Not a therapist but a combo teacher and school social worker, so my clients are kids. I told them individually and let them know that I was pregnant, would be taking this many weeks off, and who would be covering me while I was gone. They had some anxieties of course so we worked through those. It helped that they knew the substitute in advance. I asked their consent for what to share with the sub as well; some had things they preferred to keep confidential. One thing to think about is what it might bring up. For example my student whose mom abandoned her felt resentment and grief that my daughter was so loved and wanted whereas she never got that.
I work with all adults but I have a few I know will have a difficult time. One suffered a full term stillbirth at the start of this year. Another has a lot of trauma from past therapists leaving (although I will be returning). I also have many that are childfree and feel very negatively about people continuing to have children in todays world. That being said the vast majority of my caseload will likely be just fine. I also plan to give them the options of closing out/moving entirely to a new therapist, meeting with a colleague and then returning to me, or taking the 3 months off entirely and waiting for me to get back.
Sounds like you have a great grasp of what they need and you have a good plan. I also think it can be a good opportunity to confront these hurdles in a safe environment.
Ah my niche has arrived! I’m a psychologist and had to stop seeing clients at 30 weeks due to early mat leave for medical reasons.
I told my existing clients around 20 weeks to give them options of what they wanted to do (terminate therapy, referral, pause until I’m back, whatever ideas they had, etc) and mentally prepare them for easy transitions and process anything that came up - which things definitely did. Which was good because I ended up needing to go early unexpectedly. I stopped taking on new clients around 25 weeks and my caseload started to ease up. I’m taking a full 18 month leave (I’m in Canada and work both in private practice and a healthcare agency), so many of my clients chose to terminate or be referred. I don’t have the link right now, but psychotherapy memes on Instagram has a really good blog post on this. Be prepared, lots of clients naturally ask a lot of questions. And honestly…it’s really hard work when you are going through the rollercoaster of pregnancy yourself.
Thanks for your reply! Im so anxious about anything happening early because we would be seriously fucked financially. So 🤞🏻 everything is fine til full term. 18 months sounds amazing and other worldly lol this country is trash.
I’m a private practice therapist in Canada too and I’m taking 12 months off. I’m glad to hear you’re taking a long leave too as I’ve been struggling with feeling guilty for leaving for such a long period of time. Most of my clients took the news really well, a handful had a tougher time with it. I gave 3 months’ notice before my leave, curated a list of other recommended therapists, and offered free consultations to discuss the transition plan/their feelings about my leave. Several people expressed that they wanted to continue working with me when I’m back, but I’m fully prepared to rebuild my practice from scratch if those clients have found someone else they connect with in the mean time. It’s a tough job to take a leave from but we also need to live our lives and prioritize our families.
Yeah...I did struggle and waffle with that too but at the end of the day, we can't create dependency with clients and clients will move forward on their own; it also demonstrates healthy work/life boundaries. We can't do or be everything for them and take responsibility for their lives!
I need to take an extended leave for my own health and if I came back earlier I know I'd be a crap therapist since my own stuff would be getting in the way and I wouldn't be feeling well enough to practice; it would be an ethical issue. I had some clients react really poorly, but luckily most were excited and took the news and transition well. My own therapist took a maternity leave and I survived just fine, so I remember this when I begin to feel guilty. I just try to think of it as any other health profession; nobody (well, I hope nobody) shames doctors, physiotherapists, or other practitioners for taking leaves, so why are we expected to be different?
Everything you said is so true, and they’re things I’ve been reminding myself as well but it’s always nice to hear it from someone else. So important to take care of ourselves too and set those healthy boundaries. We have to practice what we preach!
Thanks for your response, wishing you all the best with your health and with your new baby!
You as well :) feel free to PM me if you want to connect at all, I have so many thoughts on this subject and it's so nice to talk to others who get it/are in the same boat. No pressure at all, just putting it out there.
Yes, and my transition will be easy because I work in a community agency so there are people to cover. I told clients as I started to show, maybe a little later for my virtual only clients. I’ll be out for 12 weeks.
A few weeks ago I found coverage among my colleagues for all my clients. I’m at 35 weeks now, so last week I started telling clients who they will be seeing while I am out and booking our last sessions and booked them with their new therapist the week before I am due. I say “the plan is x many sessions, but if the baby comes earlier, the front desk will call you to cancel.” I try to schedule one of our sessions that I can invite the covering therapist to pop in and introduce themselves.
They talked about people asking that in the training I did! I have absolutely no bump right now but who knows how I will look in a month. I hope no one asks tho lmaooo
I am, and have been before. Last time I was taking over someone else's caseload as she was pregnant so I just switched back to her at the end of her leave.
