Try Therapy for a Change
copyright 2011 Antonia Caretto
www.BeTreatedWell.com   
Antonia Caretto, Ph.D., PLLC  (248) 553-9053   
    Business of Psychotherapy

    Just as listening like a therapist often involves listening for what is not being said, part of having a successful psychotherapy practice is about the
    business as much as it's about the psychotherapy.  Business decisions I have made have been well thought and based on years of personal experience.
    Understanding the philosophy which underlies my business decisions may be just as important as understanding the theories of psychology I employ.

    Insurance:

    I do not bill any insurance companies.  I provide statements which many of my patients chose to submit to their insurance company.  Many do
    receive some reimbursement.  This was considered a risky business decision which I made based on my strong beliefs about the sanctity of the therapy
    relationship.  I chose to ignore the myth that a psychotherapist must accept insurance.

    Do I lose potential patients because of this?  Yes.

    However, the decision may be part of why my business has remained steady even though other businesses have struggled; Among other things, the
    fact that I do not accept insurance acts as a self-selection process whereby patients who work with me make an early and conscious commitment to
    invest in therapy.  My education about insurance cam from working in free clinics, Community Mental Health, for-profit facilities and  for a large
    managed care company.


    Community Involvement:

    Another business decision I made, based on personal philosophy rather than short sighted financial gains, was to give services freely to the
    community.  I hold a spiritual belief about the rewards of living one’s life in a loving and giving way.

    Could those hours have been spent seeing more patients and trying to make more money?  Yes.

    Through giving in the community, people know that I care and I gain a fuller perspective of the issues impacting a wide range of individuals.  I
    spend many hours providing pro bono services in a variety of ways; on site consulting at schools; presentations to Primary Care Physicians and other
    professionals; developing programming; and meeting with college students about careers in Psychology and Education.  None of the instructors in
    my graduate program were just academicians - having real world experience is valuable.

    Collegiality:

    When I started practicing as a Psychologist I also made a decision to take time to communicate with other professionals rather than fearing that
    other providers are competition.  

    Do I refer my patients to other providers and inform potential patients about  treatment options, thereby sending business away?  Yes.

    These other professionals appreciate that I share in the caring of our patients and those I share with  know that the collaborative work is an
    important part of quality treatment. Whether it is online communication with those around the world who are experts in their fields, or the more
    frequent (early in the morning, late in the evening or even weekend) conversations with other local providers, I focus on my patient ‘s needs rather
    than my own ego needs.  In the long run, providing quality care is what the bottom line.  I learned a lot about working as a team on Inpatient
    psychiatric hospital settings.

    Scheduling:

    I work Monday through Thursday and regularly take vacations.

    Do I not make money when I am not at work?  Yes.

    Time off is a crucial part of taking care of myself and preventing burn-out, allowing me to be fully mentally present when I am in session with a
    patient.  This is also why the business of my psychotherapy practice (phone, computer, files, etc.) are in an office separate from the consulting room.  
    During appointments I am ready and able to focus completely on the patient's communication.  Leading by example by taking care of my own
    mental health is vitally important.

    Fiscal responsibility:

    Finally, a strictly financial business decision that I made when I entered solo practice was to receive payment at the time of the appointment
    (weekly).  

    Have I had to temporarily or permanently suspend scheduled appointment s because a patient cannot comply with that part of the treatment plan?  
    Yes.

    As a result of this policy, I can do less  collection work and more therapy and/or continuing education, etc.  Also, without cash flow worries I have
    been able to not raise my rates since March 2004.  I value the services I provide and encourage patients to take responsibility in all aspects of their
    lives.