hold space. Let's just hold space, and help. Just be present. That's it. It's all about the relationship.” And then, now she's flourishing, and like, “Oh, yeah, this is fucking awesome. I love this every day.” I think we get lost in that. And I think you made a good point, go back to basics, and just hold that space, and remember, it's just about the relationship. It's not about fixing.

VICTORIA RODRIGUEZ:  Yeah, and I think too, it comes down to that system of when you work in community mental health, unfortunately, it is about fixing. They do want to see results. They want to see results that they want to see. So maybe not even the results that the client or you want to see. A lot of that is just taking that mentality out of when you go into private practice. Or you can even start to explore that for your listeners who are still in grad school,   exploring where is this guilt coming from? Where is this imposter syndrome coming from? And where or why do I feel this need to fix people? And what messages have I received? Because I think we do receive that from these systems like Medicaid or Medicare that are very much wanting to see specific outcomes. So that's difficult as well, as I'm sure it was for Jen, of just figuring out what does it mean to help people that are not as high of a need that I might see in community mental health?

And even to your point about imposter syndrome with taking a vacation, I will always view that as problematic when a clinician says, “I cannot take two weeks off. My clients depend on me.” And then, it either becomes, A, are you dependent on your clients for that sort of validation for your imposter syndrome? Is that how you're dealing with your imposter syndrome? Or it's B, they really do need a higher level of care, and then, you're burning yourself out, and you're not practicing as ethically as you could be with them. I think that's a really great point that you bring up.

PATRICK CASALE: Yeah, I see that a lot. Because I take 12 to 15 weeks off a year and I talk about this regularly. And the responses I get, other than, “How I wish I could do that.” Is like, “How can you do that to your clients? How can you step away so often?” And that wasn't always the case, but I've had to get really comfortable with the fact that if I'm around or I'm not around, the outcomes are probably going to be the same. I cannot control action and dictate circumstance. So just really recognizing higher levels of care are sometimes important to assess for, and refer out to in an outpatient setting because we only have so much capacity and resource when we're working for ourselves. 

And I really want to think about how imposter syndrome starts to show up for new providers? Usually, it's perfectionism, “I can't launch my website until it's perfect, because people are going to see it. It's never going to be good enough, I'm fraudulent, I am incompetent, I'm not good enough.” We do a lot of comparison, especially, on social media. That comes up a lot in these Facebook groups. “Hey, so and so gets more likes, hey, my stuff isn't as good as so and so, I'm never going to be successful.” And I really want to help people combat that narrative of, everyone gets to make this what they want it to be because it is a small business. You are an entrepreneur, you get to make your business whatever you want it to be with whatever amount of money you want to charge. 

And going back to your Medicaid, Medicare statements, if we're always focused on productivity, we're always focused on outcome. We're operating from the medical model. We're doing that for insurance purposes. That is not great client care. Most of our clients don't necessarily even have end goals or need smart goals all the time. They're just like, “I need a place to talk. I just need a place to be present and talk about shit in my life that's going on.” If we're always measuring outcome, it really takes away from the work that we're doing too.

VICTORIA RODRIGUEZ:  Yeah, absolutely. That was a huge difference for me starting off, because after every session I would kind of annoyingly ask, “Okay, how do you feel this is working for you? How do you feel you're moving towards your goals?” And finally, thank God, one of my clients was like, “You have to stop. I'm just coming here to talk about my family, get this out.” And not to say that we're not working towards goals. But we know from the research that therapy in and of itself, just the relationship is the number one indicator of therapeutic value. However much you want to argue moving towards goals, it's in the research. That is the most valuable stuff that we bring to therapy. 

PATRICK CASALE: Yeah, and I think that you're right. When you transition out, you start working with clients with their own agendas. We sometimes try to dictate or push our own. Like, “Hey, how do you feel this is working?” Like you said, or, “When do you want to work towards A, B and C?” And they’re like, “They’re messages.” And it’s like, “Are you trying to get rid of me? Are you trying to push me out the door, because I just want to be here to just talk? I just want to process, and feel safe, and feel heard, and validated.” So you're absolutely right about the research on that. 