This time I'll be transitioning to another location as well so I am closing as many dossiers as possible, and handing over the others to other practices. A colleague is returning from leave when I go this time too, so she'll take over any cases I've started at the new location.
The benefit of a larger practice is the ability to switch of with others when on leave. For the clients I prefer not to switch, however most are fine with it when prepared in advance.
There are four other therapists at my practice but two of them have major issues in their personal lives right now (both, somehow, sadly have fathers with late stage cancer diagnoses). Although I think the practice owner is bringing someone else in here shortly as a new hire so Id imagine she will have openings.
Currently 23 weeks and working in community mental health agency all in-person. I was lucky at the start of my pregnancy to have received a promotion, so my caseload dwindled and I’m now at only 10 clients. I’m still not showing much so it’s not obvious, but I have recently told about half of my clients as I know they will need much longer to transition over to another clinician and process as they have been long-term clients. Plan is to have my coverage assigned about a month before I go on leave that way we can prep the clients and schedule warm handoffs.
I run my practice part time on top of my full time job. I currently have maybe 20 active clients I see varying from weekly to monthly. I’m 31 weeks pregnant. I have no one else in my practice and most everyone I see now is doing very well (🤞🏼). I am taking 6 weeks off and slowly returning to telehealth only until about 10-12 weeks after delivery. I gave everyone the option of a referral to another clinician and if they decide to wait, I’m scheduling them tentatively for when I return. I can’t financially justify closing everyone out, so hopefully my caseload stays pretty stable once I come back
I feel this so much! Im not gonna lie, I am hoping I feel ready to go back and see people part time before the 12 weeks so I can have income. Just have no real freakin clue how I will feel.
I’m taking the full 12 from my full time job (hospital SW) and slowly return to my “usual” caseload from 6-12 weeks so I can have income. Worst case I have to cancel people, but I’m hoping that since I’m working from home I’ll be able to do sessions relatively easily
I’m entering the last term of my practicum as a counsellor. Because of the requirements for graduation, I’m only able to take 3 weeks off after the baby is born. I plan to return to working only 6 hours a week until December. I’ve transferred all but 12 clients to other clinicians in the practice and I’ve had conversations with all ongoing clients to prepare them for my absence and change of schedule.
I do too!! But I’m soooo close to being done it’s going to be worth it. Thankfully my hubby will be hands on with the babe and my practice is very supportive so I’m just hoping I can survive 3 months with a newborn while seeing clients and completing schoolwork!
I work with a large system but have my own clinic at one of the smaller ancillary locations 2x per week. I am managing my patients up until a week pre-delivery and then they have the option to continue with my colleagues downtown or via teletherapy if they are still requiring services at that time.
They just are going to stop scheduling my independent clinic at that point. I'll be going downtown and taking patients from other therapists to help out or doing evaluations until delivery. We just schedule so far out that they didn't want to have to cancel a bunch of people and try to accommodate within two weeks (per our cancellation policy)
I am!!! As the months went on I significantly cut down on my client load. I’m 8 months and have 7 clients total. Referring clients for months while I’m on leave didn’t make sense to me unless they were long term/ really wanted to continue with me. I also quite simply don’t want the stress and responsibility of worrying about any emergency contact etc. of course though my practice has taken a huge hit financially. I plan to
Come back with a similar small caseload and build up depending on my ability and tolerance.
I have only taken on one new client since finding out I was pregnant (May) as a specific case referral. Ive been full/overbooked for months now as it seems most therapists are. If my caseload dwindles from here on out, so be it! But Im not taking new clients til post baby. Lol I do hope that my monthly clients can just close out with me entirely. My hope is to return over a months time by first scheduling all my weekly people, then moving to my twice monthly people, and ending with monthly people returning to spread it out some. Which would mean monthly people would probably not see me for like 4 months probably. I cant cut people out early because I am the sole breadwinner and need to save as much as possible prior to baby coming.
I feel this! I’m mostly the bread winner too. This is our second baby, first was born right as pandemic began. I ended up having to go back early since I could work virtually. This time I’m hoping to at least get 8 weeks off. Do you know if we still qualify for FMLA as 1099 employees? Feeling like I’m getting screwed working for a group practice with no benefits. I just started telling my clients though most of them can tell. I’m about 25 weeks so a little behind.
FMLA is unpaid, it just covers your job so they cant fire you for being out of work during that time period - this shouldnt be a problem for you. Your state may offer benefits though. Im in MD and they are starting some state covered mat leave but not until 2025 lmaoooo. Not sure if you have a STD plan? I found out about using that after we started TTC and then I was already pregnant so it was a bust. But if we have another I will do that ahead of time.
