The website STAT, which focuses on news in health care, published an editorial last month under the headline, “Physicians aren’t burning out. They’re suffering from moral injury.” Almost all of its conclusions appear fully applicable to psychotherapists as well. Could it be that we’ve been talking about therapist burnout from the wrong framework?
If you are planning to become a counselor, it is important to give thought to the time and money it will take to work your way to licensure. The timing of steps along the way could impact your choices for when to get married, have children, or maintain employment in another field.
Presented here are the typical steps to a Licensed Professional Counselor (LPC) license and some common timeframes. [Note: Specific license titles vary by state. LPCC and LCPC are also common, with the first “C” in each standing for “Clinical.”]
The mental health professions have long recognized that with our positions and our expertise comes a great deal of responsibility. In exchange for our professional status and the trust we are given to work with vulnerable people in private, we agree to act not just on behalf of our clients, but also on behalf of the larger communities who grant us that very trust. This means maintaining awareness of the laws and policies that impact our clients and communities, and working to change those policies that are not in the community’s best interest.
While each professional organization phrases this obligation differently, they agree that it is part of being a counselor or therapist. Simply put, you are expected to use your specialized knowledge and training to benefit the larger community. It is part of holding the title of a mental health professional.
In the world of private education, it isn’t uncommon for universities to be bought and sold. But recent years have seen a spike in the acquisition of private universities offering graduate degrees in mental health fields. Many students may not even be aware that their universities are now parts of larger corporations.
Three specific companies serve as case examples.
If you’re a therapist in private practice, you’re probably listed on Psychology Today. For better or worse, it’s the 800-pound gorilla of therapist directories: It gets a ton of traffic, which means its pages show up high in search results, which generate even more traffic.
Despite owning the market, the Psychology Today directory is not necessarily well-liked. Its user experience looks and feels dated. While advanced searches are possible, the main search page only allows searches by name and location. Therapists and clients alike sometimes grumble that the information therapists can share on their profiles is limited.
For a new generation of online therapist directories, the failure of Psychology Today to improve its product represents a tremendous opportunity.
ACA, AAMFT, and CAMFT continue to work with and others in Washington to get LPCs and LMFTs included as eligible providers in Medicare. Bills pending before both the House and Senate would do it. And that change would be beneficial for consumers and taxpayers alike.
Barry Duncan has an article in the current Psychotherapy Networker asking, “Why would anybody become a therapist?” The job offers low pay compared to other jobs with similar training requirements. Workers in community mental health are often stretched beyond the breaking point. And as we’ve covered here regularly, employer abuses of therapists are unfortunately common. When even a single therapist pushes back against exploitation, it makes a real difference. But that doesn’t happen very often.
Duncan’s article offers some interesting overlaps with our past coverage here. It can explain fairly well why even the best therapists can be easy targets for exploitation at work.
Look, I’m not here to defend the BBS (California’s Board of Behavioral Sciences) or any other licensing board. They’re not your friend. They require deeply flawed exams that even they know don’t work. Their disciplinary guidelines, especially around substance use issues, are unreasonably punitive. They are notoriously unresponsive. There are a lot of problems there. But it’s also true that most complaints about the BBS are based on flat-out falsehoods.
Becoming a therapist is ridiculously expensive. There’s grad school, which costs about five times as much even in inflation-adjusted dollars today than it did 30 years ago. There’s the time between graduation and licensure, which is often filled with low-paying employment. And then at the end of all of that, you take your final license exam. (Some states have bumped up some exams to be earlier in the process.) Given all the expense that leads up to it, it’s common to wonder why that last major hurdle is itself so expensive. If your education and experience should have prepared you for licensure, why should you have to do license exam prep courses in addition? And if you do go the test-prep route, why is it so expensive?
Let’s take those questions in order.
As marriage and family therapists, we have a vast body of knowledge supporting our work with families and communities. Many of the pinciples and interventions from this body of knowledge could be utilized in public policy, to great positive effect. As two examples, family breakdown could be reduced, and juvenile crime recidivism decreased, both in ways that actually save taxpayers money. Politicians of all parties should be chomping at the bit for such policies.
Except that they don’t. And the April 2009 Family Relations journal helps us to understand why not.