launching a private practice: strategies for clinical psychologists and mental health professionals

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Launching a Private PracticeStrategies for Clinical Psychologists and

Mental Health Professionals James Tobin, Ph.D.

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“Money Matters”

• American Group Psychotherapy Association Annual Conference

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Alice Miller’s “The Drama of the Gifted Child” (1979)

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Miller’s Description of the “Gifted Child”

“Quite often I have been faced with patients who have been praised and admired for their talents and their achievements … these people – the pride of their parents – should have a strong stable sense of self-assurance. But exactly the opposite is the case.

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Miller’s Description of the “Gifted Child”

“There was a mother who at the core was emotionally insecure, and who depended for her narcissistic equilibrium on the child behaving, or acting, in a particular way. This mother was able to hide her insecurity form the child and from everyone else behind a hard, authoritarian and even totalitarian façade.

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Miller’s Description of the “Gifted Child”

This child had an amazing ability to perceive and respond intuitively, that is, unconsciously, to this need of the mother or both parents, for him to take on the role that had unconsciously been assigned to him.

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Miller’s Description of the “Gifted Child”

This role secured “love” for the child – that is, his parents’ exploitation. He could sense that he was needed, and this need guaranteed him a measure of existential security.

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Miller’s Description of the “Gifted Child”

This ability is then extended and perfected. Later, these children … develop a special sensitivity to unconscious signals manifesting the needs of others” (1979, pp. 7-9)

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Your “Gifted Child” Tendencies

• Cultivating a professorial attitude and value system that entails looking out for yourself/making money/“Practicing Defensively,” etc. contradicts the selfless, “gifted child” style you likely have been living, at least to some degree, all your life.

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The Juxtaposition of “Helping Professional” with “Entrepreneur”

• These two roles or “modes of relating” are diametrically opposed (e.g., other vs. self, give vs. receive, etc.)

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Hopefully …

… training has diminished, at least to some degree, the extent to which your characterological “gifted child” tendencies may interfere with your work as a clinician and your newly-emerging professional identity.

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But the transition from graduate student to professional psychologist (“gifted child” to entrepreneur) is complex, multi-layered, uniquely personal and gradual (often taking many years).

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For me, after I was licensed, I didn’t even recognize I was experiencing a transition

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Some Components of My Transition(1) Overcoming a damaged self-esteem from

training.(2) Moderating a healthy appreciation of now

being a “Dr.” with the realization that a career as a professional psychologist requires life-long learning, intellectual curiosity, emotional struggle, and ongoing self-confrontation.

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Some Components of My Transition

(3) No longer having to appeal to “an authority figure,” get good grades, garner praise, etc. – but appealing to my own desires as a person and as a professional (e.g., Alice Miller/Winnicott’s “False Self”)

(4) Talk the talk vs. walk the walk: truly incorporating the scientist-practitioner model into my professional value system and work.

(5) Lifestyle and financial planning.

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Some Components of My Transition

(6) The sobering realization that, despite the good training I was fortunate to have received, and the endorsement of supervisors, peers, and friends, I would have to market myself as a business entity (and I had absolutely no formal training in how to do this!).

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Some Components of My Transition

(7) The gradual acknowledgment that being a psychologist is a wonderful profession that affords me the opportunity to do many different things that are personally fulfilling and rewarding!

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As you begin your own personal journey through this transition, here are the essential elements of your new fishbowl.

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Your License

Certification of Professional Qualification (CPQ)

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An Attorney

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Ethical and Legal Consultants

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Liability and Physical Insurance

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An Office

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An Accountant

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A Financial Advisor

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A Professional Community

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Individual and/or Group Supervision

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Formulating and Marketing Your Professional Identity

• (1) Website and profiling• (2) Routine professionalism • (3) Marketing • (4) Identifying “intersections”• (5) Service to the community

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(1) Website and Profiling • The contemporary “business card”• Should reflect your unique professional

persona, style, and areas of interest/specialization

• Must be actively maintained • Blog • Video • Profiling refers to ongoing paid biographies on

sites such as Psychology Today, etc.

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(2) Routine Professionalism• You are always marketing, all the time (your

routine professionalism)• Consistently seeking to help and link people

together – for free!

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(2) Routine Professionalism• Returning emails • Returning phone calls • Operating within your areas of expertise and

consistently referring to other professionals (for collaboration or evaluation)

• Contacting referral sources to you once the referral has been solidified

• Terminating cases when appropriate/not exploiting patients

• Preparing a written summary of treatment• Checking in with former patients

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(3) Marketing

• Marketing centers on the premise that you form and consistently engage your own unique audience or audiences (e.g., Constant Contact, social media, etc.) such as peers, patients, related disciplines, theoretical orientation, clinical modality, subject matter specialists, etc.

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(3) Marketing

• You review, appraise and disseminate helpful information (as well as your own work) to your audiences.

• You consistently seek to generate your own data (surveys, etc.) and distribute this information to your audiences.

• You then “sell,” directly and indirectly, to your audiences.

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(4) Identifying “Intersections”

• As you practice, you will become more and more able to recognize potential “intersections” between your own clinical interests/professional talents and the emerging needs of your audiences.

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(5) Service to the Community

• Pro bono work: psychoeducation, consultation, speaking appearances, etc.

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The Mixed Bag of Insurance Panels

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Working in an Academic or Institutional Setting

• After getting licensed, many early-career psychologists work in these settings (in addition to private practice or before starting a private practice) -- which generally has many advantages.

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Working in an Academic or Institutional Setting

• In these contexts, everything I’ve outlined is still applicable, but your marketing approach shifts to appealing not only to the needs of the patients you serve, but also to those of your administrators and colleagues.

• It is very important to (1) assess the culture carefully, and (2) identify both the pragmatic and systemic roles you will fill.

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In Conclusion The transition from student to professional

(from “gifted child” to entrepreneur) is complex, challenging and stressful…

BUT DON’T FEAR IT! YOU CAN DO IT! EMBRACE IT AND ENJOY!

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