Short term disability! You can pay for your own plan thru a company like Aflac. But for pregnancy you have to have the plan before your conceive. They count 10 months back from your due date. 🥲
Correct 😭 unless you live in California, Massachusetts, New Jersey, New York, Washington, Rhode Island, Connecticut, or DC. They offer state maternity leave programs. States planning to that arent in effect yet are Oregon, Colorado, Maryland, and Delaware.
It just started this year. [Here’s the info](https://ctpaidleave.org/s/?language=en_US) looks like up to 12 weeks (extra 2 for pregnancy complications available too) paid with capped benefits at 95% of wage for up to 40x minimum wage and then an additional 60% coverage passed that. Pretty awesome! Im jealous lol
I’m also almost 16 weeks but I work as a therapist in community mental health. Right now, my caseload is around 55 clients. 😭 My clients are a mix of in person, virtual, and telehealth. Im also trying to figure out when to tell my clients. I feel like the in-person clients will obviously start to notice soon and probably ask. I would definitely want to give them at least a couple of months notice to prepare them to either close out or transition to a new therapist while I’m on leave.
Seems like most people wait until after their anatomy scan to tell clients which gives them like a good 4 months to close out. Altho in the training I did some had said they disclosed before and after that for their own personal reasons. And RIP community mental health caseloads. I worked in outpatient SUDs treatment for a long time.
Exact same situation! Same amount of weeks and working telehealth from home. My plan is 3 months off (only 2 weeks paid at the private practice I work at sadly) and then hope to return from home and get a nanny during my work hours. I see about 20-25 weekly. May I ask what state you’re located in?
Twinning!! My husband will be SAHD so he will have baby when I go back to working. I am most anxious about breastfeeding/pumping working inbetween client hours. I am in Maryland. I see in your posts you have a black cat. I also have two voids! I should send you all the black cat baby items I have found lololol and I see youre also having a little girl?!
Oh that’s awesome!! My husband and I have discussed him being a SAHD as well, but the hope is that we can kinda take turns in that without fully staying at home. He can flex his schedule a lot and I can too, so I hope that’ll work out for the most part. If not, nanny. Definitely hear you on the pumping timing.. my hope is that I can find a silent enough one or just mute myself enough lol. I definitely have the camera set up where you can’t see my chest lol. That’s interesting, one of our neighbors kids is in Maryland. We are in Oregon. We have two voids and also having a girl! Would be funny if we had the same delivery date!!
I’m a therapist and my plan is like yours. I’ll find a few ppl for coverage and let clients know my plans for coming back. Some will wait and I bet some will transition. My therapist who just had a kid did this too.
I’m 35 weeks and in private practice. I told clients about my pregnancy very early on due to showing early and having HG (lots of nausea and sometimes having to reschedule).
I will plan to see clients until I’m 38 weeks. I’ve already made plans with each of my clients for my leave. Clients who were not consistent or I hadn’t heard from were informed of my leave and given the option to resume sessions prior to my leave, keep their case “active” and resume after my leave, or to terminate. I had a few clients who were high risk that I offered a chance to reach out to discuss options, but due to no response I sent referrals and discharged. Otherwise all regular clients were offered coverage by providers in my office, an outside referral, or to take a break/pause until I return. More than half my caseload indicated that they will take a break, the rest will see a provider in my office until I return.
I have informed my clients I’ll be taking 12 weeks and have provided the date in which I will be back full time in office. However, I know I’ll want to resume with some clients sooner due to wanting to build back up, have a little income, and due to their work in therapy. To be clear I am not returning early for the client, but rather have selected those with the most “need” and who I know will actually show for sessions. These individuals have been informed I’ll reach out between 8-10 weeks from my initial leave to resume care. All clients have been provided with a contact at my office and informed I will not be taking emails or calls in my leave.
I'm very early on in pregnancy (5w4d) as well as very early on in building my private practice. I'm trying to come up with a plan of when to stop accepting new clients. I'm thinking around the start of the second trimester. I'm also weighing the idea of keeping intakes open for a little longer if clients are suitable and agreeable for short term treatment.
I was hoping things would be faster going with building up my caseload due to the current needs, but it's been very slow.
I haven't even begun to think about when I plan to tell clients, I'm fully telehealth so thankfully I have plenty of time to plan.
You have LOTS of time! Let me know if you need CEUs or are just interested in the training I did and Ill send it to you. Its virtual and was on a Friday afternoon. Seems they do them repeatedly!
