Recently, I interviewed Dr. Steven Walfish, the co-author with Dr. Jeffrey E. Barnett of “Financial Success in Mental Health Practice: Essential Tools and Strategies for Practitioners” about his book and also surviving as a private mental health practitioner. I think that most mental health practitioners who are in private practice or are planning to be in the future will benefit from this book.
What inspired you and Dr. Barnett to write this book?
I was a frequent responder on list serves regarding the business of practice. An Acquisitions Editor at APA Books asked if I would be interested in writing a book about the financial aspects of running a practice, as there were no such reso
urces out there at the time.
What is your background in private practice?
I went into part-time practice in Tampa, Florida upon receiving my PhD in Clinical/Community Psychology in 1981. After I completed a Research Fellowship I then took the plunge into full-time practice. I remained in practice in Tampa until 1992 when we moved to Seattle. I was in full-time practice in Edmonds and Everett, Washington for ten years. We then moved to Atlanta. I was a visiting professor first at Kennesaw State University, full-time as I started my practice, and then two years later was a half-time Visiting professor at Georgia State University as my practice continued to grow. In 2006 I stopped teaching and concentrated solely on my practice.
Are you working on any other writing projects?
Jeff Barnett and I just completed another book for APA Books that will be published
this summer titled, Billing and Collecting for Your Mental Health Practice: Effective Strategies and Ethical Practice. It is a continuation of our emphasis on our first book in that mental health professionals receive little, if any, training/guidance on the business aspects of a private practice. The book focuses on how to bill and collect and to avoid ethical or illegal behaviors in the process. Lisa Grossman, a Psychologist in Chicago, have just signed a contract for Springer Books titled, “Translating Research into Practice: Researcher and Clinician Perspectives. Academics/researchers will present the evidence-based research on a large number of clinical problem areas and then clinicians will comment on what it is like to try and implement evidence-based practices within clinical practice.
When you’re not writing what else do you do?
My wife is an artist so we go to openings. We also enjoy dining out in the wide variety of restaurants that Atlanta has to offer. I also enjoy watching our local sports teams.
What are other books that you have written?
In 2001 Allen Hess and I co-edited, Succeeding in Graduate School: The Career Guide for Psychology Students. It looks at the application process to grad school, then how to make it through (both academically and politically) through the rigors of program, and then looks at career options. In May of 2010 APA Books published a book that I edited titled, Earning a Living Outside of Managed care: 50 Ways to Expand Your Practice Many people want a practice that falls outside the purview of managed care. Very few know how to accomplish this in their practice. The book presents vignettes of people who are doing this and they discuss their interest in the area and if the reader is interested how to learn more about incorporating the practice activity into their practice.
What are some of the top pitfalls that private practitioners find themselves in?
I think the main one is not viewing our practices as a ‘small business” and that we are ‘small business owners.” Another key one is ignoring our entire skill set (assessment, psychotherapy, consultation, writing, research) in helping us to make a living in independent practice. I believe too often people say, “I only do this or I only do that.’ It limits our options to deliver good services or to develop products.
What tips do you have on thriving in mental health private practice?
Jeff Barnett and I have 20 Principles of Private Practice Success that we present in our book.
Here are the top 5:
1. You Need To Resolve the Conflict Between Altruism and Being a Business Owner
2. It Is Essential That Mental Health Professionals Have Ready Access To Competent Professionals To Answer Questions Outside of Their Areas of Expertise. To Ignore This Places the Clinician at Ethical, Legal and Financial Risk
3. Private Practitioners Need To Become Comfortable With Negotiating From a Position Of Strength. If You Are Desperate For The Job or Income You Will Negotiate From a Position of Weakness. Strength is Found in the Ability to Say No Thank You and Walk Away.
4. Participation In A Managed Care Plan Is Not A Requirement For Being In Private Practice. If You Choose To Participate Clearly Understand, and Emotionally Accept, All Of The Financial and Clinical Ramifications and Limitations Beforehand. If You Do Not Do So You Will Be Setting Yourself Up For A Great Deal Of Frustration During Your Participation.
5. There Are Only So Many Hours In The Week That A Private Practitioner Can Earn Income. Therefore It Is Financially Advantageous To Develop Revenue Steams of Passive Income.
How should a therapist prepare themselves for opening a private practice?
First and foremost of course is to buy our book (tee hee!). Actually there are many good books out there on developing a private practice (Chris Stout, Lorina Kase, Holly Hunt, Lyn Grodzki). I would find appropriate mentors who can teach you about the ins and outs and pros and cons of private practice and perhaps they will take you under their wing. Also be prepared to pay for consultation and program development advice. Mental health professionals tend to “be cheap” and not want to pay for services that will bring them more money (or preserve the money they have) in the long run. There are also professional organizations one can join. For psychologists there is APA Division 42, Psychologists in Independent practice.
Who will benefit from your book?
Anyone considering going into practice. The review of the books have lauded how realistic and practical we try to be. In the Preface Jeff and I point out how many mistakes we have made in a combined 50 years of practice. We want others to avoid making these same mistakes.
Many of my readers work with children, what are some additional considerations when working with children in private practice?
Working with children requires flexibility in hours, especially if it is a long-term case. Parents do not like to take their kids out of school on a weekly basis. So hours may need to be offered after school, early evening, or on Saturdays to optimize filling psychotherapy slots. You also need a waiting room that is “kid-friendly” and office staff that can tolerate children with behavior problems. Working with children also requires working with the adults that control their lives (e.g., parents, teachers, school administrators). So skills in working with adults that can be difficult are an essential part of the job description.
What is one of the most rewarding things about working in private practice?
For me it is in having been able to create my own successful small business. I also get to choose my hours, client populations that I work with, and that I have no boss listening to one of my ideas and saying, “No!”
What is one of the most difficult things about private practice?
The uncertainty of the continued success of my practice. One fact about private practice is that it is always changing and evolving. Some of these changes are within my control and some are not. This is the reality of free enterprise in out culture.
How/when did you decide to start writing?
I have always written professionally, though most has been for formal journal articles. Moving into books was a natural progression for me.
Where can “Financial Success in Mental Health Practice” be purchased?
Through the American Psychological Association, Amazon.com and likely other book outlets.