3 Ways to Maximize Your Clinical Hours

“I wish it need not have happened in my time,” said Frodo.

“So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.”

You don’t have to be familiar with Tolkien’s epic works for those lines to resonate these days.

This once-in-a-century plague has fundamentally changed what was supposed to be your perfect job, practicum, internship, and fellowship.

We’ve embarked on an unexpected journey of therapy meetings over Zoom, with our sneaky sweatpants under button-ups and ties (oh yes, we all do it). We’ve dealt with the desolation of work-life boundaries, wrestled with the loss of connection with clients and coworkers, and persisted despite feeling like butter scraped over too much bread.

There are fewer in-person events and responsibilities, and, for a significant chunk of 2020, there were fewer clients to see. The trend of people seeking mental health services appears to be going back up, but many of you are still struggling to get the clinical hours you need for program requirements, licensure, and financial stability.

Know that you are not alone, and know that you have options.

So, how should you use the time you’ve been given?  Let’s dive in.

Making the Most Out of Your Time

When the pandemic first began, I experienced a sizeable drop in my caseload.

People didn’t really like the idea of teletherapy (and they were a lot more stressed about things like finding toilet paper, hand sanitizer, and beans). And at first, I totally kicked back and used the spare time to relax. After all, back in March, we thought the pandemic was only going to last for a month. But here we are, and it looks like things are going to stay this way for a while.

Even before the COVID crisis, though, students and clinicians were struggling to make the most out of their time — not because we are lazy or unmotivated, not because we don’t know what to do, but rather because of what we decide to do with the time that is given.  

So, how do we make better choices with our time?  Here are three ways you can get the most out of your clinical hours.

1. Be Flexible

When I first started working in private practice (before the pandemic started), the eight-to-five Monday through Friday workflow was fully ingrained in my system. After years of practicum and internship training experiences that required being on-site during specific times of the day, something just felt right about maintaining those hours.

After a few months of setting my available hours to fit that frame, I realized that certain blocks never got filled. My mornings were always empty. My afternoons and noon-o-clock slots were constantly overbooked. What was going on?

I eventually realized a few “well, duh!” reasons for this:

1. Kids and teens go to school during business hours. As someone who works primarily with younger clients, this was a barrier to doing the kind of work I most valued.
2. Working adults can’t always afford to take time off in the middle of the day. Plus, (effective) therapy brings up strong emotions, and not everyone feels comfortable going from having those and then immediately going back to work.
3. People don’t always like waking up before 8am. (As a morning person, I’ll never understand this!)

My solution?  I changed up my schedule.

I started doing 4-10s (four days a week for ten-hour blocks). I tried taking certain weekdays off and working on weekends instead. I set up some days to start early in the morning while others extended into the late evening. Before I knew it, my clinical schedule was totally filled up.

Here are a few more ways to use flexibility to gain more clinical hours:

• If you have the proper supervision and training, consider working with a population or a presenting concern that has more demand than your setting is able to meet. For example, if your scheduling team is always turning away couples seeking couples counseling, you could gain a few more hours by being willing to add that kind of work to your schedule.
• Consider adding a supplemental practicum or internship on the side if your current one isn’t giving you enough client hours.
• Consider other activities that aren’t clinical per se, but still count towards your total hour count. To learn more, check out this article.

While some organizations may still have certain requirements for how you use your time, chances are there is some room for you to make changes in order to maximize direct client service — all you have to do is ask.

Speaking of which, let’s move to our next tip.

2. Be Assertive

Graduate school teaches us so many important skills: how to convey empathy, how to accurately diagnose, how to practice ethically, and more.

However, grad school doesn’t really teach us how to be assertive. So, you might be struggling to get hours — but are you making a strong enough push for what you need?  In a world where mental health professionals are unable to keep up with the unending demand for psychotherapy and assessment services, why would you not be getting the time you need?

Be willing to be a self-advocate and ask for what you need. Tell your supervisor, manager, or program director that you aren’t getting the hours you need. If you’ve told them once, tell them again (and keep on trying — the squeaky wheel gets the grease!). You may even have to consider moving on or adding another practicum if your current practicum, internship, or job isn’t giving you what you need.

Some tips for being an assertive self-advocate:

1. Stand up for yourself the way you would for a friend or colleague.
2. Communicate through multiple channels (in person, email, phone call).
3. Clearly state that you aren’t getting the clinical hours that you need based on your contract, training requirements, or licensure requirements. Come to the meeting with suggestions for how to remedy the situation or ask them to make a plan with you.
4. Be willing to do the risky thing of leaving a comfortable position in order to do the work you want.

So, what if you’ve tried being flexible and you’ve been as assertive as you can be?  That brings us to our third and final tip.

3. Be Creative

I don’t just mean you should be creative with how you use your time — I want you to use your time to create.

Build your own website. Publish an awesome blog post, or go all in and write a book. Make a video designed to help your ideal client (here’s one I made to help parents of kids who are struggling in school). Design an informational brochure or handout for your clinic on a topic that you know a lot about. You can create something that others can use while also furthering your personal goals.

Although you can’t always count creative works in your clinical hours, there are so many reasons why you should consider creating with your additional time. Let me give you three:

Reason #1 — Impact

Mental health professionals have the opportunity to reach people far beyond the therapy office. Whether you are a graduate student or a longtime practitioner, your community can really benefit from your knowledge, wisdom, and insight. You have the power to make our world a better place by sharing psychology with others through writing, speaking, and other creative pursuits.

Reason #2 — Money

If you are struggling to make ends meet because of reduced clinical hours, you can use your time to provide for yourself by creating works that generate income. For example, I wrote a book while I was a humble (totally broke) grad student. My book creates passive income, meaning I don’t have to do anything with it and it brings in a good chunk of change each month.

Reason #3 — Prestige

If you are trying to land the perfect internship, fellowship, or job, nothing quite raises eyebrows (in a good way!) than having a creative work on your CV. It’ll be a lot easier to get an interview at a child therapy clinic if you wrote a book on therapy for kids, for example. Even smaller creations, such as a guest post or a short video published on YouTube, can serve as talking points in your interview or cover letter.

Here are a few specific creative things you could start today:

1. Start a blog series on your favorite counseling topic and post it on your Facebook, LinkedIn, or other social media profile
2. Make a video for prospective students looking to join the field where you talk about your experiences and offer advice to others
3. Paint or draw a feelings wheel or emotion chart for your clinic to display
4. Submit for a poster or session presentation at APA or your state psychological association conference
5. Write a mini-book, even just 15-20 pages, and publish it on Amazon (it’s free!)

Sendoff

When I was learning to drive, my dad taught me where to hold my vision.

Focus on what’s close by, but keep looking ahead to the distant road.

He wanted me to be aware of immediate dangers while also having a strong sense of where we were headed.

Let’s be real. Stressed out, starving graduate students aren’t privileged enough to think beyond this week, this month, or this year. You shouldn’t neglect those short-term needs. Take care of yourself and your family.

But also, keep coming back to that distant road, and find ways to honor the hours yet to come. Change things up, be assertive, and create something new so that where you are headed is better than where you are today. You deserve nothing less.