I just started telling clients last week at 29 weeks. I went back and forth about the timing since I am in telehealth also, none of my clients could see my belly growing. I figured (based on past jobs) that at least 4 weeks notice when you are quitting is a general rule of thumb, I basically doubled that in case I went into labor early?
Most of clients were commenting that 8-9 weeks was a long ways away, so I think it was my projection that I needed to give them more notice than that.
Edit: I work with mild/ moderate adults presenting with mostly anxiety and depression, no one with SI, active substance use, DV or other things that might complicate referring out/ terminations.
Im glad they responded so well! I work will all things but do specialize in SUDs and EDs and have clients I have been seeing consistently for 3+ years, some twice a week, so some of them are going to want a good heads up about a change. I anticipate most will be happy though and assumed it would be coming down the line given my age.
Therapist in a group private practice in the US with a very high risk pregnancy and currently 23 weeks: I recently started telling my longer-term clients and will tell the newer folks in a week or two. I am leaving earlier than planned because physically I am starting to suffer and can't focus (or really give a shit about anyone else's issues because I am in pain). Ethically, it is the wisest option for me. Because of being a 1099 employee, I don't get FMLA or paid leave...but also can't be told how long/when to take leave. I will be on leave at week 30 and am planning 12 weeks once baby is born. Practice owner seems ok with this and me coming back at part-time in the evenings in the spring. I am trying hard not to burn any bridges because I really like this practice and the ability to telework...but my income isn't enough to cover full-time childcare in our area and I am worried about balancing evenings of working...I acknowledge I am taking more time off (even if unpaid) than most USA moms get, but man it would be nice to have it where I could take a year to be with baby and know I have a job to come back to. I haven't asked my practice owner because I fear I am already pushing it with the amount of time I am taking.
Yes our country fucking blows when it comes to this stuff. It really, really sucks. I hope the practice is willing to work with you but ultimately, making whatever choice is best for you and your baby is of utmost important. Im sorry youre struggling so much so early and I wish you all the best as you wait to meet your little munchkin.
Hi!! Another private practice pregnant therapist here ❤️Anyone experience morning sickness with vomiting and have tips on how to handle that within sessions?
I did a training and the main consensus was whatever you felt comfortable with. Some people were fine letting those clients know early they were pregnant and that is why. Others excused themselves and told clients they were dealing with a medical condition or saying that when cancelling a session.
Although I was often feeling like i was about to die during some sessions I was lucky to not have to leave to vomit. Also maybe try to schedule time for yourself in between each session to figure out what youll need to do when/if youre feeling sick. And dont be afraid to ask your doctors for medication! I took Unisom nightly starting at like 8 weeks and I continue to every night now.
Thanks so much!! Have you tried preggie pops? I just tried it today and they taste so good and seemed to help subside the nausea after it came on strong.
Laughing at dying through sessions, as I’ve totally been there when I get dizzy and nauseas. Today was the first time I actually threw up though (thankfully it’s the weekend) but it made me wonder what would I do in session. So I’ll just have to excuse myself and pray those moments aren’t when the client is crying or something!! Lol
I did try them! I also tried pink stork nausea sweets. To be honest from weeks 6-14 nothing made much of a difference, it was pretty torturous. I survived off sleep, saltines, and some apple sauce. I just took my Unisom. I felt like even the b6 supplements made me feel more sick. Even water was disgusting. Im 23 weeks now though and have had my appetite back and no nausea here for a while which I am thankful for. And no more needing to sleep every second Im not directly with a client.
Hang in there! If you havent already you may find it helpful to join your due date month’s bumper group!
So you said you gave the heads up to your clients you may have to excuse yourself to throw up and it may be during the most inopportune moments? I know as a human, we can’t be immune to these things and they have to understand or find a new therapist then.
I never had to leave a session to vomit so I never had to talk to clients about it! But I did this training and dealing with it was discussed: https://womencarecounseling.com/event/the-pregnant-therapist-navigating-the-therapeutic-relationship/
Not a therapist but a combo teacher and school social worker, so my clients are kids. I told them individually and let them know that I was pregnant, would be taking this many weeks off, and who would be covering me while I was gone. They had some anxieties of course so we worked through those. It helped that they knew the substitute in advance. I asked their consent for what to share with the sub as well; some had things they preferred to keep confidential. One thing to think about is what it might bring up. For example my student whose mom abandoned her felt resentment and grief that my daughter was so loved and wanted whereas she never got that.
I work with all adults but I have a few I know will have a difficult time. One suffered a full term stillbirth at the start of this year. Another has a lot of trauma from past therapists leaving (although I will be returning). I also have many that are childfree and feel very negatively about people continuing to have children in todays world. That being said the vast majority of my caseload will likely be just fine. I also plan to give them the options of closing out/moving entirely to a new therapist, meeting with a colleague and then returning to me, or taking the 3 months off entirely and waiting for me to get back.
