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.
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.
California suffers from a severe and worsening mental health workforce shortage. In fact, much of the US is in the same boat. There simply aren’t enough qualified mental health professionals to meet our country’s needs.
At the same time, therapists in private practice often complain about their local markets being saturated. There are so many therapists in some places, it seems, that it’s hard to get a career off the ground.
As it turns out, there’s truth to both of these perspectives.
From students and colleagues alike, I often hear statements to the effect of “There are a lot of bad therapists out there.” As I understand it, “bad” in this context has a variety of meanings, ranging from ineffective to unethical. At either end of that spectrum, though, the next question is usually the same: How do they stay licensed?
In January we launched our #PostThePay campaign. Every California job applicant has a legal right to know the pay of the position they’re applying for. When employers post pay information in job announcements, they save themselves time and promote fair wages in the mental health field. But how can you help ensure fair wages if you’re already employed? What if you know the pay of a position, but aren’t quite satisfied about it? Here are some ways you can advocate for better pay in therapy and counseling jobs.
If you haven’t noticed, telehealth is an ongoing theme around here. Last year, we posted on what we know and don’t know about online therapy, and four reasons to move your practice online. I also proudly chaired the workgroup that developed AAMFT’s Best Practices in the Online Practice of Couple and Family Therapy, which is available for free here.
We know a lot of therapists are still worried about using technology in their practices, and we have good news — regulations are getting clearer, and so is the technology itself. In short, it’s easier and safer than ever to move part or all of your therapy practice online.
Tyra and I both hear a lot of horror stories. It goes with the territory. Therapy is hard work, and community mental health work is especially challenging. Clients may have severe mental health problems, other major health concerns, substance use struggles, inconsistent employment or housing, and a wide variety of other social and environmental problems — all overlapping. The therapists doing their best to help clients in these settings are themselves often overworked and underpaid. Many are in the early stages of their careers, making it more difficult to know what’s normal in that kind of work setting. How can you tell when a work environment in community mental health is need of fixing? How can you tell when it’s better to just leave?
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.
Therapists and counselors are increasingly required to formally gather outcome data on their work. This is good: The more data that we have on our work, the more intentional and effective our clinical decisions can become. Regularly collecting and attending to outcome data, therefore, suggests constant movement towards improvement.
Many therapists struggle, however, with questions about what data to gather, and how to best gather it. Even among those who philosophically agree that regularly collecting outcome data helps to more meaningfully direct therapy, they often don’t do it.
Thankfully, there are a number of easy ways for therapists to collect outcome data. Many come at no cost. The following are just three of the many different tools/assessments therapists can use to collect and interpret outcome data.