Just curious

[LadyHalcyon]

How many individual therapy sessions can you have in a day before you are just done. I think mine is 7, maybe even 6 depending how they are spaced out.

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[calimich]

interesting question...I see clients one day a week in private practice and am finding my limit to be about the same as yours. There have been a few weeks when I saw 8 clients in 9 hours (4 in a row, lunch, repeat) and that did not feel sustainable; 6 in 9 feels "easy" and 7 in 9 just about right. I'm new to private practice and still figuring out the most efficient billing/admin workflow so that I really can be done with the practice when I leave at 5pm in order to be fully present with family when I'm home.

also curious to hear how others manage this

 

[Groupthink]

6 clients in an 8 hour day is sustainable for me. I am exhausted if I push to 7. But I also supervise trainees, teach seminars, and cover crisis walk-ins, so my time and responsibilities are varied. If I was only seeing clients, I could probably do 7 a day.

TBH, I still feel as if I'm on the road to burnout. I'm within a year of having received my license, so I'm hoping this feeling will go away once I have more experience.

 

[FreudianSlippers]

As a post-doc at a counseling cent erwe typically see 4 to 6 per day. Do you all stick to 45-50 minute sessions and just try to finish all charting in the 10 minutes after each session?

 

[LadyHalcyon]

I'm bad. I tend to do full hour sessions and save my notes for later but I know I'm rare and many of my coworkers due the 45 min session. BUT if billing an hour for certain Medicaid then it has to be at least 53 min

As a post-doc at a counseling cent erwe typically see 4 to 6 per day. Do you all stick to 45-50 minute sessions and just try to finish all charting in the 10 minutes after each session?

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[LadyHalcyon]

interesting question...I see clients one day a week in private practice and am finding my limit to be about the same as yours. There have been a few weeks when I saw 8 clients in 9 hours (4 in a row, lunch, repeat) and that did not feel sustainable; 6 in 9 feels "easy" and 7 in 9 just about right. I'm new to private practice and still figuring out the most efficient billing/admin workflow so that I really can be done with the practice when I leave at 5pm in order to be fully present with family when I'm home.

also curious to hear how others manage this

I agree. 7 in 9 is ok but 8 in 9 hours is no bueno. I think 7 may be my limit

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[Therapist4Chnge]

I do 4-7 sessions per day (it’s a mix of intakes, feedback sessions, psychoeducation, and brief interventions). I’ve found anything more than 4-5 makes me cranky bc I’m not a people person. I very much prefer to do my evals, feedbacks, and refer out. I’m finally starting to hire mid-levels to hand off all of the follow up appts.

 

[LadyHalcyon]

I do 4-7 sessions per day (it’s a mix of intakes, feedback sessions, psychoeducation, and brief interventions). I’ve found anything more than 4-5 makes me cranky bc I’m not a people person. I very much prefer to do my evals, feedbacks, and refer out. I’m finally starting to hire mid-levels to hand off all of the follow up appts.

I think I want to do this. In an ideal future I would like forensic evaluations to be about 30% of my business, maybe 50% be therapy, and then I would like to supervise etc

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[Therapist4Chnge]

My ideal split would be 1-2 IME’s per month, a few neuropsych evals per week, and a couple of pre-surg evals per week. I’ll do the feedback sessions and I hand off the follow-up work to mid-levels. I don’t mind doing some educational and behavioral interventions for a handful of sessions, but I have zero desire to do any kind of traditional therapy; it’d be less than zero if that were possible.

 

[deleted343839]

I don't love doing evals but I quite enjoy providing short-term psychotherapy and carrying a handful of long-term cases. In an 8-hour day, I am happiest with 6 sessions but can do 7, especially if most of those are established patients. 7 sessions in 9 hours would be OK too. Especially if only one day/week.

 

[LadyHalcyon]

I don't love doing evals but I quite enjoy providing short-term psychotherapy and carrying a handful of long-term cases. In an 8-hour day, I am happiest with 6 sessions but can do 7, especially if most of those are established patients. 7 sessions in 9 hours would be OK too. Especially if only one day/week.

I also love therapy too but I really think that 6 is my ideal and 7 is my limit

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[calimich]

As a post-doc at a counseling cent erwe typically see 4 to 6 per day. Do you all stick to 45-50 minute sessions and just try to finish all charting in the 10 minutes after each session?