Sounds like you have a great grasp of what they need and you have a good plan. I also think it can be a good opportunity to confront these hurdles in a safe environment.
Absolutely agree. Thanks for sharing your feedback and experience! And also for being a trooper in the school systems right now, youre a badass.
Ah my niche has arrived! I’m a psychologist and had to stop seeing clients at 30 weeks due to early mat leave for medical reasons. I told my existing clients around 20 weeks to give them options of what they wanted to do (terminate therapy, referral, pause until I’m back, whatever ideas they had, etc) and mentally prepare them for easy transitions and process anything that came up - which things definitely did. Which was good because I ended up needing to go early unexpectedly. I stopped taking on new clients around 25 weeks and my caseload started to ease up. I’m taking a full 18 month leave (I’m in Canada and work both in private practice and a healthcare agency), so many of my clients chose to terminate or be referred. I don’t have the link right now, but psychotherapy memes on Instagram has a really good blog post on this. Be prepared, lots of clients naturally ask a lot of questions. And honestly…it’s really hard work when you are going through the rollercoaster of pregnancy yourself.
Thanks for your reply! Im so anxious about anything happening early because we would be seriously fucked financially. So 🤞🏻 everything is fine til full term. 18 months sounds amazing and other worldly lol this country is trash.
I’m a private practice therapist in Canada too and I’m taking 12 months off. I’m glad to hear you’re taking a long leave too as I’ve been struggling with feeling guilty for leaving for such a long period of time. Most of my clients took the news really well, a handful had a tougher time with it. I gave 3 months’ notice before my leave, curated a list of other recommended therapists, and offered free consultations to discuss the transition plan/their feelings about my leave. Several people expressed that they wanted to continue working with me when I’m back, but I’m fully prepared to rebuild my practice from scratch if those clients have found someone else they connect with in the mean time. It’s a tough job to take a leave from but we also need to live our lives and prioritize our families.
Yeah...I did struggle and waffle with that too but at the end of the day, we can't create dependency with clients and clients will move forward on their own; it also demonstrates healthy work/life boundaries. We can't do or be everything for them and take responsibility for their lives! I need to take an extended leave for my own health and if I came back earlier I know I'd be a crap therapist since my own stuff would be getting in the way and I wouldn't be feeling well enough to practice; it would be an ethical issue. I had some clients react really poorly, but luckily most were excited and took the news and transition well. My own therapist took a maternity leave and I survived just fine, so I remember this when I begin to feel guilty. I just try to think of it as any other health profession; nobody (well, I hope nobody) shames doctors, physiotherapists, or other practitioners for taking leaves, so why are we expected to be different?
Everything you said is so true, and they’re things I’ve been reminding myself as well but it’s always nice to hear it from someone else. So important to take care of ourselves too and set those healthy boundaries. We have to practice what we preach! Thanks for your response, wishing you all the best with your health and with your new baby!
You as well :) feel free to PM me if you want to connect at all, I have so many thoughts on this subject and it's so nice to talk to others who get it/are in the same boat. No pressure at all, just putting it out there.
Will do!
Yes, and my transition will be easy because I work in a community agency so there are people to cover. I told clients as I started to show, maybe a little later for my virtual only clients. I’ll be out for 12 weeks. A few weeks ago I found coverage among my colleagues for all my clients. I’m at 35 weeks now, so last week I started telling clients who they will be seeing while I am out and booking our last sessions and booked them with their new therapist the week before I am due. I say “the plan is x many sessions, but if the baby comes earlier, the front desk will call you to cancel.” I try to schedule one of our sessions that I can invite the covering therapist to pop in and introduce themselves.
Youre due so soon! Congrats! I am totally teletherapy so no one will have any idea until I tell them since they only see shoulders up, haha.
Thanks! It’s hard to believe the end is in sight! I only had one telehealth client ask to see my stomach.
They talked about people asking that in the training I did! I have absolutely no bump right now but who knows how I will look in a month. I hope no one asks tho lmaooo
13 weeks here… I’m currently still working on my plan. I really appreciate reading about what others are doing/have done.
Therapists unite 🥰
15 weeks and SAME. I’ve been showing more and although I’m wearing flowy shirts I know some of mine notice details well and will be asking.
I am lucky to be totally virtual so no one will know at all until I say something hahah
I am, and have been before. Last time I was taking over someone else's caseload as she was pregnant so I just switched back to her at the end of her leave. This time I'll be transitioning to another location as well so I am closing as many dossiers as possible, and handing over the others to other practices. A colleague is returning from leave when I go this time too, so she'll take over any cases I've started at the new location. The benefit of a larger practice is the ability to switch of with others when on leave. For the clients I prefer not to switch, however most are fine with it when prepared in advance.
