Q: You talk a lot about multiple income streams for a successful practice. In my practice, I have incorporated that concept and do traditional talk therapy, work with insurance and managed care companies, contract with employee assistance programs, give speeches on parenting and positive communication, and conduct a mood disorders support group. As I have learned, in order to keep my practice viable, I need to look toward the future. What new possibilities are emerging for 2008 and beyond?
A: We do advocate that today’s counselor in private practice maintain multiple income streams to have a thriving practice. The practice of professional counseling is constantly evolving, and the counselor in private practice needs to stay informed of new trends, therapies and avenues to use and enhance their counseling skills.
We have always recommended reading Psychotherapy Finances to stay abreast of what other entrepreneurial mental health professionals are finding successful. This monthly newsletter details income streams that have worked for others and highlights new trends in the field. A one-year subscription is $79. For more information, go to psyfin.com.
One new avenue for professional counselors that seems to be gaining momentum is in the area of collaborative law. Collaborative law is designed so that the professionals most qualified to address the complex issues of divorce can provide services to families. It relies on clients, attorneys, mental health professionals and financial advisers to form a team, bound by a formal agreement. Instead of pursuing litigation, team members find creative solutions and maximize benefits to the family by using their communication, mediation and professional skills. Collaborative law is a new way to help families deal with the pain of divorce and learn new ways to form healthier relationships post-divorce.
The role of the professional counselor is to assist each of the parties to deal with the process more effectively. In addition to helping clients deal with the emotional aspects of the divorce process, the professional counselor also assists with identifying self-defeating behaviors, improving communication, prioritizing needs and goals, and maintaining a future orientation.
We encourage you to seek more information on this new approach to divorce. A few helpful sites:
Q: What do you think of asking clients to pay for materials used in sessions such as play therapy or art therapy where the materials are consumed? I use wooden blocks, small electric motors, wheels, art supplies and other materials. The kids I work with take the projects home, and I want to continue doing this because it really helps them with their self-esteem and problem-solving abilities. My problem is with managed care limiting my fee. The cost of these materials is coming out of the income of my small practice and adding to my overhead.
A: You cannot bill a managed care or insurance company for materials. We conducted a short survey of counselors and found that some absorb the cost of these supplies, while others ask the clients to pay for consumables.
Larry Freeman, the American Counseling Association’s director of ethics and professional standards, advises that a counselor must have such fees written into the initial informed consent document signed by the client and/or the parent or guardian before the first session.
We acknowledge that such cost can add to the overhead of a small practice, and the decision to add this cost or absorb it should be made by the individual clinician. Our opinion is that it should be a one-time charge, outlined in the informed consent at the time of intake, and discussed with the client.
Stay tuned for more information coming in the next few months regarding implementation of a required transfer plan, as addressed by the 2005 ACA Code of Ethics (Standard C.2.h., “Counselor Incapacitation or Termination of Practice”). We will be posting a bulletin on the “Private Practice Pointers” section of the ACA website (www.counseling.org) detailing the essential components.
We hope to see you at the ACA Conference in Hawaii. We will be signing our book, The Complete Guide to Private Practice for Licensed Mental Health Professionals, at the ACA Bookstore in the Convention Center on Thursday, March 27, from 5:30-6:30 p.m. We will also be presenting a preconference Learning Institute, “Starting, Maintaining and Expanding a Successful Private Practice,” on March 27.
In addition, the New York Mental Health Counselors Association will be sponsoring our workshop on private practice at its convention on April 11 at the Marriott Hotel in Albany, N.Y. For more information, visit www.nymhca.org.
Finally, the Illinois Mental Health Counselors Association will be offering the workshop on June 8. More information is available at www.imhca.org. ACA members can e-mail their questions to Robert J. Walsh and Norman C. Dasenbrook at firstname.lastname@example.org and access a series of “Private Practice Pointers” on the ACA website at www.counseling.org.
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