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Friday, 10 February 2012

Private Practice: Who Will You See?

This post is part of a series on private practice issues that will be appearing on Fridays for the while, leading up to a series of workshops (based on my book Private Practice Made Simple) taking place in Calgary, Toronto, Ottawa, Vancouver, and Edmonton in March 2012 (information here).

When setting up your practice, or when you are fine-tuning it based on your preferences, your expertise, or the people in your community seeking help, it’s best to abide by a principle that I suggest to clients: Don’t worry without paper.

There’s no point in grinding over an issue in your mind if you’re going to wander off onto another topic or forget what you’ve decided.

So rather than thinking about your practice while driving, or in the middle of a movie, or when avoiding your tax form, devote your full attention to the task. Sit down with a piece of paper and write down whom you want to see, whom you don’t want to see, and what mix of clients would suit you best.

Want some structure to your contemplation? Use the “Practice Populations” exercise sheet adapted from Private Practice Made Simple (New Harbinger Publications, 2011) and posted online at  The direct link is here.

The form has three sections:

Ages and genders. Think about the various stages of life, the genders, and whether you will see couples and/or families. Perhaps you will want to indicate your preferred mix (“mostly senior women but partly a wider age range and some men for balance”). Or perhaps you would like to see certain groups only for certain issues. For example, perhaps you will see adults for a wide range of concerns, but you only want to see teens if they present with eating disorders.

Population groups. In addition to the broad cross-section of people that most therapists see, perhaps you would like to focus your recruitment efforts on a few particular types of people, either because they are ill-served in your community or because you have special expertise. Perhaps you speak Portuguese and could offer services in that language. Perhaps you have a special interest in multiple sclerosis, or transgendered people, or skiers, or Buddhists, or people recovering from stroke, or police officers, or students, or people going through in vitro fertilization. Make a note of the populations you would like to see, as this will guide some of your promotional work.

Concerns. This section of the form overlaps somewhat with the previous one, but here you will emphasize the focus of attention during your meetings with the client, regardless of whether they are gay or straight, Muslim or atheist. Perhaps there are specific DSM or ICD categories you like to treat. Consider taking down your diagnostic manual and flipping through it to spark your ideas. Also consider writing down groups that you really want to avoid, either out of preference or expertise (“I have no success with eating disorders”). Then consider issues that don’t involve specific diagnoses: custody and access disputes, return to work after disability leave, forensic issues, bereavement, and so on.

Keep the form with you for a few days. Additional thoughts will pop into your head.

Run your results past a colleague in private practice and ask for feedback. Does it sound reasonable? Have you been too broad or too narrow? Are there enough potential clients in your community, and are there too many or too few practitioners serving those groups?

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Want more information on operating a private psychotherapy practice? 

Check out my book Private Practice Made Simple.  It contains information on starting a practice, creating a space, designing a website, getting referrals, managing finances, avoiding burnout, and much more.

The book is available at bookstores, from the Changeways Clinic website, and through Amazon here.

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