And I just want to challenge new therapists to think about the fact that it is about the relationships. So when you feel like you had a session that didn't go well, maybe it felt like it was just off, you start to question, “Am I a good therapist? Am I competent? Can I be a competent business owner?” And those thoughts will come up. They came up for me all the time. Just go back to the fact that it just may be that the relationship isn't the right one, that it just may not be attunement, and that's okay. You can't be everything for everybody. Not every client is going to be a good fit for you. It has no reflection on you as a professional if the relationship isn't there. That's a good indicator that it's time to refer out to someone else.

VICTORIA RODRIGUEZ:  Yeah, definitely. I love how you're bringing up even with this imposter syndrome, almost like this fear of referral. Like referral is going to mean that you're a fraud and that you weren't able to help them. And I would just challenge new therapists as well as they're figuring out what it looks like to refer. If one of my students that I supervise in my program, if they're not able to tell me something they do good, if they're only listing off things that, “Oh, I messed up here.” Or, “This session was terrible. All my sessions are terrible. It's all terrible.” If you cannot tell me one thing that you did well, that is a deficit. You need to be able   to point out what does good therapy look like? What is one thing that you did well, or that you're fixing in the session? 

Honestly, it's for them as well as their clients, because when you move into private practice, and that goes back to niching. You are going to have to be able to say what you do well. And that might be part of your imposter syndrome healing. Again, that's something you can explore in coaching or in therapy to help you out with that. 

PATRICK CASALE: Yeah, absolutely. And niching brings up imposter syndrome because there's vulnerability in saying, I specialize, or I'm the expert in this population, or this struggle, or issue, because it's like, how can I ever be the expert? But in reality, it's like, who do I really enjoy working with and whose struggles do I really, really, really understand? And niching is important in terms of marketing. Nobody's going to pay you out of pocket if you don't know who you work with if you're kind of all over the place in your marketing. And I hear this all the fucking time. I'll talk about this forever. I see so many website audits now or site today profiles that say like, “I'm a trauma-informed therapist, and I'll walk alongside you.” And my website has pictures of stacked rocks, and blah, blah, blah, blah, blah. And I'm like, yeah, be authentic. You don't know who you work with. And if this is coming across to clients, they're going to look at it and be like, “Nah, pass. I'm moving on to someone who really gets my struggle.”

So it's okay to really niche down, to hone in. You don't have to be unbelievably specific, but I would really challenge people to start thinking about the fact that you need to know your ideal client’s pain points, their struggles, their concerns, and you need to get it. You need to be able to verbalize it in their language. And I know that brings up vulnerability and insecurity, but it will also create instantaneous rapport building without the client ever even meeting you.

VICTORIA RODRIGUEZ:  Yeah, absolutely. And when you bring that up, about niching down, and I'm just thinking about this for the first time, and it's making me curious, where are those messages that you hear that you cannot proclaim that you're an expert unless you have XYZ training? And of course, I don't want to suggest that you should be practicing a very specific modality, or with a very specific population without training, but it almost seems like it's gone in the completely opposite direction, where there is this intense gatekeeping, where if you are not trained in this specific modality you cannot work with this type of client. Or, I hear the word unethical [INDISCERNIBLE 00:20:48] thrown around a lot without really giving reason why just on like those Facebook groups that you brought up. 

And I feel like, for me, that's almost messages that I've internalized that kind of feeds my imposter syndrome. That might not be everybody's experience, but certainly that fear of proclaiming, “No, I'm an expert, or I'm at least proficient in treating this in this population. I have actually had a lot of training.” So, almost just going back to CBT of just challenging those thoughts and saying what? That is not necessarily accurate, and where are these messages of improper gatekeeping coming from that I received?

PATRICK CASALE: Yeah, well said, and like you said, certain populations, obviously, everyone listening, we're not advocating that you go proclaim that you're a specialist in disordered eating if you have no experience in disordered eating, etc. However, you can certainly proclaim that you are an expert in certain population’s struggles. For example, when I started, I worked with men struggling with addiction. I am a man who used to be an active addiction. I can proclaim in a way that not only do I have my licensed clinical addiction specialist license, but I know what it's like to walk that walk and talk that talk, and what it's like to go through those experiences. So the more you can start to do that, and I'm a firm believer that our ideal client population is some version of ourselves, and that might evolve over time. So right now, my ideal population is high-achieving perfectionistic entrepreneurs, which is a version of myself. 