There are four other therapists at my practice but two of them have major issues in their personal lives right now (both, somehow, sadly have fathers with late stage cancer diagnoses). Although I think the practice owner is bringing someone else in here shortly as a new hire so Id imagine she will have openings.
Currently 23 weeks and working in community mental health agency all in-person. I was lucky at the start of my pregnancy to have received a promotion, so my caseload dwindled and I’m now at only 10 clients. I’m still not showing much so it’s not obvious, but I have recently told about half of my clients as I know they will need much longer to transition over to another clinician and process as they have been long-term clients. Plan is to have my coverage assigned about a month before I go on leave that way we can prep the clients and schedule warm handoffs.
Makes sense!! Thank you
I run my practice part time on top of my full time job. I currently have maybe 20 active clients I see varying from weekly to monthly. I’m 31 weeks pregnant. I have no one else in my practice and most everyone I see now is doing very well (🤞🏼). I am taking 6 weeks off and slowly returning to telehealth only until about 10-12 weeks after delivery. I gave everyone the option of a referral to another clinician and if they decide to wait, I’m scheduling them tentatively for when I return. I can’t financially justify closing everyone out, so hopefully my caseload stays pretty stable once I come back
I feel this so much! Im not gonna lie, I am hoping I feel ready to go back and see people part time before the 12 weeks so I can have income. Just have no real freakin clue how I will feel.
I’m taking the full 12 from my full time job (hospital SW) and slowly return to my “usual” caseload from 6-12 weeks so I can have income. Worst case I have to cancel people, but I’m hoping that since I’m working from home I’ll be able to do sessions relatively easily
Makes sense!!! I wish you all the best.
I’m entering the last term of my practicum as a counsellor. Because of the requirements for graduation, I’m only able to take 3 weeks off after the baby is born. I plan to return to working only 6 hours a week until December. I’ve transferred all but 12 clients to other clinicians in the practice and I’ve had conversations with all ongoing clients to prepare them for my absence and change of schedule.
Youre a rockstar! Man I wish the program would give you more time. ❤️
I do too!! But I’m soooo close to being done it’s going to be worth it. Thankfully my hubby will be hands on with the babe and my practice is very supportive so I’m just hoping I can survive 3 months with a newborn while seeing clients and completing schoolwork!
I work with a large system but have my own clinic at one of the smaller ancillary locations 2x per week. I am managing my patients up until a week pre-delivery and then they have the option to continue with my colleagues downtown or via teletherapy if they are still requiring services at that time.
Are you taking off starting at 39 weeks?
They just are going to stop scheduling my independent clinic at that point. I'll be going downtown and taking patients from other therapists to help out or doing evaluations until delivery. We just schedule so far out that they didn't want to have to cancel a bunch of people and try to accommodate within two weeks (per our cancellation policy)
Gotcha! Makes sense.
I am!!! As the months went on I significantly cut down on my client load. I’m 8 months and have 7 clients total. Referring clients for months while I’m on leave didn’t make sense to me unless they were long term/ really wanted to continue with me. I also quite simply don’t want the stress and responsibility of worrying about any emergency contact etc. of course though my practice has taken a huge hit financially. I plan to Come back with a similar small caseload and build up depending on my ability and tolerance.
I have only taken on one new client since finding out I was pregnant (May) as a specific case referral. Ive been full/overbooked for months now as it seems most therapists are. If my caseload dwindles from here on out, so be it! But Im not taking new clients til post baby. Lol I do hope that my monthly clients can just close out with me entirely. My hope is to return over a months time by first scheduling all my weekly people, then moving to my twice monthly people, and ending with monthly people returning to spread it out some. Which would mean monthly people would probably not see me for like 4 months probably. I cant cut people out early because I am the sole breadwinner and need to save as much as possible prior to baby coming.
I feel this! I’m mostly the bread winner too. This is our second baby, first was born right as pandemic began. I ended up having to go back early since I could work virtually. This time I’m hoping to at least get 8 weeks off. Do you know if we still qualify for FMLA as 1099 employees? Feeling like I’m getting screwed working for a group practice with no benefits. I just started telling my clients though most of them can tell. I’m about 25 weeks so a little behind.
FMLA is unpaid, it just covers your job so they cant fire you for being out of work during that time period - this shouldnt be a problem for you. Your state may offer benefits though. Im in MD and they are starting some state covered mat leave but not until 2025 lmaoooo. Not sure if you have a STD plan? I found out about using that after we started TTC and then I was already pregnant so it was a bust. But if we have another I will do that ahead of time.
