Making the transition from agency social worker to private practice
September 6, 2020 10:12 AM   Subscribe

I know there are some therapists on here and have asked a question or two before. This one is just a practical nuts and bolts question about going from "I work a typical social work job without a huge amount of clinical content" to doing some private practice. More details below. Sorry to post anonymously; this is the content area where I most want to be 100% not googlable. If you indicate you'd like to discuss this more one on one, I'll memail you.

First of all I should say "asking the invisible people in my phone" is not my sole tack here, in case this seems like a dumb place to be doing this. But I want a range of advice.

Anyway, the good news is I got my license. The bad-ish news is it has been a decade or more since I've done anything resembling psychotherapy, because the field is messed up and frequently to get your hours and pay the rent, you need jobs that are heavier on casework. I know there's clinical content in lots of kinds of work if you look for it but...yeah.

I'm wondering about a few things, then.

-How to get back to feeling confident about providing psychotherapy before actually attempting to do so. Read books? Take classes? What helped you, if you did this?

-How to find a network of other therapists to ask questions like this and perhaps form a peer consultation group.

-What are the nuts and bolts of being able to take private pay clients and insurance clients? The only one I know offhand is malpractice insurance, but I don't know where to get it other than as a member of otherwise useless NASW.

-Off chance: has anyone fired up a private practice right now in the age of no-contact? What are the places to find Zoom clients and what kind of HIPAA type stuff do you need to do to make sure you're ok doing online therapy? I mean hopefully by the time I'm actually making this happen, we'll all be happy and free again but who knows.

-Any other advice!

Thank you!
posted by anonymous to Grab Bag (6 answers total) 2 users marked this as a favorite
The answer depends on (if you're in the US) which state you live in.
posted by Obscure Reference at 11:10 AM on September 6, 2020

MeMail me.
posted by crunchy potato at 11:57 AM on September 6, 2020

The absolute number-one piece of advice I have, in terms of clinical skills, is to remember that you don't need to know everything, because it's not your job to solve your clients' problems. That's their job, and they're always going to know more about it than you will, because they are experts on their lives in a way that you can never be. What you are doing is creating a safe container for them to sift through everything with you, so that you can ask questions about what you're sifting through and maybe find some connections, hazards, or invitations in all that stuff that could help them make sense of it.

I think therapists who are new or rusty often get panicky because they think they've misplaced their magic wand. Especially if you've been doing a lot of casework, where you likely did have accesses to resources that the clients themselves did not and so you were solving problems at least some of the time. Remember that therapy is not about magic wands.

Read Letters to a Young Therapist by Mary Pipher.
posted by lapis at 2:34 PM on September 6, 2020 [2 favorites]

If you are considering taking insurance or if you think your private pay customers are going to try to be reimbursed by their insurance, I highly recommend Barbara Griswold's book, Navigating the Insurance Maze.

For questions about telehealth and HIPAA, check out Person Centered Technology .

LPCC and LMFT are more likely to be in private practice - look for their local professional societies, it may be easier to find on the state level and then search for a local chapter. They often have list-serves or forums for members that are great for asking questions and bailing a professional network.

Finally, consider asking someone that you respect to serve as your clinical coach. While you don't need supervision from a licensing perspective, paying someone for an equivalent role - to give you a safe space to discuss your cases and advice from someone whose experience you trust - is invaluable.
posted by metahawk at 4:37 PM on September 6, 2020

Also, there are so many facebook groups for therapists - I'm sure you can find several that fit different aspects of your needs.
posted by metahawk at 4:38 PM on September 6, 2020 [1 favorite]

Online platforms like BetterHelp, Talkspace, and Pride Counseling might be a good place to start, since they have the technical aspects already figured out.
posted by Pwoink at 5:55 PM on September 6, 2020

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