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Harnessing the Winds of Change - Page 5

A Paradigm Shift

In 12-step programs, a story told to motivate newly recovering addicts is about a person who walks down a street absentmindedly and falls into a pothole. If the person is an unrecovered addict, he or she keeps walking down the same street and falling into the pothole, evoking Rita Mae Brown's definition of insanity: "doing the same thing over and over again, but expecting different results." An addict further along the recovery process sees the pothole and tries to circumvent it, sometimes successfully, sometimes not. The paradigm shift in recovery occurs when the addict decides to walk down a different street.

Can private practice walk down a different street? The place to start is noticing our resistance to altering the traditional methods of finding referrals, billing clients, and positioning ourselves with the public. Marketing guru Seth Godin, author of Survival Is Not Enough, offers an improved mind-set for the small business of today: "Change is not a threat, it's an opportunity. Survival is not the goal, transformative success is."

Dana Ackley, author of the pioneering book Breaking Free of Managed Care, sees the challenges we face as a potential blessing. "This might be the best thing that could happen to those in private practice," Ackley says, "if it forces psychotherapists to redo their relationships with the insurance companies and rethink their way of interacting with the public. Those who tied themselves to the medical model have now reaped what they sowed. Private practitioners have become dependent upon insurance companies. This relationship has become abusive. Just as in abusive marriages, dependency relationships are maintained out of the false belief that I can't get along with him or her.' Therapists need to think about what they'd tell an abused spouse about giving up dependency relationships, and then take their own advice."

Full recovery for private practice would mean no more hand-holding with insurance companies, or accepting their low fees as fair trade for meager referrals. We'd stop self-identifying with the medical model and find another way to define ourselves, perhaps "necessary human education" or "the prerequisite for wellness." We could drop the jargon and diagnosis codes while we decide if we want to present our product as an art or a science. We'd learn to face the public squarely, on footing equal to that of other service-oriented professionals, and find the words to explain who we are, what we do, and why psychotherapy is important. We'd appreciate that being a small business allows us to be flexible, respond to feedback, and routinely measure client results in order to create practices that follow consumers' needs and desires. We'd seek ways to increase market share for everyone within the profession, building alliances among therapists for advertising and PR efforts, and putting more pressure on our associations to help educate the public about the legitimacy and value of counseling.

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