When the Therapist is in Crisis: Personal and Professional Implications for Small Community Psychotherapy Practices

Nine years ago our son was seriously injured; our lives, previously so private, suddenly became very exposed. As a therapist in a small community, I do not have the luxury of much privacy or anonymity. When I experienced this sudden crisis, practical and psychodynamic issues came into play in my therapeutic relationships. My husband and I each have private practices with offices in the same building and previously also in our home. We faced new challenges while attempting to provide for our clients and care for our son. There were issues of coverage for our practice, how much information about our crisis to reveal, and coping once we felt ready to return to work. Likewise, we have colleagues who have also experienced turmoil in their personal lives from serious illness or addiction, death of a spouse, or divorce. This article is a result of conversations with some of these colleagues as well as our own experience. The article addresses the issues therapists struggle when in a crisis, such as losing privacy, setting limitations on work, handling client reactions, and becoming aware of and managing feelings and behaviors when one is vulnerable. It also offers suggestions to therapists for preparing to meet client needs in the event such crises arise.