Thank you to everyone who responded to our February Clinician's Quandary. Here are some of the top responses! Submit to next month's Clinician's Quandary here.
February Quandary: My office is in my home, which means clients sometimes observe elements of my personal life. I’ve had clients ask me about my electric car in the driveway, whether they can pet my dog (who sometimes barks), and where my kids go to school (there are often toys in the yard). In the past, I’ve gently asked these clients if we can stay on topic, but I worry that response seems callous. I'd love some creative examples of how others have dealt with this in their practices.
1) Assume Good Intentions
Willie Nelson’s father once said, “If you build a house of quality in the woods, the world will beat a path to your door.” So yes, while having an office in your home can be wonderful, convenient, and the shortest commute ever, there’s plenty not to like: a lack of privacy, nosey neighbors, nosey clients, an ongoing fear of being “Zillowed,” and freaking out that clients could slip and fall on an icy walkway and sue you into oblivion.
As a therapist who works from home, I’d assume good intentions and view personal questions as opportunities to join with clients and, while not disclosing too much personal information, to reassure them that I’m a regular person, just like they are. If that doesn’t work, there’s always the option of launching into a breathless, boring, and minutely detailed speech about your dog, car, kids, and then saying something along the lines of “Oh gee, I forgot to ask about [whatever therapeutic issue you and the client might’ve been dealing with].”
Since coming to a home office can spike people’s anxiety, I like to put prospective clients at ease by having pictures on my website of the entrance to my office. I also let them know during our initial phone call that my office is attached to a house in a residential neighborhood. Then, I ask if they have any questions. A home office may not be for everyone, but for therapists who have one, it can be yet another way to experience the work we do.
Jay Lappin, LCSW
Haddon Township, NJ
2) Look for Opportunities to Deepen Therapy
Having a home office is a powerful form of self-disclosure. Not answering the personal questions that clients tend to ask when they’re in your home does feel cold to me. After all, you’ve already revealed your values, tastes, and lifestyle.
My client Candace was a single woman in her mid-30s. Every time she came in for an appointment, she had to walk past the rows of kids’ coats in the hall, my sometimes-messy kitchen, and into my waiting room with toys and games stuck in corners. The reality of my family life was everywhere. It reflected all that she yearned for and couldn’t make happen in her own life: having a family.
Naturally, we hadn’t discussed her feelings about my home. But about a year into her treatment, I opened the door to my office and she was in tears. I asked what was wrong. She gave a sweeping arm gesture that encompassed the room and said, “All this. The feel of all this is the only thing I ever wanted.” Then she sobbed hard. I sat down on the sofa next to her as she wept.
The issue really isn’t to self-disclose or not. In your home office, you already have. The key to successful self-disclosure is making sure it’s serving the client. I share that my marriage and family life have had plenty of struggles (including keeping a neat kitchen!). But it’s always in the hopes of normalizing the challenges of everyday life to help people feel less critical of themselves, and ultimately, less alone.
The day that Candace broke down in my waiting room deepened our connection, and our therapy truly began. I wish I’d asked her what it was like coming into my home sooner.
David Treadway, PhD
3) Watch Out for Slippery Slopes
I think that answering a client's questions about your personal life—as innocent as they might seem—could actually lead down a slippery, counter-therapeutic slope. Therapists should feel no more obliged to answer extraneous queries than clients should feel compelled to share something they're not yet emotionally prepared to share.
If this therapist does respond to his clients’ personal questions, he is in boundary-crossing territory and has indirectly invited his clients into that space. Therapist disclosure can be tricky and requires both good clinical judgment and considerable constraint. After all, we all like to talk about ourselves!
If I was in this clinician’s position, I might respond by saying something like, “Interesting that you'd pick up on this. It must be funny to see me not just as your therapist, but as a family member, spouse, parent, and pet owner. Might that somehow feel a little strange or awkward to you? What do you think might be underlying your question? Is that something maybe worth talking about? I wonder whether it might be challenging for you to see me in a kind of restrictive role with you. How might that feel?”
Leon Seltzer, PhD
Del Mar, CA
4) Welcome the Client’s Parts
In deciding to have a home office, I knew I’d need to be comfortable with clients seeing “more of me” than I was used to. If they ring the bell before I get to the door, the dogs—crated upstairs—will bark enthusiastically. In fact, our first exchange is often about the dogs: What breed are they? How old are they? Inevitably, as I answer these questions, we begin to connect over our mutual love of dogs. The more personal questions about kids, cars, and family may come later.
Depending on the client, I might say something like, “I’m willing to answer your questions, but before I do, can you tell me about the part of you that’s asking? Is the part hoping for any particular answer?” If I answer the questions, I might ask, “How is it to hear my answers? Are any a surprise? Do they make you feel any more or less connected to me? More or less confident that I can help you?”
If I’m not comfortable answering a question, I’ll say so, and encourage the client to talk about what it feels like to hear me say that. Typically, clients recognize and appreciate my modeling boundary setting and self-care.
At least for me, seeing clients in my home seems to level the playing field in a way that results in a deeper connection. Just last week a client was telling me that he never felt like he had a voice in his family. He felt like his emotions—anger, in particular—were muted. As soon as he finished his sentence, we heard my teenage daughter screaming at someone from somewhere in the house. We both just smiled. Obviously, all parts are welcome here!
Tish Miller, LCSW
5) Have a Contract
In my experience, clients have been very respectful of the boundaries I establish at the beginning of the counseling relationship. I’d recommend this clinician have her clients sign a document at the beginning of treatment acknowledging that they understand the uniqueness of her boundaries in having a home office. That way, she can eliminate the risk of needing to address this further during treatment, which could damage the therapeutic relationship.
I’d also recommend this therapist minimize the personal elements in and around her office, like children’s toys, or create privacy by putting fencing around parts of the house that aren’t part of the office. If you’ve decided to make your home your primary place of business, personal privacy and safety should be a high priority.
Debra Newman, LPC
We'll post a new response to each Clinician's Quandary on the first Tuesday of every month! See how to submit to next month's Quandary here.
March Quandary: My client Raisa is a sophomore in high school. She says the girls in her class are bullying her with insults like “slut” and “whore.” The mother has been in touch with the school, but the administrators said there’s not much they can do and that teenagers say things like that. Raisa is incredibly distressed by it all. How can I help her?
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