Today we’d like to introduce you to Sarah Fargo O’Brien.
Alright, so thank you so much for sharing your story and insight with our readers. To kick things off, can you tell us a bit about how you got started?
Well, I knew a long time ago I wanted to be a therapist. In fact, I wrote my college entrance essay on the dream of having my own private practice and walking to work everyday. Fast forward about 20 years and I’m living that dream! But it didn’t start off that easy or rosy.
My first several years as an MSW came with tough work environments. Some, most, had bad leadership and little support. All were extremely stressful positions with little pay. I worked in Mental Health Skill Building at Richmond Behavioral Health Authority as my first job out of graduate school. This required me to meet with clients at their home and transport them to necessary places in the community. As a white person working with mostly black clients, and zero training for this dynamic, I had to rely on my own personality and street-smarts, so to say, to connect with clients living very different lives than I was. Although it wasn’t the most ideal work situation, my clients were not the issue. I was able to connect over things like music, TV, movies, food, and pets and build excellent rapport with everyone I was there to serve. It was great experience even though changes in leadership and job requirements, with little to no support for obtaining licensure, put me in a position to find new employment.
I thought my next position would be a little better, as a now Licensed Clinical Social Worker, working as an outpatient clinician for Hanover County CSB, I was mostly office-based with limited in-the-community expectations. Although a few of those were incredibly stressful and at times felt unsafe and unethical. For example, visiting open clients who had been incarcerated at the jail. No one walked me through this and yet I had to show up and just figure it out along the way, not ideal. Also, on-call shifts for the entire county where I was responsible for completing TDO assessments for crisis hospitalization, overnight, by myself, was the most stressful and most dangerous part of the job. Working all day to then being up all night and driving home 30 minutes in the morning started to feel scary when I was foggy, groggy, and hazy. I advocated for my needs as a worker and for policies to potentially be adjusted to offer more comprehensive support for social workers on the ground level of care, but was rebuffed and denied. Once realizing I wasn’t really going to be considered and supported as a human being doing the job, I knew I couldn’t continue to work there.
After over 8 years in practice, I was burned out and ready to leave the field entirely. Working for public mental health agencies was not going to be sustainable, due to both the low pay for well-educated and well-trained mental health providers and the insane expectations for the lowest paid workers at the agency. I was not okay with the system as is and decided it would not work for me as a viable employment option. So, I got started on my long-ago dream–starting my own practice. I did just that! And in about a year, after building my practice while working full-time for the agency, I was able to leave that grueling position behind and regain some autonomy, and safety, over my practice. It cured my burn out symptoms and I began to enjoy the work with clients once again, now that I had capacity to actually do the work.
Now, it’s been nearly 10 years since I started my practice, and there has been no looking back! I can adjust my caseload size per my personal and professional needs; I make so much more than in any agency setting; I feel safer; I can practice ethically; and I have been able to diversify my work to stave off burn out, which had been creeping up again post the pandemic wave of uncertainty and fear that had many accessing therapy. As a result, I made some new adjustments to my work and expanded services to include skills coaching, leadership and business consulting, writing, speaking, developing content for courses and mental health apps, and even hosting my own podcast for a while! In addition, I have expanded into other roles including assignment as the Director of Student Wellness for a nonprofit out of New York and becoming adjunct faculty at Cleveland State University’s Master of Social Work program.
I’m proud to say that I’ve created a sustainable business, well businesses, with never having had a business course, a business coach, or business attorney to guide the way. I’ve built my practice and my consulting business from the ground up, without capital or loan, and have managed to be profitable and pay myself a living wage salary the whole time! Now, I offer private practice consulting for other clinicians interested in doing the same thing, with hopes that with more independent clinicians, who have control over their workload, we can keep good providers in the career field and practicing.
We all face challenges, but looking back would you describe it as a relatively smooth road?
