By Emily Hanlon
When I found out I was pregnant, I was obviously excited and over the moon! But trying to navigate extreme morning sickness while keeping the pregnancy quiet in my first trimester was extremely challenging! During those first 19 weeks, I was so unwell that in between clients I would have an ice pack on my head, anti-nausea medication on standby, and salty crackers by the dozen.
But, by far the trickiest part of being a pregnant psychologist, was informing the families I work with, that I would be going on leave. Now, don’t get me wrong, 99% of my families were absolutely ecstatic for me and started buying me little baby gifts almost immediately. However, as anyone who has changed jobs or gone on extended leave as a psychologist knows, transitioning your clients to colleagues is a complex and tricky experience. For me, this happened in four stages.
Stage One: Telling Parents.
I was actually quite anxious to tell the families I work with, which turned out to be unnecessary (just goes to show that I need to take my own advice on worrying once in a while!!) I told the parents of my younger clients prior to telling my clients. For me personally, this felt most appropriate. For my older clients, it varied depending on their cognitive capacity. I made the decision on a case-by-case basis whether to tell them with their parents or wait and tell the parents first.
Before telling clients and families, my number one piece of advice is to try and have answers to the questions you anticipate them asking. I anticipated that my clients would ask me:
1. When are you due?
2. When are you going on leave?
3. Are you going to come back?
4. How long are you going on leave for?
5. Do you have anyone here you would recommend we see?
I had answers ready for all these questions which, in my opinion, showed my clients that I had genuinely considered their interests in this situation and not just my own. Now, because no one can ever be sure what the future holds, I would answered the questions like this:
1. When are you due?May 25th is my due date, but I guess the baby will let me know when he is ready!
2. When are you going on leave?I’m planning on going on leave on XXX, but I will organize handovers before this so that I am still around for a week or two to help figure out any issues that may arise.
3. Are you going to come back?That is most definitely my plan right now!
4. How long are you going on leave for? I’m planning on coming back on XXX, but it will all depend on how both myself and the baby are travelling.
5. Do you have anyone here you would recommend we see? My job for the next month is to sit and match my clients with our clinicians. Everyone who works here are excellent at their jobs! I just want to make sure that I can match clients with clinicians who I think they will connect with. As soon as I have more of a plan, I will let you know!
Telling parents, for me, was relatively simple. Like I said, most families were very happy for me and the first questions they asked me were ‘how have you been feeling?!’ Some of the families I work with who have children with autism and other disabilities, were understandably nervous about how their child would cope with such a big change in their routine. Here, I would assure the family that we would take as much time with the handover as necessary.
Stage Two: Telling Clients.
Most of my clients were extremely excited about the fact that I had a baby in my belly. They wanted to know whether it was a boy or a girl and most would ask if they could touch my belly. For younger clients (under 10), I would praise them for asking permission first and then would allow them to do this. This was a very personal decision and one that I understand not everyone is comfortable making, so if you are not comfortable doing this, you can say something like: ‘you know, the baby isn’t actually moving yet so there’s nothing to feel! But how about we draw a picture of what you think the baby is going to look like.’ This is a script I would use for some of my older clients with high-needs disabilities, not because I felt uncomfortable, but because I didn’t want them thinking it was OK to do this to women in the community who may not feel comfortable.
When telling clients, I think it is important to tell them that you’ll need to take some time off to look after the baby. Some clients have taken this well, while others have asked why my husband can’t be the one to stay home and watch the baby! A couple of my older disability clients have been a little upset and have said things like ‘you’re leaving me just like everyone else’ This is tricky, as unfortunately in the disability sector, there is a lot of staff turnover with regards to support workers, so sadly, this is something that these clients deal with frequently. For me personally, I have found that it has helped to emphasis that I am not leaving but rather going on leave and having a discussion of exactly what this means.
Regardless of their reaction, taking time to talk through the process and acknowledging their worries, is a very important part of the whole process.
Stage Three: Including Clients in the Process.
For those of you who follow me on Instagram, you would have seen that I created a ‘name suggestion’ list. I keep it on my white board in my clinic room and encourage my clients to leave name suggestions. DISCLAIMER: you will get some absolutely outrageous yet hilarious suggestions. But it is a really fun way to include them in the process. Another way I have included clients in the process is to have a poster up in the office showing what kind/size of fruit the baby is each week. My clients seem to find this both fascinating and hilarious all at the same time!
Once I had taken time to match my clients to clinicians, I made sure I did handovers with all clinicians. Please note: it is really important not to tell the clients the name of the clinicians you have suggested until you have run the case by the clinician and they agree that they feel that it is a suitable match for them! This also gives me an opportunity to let the clinician know anything specific that the client needs in session. This may include a visual schedule, the incentive of a prize box, access to a sensory box, and so on.
After the hand overs have been completed, I inform the families of my choice, and encourage them to read the clinicians profile on our website. It is only THEN, that I talk to my client about the clinician I have chosen. I may show them photos from the website and give them five cool (pre-determined and approved) facts about the clinician that I think will help develop rapport.
Stage 4: Handing Over Clients.
It is not always possible as I work different days to some of the clinicians I am handing over to, but where possible, I have tried to introduce my clients to their new therapist while I am in session. For example, I may tell the client that the new therapist is coming in and spend a few minutes discussing this. I’ve then brought in the new therapist and spent 10 minutes with all of us in the room. Then I’ll say something like ‘you know what, XXX is really good at UNO. He is actually the UNO king. How about I step out for a second and you guys can play a game so he can show you how epic he is?’ If it’s going well, I’ll then step out and give them some time. When I go back in, the new therapist, if there is time, may spend 5 minutes with the parent just quickly introducing themselves. If a face to face handover is impossible, I just encourage the new therapist to take as much time rapport building as possible!
One thing I have done as well, is have a backup plan for every client. As you would all know, not every therapist is a good match for every client, and that is ok! It’s no one’s fault; it is just the way it is. By having a backup plan, you are able to quickly resolve any issues that may arise with minimal stress, all before the baby is even born! I’ve also made sure to leave this list with the admin team so that, if the issues arise after I am already on leave, there is still a plan for everyone to follow.
As you can see, it is a lengthy process. Currently, I have 59 clients on my caseload, so organising their transfers has been no easy feat!! But it is such an important thing to consider when going on leave, for both myself and my clients!