Independant Practice for the Mental Health Professional

Ralph Earle, Dorothy Barnes

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9780876308387
• eBook ISBN: 9781134866533
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Marketing, office planning, networking, managed care, legal liability. These are probably not the words that encouraged your decision to pursue a career in the field of mental health. Before practicing the clinical aspects of therapy, most mental health professionals must first deal with the business of therapy. Independent Practice for the Mental Health Professional, co-written by a veteran therapist and a therapist just beginning in her practice, offers the information needed to balance the demands of running a business along with being a therapist. Based on Joan Beigel and Ralph Earle's previous work, Successful Private Practice in the 1990s, this book offers specific tools for building a successful private practice for the next century. Independent Practice for the Mental Health Professional provides the reader with the experience and time-tested lessons of one author who has been in practice since 1971. At the same time, the co-author, who began her practice in May 1998, addresses the thoughts and concerns of those therapists soon to enter, or thinking about entering, private practice. In this book, readers will learn · the pros and cons of going solo or joining a group practice · the legal issues connected to running a private practice · how to market themselves as well as their practice · how to arrange physically their office, manage personnel, and collect fees · how to maintain a thriving practice in the age of managed care The authors provide worksheets and examples of successful planning for the growth of a practice. When combined with hard work and a business-minded attitude, these techniques can be a recipe for success. As a result, this book is a valuable resource for therapists thinking about entering private practice, and beginning and experienced therapists hoping to improve their own practice.

PART

I

PRIVATE PRACTICE AND PERSONAL IDENTITY

1

CHAPTER

Define Yourself to Define Your Practice

Independent practice for the mental-health professional means different lifestyles, personalities, and practices. Therapists in private practice design their careers in ways that usually are not available to therapists in other settings. This freedom constitutes one of the main motivations for going into independent practice. Although the designs may look different, the common thread is choice.

An alignment takes place when a therapist enters private practice. Personal and professional identities come together as part of the marketing package needed for an independent professional to thrive. Personalities, styles of therapy practiced, and business personas become congruent.

To be successful in private practice, you need to know and understand your own personality and motivations for being an independent practitioner. There are a variety of personality characteristics that can contribute to success in a business venture of any type. Certain traits seem to lend themselves to being able to function in private versus community agency settings.

It is our experience, however, that personality type is most relevant in determining how you will structure your marketing and business time, as opposed to whether you are suited for private practice. By defining who you are you can consciously choose a business strategy that allows you to stay in private practice, resist burnout, and get what you want from the business of doing therapy.

The Helper and the Entrepreneur

How do you develop that congruence between self and practice? The independent practitioner lives at least two major roles: helper and entrepreneur. What are the stereotypic traits associated with success in each role? Stop now and create two lists. Title the first list “The Traits And Stereotypes Of A Helping Professional.” Name the other “The Traits And Stereotypes You Associate With An Entrepreneur.” Take some time and write down any label or trait that comes to mind for each list. This exercise can be used in a group setting and often is enlightening and entertaining.

Compare the lists you created with the lists we present below. The following lists are a composite of the responses we have received through workshops, seminars, and conversations with other professionals.

Helper	Entrepreneur
receptive	aggressive
objective	persuasive
process-directed	product-directed
altruistic	materialistic
female	male
yin	yang
people-centered	market-centered
educated	streetwise
introverted	extroverted
noble poor	ignoble rich
ethical	unscrupulous
Bambi	Jaws

The problem seems obvious: These two roles are mutually exclusive, equally unrealistic, and in our opinion unfair. We currently are involved in writing a gender book, because it is our experience that male and female roles are often the first hurdles to cross when evaluating effectiveness in many professional settings. Certainly many females are successful entrepreneurs, and many males are effective helping professionals.

Adhering to these stereotypes, while trying to resolve the conflicts inherent in them, is impossible and leads to the failure of many practices and to severe burnout among many practitioners. Belief in these stereotypes is one reason therapists have trouble with areas of their business such as public speaking, setting fees, advertising, or talking about what they do.

