| Lutecium a non-school of Lacanian/Freudian Psychoanalysis San Francisco, California |
| The Business of Private Practice; the politics of privacy in the mental health world in dollars and cents. Kristopher Lichtanski, Ph.D. |
| This Workshop is offered Sunday, January 18, 2009, 10am - 2pm Flood Building, 870 Market Street, San Francisco ________________________________________________________ |
Psychotherapy, as a healing journey and an ethical practice, necessarily requires suspension of personal needs on the part of the
therapist. In promoting an examined life for ourselves and for our clients, we create a space free of the habitual demands and
expectations of having to please and be pleased; a space in which the therapist’s freedom to think translates into the client’s freedom
to be and to become… Such a process inevitably involves a highly private engagement based on inherent trust as well as explicit
contract between the parties involved.
Yet, it is no secret that the mental health industry comprises more than clients and therapists. Insurance agents, administrators, legal
teams, and “the bottom line” are no longer silent partners in the (no longer) private engagement between the therapist and the client.
In his book On being a psychotherapist, Carl Goldberg (1991) remarks: “The practitioner who works within an institutional setting is
influenced by the mores, values, and philosophy the key institutional personnel have toward psychotherapy. (…) Much of the
practitioner’s time as a clinician or psychotherapist, whether she/he realizes it or not, deals with the chafe and the unsettling feelings in
the clients that come from negative or resistive views about psychotherapy in these institutions. (…) Often the practitioner may have to
decide whether it makes sense to take either a therapeutic or an administrative role with any particular client. If these two positions are
in conflict, [the therapist’s] relationship with clients can be severely impeded” (p. 141).
Is it possible, then, to practice psychotherapy in the current climate of crumbling institutions? How does one avoid the
schizophrenogenic effects of the demand for divided loyalties: to the clients, to the profession, to the institution and its management
leadership, and last (though certainly not least) to one’s own ethics? While burn out prevails and many highly trained and well-
prepared clinicians are fleeing the field altogether (frequently disillusioned), some consider or have already moved to the private sector.
However, building, expanding, and maintaining a private practice is not an easy endeavor, particularly when graduate schools offer no
preparation for it and those with established, successful practices rarely share their “secrets.” The scarcity model – there are too
many therapists out there and there are not enough clients to go around – dominates the field. Is it possible to make a living in private
practice while maintaining one’s values and ethics? Is it possible to be free to think one’s own thoughts while providing for one’s own
well-being and welfare as well as that of the clients’? Can it be, perhaps, that the idea of the therapist’s suspending of his or her needs
has been stretched beyond the potential benefit to our clients?
The purpose of this workshop is to fill in the gaps between the discourse of healing and the discourse of business, and to explore the
act of service (too frequently defined as “sacrifice”) and the act of profitable exchange (too frequently defined as “greed”) in the
practice of psychotherapy. This workshop is suitable for those who are just thinking about starting private practice as well as for those
who want to make an existing one more successful. Both licensed and pre-licensed (license-eligible) clinicians are welcomed.
In the first part of the workshop, we will explore the psychological factors related to the opening and maintaining a private practice
psychotherapy office. Habits and characteristics of successful practitioners will be examined in juxtaposition with the most common
fears, blocks, and risks involved in undertaking the endeavor of private practice. Ability to articulate one’s goals and desires as well as
what it is that we are offering is a basic structure necessary to support and carry our work and an essential skill that will be stressed in
this part of the workshop.
The second part of the workshop will be devoted to the basic business and financial elements of running the private practice. We will
discuss the creation of a business plan, marketing and advertising strategies (obtaining referrals), setting financial goals and
expectations, and setting and collecting fees. Understanding of the dynamics, patterns, and rhythm of the private practice
psychotherapy business will be stressed in the second part of the workshop. Financial potential will be addressed in the context of
myths and realities of entrepreneurial work.
therapist. In promoting an examined life for ourselves and for our clients, we create a space free of the habitual demands and
expectations of having to please and be pleased; a space in which the therapist’s freedom to think translates into the client’s freedom
to be and to become… Such a process inevitably involves a highly private engagement based on inherent trust as well as explicit
contract between the parties involved.
Yet, it is no secret that the mental health industry comprises more than clients and therapists. Insurance agents, administrators, legal
teams, and “the bottom line” are no longer silent partners in the (no longer) private engagement between the therapist and the client.
In his book On being a psychotherapist, Carl Goldberg (1991) remarks: “The practitioner who works within an institutional setting is
influenced by the mores, values, and philosophy the key institutional personnel have toward psychotherapy. (…) Much of the
practitioner’s time as a clinician or psychotherapist, whether she/he realizes it or not, deals with the chafe and the unsettling feelings in
the clients that come from negative or resistive views about psychotherapy in these institutions. (…) Often the practitioner may have to
decide whether it makes sense to take either a therapeutic or an administrative role with any particular client. If these two positions are
in conflict, [the therapist’s] relationship with clients can be severely impeded” (p. 141).
Is it possible, then, to practice psychotherapy in the current climate of crumbling institutions? How does one avoid the
schizophrenogenic effects of the demand for divided loyalties: to the clients, to the profession, to the institution and its management
leadership, and last (though certainly not least) to one’s own ethics? While burn out prevails and many highly trained and well-
prepared clinicians are fleeing the field altogether (frequently disillusioned), some consider or have already moved to the private sector.
However, building, expanding, and maintaining a private practice is not an easy endeavor, particularly when graduate schools offer no
preparation for it and those with established, successful practices rarely share their “secrets.” The scarcity model – there are too
many therapists out there and there are not enough clients to go around – dominates the field. Is it possible to make a living in private
practice while maintaining one’s values and ethics? Is it possible to be free to think one’s own thoughts while providing for one’s own
well-being and welfare as well as that of the clients’? Can it be, perhaps, that the idea of the therapist’s suspending of his or her needs
has been stretched beyond the potential benefit to our clients?
The purpose of this workshop is to fill in the gaps between the discourse of healing and the discourse of business, and to explore the
act of service (too frequently defined as “sacrifice”) and the act of profitable exchange (too frequently defined as “greed”) in the
practice of psychotherapy. This workshop is suitable for those who are just thinking about starting private practice as well as for those
who want to make an existing one more successful. Both licensed and pre-licensed (license-eligible) clinicians are welcomed.
In the first part of the workshop, we will explore the psychological factors related to the opening and maintaining a private practice
psychotherapy office. Habits and characteristics of successful practitioners will be examined in juxtaposition with the most common
fears, blocks, and risks involved in undertaking the endeavor of private practice. Ability to articulate one’s goals and desires as well as
what it is that we are offering is a basic structure necessary to support and carry our work and an essential skill that will be stressed in
this part of the workshop.
The second part of the workshop will be devoted to the basic business and financial elements of running the private practice. We will
discuss the creation of a business plan, marketing and advertising strategies (obtaining referrals), setting financial goals and
expectations, and setting and collecting fees. Understanding of the dynamics, patterns, and rhythm of the private practice
psychotherapy business will be stressed in the second part of the workshop. Financial potential will be addressed in the context of
myths and realities of entrepreneurial work.
Fee: $80