Psychotherapy private practice questions

[tiger1]

Hi everyone!

 

I am interested to hear from people who have private experience as clinical psychologists or psychotherapists.

 

I do have mental health experience at the present, as well as extensive experience working in hospitals and other public institutions in Ontario in a clinical (non-psychology) role. I dislike the public sector, due to poor quality of services I have observed, as well as complete lack of autonomy or innovation when it comes to service providers. Working on a mental health or general medicine ward, I have often felt that patients get less than the minimum required amount and quality of therapy to progress. In Canada, particularly Ontario, hospitals often fail to provide psychotherapy. Social workers deal only with financial, housing, discharge issues and most of them do not provide therapy to inpatients. Psychologists are not employed in councelling roles in the hospitals, and psychiatrists barely have the time to ask the patient if they feel suicidal today. To them, the money is the same regardless of how long they take to talk to the patients.

For these, and other reasons, I dislike the public sector in Ontario, and especially the inpatient psychiatry sector.

 

I am not decided yet on committing to a PhD program. But, I would like to  provide psychotherapy services with a Master's and I am willing to put in my best effort into becoming a good therapist, including taking additional courses and training. I want to feel fully prepared to face my clients. Unfortunatelly, PhD is out of my radar. I have a lot of responsibilites, such as family, which make it harder (and even impossible) for me to spend another 4-5 years in school.

 

I was recently talking to a psychologist in private practice. He refused to comment on the field and just said that it was "extremely stressful" and that "he loves being self-employed versus working for someone".

 

 

Could you please help me with more feedback on what does it feel like to provide private therapy? I have to do my research before investing time, money and dreams.

I am trying to think of more specific questions, such as "Is the competition fierce?"; "Do you have enough clients?", "Do you often feel threatened or intimidated by agressive clients?"; "Is the hassle of running your own business taking away the joy of working?". What else do you want to tell me? How does it feel like to be out there, practicing as a private therapist? What are the advantages in this type of setting? I am asking mostly about disadvantages in the previous questions, because to me, the field appears extremely attractive and I am afraid I might be discounting some negative factors.

 

Thank you to all who reply. I am also open to private messages.

Edited June 10, 2015 by tiger1

[tiger1]

I really hope there is some therapists or psychologists out there who are eager to share a positive experience. Why does it seem impossible to obtain advice before committing to more studies? All other health disciplines do it. Where should I look for a mentor? My experience is heavy hospital based and I do not have much contact with private practitioners.

My motives to go into the field are:

1. I find it incredibly interesting and constantly developing.

2. I want to serve the public. I know it sounds basic, but it is true. I want to provide services to people who fall in between the gaps of the system.

3. I think there is a great demand for services and every practitioner contributes in different ways. I believe there is a space for people using different approaches and targeting different populations.

See # 4.

4. Long time ago I spoke to a plastic surgeon. He was advising me to go to medical school and follow his path and so on. I told him I was not interested in medical school, which is still true. Joking, I asked him why was he trying to create more competition to himself. What he said was: " I am not afraid of competition. There is another clinic that opened close to us some time ago. I do not mind. The thing is they can't take my clients. My clients are mine, because my approach is unique and they are suited for it. Same way, I will not be able to attract the other surgeon's clients".

Does this apply to therapy as well?

Edited June 11, 2015 by tiger1

[when]

I must admit, the only clinicians I know well are ones who don't just work in private practice, but also either teach, do research, or both. Perhaps it's not the same, but for what it's worth, they love what they do in private practice and they're able to keep a decent client base a couple days a week. Someone else I know became a psych. associate after finishing her MA and eventually opened up her own practice, where she now employs a large team of psychologists and other professionals. Mind you, it's in the area of motor vehicle accidents and traumatic brain injury, which sorely needs psychologists in many parts of the country, so I'm sure that's a factor. I can tell you more in private message, if you want, and there also might be another way to get a bunch of answers from psychologists.

[tiger1]

Thank you when, sorry have been on vacation and could not respond earlier.