And that will evolve as we grow, as we learn more, as we train more, and as we kind of get more insight into who we like to work with. It's not a bad thing to say I like to work with clients A, B, and C, or traits A, B, and C, or struggles A, B, and C, and I don't like to work with client A, B, and C. That is okay, because if you don't like to work with certain types of clients, you're doing the client a disservice by continuing the relationship. I want everyone to also just think about what Victoria said about referring. Referring is a strong tool in your tool belt, and it's appropriate for your client because you're actually doing the client a service by being able to have them land on their feet in the appropriate level of care or with the appropriate provider.

VICTORIA RODRIGUEZ:  Yeah, and I'm going to quote Kelley from the Private Practice Pro. She says all the time, when you refer out it will come back to you tenfold. Like, you were just doing the best thing not only for that client but for your business as well. So that can be something as well that you keep in your toolbox to kind of fight that imposter syndrome of know what I'm doing is actually healthy for me, it's healthy for the client, it's healthy for the business.

PATRICK CASALE: Yeah, absolutely. I believe in the abundance mentality in that regard. And networking is crucial, two-way dual relationships, reciprocal relationships with other providers. We need to be able to understand that referring out appropriately comes back around. If I'm going to refer people out that I don't work with, kids, teenagers, families, couples, clients struggle A, B, and C, it's going to come back around, because I do work with things that other people don't work with. So we just have to recognize that we can build each other up and all be successful simultaneously. And I know that success can be defined very differently for people, but just working through your fears, taking that leap from community mental health and into private practice. I haven't met a single person who did that, who regrets it. Who was like, “You know what? It was fucking scary. I was really overwhelmed. But a year later down the road, I'm working my own hours, I'm setting my own schedule, I take off when I want to take off, I don't have to answer the on-call phone anymore. I don't have middle management breathing down my neck about productivity.”  

The list goes on and on. All of the reasons we leave community mental health jobs, they're all the same. I just want everyone to really own that, and just soak that in, because entrepreneurialship is really a beautiful thing. It's very freeing. There's a lot of autonomy. It's also not easy. There are speed bumps, there's bumps along the way. I've been in New Orleans. There's craters in the road [INDISCERNIBLE 00:24:31], and there's an ebb and flow to this. Don't start to consider or ask yourself, “Did I make the right decision? Can I do this successfully?” when things don't go well, because they're not going to go perfectly all the time. If they did, everybody would leave community mental health today.

VICTORIA RODRIGUEZ:  Yeah, wow, that's so powerful. Just thinking about that was totally right. When I think about what stops people from leaving community mental health or taking that job, I do want to be clear that you even entrepreneurs in any setting are likely to experience imposter syndrome. But again, there's just something special about almost that workplace trauma, or that secondary trauma that comes with community mental health that might make us more susceptible to imposter syndrome. And even that point that you brought out about, it's something that you need to fight. One way that I like to view imposter syndrome is, and I'm sure we're going to get into this later too, but I do not teach it as it is necessarily or all the symptoms of it aren't necessarily a bad thing. Asking yourself, “Did I make the right decision?”  Reviewing decisions you've made, being humble about the expertise that you put out in the world, the problem is that not everybody is playing by those same rules. 

If you are a black woman, or a woman, or a person of color, you really have to ask yourself, “Is this imposter syndrome, or is this workplace trauma? Is this trauma that I've experienced that is now showing up that looks similar to imposter syndrome?” Because I might experience imposter syndrome, but my co-owner is a black woman, what is coming up for her might actually be workplace trauma. So that's something to explore as well.

PATRICK CASALE: Yeah, great point. I just spoke at Therapy Reimagined about colonialism and imposter syndrome. And when we have institutionalized and systemic racism, and even just a society that is really patriarchal in nature, the workplace environment isn't necessarily catered to women, especially, women of color. And if there's messaging for generations that you're not as good as enough, you're not as smart, we just let you be here. Of course, you're going to question your fucking competency. It just makes sense why there would be that extra layer of insecurity or vigilance about it. And that's definitely a big component of this, so definitely, different layers to imposter syndrome. And it shows up when we're growing, it shows up when we're taking risks, especially, as entrepreneurs. If we're going to leave a steady, secure job to go into the unknown, of course, we're going to question our competency, whether or not we're going to be successful. 