Oh my, absolutely not! I mentioned some of the difficult road previously, however I can expand. I was well-educated and well-trained to provide direct care/treatment to individuals with mental health diagnoses. However, I was not well-trained in providing crisis intervention services. I was not trained on how to manage poor leadership and decisions they made that impacted me and my work with clients in agency settings. I was not trained at all on how to run a business or an ethical mental health practice. The self-learning required to make my practice profitable was immense. In addition, I was working a full-time, very demanding and exhausting, agency job while building my practice on the side, working a full 6 days a week seeing adults with mental health disorders, for nearly a year. That was a lot! But I didn’t have the money to just quit my job and then start my practice, I needed income from the practice before I could quit, hence the double workload for a while. It was certainly a sacrifice, and it was really stressful, busy, and overwhelming at times, but I am happy to have done it and achieved such success in my practice.
Appreciate you sharing that. What should we know about Thrive & Shine Counseling, Coaching & Consulting?
I started with the practice, Thrive & Shine Counseling in 2016. Then in 2023 became a 2x founder with Thrive & Shine Coaching & Consulting. What sets me apart from other therapists and other coaches/consultants is that I operate from a Trauma Informed perspective, in all of my work, not just clinical client sessions. This means I take into consideration folks’ lived experiences of trauma and use that knowledge for better decision-making that is inclusive of all folks. From digital product and course development, to marketing materials, to collaborations and partnerships, to forms and policies, to business practices and co-authoring books, I use trauma informed principles and practices as the guide for my work.
Clinically speaking, I specialize in treatment for adults diagnosed with Anxiety Disorders, Substance Use Disorders, Trauma Disorders, and early attachment wounds and relationship issues. I hold a few specialty certifications including Certified Clinical Anxiety Treatment Professional, Certified Tele Mental Health Provider, Certified Dialectical Behavioral Therapy Provider, as well as, being licensed in both Virginia and Maryland.
Outside of my clinical work, I am a vetted and verified Subject Matter Expert for mental health and trauma informed care for a national affinity group of multi-disciplinary professionals. With this organization I write articles, participate in adult-learning workshops, develop content for our mental health support app, and serve on the vetting team for new professionals looking to join. I’m also a 3x international bestselling author, developer of digital wellness products, private practice consultant, skills coach, thought leader and leadership strategist, and champion for psychological safety and workplace wellness.
In addition, one of the things I’m most proud of, is creating a ground-breaking new tool: the Trauma-Informed Crisis Response Guide. This step-by-step guide can be easily used and followed by any person, in any setting, to navigate the steps to address a mental health crisis in action. There is no requirement to be a mental health professional to utilize this tool. It has been developed for anyone to be able to recognize, and respond appropriately, to a mental health crisis, particularly in a workplace or non-healthcare setting. Completely trauma informed in design, in language, in interventions and de-escalation options, and post-crisis response self-care.
Where we are in life is often partly because of others. Who/what else deserves credit for how your story turned out?
A few local clinicians have been a sounding board or support throughout my private practice experience, including my long-time friend and business accountability partner, Catherine Turner. I have served on the board for the Virginia Society of Clinical Social Work-Richmond Chapter, and long-time president, Chris Jenkins has been a steadfast presence.
In addition, my mentors and colleagues at the national affinity group-Integrate Trauma Informed Network- have been vital in branching into new areas of business, without burning out or getting retraumatized in business partnerships, collaborations, and contracts. Namely, Julie Johnson (founder of Integrate), Katie Kurtz, Nicole Lewis-Keeber, and Fihmiya Hamdan are my go-to crew for everything related to trauma informed care, including for myself! Their support and accountability is unparalleled to anything I’ve had to date in the self-employed business world.
Pricing:
- 1:1 Skills Coaching- $150
- Individual Psychotherapy- $220
- Business Consulting- see package info
- Trauma Informed Consulting- $300
- TI Crisis Response Guide- $550
Contact Info:
- Website: https://www.sarahobrienlcsw.com
- Instagram: https://www.instagram.com/timelesstherapist/
- LinkedIn: https://www.linkedin.com/in/sarahobrienlcsw/
- Youtube: https://www.youtube.com/@timelesstherapist
- Other: https://medium.com/@thriveandshineCCC
