Uncharted waters: Expanding a psychotherapy practice in uncertain times.

Uncharted waters: Expanding a psychotherapy practice in uncertain times.

“We’ll never make it!”

Glum from Gulliver’s Travels by Jonathan Swift

It started as early as my first year of college, some 20-odd years ago. I was in an abnormal psychology classroom in Boston, eager to finally get moving on my wished-for career as a psychologist that I had dreamed about for years. A professor I was working with at the time (AKA Dr. Glum) seemed determined to crush my hopes and dreams of becoming a clinical psychologist. “You’ll never make it.” “There’s no future in seeing therapy clients unless you want to work 70 hours a week in a community mental health center.” “And you can forget about getting to do research unless you happen to draw the golden ticket and get an academic job, but those are pretty much going the way of the dinosaur too.” While I might be taking some liberty on Dr. Glum’s actual words, there was a clear message she was trying to impart to us. The field of outpatient psychotherapy practice was on its deathbed and we’d better run the other way, fast!

I’ve heard this mantra of “you’ll never make it” throughout much of my training and well into my career. I still hear it today on professional listservs, among concerned graduate students, and even by those of us practicing in the field. Even just this week a colleague on a professional listserv posted a link to short cartoon about the futility of attempting to become a clinical psychologist. I found the video both somewhat offensive and tired– it’s still beating the same old “you’ll never make it” tune.

Of course much of what is being said has merit. We do have the problem of too many psychologists compared to demand. And we do need to be responsive to the changing landscape of healthcare in our country. But, is it impossible for a resourceful, skilled, well-trained psychologist to be successful in developing an outpatient clinical practice in this era? I choose to believe ABSOLUTELY NOT!

In fact, we here at Portland Psychotherapy continue to expand. We continue to invest in the concept that there will be a continued demand for quality, science-based outpatient psychotherapy. And I believe that demand extends to those in solo private practices as well. I know we are often looking for referrals to other providers who practice science-based psychotherapy and are frustrated when our “go to” referrals are often full. There is, and I think there will continue to be, demand for clinicians who are exceptional at what they do.

So rather than giving up, maybe the thing to do is focus on what makes us unique. In the case of clinical psychology, what I think us unique among other mental health providers is our strong foundation in and commitment to science. That means not only practicing “evidence-based” therapy, but also “science-based” therapy. For me, that also means being a true scientist-practitioner, one whose clinical work is informed by research. And just as science is always progressing, so too does our field need to continue to progress.

I maintain that all of the fear-mongering that’s been tossed around for at least the last 20 years is both destructive and disingenuous. Even with the glut of psychologists, it’s not like people are going unemployed. The APA Center for Workplace Studies reports that less than 1% of psychologists (Ph.D. or Psy.D.) can’t find a job. Dr. Glum was wrong! It is possible to develop a thriving clinical practice. It’s even possible to research in private practice, like we do at Portland Psychotherapy. So, if this is your passion, become exceptional at what you do, focus on what makes your contribution unique, and be resourceful. Rather than trying to scare off our competition with the “you’ll never make it” cries, join forces with other like-minded colleagues who are dedicated to being exceptional at what they do, let others know about your excellent work through good marketing, and work together to help support each other.

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