niblet-head, I pasted your question in an email to my mom who has been a licensed clinical social worker for a number of years. Her answer follows.
(I feel a compulsion to say my mother knows all about paragraphs, but she fired back this answer off the top of her head at 10 o’clock at night)
carlotta’s mom says…
what I like best about being a psychotherapist is “making connections”
between myself and the client, the client and him/herself, couples, families, and
even making connections with myself through insights in the therapy room. These
connections can help people transform their lives, or get free of lifelong burdens
of fear and grief. Or the transformation can be about connections with possibilities,
ideas, skills and talents a person didn’t know were available to them. This is
exciting and moving stuff!
HOWEVER, I HATE the BUSIUNESS of psychotherapy . Yet,
like any other service, in this society, there has to be a way to deliver the service,
and that means business of some sort, whether it is in a public agency, through
insurance companies (“3rd party payors”) or a personal private arrangement
with your “client”. Ironically, the best personality for a psychotherapist,
warm, caring, accepting, seeing the big picture rather than the nit-picky details,
is the exct wrong personality to run a business! So therapists are notoriously
bad businesspersons. Then we don’t make any money. Then we feel frustrated and
underappreciated. We want someone to take care of US! But when we get that, like
working for an agency which guarantees benefits and a regular (as opposed to an
“irregular”) paycheck, we are now working FOR a business, instead of
BEING the business. Then we complain and carp and talk about how things should
be better run, when we don’t have a clue, or the will, to run it better ourselves!
There are those gifted people who can do both, be good and caring therapists who
know how to make a business run, and are not ashamed to do it.
Would I do it again?
Yes, if I could have one or two business courses along with all the clinical courses.
Right now, I fear psychotherapy is becoming either very rote and prescribed, or
it is a “hobby” for rich, or subsidized people (like people who have a
spouse with a real job!). Not only that, we can’t decide if we are medical professionals,
which would allow us to use the models that doctors and nurses use of a caring,
service-oriented business; or if we are “personal growth” practitioners,
like massage therapists, personal trainers, music therapists, etc., who don’t expect
to make much money, but trust that their work is good and important enough for people
to pay out of pocket for services that are not medically necessary, but extrememly
helpful and life-enhancing. The people who make any money diversify. They write
books, teach other therapists, give workshops, and gradually see fewer and fewer
clients, who have to wait weeks or months to get in to see the “expert”.
One needs a good and steady income and business sense to truly have “professional
independence”. You cannot be truly “independent” until you can
operate without insurance companies or an agency’s umbrella. That is very hard
to do in this economy. When it’s good, when the “connections” are made,
it’s VERY good. When it’s bad, you wonder if you should be sitting in your client’s
chair and asking for THEIR input! But, I love it! Now to figure out if I can afford
to keep doing it, or learn to change my personality just enough so that I can earn
a living. Thanks for asking! Love, Mom