It’s fairly common knowledge that the gender balance of a profession and the pay in that profession are correlated. Jobs populated primarily by women pay less, on average, than those populated primarily by men. But it’s rare to get a clear sense of why that’s the case. The therapy world offers a rare exception. It used to be that most therapists were men. Today, the overwhelming majority are women — and pay is meaningfully lower. But we actually know which change came first.
We’re big fans of Scott Miller and his Top Performance Blog around here. Miller has allowed his career to be guided by emerging research, a trait that is surprisingly rare in the psychotherapy world. It has led him to some very useful conclusions about how we can become more effective. Deliberate practice and using outcome data are two specific things that we all could do that would almost certainly improve our outcomes.
There are many things about his work to admire. But what I appreciate most is his skill at walking the difficult line between being alarmist — it’s kind of a big deal that therapy outcomes haven’t gotten better in 40 years — and being supportive and uplifting for therapists who are doing their own part individually to improve. So it was an honor to meet him at the 2017 Evolution of Psychotherapy Conference, and to have him interview me earlier this year for his blog.
From the time you were in graduate school, your instructors and supervisors have likely emphasized the importance of self-care. Burnout is a real risk in the world of counseling and psychotherapy, and you have to be able to take care of yourself in order to avoid it.
These messages come from a good place. But they ignore reality for many therapists, especially those early in their careers. And those messages often come with dangerous assumptions and a dark undercurrent: If you’re having a hard time, it’s your own fault.
In late 2017, I sat down with my friends at LA-CAMFT for a wide-ranging discussion of issues that impact prelicensed therapists. Advocacy is sort of my jam, so we knew that advocacy would be a big part of the discussion. But we also got to talk about interviews, health insurance, employment, exams, and a lot of other issues relevant to early-career therapists.
Back in January, we launched #PostThePay in hopes of making life a little bit easier for prelicensed therapists and those who employ them. As we described then, too much time is wasted by those on both sides when applicants for a therapy or counseling job wouldn’t take the pay scale that the job offers. Furthermore, California law now requires that employers provide the pay scale to any applicant who asks — so why not just put it in a job announcement?
We’ve spent the last two episodes talking about student loan debt. It’s reshaping the mental health professions. Two doctoral students were kind enough to share with us their own personal stories. In this episode, we talk about the great hope for many who are in the deep end of student loan debt: Public Service Loan Forgiveness.
We’ve talked here many a time about employment of prelicensed therapists. Most of our discussion has focused on employer abuses and how you can push back. But of course it’s worth noting that plenty of employers are fantastic, and that even a lot of the illegality in employment arrangements can be chalked up to well-meaning mistakes rather than purposeful villainy. It is in that spirit that we approach what seems to be one of the most common structures for paying prelicensed therapists who work in private practices here in California: Fee splitting.
In our last episode, we talked about how student loan debt is crushing the mental health professions. This time, we get a lot more personal. For this episode of the Psychotherapy Notes podcast, we interviewed two graduate students working on their doctorates at a private university in southern California. By the time they both graduate, they will together owe more than half a million dollars for their education.
It’s a sea change. And we don’t just mean the cover, which finally lets go of the pathway-in-the-forest image that graced the first four editions. The fifth edition of Basics of California Law for LMFTs, LPCCs, and LCSWs, which is available now for preorder, is the biggest change since I wrote the first one.
The new edition is updated to 2018 law and professional ethics codes, and includes new material on:
- Employment Law, including wages, sick leave, termination, and more
- Family Law, including marriage, separation and divorce, custody, and more
- Supervision, including supervisors’ legal responsibilities
- Some of the biggest current controversies in state law for psychotherapists
Good news and bad news, I suppose, from today’s meeting of the California Board of Behavioral Sciences. The most important good news surrounds the 90-day rule for supervised experience between graduation and registration as an associate. Good stuff first!