I do stick to the 50 min session -- although in my very first private practice session I totally lost track and went the full hour. Although it had been a few years since intern & postdoc (also at a UCC), I think I was still operating on their schedule where we started sessions 15 mins after the hour and ended on the hour; their policy was to complete all notes same day so I became efficient at ending sessions on time and getting my note done. Of course intakes take a bit longer to write up.

I'm also navigating when to collect $$. I take insurance so there is a copay, and I currently have one full fee cash client; some pay at the beginning, some at the end. Most pay the copay with a credit/debit card, but there are a few who pay cash and at first I was unprepared to give change back.

Folks who bill insurance, do you submit claims weekly? every other week? monthly?

 

[ClinicalABA]

I usually do 3-4 assessments/feedbacks ( ~3 hours direct patient contact), 3 50-minute intakes, and maybe a 2 hour home-based BCBA supervision or parent training session per week. I max at around 4-5 patient contact hours per day. Did some full days of intakes recently (6 clients, 50 min.each), and thought I would either go insane or fall asleep by the 4th or 5th one).

Some of what I can do is related to the age of the kiddo I’m testing. Kids under 3 aren’t that tiring. Kiddos 3.5-4.5 are exhausting! They’re too old for the Baylee-III norms, but often too young to be interested in the stimulus materials of the WPPPSI-IV/SB-5 and the PLS-5 (too many “point to the picture type items). They require a lot of redirection, herding back to the table (which is still really small for me to be getting up and down from so much,), and mentally exhausting negotiation of the next task/break cycle). 2-3 hours of that in a day and I’m done!

 

[WisNeuro]

I'm at 3-4 evals a week outpatient. Inpatient varies quite a bit, but I may see 1-2 brief evals on inpatient units a week. In at 7, out by 2-2:30 most days.

 

[dynamicdog]

Right now I see about 25 psychotherapy patients in a 3 day period and that is because office rental is so high where I am that I feel I need to make the most of it. I don't ever see more than 5 people back to back and usually that number is 4 or less. I try to have "lunch" or at least an hour break after seeing that many people. I also try to get outside, take walk, etc. Additionally, I tend to do about 1-2 private psych assessments a month. I'm busy, which is good and bad.

One thing I am noticing is different types of patients take different amounts out of me. For instance, I can't see multiple children under 14 in a row (in fact I won't see children on the insurance panels I take anymore) but I could see 4-5 college students/early 20s individuals. I also won't do more than 2 couples in a day.

OP, good question and something I am continually evaluating and re-evaluating.

 

[LadyHalcyon]

Right now I see about 25 psychotherapy patients in a 3 day period and that is because office rental is so high where I am that I feel I need to make the most of it. I don't ever see more than 5 people back to back and usually that number is 4 or less. I try to have "lunch" or at least an hour break after seeing that many people. I also try to get outside, take walk, etc. Additionally, I tend to do about 1-2 private psych assessments a month. I'm busy, which is good and bad.

One thing I am noticing is different types of patients take different amounts out of me. For instance, I can't see multiple children under 14 in a row (in fact I won't see children on the insurance panels I take anymore) but I could see 4-5 college students/early 20s individuals. I also won't do more than 2 couples in a day.

OP, good question and something I am continually evaluating and re-evaluating.

That is pretty much exactly how my schedule is set up; this is my second week. I have 3 therapy days and one testing day. Every other Monday I will also be working on forensic evaluations. I think 4 in a row is my limit and 7 in one day, although there have been a few days where I saw 8 and I felt drained and not present. I also have been seeing more teens these past two weeks, a population I haven't really worked with since 2014. It's interesting the comment you make about children because I too am discovering it's more exhausting and not as fulfilling in some ways.

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[cara susanna]

My limit is 6, pretty much. Which is interesting because I've learned that, even if the sessions are brief (like 20-30 min in the Primary Care setting), it doesn't make any difference in how tired I feel at the end of the day. You'd think briefer sessions would raise my limit, but nope.

 

[calimich]

very interesting to notice how different clients take different kinds of energy from us. I currently have two clients where 90% of our sessions are in Spanish. Scheduling them back to back is definitely easier for me than switching languages by the hour.

edited to add: and my Spanish speaking clients are from different countries, so somewhat different local dialects, different slang, different cadence of speech. I certainly feel challenged and rewarded through my work with them.

 

[awishingstar]

I'm in private practice. I book 7 a day, after cancellations and no-shows I tend to average 5-6 a day. 5 is PERFECT, 6 is doable, 7 is exhausting if it's stacked poorly but can be fine too. I'm taking on more assessments lately so I'm hoping to have 2-3 mornings that are just one assessment + report writing.