Let’s talk about this article on developing a therapist brand.
I’m a couple weeks late on this, but it was certainly an eye-grabbing read, as I’m currently in graduate school, so it was good “water-cooler” fodder around the lab. It’s the kind of article that I would be tempted to dismiss at first, writing it off as “selling out” and no different from the approach that pop-psychology folks have utilized to make a name for themselves and a quick buck (I’m looking at you, Dr. Phil). However, this article isn’t wholly about that, it’s more about trying to scrape together a solid living in an environment that requires you to separate yourself a little to have some sort of success. But given that, there are still parts of this article that raise my hackles, so I’ll go into a little detail about what from this article I like (or at least understand), and what rubs me the wrong way. Keep in mind it’s not the article or author that I’m criticizing when I write that I “don’t like” something, it’s more about the methods people use to sell themselves (in fact, I think the author handled it really well, interjecting when she felt something was at odds with her training).
What I like (or understand):
-Maintaining a web site:
This is a necessary step in my eyes. Having a competent, professional webpage is certainly good for enhancing your credibility; and it also is a good step towards improved communication. I know when I was applying to grad school, I appreciated well done departmental websites, and I was definitely impressed when faculty members maintained clean, elegant personal or lab websites. It certainly gave me more confidence that I was looking at a professional, productive lab. I would imagine the same applies to therapists, having a slick, well-designed websites helps your business out, and if you are private practice, you are running a business. The caveat is that a slick website shouldn’t make up for lack of credentials, but it definitely is a requirement nowadays.
What I could be convinced to like but currently don’t:
-Branding yourself as a specialist:
This tactic has the potential of bordering on the lines of misrepresentation. It’s one thing to become a true expert in a certain field of clinical psychology, to put in the hours, see the clients, keep up with the research, all in service of becoming well-versed and authoritative in a certain subject. I wholeheartedly endorse that approach. That approach leads to great clinicians being developed, great researchers, and truly informed people that can really make a significant impact in a certain domain. But something about the way the specialization is presented in this article makes me think it is more about capturing a certain piece of the market by catering to a specific form of psychopathology (Oh right, the “thriving but untapped market” statement). Call me naive and stuck in the academia world, but I want to specialize in a certain part of psychology because it really interests me, and the motivation to increase my knowledge in that area comes from that interest. For me, specializing in something because I want to hit the “untapped market” just wouldn’t work, because I wouldn’t do it well unless I was interested in it already. I do think there is something of substance behind “finding a niche,” but something about the way it is presented here seems a bit too cynical for my taste.
What I don’t like:
This idea was brought up in the article was about offering “life coaching”, which consists of quick consultations over the phone, rather than extended therapy, to help people out. There’s a couple things about this that I’m not entirely comfortable with. First, the ethics of this are slightly murky. Clinicians are likely to be licensed in the state in which they are practicing and physically located, so doing consultations on the phone if someone is out-of-state may be unethical because the clinician isn’t licensed in the state where the client is located. Of course, there are guidelines for this, but overall, the practice is not one of my favorites. In my opinion, this consultation idea is certainly toeing the line between therapy and not therapy with regards to establishing a client relationship with somebody. An additional ethical dilemma is that of being (or not being) in the room with your client. You lose a lot by not being in the room with the person you are talking to, and something like Skype might help settle that concern, but over the phone, you are losing all sorts of nonverbal communication that might be useful for your therapeutic relationship. I get that it is problem-focused, and likely to be easier completed on the phone, but if it were me, I’d prefer to see someone in person.
-Instant message therapy:
I do not like this idea, and it seems like the author doesn’t either (she was more diplomatic about it than I will be). Can you imagine trying to construct a therapeutic alliance over instant message? How am I supposed to practice empathy? If I am uncomfortable about consulting over the phone, I am so much more uncomfortable with trying to do therapy through messages. It doesn’t seem to be ethical in terms of confidentiality issues or licensing issues, and you lose out on a ton of nuance by not seeing someone in person. Also, where’s the research? A quick literature search turned up 6 articles on APA PsycNET on instant message therapy, so I’m not seeing much in terms of validation. Note that this is separate from talking about online therapy, as people have done solid research showing that you can computerize therapies such as CBT or exposure therapy to good effect. Instant message therapy, which one of the people in the article touts for its anonymity by likening it to Facebook (which by the way, is mostly not anonymous), is more like an emotional gloryhole; you don’t care who’s on the other side as long as it makes you feel better. That type of impersonality does not have a place in my personal conceptualization of therapy.
Okay, so I ended up with more things I didn’t like than things I did like, which I guess isn’t surprising, seeing as I wanted to knee-jerk dismiss the article. However, this article is certainly illustrative in terms of the climate and business realities facing therapists trying to carve out a profession for themselves in private practice. I agree that therapists cannot just proceed as they have been proceeding in past years, but I would argue that we can do better than this in terms of modernizing the field and adapting to the market. This post is already getting out-of-hand long, so I’ll leave that discussion for another day.