My ideal caseload is only ten to an absolute maximum of fifteen clients a week. My choosing to have a small caseload is definitely to your advantage. When I worked at a mental health center, we were strongly encouraged to meet with 30 clients a week. Some counselors in private practice see as many as 40 plus! While scheduling a lot of sessions is good for a therapist’s pocket book, it’s not good for you. You don’t want a burned-out therapist. You want someone who’s doing the work for the joy of it, not financial necessity. When I reach my chosen capacity, I keep a waiting list.
Working with a deliberately small caseload is especially important for the way I work. Sadly, the default, “modus operandi” of traditional counseling is to ask “How was your week,” followed by, “And how do you feel about that?” How easy for a counselor employing this approach. Yes, relating your week might feel good, however this is not necessarily correlated with your positively evolving. Friends or coffee-groups can serve this same, basic purpose. Simply being listened to does not necessarily correlate with your personal evolving beyond your issues. My bias, and experience, has been that evolving beyond personal issues entails employing a different approach. These different, more powerful modalities involve preparation. I feel a responsibility to help the client quickly, gracefully evolve beyond their issues. Having a deliberately small caseload gives me the necessary time to prepare cogent, effective interventions.
Yes, I initially had concerns regarding the efficacy working via telecommunication. I was pleasantly surprised. The sessions offer remarkable flexibility for distant clients in terms of scheduling and ease of access. All that’s necessary is the client creating a quiet space and time within their home.
I even worked with one woman whose quietest, safest spot, as she lived with an abusive spouse, was in her vehicle. She would drive to a safe, quiet location and access me via teleconferencing. When I realized she was in her vehicle, I was tempted to reschedule the session. She explained, with an abusive spouse, the vehicle was the safest and most private place for her. I learn a lot from clients. Our sessions went tremendously, and she’s safe and out of the abusive relationship now. She’s upgraded her employment and finances. She’s also involved in a healthy, new relationship.
So, if Skyping and Zooming are your best option, it can work. All you need is a stable internet access, and a quiet, safe spot. On one occasion, the internet went down, and we were able to resume the session via cellphones. The session proceeded and went well.