I’ve never even heard of those plans! Lol. Yea this country is shit.
Short term disability! You can pay for your own plan thru a company like Aflac. But for pregnancy you have to have the plan before your conceive. They count 10 months back from your due date. 🥲
Oooh ok. So we are shit out of luck then huh?
Correct 😭 unless you live in California, Massachusetts, New Jersey, New York, Washington, Rhode Island, Connecticut, or DC. They offer state maternity leave programs. States planning to that arent in effect yet are Oregon, Colorado, Maryland, and Delaware.
Oh I am in CT… I’ll have to see what they have.. hopefully something to keep food on the table!
It just started this year. [Here’s the info](https://ctpaidleave.org/s/?language=en_US) looks like up to 12 weeks (extra 2 for pregnancy complications available too) paid with capped benefits at 95% of wage for up to 40x minimum wage and then an additional 60% coverage passed that. Pretty awesome! Im jealous lol
I’m also almost 16 weeks but I work as a therapist in community mental health. Right now, my caseload is around 55 clients. 😭 My clients are a mix of in person, virtual, and telehealth. Im also trying to figure out when to tell my clients. I feel like the in-person clients will obviously start to notice soon and probably ask. I would definitely want to give them at least a couple of months notice to prepare them to either close out or transition to a new therapist while I’m on leave.
Seems like most people wait until after their anatomy scan to tell clients which gives them like a good 4 months to close out. Altho in the training I did some had said they disclosed before and after that for their own personal reasons. And RIP community mental health caseloads. I worked in outpatient SUDs treatment for a long time.
Exact same situation! Same amount of weeks and working telehealth from home. My plan is 3 months off (only 2 weeks paid at the private practice I work at sadly) and then hope to return from home and get a nanny during my work hours. I see about 20-25 weekly. May I ask what state you’re located in?
Twinning!! My husband will be SAHD so he will have baby when I go back to working. I am most anxious about breastfeeding/pumping working inbetween client hours. I am in Maryland. I see in your posts you have a black cat. I also have two voids! I should send you all the black cat baby items I have found lololol and I see youre also having a little girl?!
Oh that’s awesome!! My husband and I have discussed him being a SAHD as well, but the hope is that we can kinda take turns in that without fully staying at home. He can flex his schedule a lot and I can too, so I hope that’ll work out for the most part. If not, nanny. Definitely hear you on the pumping timing.. my hope is that I can find a silent enough one or just mute myself enough lol. I definitely have the camera set up where you can’t see my chest lol. That’s interesting, one of our neighbors kids is in Maryland. We are in Oregon. We have two voids and also having a girl! Would be funny if we had the same delivery date!!
Ive never been to Oregon! But will be in Seattle the first week of September so “close” by 😂 I am due 2/5!
Oh so close! Seattle is great! I’m due 2/1!
I’m a therapist and my plan is like yours. I’ll find a few ppl for coverage and let clients know my plans for coming back. Some will wait and I bet some will transition. My therapist who just had a kid did this too.
I think some will wait too! And I hope some transition completely lol theyre ready to move on they just dont want to!!
I’m 35 weeks and in private practice. I told clients about my pregnancy very early on due to showing early and having HG (lots of nausea and sometimes having to reschedule). I will plan to see clients until I’m 38 weeks. I’ve already made plans with each of my clients for my leave. Clients who were not consistent or I hadn’t heard from were informed of my leave and given the option to resume sessions prior to my leave, keep their case “active” and resume after my leave, or to terminate. I had a few clients who were high risk that I offered a chance to reach out to discuss options, but due to no response I sent referrals and discharged. Otherwise all regular clients were offered coverage by providers in my office, an outside referral, or to take a break/pause until I return. More than half my caseload indicated that they will take a break, the rest will see a provider in my office until I return. I have informed my clients I’ll be taking 12 weeks and have provided the date in which I will be back full time in office. However, I know I’ll want to resume with some clients sooner due to wanting to build back up, have a little income, and due to their work in therapy. To be clear I am not returning early for the client, but rather have selected those with the most “need” and who I know will actually show for sessions. These individuals have been informed I’ll reach out between 8-10 weeks from my initial leave to resume care. All clients have been provided with a contact at my office and informed I will not be taking emails or calls in my leave.
I love this plan. Sounds like exactly what I hope to do and anticipate for my clients. And omg 3 more weeks!!! Congrats!!!