Many private-practice therapists have been accused of being “hustlers”—the quintessential entrepreneurial bad person—on the basis of this helper entrepreneur dichotomy. In his second year of family therapy practice with a group in Scottsdale, Arizona, Ralph received an envelope from the Board of Psychologist Examiners. This is not the kind of mail a therapist wants to receive under any circumstances, but certainly not when he or she is new in town and just beginning a practice. Inside the envelope was a letter that a Phoenix man had sent to the state Board, which stated that Ralph was a hustler and documented the man’s unhappiness with Ralph’s behavior. The Board wanted Ralph to let them know what had happened from his point of view. He replied, and then they sent a letter to the man that indicated that what Ralph had done was standard operating procedure and not a problem. Some of Ralph’s friends told him, “He was really giving you a compliment.”

Although Dorothy, being new to the profession, has not yet received the brand of “hustler,” she has noticed her reluctance to talk about fees and a tendency to go as low on a sliding scale as the patient deems necessary. One client asked for a greatly reduced fee due to a divorce and current shortage of assets and funds. The sessions went on for a time, and the continuing theme of “no money” continued. During a group session the client forgot his declaration of poverty and admitted to having a great deal of money and assets. Dorothy’s fear of being considered a “hustler” led to her shortchanging her own practice.

One of the first areas with which you must come to terms when entering private practice is the issue of money. There is no single right way to do therapy, and there is no single right way to determine business practice for doing therapy. We, Dorothy and Ralph, choose an approach or some mixture of approaches based on context: our own personalities, our training and experience, the patient’s personality, and our assessment of the problem at a particular time. Likewise, there is no single right way to conduct business. We choose activities and strategies based on context: our own personalities, our training and experience, our market, and our goal at a particular time. Notice that training and experience appear in both lists.

When therapists join Ralph’s practice, Psychological Counseling Services (PCS), they often say, “I’m trained in [whatever style of therapy], or at least feel most comfortable there.” There is never any mention of training in the business of independent practice. Most therapists are very comfortable with the kind of therapy they do because they are well trained. They are not comfortable with the idea of running a business because they have received no training, unless they come from a business background. In our opinion, it requires more than just therapeutic technique to make a business successful, whether in an office behind closed doors or in public.

The Independent Practice “Personality”

We include here a dialogue between us, discussing our ideas of qualities or characteristics that we think are important in independent practice. This dialogue is meant to encourage you to have a similar dialogue with others in the field, as a means of beginning to define your ideas about private practice. In Chapter 2 we present portraits of professionals who are currently in private practice. Here we give you our own perspectives, with Ralph as a senior independent-practice therapist and Dorothy as a junior independent-practice therapist.

Listening In

Ralph (R): Dorothy, as a therapist just embarking on a career in counseling, what qualities do you think are important for somebody in independent practice?

Dorothy (D): Flexibility and creativity come to mind.

R: Flexibility and creativity—both good words and necessary qualities. Flexibility and creativity are needed for the business and the clinical sides of independent practice.

D: Ralph, I’m curious about the qualities you look for when thinking about hiring a therapist to be part of your practice at PCS.

R: Self-motivation is essential for all therapists, and it becomes especially important to me when I’m thinking about hiring someone. Motivation dictates whether or not a person will provide her or his own clients, along with the clients that come from others in the practice.

D: It seems to me that motivation is a quality that has to come with the person, and probably cannot be taught.

R: Historically, I’ve been unsuccessful teaching someone to have motivation if they do not already have that when they come into our practice. In fact, probably the most frustrating part of administering a group practice for me has been to try to teach someone, who may be a very capable therapist, to be motivated to do the work it takes to build a practice.

D: For me it has been important to determine my motivational level in order to help me make decisions about time spent in both building my practice and the types of activities to pursue.

R: That’s a great point. Another quality that seems to be important is having autonomy to make decisions. I enjoy working with people who really do have a great deal of autonomy and are not reliant on me or others to make basic decisions.

D: Working as an intern at PCS, and later as an employee, I was both pleased and overwhelmed in the beginning about how many choices I had the freedom to make.

R: The learning curve in any new situation certainly applies to being a clinician in a private practice setting. Being an intern in such a setting can be a nonthreatening way to check out the possibility of working as an independent practitioner without the stress of having to secure clients.

D: Tell me more about autonomy and how that blends with being a team player.

R: Over the years I’ve understood just how important it is to be a team player if you are working independently with other clinicians. Basically, a person who enjoys being part of a team will find working in a practice such as ours to be very meaningful. A person who may be autonomous and want to work completely alone may do better in a solo settin...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Contents
• Preface
• Acknowledgments
• Part I: Private Practice and Personal Identity
• Part II: Public Identity
• Part III Professional Identity
• Appendix
• Suggested Readings
• Index