November 1st, 2011

Private Practice Made Simple

By Randy J. Paterson

New Harbinger Publications, Inc.

Oakland, Calif., 2011

 Book offers soup-to-nuts collection of tips

Reviewed By Paul Efthim, Ph.D.

Whether you are fresh out of training or in mid-career, opening a private practice can be a frightening prospect. A recent book by Vancouver psychologist Randy Paterson offers a soup-to-nuts collection of tips on how to launch and manage a successful psychotherapy practice while managing the inevitable anxieties along the way.

Having built a private group practice and given workshops on the topic, Paterson knows the territory well. He has produced a well-written guidebook that will appeal to many, if not most practitioners on the verge of hanging out a shingle.

Adopting a conversational style, the author offers an opinionated perspective while wisely keeping his own personality in the background. For example, he strongly encourages setting up a Web site (a highly cost-effective way to market one’s practice) but is equally forceful in his advice to not write a blog (too time-consuming and not important for generating new business).

Many of his recommendations involve the myriad yet important details: how to arrange the office, how to organize patient charts, dos and don’ts of clothing, budgeting, hiring assistants. Paterson dispenses advice on these potentially hypnotic topics with a wry sensibility. One helpful hint evoked the image of a New Yorker cartoon: he cautions therapists to avoid the “halo effect” created by hanging diplomas behind your chair so that patients see you framed by your qualifications.

Other sections of the book take a look at important emotional dimensions of private practice, including anxieties about dealing with money (“Did I give enough in this session to merit the fee I’m charging?”), hidden concerns about competence and readiness to practice independently, dealing with fiscal uncertainty and avoiding social isolation. The first chapter presents top-10 lists of the fears and fantasies clinicians report about going into private practice. The book closes with a chapter offering sage advice about avoiding burnout over the long term.

One drawback is a neglect of some key areas of practice management such as billing, dealing with insurance companies, collections and getting paid, communications (e.g. whether/how to use email) and cancellation policies. Perhaps these areas were not covered because the author is trying to target practitioners in both Canada and America, which have differing medical, legal and regulatory systems that affect these areas of practice.

To its credit, the book offers free online access to supplementary materials and downloadable forms through the publisher and through the author’s practice Web site, Changeways Clinic. However, most of these materials are self-help worksheets for therapists setting up their practice, in keeping with the author’s clinical orientation which tends toward problem-solving and behavioral approaches to treatment. Missing but more desirable would be sample forms for informed consent, release of information and the initial clinical interview.

On the whole, this volume, unlike some others on the market, strikes an excellent balance between focusing on the business of practice while also offering help with the psychological aspects and developmental tasks involved in going out on one’s own.

Paul Efthim, Ph.D. is a licensed psychologist in private practice in Brookline, Mass. and holds a faculty appointment at the Boston Institute for Psychotherapy.

By Paul Efthim PhD

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