Anybody who’s been making a living as a therapist in private practice for a while will readily tell you that things aren’t what they used to be. Sure, incomes are down. Reimbursements aren’t what they used to be. Referral sources have changed. It takes more effort and marketing savvy to keep a practice afloat. But many practitioners still carry on as if it were still 1980-something and their potential clients are fundamentally the same as those who sought therapy three or more decades ago.

The September/October Networker, The Selling of Psychotherapy: What Are the Rules in the Today’s Consumer-Driven Market, is dedicated to the idea that there’s something more going on, a fundamental shift in the attitudes of people coming to us for help– the patients of yesterday have become the educated mental health consumers of today. In this issue’s cover story, therapist and business coach Lynn Grodzki provides an eye-opening road-map to both this shift in clients’ attitude and how we as therapists can most productively respond to it. Here’s a sample of Lynn’s take on the sea change taking place in our profession right now:

Just 25 years ago, the psychotherapy field was still at the tail end of the Golden Age of Therapy.

Most clients accepted the challenge of therapy as serious, life-changing work, despite the ambiguity and sometimes mystifying ritual of the weekly or biweekly therapy appointments. Those who asked to know track records, who insisted on dictating what they wanted out of therapy, who tried to put limits on the length of treatment or haggled over fees, were seen as caught in the scramble of their own resistance. Of course, it was hard and expensive and time consuming to be in therapy, but therapists and their clients had a sense of being privy to a secret tool, a demanding yet rewarding process for living the well-examined life.

Today therapists are no longer seen as elite healers, but commonplace service providers of healthcare. The devaluing of therapy has made it more accessible to the public–something most would agree is a good thing–but has created a precipitous change in the way therapy is valued and delivered.

In working with therapists to build their practices, I’ve started calling this new type of client educated consumers or ECs for short. This term helps therapists better understand clients who, despite a lack of education about the methods or history of therapy, possess a deep knowledge about finding and purchasing what they want. To serve these ECs, we need to learn to do things differently—to articulate services more clearly in ordinary language, highlight and concretize the value of therapy, measure and underline progress within each session.

Our September/October issue will be challenging to those of us who first entered the therapy profession because we wanted an alternative to competing in the go-go corporate marketplace. But this issue makes clear that if we wish to stay professionally alive, it’s time to recognize that the choice between being dedicated clinicians and being smart business people is a false one. Or as Lynn puts it, “If you want to dance with the new economy and not get stepped on, you’ve got to be light on your feet, ready to turn—if not on a dime, at least on a quarter—and master some moves you never imagined yourself performing.”

Click here to check out the new September/October Psychotherapy Networker.

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Rich Simon

Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day.