My masters in not in social work or psychology, but I am in a profession related to psychology. I am not sure that I want to actually go into becoming a psych associate. With the current changes in Ontario, I would prefer to just become a therapist.

[LebaneseKafta]

I'm not a psychologist but I worked for one for 6 years in her private practice as well as personally with her kids. Firstly, since the licensing and approval of the college of registered psychotherapists of Ontario, clinical psychologists in private practice are finding it very hard to keep clients since psychotherapists can provide therapy as licensed healthcare professionals for a fraction of the price albeit with a lot less training in therapy and far less understanding of more complex issues. That is not to say psychotherapists aren't qualified to provide therapy, obviously many are but the additional training of psychologists and having approved programs across canada with specific requirements for licensure that are the same across the board ensures that psychologists are more so competent to provide therapy. Regardless, psychologists in private practice are losing their clients to psychotherapists so many of psychologists are moving from private practice back to the public because of this, in Ontario at least. So you definitely have come at a right time if that's what you want to do. Also, since hospitals etc. are not hiring that many psychologists it leaves them being pushed into domains that are not involved much in therapy. The psychologist I worked for works in an area where psychotherapists have not yet been able to infiltrate and is now getting a slew of psychologists wanting to get supervised by her so that they can move from private therapy to this area (I'm leaving it out because its quite specific and only very few people work in this area in Ontario as I don't want her identity revealed). In terms of what you want to do, an MA to do therapy you will easily find work as now therapy in the private sphere will be dominated by those with MA degrees in many things such as counselling, psychotherapy, etc etc etc who then become registered psychotherapists (since their is no specific licensing requirements and no 'approval' of specific school programs). In terms of where CLINICAL PSYCHOLOGISTS will now fit into the mental health field they will most likely become more and more involved in assessment and diagnosis since psychotherapists cannot do that and less involved in therapy as this will most likely become the domain of psychotherapists unless it is complex cases which in that instance they will become involved as again since psychotherapists have less training they will be unable to deal with these cases. This is just my opinion based on my experiences and what I've been hearing lately from students, psychologists, profs, etc. 

Edited June 26, 2015 by LebaneseKafta

[tiger1]

I'm not a psychologist but I worked for one for 6 years in her private practice as well as personally with her kids. Firstly, since the licensing and approval of the college of registered psychotherapists of Ontario, clinical psychologists in private practice are finding it very hard to keep clients since psychotherapists can provide therapy as licensed healthcare professionals for a fraction of the price albeit with a lot less training in therapy and far less understanding of more complex issues. That is not to say psychotherapists aren't qualified to provide therapy, obviously many are but the additional training of psychologists and having approved programs across canada with specific requirements for licensure that are the same across the board ensures that psychologists are more so competent to provide therapy. Regardless, psychologists in private practice are losing their clients to psychotherapists so many of psychologists are moving from private practice back to the public because of this, in Ontario at least. So you definitely have come at a right time if that's what you want to do.

Thank you for your reply. I have a clinical Masters MSc and currently work with the mental health population in hospitals, so I will not be the next MA therapist. It makes no sense to me to pursue PhD without strong research interests.

I think that clinical psychologists are not that much threatened by psychotherapists. It is arguable, whether all licensed psychologists in ON are more qualified than psychotherapists to provide therapy. Actually, some focus more on other areas during their PhD studies and a lot appear somewhat estranged from the average mental health client. I went to psychologist myself for advice and spent a lot, I mean a lot of money for a very little help. I went to a "life coach", who was really talented and surprisingly able to provide the quality of service I was looking for.

A lot of people gather useless papers to appear more competent. Therapy to me requires a combination of talent, education and experience.

I appreciate the credentials most psychologists hold, but in reality one's research on the influence of visual light stimuli on mice behaviour does not make a lot of difference to a person in need of efficient therapeutic approaches. And paying almost 200$ per hour when you need mental help does not feel very helpful.

Edited June 26, 2015 by tiger1