The holidays have come and gone, so I have a question for you: Did you take some time off for vacation?
“Vacation? What vacation?” you might be asking yourself, particularly if you’re in private practice and every session can mean a bill paid, or if you’re getting your hours and every session is a step closer to 500 or 1000. Maybe you’re concerned about how your clients would do without you, and visions of What About Bob? dance through your head.
The holidays are a stressful time for many people, and some clients may have felt they needed you more than ever during this period of parties, families, gifts, and great “cheer.” You might have felt tempted to be more available than usual – maybe by phone or text – to get through the special occasions. Who could have left during this time without risking AAMFT Code of Ethics 1.11 Non-Abandonment? “Marriage and family therapists do not abandon or neglect clients in treatment without making reasonable arrangements for the continuation of treatment.”
The key to abiding by this standard is the clause “making reasonable arrangements for the continuation of treatment.” Reasonable arrangements can include a number of things regarding a vacation period. First, have a couple of sessions in which you tell the client you will be taking a vacation. Communicate in a positive manner, without apology and without many details about where you’re going (or if it’s a staycation). As with any self-disclosure, the only necessary information is directly relevant to the client; i.e., that you aren’t going to be available for a specific period of time. Bring it up over the course of a couple of sessions to process feelings, giving you the opportunity to get through immediate reactions such as anger, fear, or bravado. For the sessions leading up to vacation, do your best to avoid “deep dives” into trauma or conflict. Instead, discuss issues that may develop while you’re out and outline coping mechanisms the client can employ. You could develop a written safety plan noting potential scenarios and resources, or co-create a “transitional object” (e.g., rock, blanket) for clients to use to ground themselves while you’re gone. You can also talk about this vacation as your self-care, modeling for the client that you “practice what you preach.”
A second reasonable arrangement is finding a colleague willing to be available to your clients in case of emergency. It is helpful, though often not practically feasible, to introduce client and colleague. At a minimum, talk to clients about your colleague and why you chose that person to stand in your stead. Be sure to talk with your colleague about compensation, or lack thereof. For example, if there is no emergency while you’re gone, does the colleague expect any remuneration? If there is contact by phone call but not in person, is there a fee earned? Get everything in writing.
Why would one take a vacation, though, if it’s going to necessitate all this preparation? Dictionary.com defines vacation as “a period of suspension of work, study, or other activity, usually used for rest, recreation or travel; freedom or release from duty, business, or activity.” Rest, freedom, and release are all important qualities that are not possible if a therapist is still checking emails or taking phone calls and texts. True vacations require protections of your boundaries to actually “get away,” mentally even if not physically. Failure to rejuvenate increases the risk of compassion fatigue, burnout, and impairment, eventually prompting another standard of the Code of Ethics: 3.3 Seek Assistance. “Marriage and family therapists seek appropriate professional assistance for issues that may impair work performance or clinical judgment.”
So for those that have taken a vacation, bravo! For those who have not, be sure to take your vacation, knowing that you’ve made reasonable arrangements for your clients. As a result of this self-care, you might even find that you do better therapy in the long run!
Dr. Laura Bryan, LMFT, is the Ethics Committee Chair for the North Carolina Association for Marriage and Family Therapy. She is the Site Director for the Marriage and Family Therapy Program at Pfeiffer University (Raleigh/Durham campus). She follows her own advice about vacation in various locations, most recently in the Outer Banks of NC!