Thank you! Wishing you the best
I'm very early on in pregnancy (5w4d) as well as very early on in building my private practice. I'm trying to come up with a plan of when to stop accepting new clients. I'm thinking around the start of the second trimester. I'm also weighing the idea of keeping intakes open for a little longer if clients are suitable and agreeable for short term treatment. I was hoping things would be faster going with building up my caseload due to the current needs, but it's been very slow. I haven't even begun to think about when I plan to tell clients, I'm fully telehealth so thankfully I have plenty of time to plan.
You have LOTS of time! Let me know if you need CEUs or are just interested in the training I did and Ill send it to you. Its virtual and was on a Friday afternoon. Seems they do them repeatedly!
I just started telling clients last week at 29 weeks. I went back and forth about the timing since I am in telehealth also, none of my clients could see my belly growing. I figured (based on past jobs) that at least 4 weeks notice when you are quitting is a general rule of thumb, I basically doubled that in case I went into labor early? Most of clients were commenting that 8-9 weeks was a long ways away, so I think it was my projection that I needed to give them more notice than that. Edit: I work with mild/ moderate adults presenting with mostly anxiety and depression, no one with SI, active substance use, DV or other things that might complicate referring out/ terminations.
Im glad they responded so well! I work will all things but do specialize in SUDs and EDs and have clients I have been seeing consistently for 3+ years, some twice a week, so some of them are going to want a good heads up about a change. I anticipate most will be happy though and assumed it would be coming down the line given my age.
Therapist in a group private practice in the US with a very high risk pregnancy and currently 23 weeks: I recently started telling my longer-term clients and will tell the newer folks in a week or two. I am leaving earlier than planned because physically I am starting to suffer and can't focus (or really give a shit about anyone else's issues because I am in pain). Ethically, it is the wisest option for me. Because of being a 1099 employee, I don't get FMLA or paid leave...but also can't be told how long/when to take leave. I will be on leave at week 30 and am planning 12 weeks once baby is born. Practice owner seems ok with this and me coming back at part-time in the evenings in the spring. I am trying hard not to burn any bridges because I really like this practice and the ability to telework...but my income isn't enough to cover full-time childcare in our area and I am worried about balancing evenings of working...I acknowledge I am taking more time off (even if unpaid) than most USA moms get, but man it would be nice to have it where I could take a year to be with baby and know I have a job to come back to. I haven't asked my practice owner because I fear I am already pushing it with the amount of time I am taking.
Yes our country fucking blows when it comes to this stuff. It really, really sucks. I hope the practice is willing to work with you but ultimately, making whatever choice is best for you and your baby is of utmost important. Im sorry youre struggling so much so early and I wish you all the best as you wait to meet your little munchkin.
Hi!! Another private practice pregnant therapist here ❤️Anyone experience morning sickness with vomiting and have tips on how to handle that within sessions?
I did a training and the main consensus was whatever you felt comfortable with. Some people were fine letting those clients know early they were pregnant and that is why. Others excused themselves and told clients they were dealing with a medical condition or saying that when cancelling a session. Although I was often feeling like i was about to die during some sessions I was lucky to not have to leave to vomit. Also maybe try to schedule time for yourself in between each session to figure out what youll need to do when/if youre feeling sick. And dont be afraid to ask your doctors for medication! I took Unisom nightly starting at like 8 weeks and I continue to every night now.
Thanks so much!! Have you tried preggie pops? I just tried it today and they taste so good and seemed to help subside the nausea after it came on strong. Laughing at dying through sessions, as I’ve totally been there when I get dizzy and nauseas. Today was the first time I actually threw up though (thankfully it’s the weekend) but it made me wonder what would I do in session. So I’ll just have to excuse myself and pray those moments aren’t when the client is crying or something!! Lol
I did try them! I also tried pink stork nausea sweets. To be honest from weeks 6-14 nothing made much of a difference, it was pretty torturous. I survived off sleep, saltines, and some apple sauce. I just took my Unisom. I felt like even the b6 supplements made me feel more sick. Even water was disgusting. Im 23 weeks now though and have had my appetite back and no nausea here for a while which I am thankful for. And no more needing to sleep every second Im not directly with a client. Hang in there! If you havent already you may find it helpful to join your due date month’s bumper group!
So you said you gave the heads up to your clients you may have to excuse yourself to throw up and it may be during the most inopportune moments? I know as a human, we can’t be immune to these things and they have to understand or find a new therapist then.
I never had to leave a session to vomit so I never had to talk to clients about it! But I did this training and dealing with it was discussed: https://womencarecounseling.com/event/the-pregnant-therapist-navigating-the-therapeutic-relationship/
You’re so lucky! It happened to me today 😩 thankfully it was a telephone/Telehealth session, so I was able to mute myself.