And you're right, there are positives. Humility is a positive thing, questioning whether or not you did a good job is a positive thing. It means that you care about the outcome. Taking a lot of that ego away, but not letting it become paralyzing, not letting it prevent you from taking that next step and growing, because fear and growth go hand in hand. And anxiety and growth go hand in hand. We don't grow in stillness or in being complacent, so really just remembering that it can show up in paralyzing perfectionism too. And you can start to make these excuses in community mental health of, “I can't take the leap until I have 20 clients on my practice caseload that I see at night.” If that's the case, great, but that may not always happen. And sometimes we have to step out of our comfort zones to grow into more space, to have more availability for clients to schedule, to make more time for networking. We can't do those things if we're working 50 or 60 hours a week. It's really hard to juggle both at the same time.

VICTORIA RODRIGUEZ:  Yeah, and even as you're bringing that up, I'm just like, “God damn it.” My supervisor gave the same advice of sort of like, “Look, when you leave make sure you have 20 clients.” And this was a supervisor. When you have a really good supervision relationship, I was like, “I just want to be you. I want to take everything that you're teaching me, you have a successful practice, I want to have that for myself as well.” And even part of that imposter syndrome was figuring out her practice is just going to look different from mine. And it's going to look different from the next supervisors. But yeah, for me, I did not wait until I had a full caseload to make that decision to leave. 

And again, that's because of my privilege. I had money saved up. I took extra work doing online therapy on the side. For me, it almost just became so unsustainably, emotionally, especially after Hurricane Ida, and losing our home temporarily. I could not do community mental health at the same time. And even when you're bringing up what was the breaking point for you, I'm rethinking it now as we're talking. It was the point where they just did not give a shit about us about after a hurricane. And not to say, they gave us time off, but it wasn't enough. It's not sustainable to take care of everything that we needed to take care of as employees, even as supervisors who were also out of their homes as well. I think for me leaving before I had a full caseload was just what I had to do. What I had to do for me, for my mental health, and for my family, and what helped, again, going back to your episode, which I can't wait to hear about money mindset and abundance mindset, is that I charged enough so that I did not have to have a full caseload before feeling comfortable to leaving.

I now replaced my entire income. Oh my God, this is so embarrassing with five to 10 clients that I had versus community mental health. For me, it was like, “Well, it's a good time. This is a good time. I'm comfortable in that decision.” Even though I still have that imposter syndrome, I could not let that imposter syndrome hold me back from doing what I needed to do to take care of myself, my financial well-being, and my family's financial well-being. 

PATRICK CASALE: Yeah, it's really powerful, and going through a natural disaster as a community and being expected to show up, that's got to feel so unbelievably challenging and as if you're too taken for granted, and under-appreciated as well simultaneously. And the fact that you can make your income back in five to 10 hours, I want everyone to hear that you can do that. And it's really easy to get caught up in the mindset of this paycheck is secure, my shitty health benefits that they give me are secure, even though the deductible’s $10,000. And in reality, you can replace that income so easily. And it does not take long to start to see the benefit of going out on your own and creating your own thing. I just want everyone to hear that.

Just some quick tips to deal with imposter syndrome. Typically, we're trying as much as we can to do self-compassion, but I like to try hard to give ourselves permission to make mistakes. I think imposter syndrome and fear come with failure and struggle, and we're not going to get it right the first time and it's not going to be perfect. Give yourself permission to start something new, and not know how to do it to be able to make mistakes and to pick yourself back up. I also like really making it playful,  giving it a funny voice, giving it a funny name, just going back to that inner child piece where it's like we've got to be a little bit less vulnerable and surround yourself with good mentorship, therapy that also helps good supervision, good support systems, colleagues who build you up.  This is not an abnormal or unique situation if you're experiencing it, plenty of people do. That's why it's talked about all the time in the therapy world. 

Hope this was helpful. And Victoria, I really appreciated having you on and please tell the audience like where they can find more information about what you're doing, and your business and everything like that.

VICTORIA RODRIGUEZ:  Sure, thank you so much, Patrick. You can find at My Car is My Office on all social media handles. That’s where I talk about all things community mental health. I’m very excited to now offer trainings and consulting for community mental health agencies and for those of you transitioning out of community mental health, so you can find me, again, that’s www.mycarismyoffice.com. 

PATRICK CASALE: I love it. Well, thank you so much, and thanks everyone for listening to the All Things Private Practice Podcast. You can download, subscribe, share. Every Monday there’s a new episode. If you’d like to be a guest go on the website, allthingspractice.com, and submit the form. If you would like to do more business or small business, or private practice coaching, there’s information on my website. I also moderate the All Things Private Practice Facebook group as well. Thank you so much, and we will see you next Monday.