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As the Founder of an Intensive Teen Therapy Program, 'Setting Boundaries' Is Hard. Here's How I Learned to Do It. Sometimes, "setting" boundaries means "letting it all out."

By Carter Barnhart

This story appears in the July 2022 issue of Entrepreneur. Subscribe »

Carter Barnhart founded Charlie Health to provide therapy for at-risk youth. Part of her job is being available at all hours of the day.
Image Credit: Masha Maltsava

As entrepreneurs, we're often told to set boundaries. But that can be challenging when work and life are so intertwined — especially in the early stages of a fast-growing company.

I'm the founder of Charlie Health, an intensive virtual therapy program for teens and young adults. We launched in mid-2020, as rates of depression and anxiety among youths skyrocketed. Because Charlie Health offers care to patients 24/7, we're a first and last resource for families in need. And as the founder, I'm truly the last line of defense. If everyone else on my team is unavailable, the call goes to me — no matter the time of day or night.

Related: Why Setting Boundaries Is the Secret to Preserving Energy and Focusing on What Matters

My friends will tell you it's hard to hang out with me. I get calls at breakfast, during movies, on Saturday nights. Clearly, the timing of these calls isn't ideal, but when they happen, I try to reframe the situation. I tell myself — and I promise I'm not bullshitting you here — I'm lucky to be taking this call.

That's because I'm lucky to be alive.

I grew up in the Philadelphia suburbs, in an amazing, intact family with parents who loved me and did their very best to keep me safe. But when I was 14 years old, I went to a concert and was sexually assaulted. In the aftermath, I struggled with PTSD, anxiety, and depression for two years. My parents sent me to countless therapists, doctors, psychiatrists, and even Reiki healers. Finally, our pediatrician recommended a new residential treatment center for girls with sexual trauma called Newport Academy. I was their second patient ever. After 45 days of residential treatment, I was able to heal. So I became obsessed with the idea of how I got to be "the lucky one." I started interning at Newport in college and then worked there for 11 years. But I began to realize that, despite our ability to open more treatment centers, we weren't getting to the root of the biggest issue. I wanted to help the most at-risk kids the healthcare system often leaves behind.

That's how Charlie Health was born. A lot of people told us we'd never be able to offer this kind of treatment to families in rural areas or families with Medicaid, but we proved them wrong. In under two years, we've grown to nearly 300 employees and treated thousands of patients in behavioral health "deserts." To say the work is rewarding is an understatement, since we're saving lives. But as you might expect, it's also heavy. It's my job to make sure that my team and I take care of ourselves.

Related: How to Set Boundaries as an Entrepreneur

To do that, we label our own needs and experiences. One of the words we use is "dysregulated," which comes from behavioral health. Like, "I am out of my mind right now!" After a difficult call, someone on my team might tell a colleague, "Hey, I'm dysregulated. I need you to tap in. I'll be back in 15." Another word we use is "preamble." If someone's really frustrated, we'll start a meeting by saying, "I need to preamble." Then we can share what's on our minds before going into solutions.

You may not think of this as setting boundaries, but it is. Creating a structured space to examine a negative situation allows us to reframe it and reflect on what matters most.

All founders feel a personal responsibility for their companies, and that creates a lot of pressure. To me, the best way to cope is to stay close to my purpose — my "why." I meditate every morning and every evening. Sometimes a family tells me a story so heartbreaking I can't shake it. But that night, I meditate on that family. They become my new why, my reason for taking the next call — no matter when the phone rings.

Related: Why Your Mental Health Is the Key to Your Success in Business

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