Psychotherapy - Business Or Help?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The topic of financial relations between a client and a psychotherapist arises very often in coach sessions, supervision, in balint groups, etc., because they are an integral part of psychotherapy. We are used to discussing the topic of money from the point of view that "if you want professional help, then your therapist should be able to attend modern expensive trainings, personal therapy, etc." At the same time, almost no attention is paid to the issue of the fact that previously there was no fixed payment in psychotherapy, and the client paid exactly as much as it was significant for him, since this was one of the important motivating elements for him to change. Even now, some experienced therapists, when they note that the client is stuck in his development, they increase the cost of services, and there is a kind of progress in the therapeutic relationship (if that is not a formula;)). We often read articles about the reasons for clients leaving therapy, where, of course, a lot of space is given to personal experiences, defense mechanisms, the complexity of the client history, but almost no one says that very often the client is faced with a mismatch of his expectations with financial contributions. Therefore, I will start the article with the most important:

Psychological services are free

This is not to say that a person is thrown in trouble because "psychologists are too expensive a pleasure for the elite." There are actually a lot of specialists who, literally, do not need to pay anything for the provision of psychological assistance, and they work almost everywhere: kindergarten-school-college and university; polyclinic-hospital-social service; firm-organization-enterprise; crisis services, volunteer movements, online information resources; specialized forums (where you can communicate anonymously and at the same time gather a consultation and get advice from several specialists at once).

Often a person does not need global transformations, but follows fashion - to work with a psychologist. In fact, one just needs to speak out, another to receive the same notorious recommendation, the third to understand what is happening and where, how it can be changed on its own, what to read, etc.

Even in psychosomatics, thousands of people cope without psychotherapy, receiving treatment from a specialized doctor or psychiatrist. At the same time, they are "afraid" to go to the latter, although by and large a doctor of a narrow specialty can prescribe treatment for the same IBS and other organ neurosis. Moreover, from my own experience, I know that for the treatment of the same cardioneurosis, you do not need to immediately build pictures of yourself with a straitjacket and a lobotomy, but you can simply get a prescription for simple herbal drops or teas from a local therapist or cardiologist. And with proper implementation of the recommendations, forget about it in a couple of months, which happens in more than 70% of patients with such a diagnosis - cheap and cheerful.

Free doesn't mean bad

Our orthopedist from the children's clinic often recalls the case when a "mother" from his own area came to see him in a private clinic and complained for a long time about how stupid orthopedist they have in the clinic and how wonderful they are here (I forgot my glasses;)). The reasons why good professionals advise in those very crisis services, schools, hospitals, etc. are varied. Without further ado - someone collects material for a dissertation, someone takes some of the clients for a charitable purpose, someone chooses this as a form of advertising, someone thus solves specific issues of employment, pension or insurance and stable wages, etc..d. Moreover, all seasoned specialists start somewhere, and if they were negligent in their place in a school or clinic, they would never have become what they have become. And "forming" in this workplace as professionals, they automatically set the direction for colleagues, who will remain to work there for their own reasons. At the same time, there is no guarantee that by turning to a private practitioner you will receive professional help, because it is not the price that plays a role here, but competence and experience. Now is not the time when private means the best, qualified and even legal. Let's think more flexibly.

A paid psychologist is not always a businessman

Based on the above, the other side of the issue appears. Very often, specialists working for the state conduct a kind of private reception. They are assigned to a state institution, which calculates salaries and the flow of clients gets to them automatically in connection with the position of a psychologist in a state structure. Thus, they do not pay (or pay a minimum by agreement with their superiors) money for renting an office or audience for groups, advertising and promotion, they do not pay taxes and salaries to other specialists who would do part of their work, etc. All this allows them put as much as possible low price for their services … This is an answer to the question why a consultation with a professor at an institute can cost less than a consultation with a young specialist from a private trader - not because he is more stupid, but because he does not have such costs that need to be recouped. Good or bad for the client is difficult to say. On the one hand, this is beneficial because the price is minimal, on the other hand, in fact, they use the services of the same specialist who works in this institution and free of charge. Unless only the flow is so great that it is difficult to squeeze into a live free queue.

A beginner does not mean incompetent

People are not born with a psychology degree in their hands, as with any other degree. Beginners have a big plus in being careful. They are more inclined to work in the field of their direction and are more eager to learn, get something new from colleagues. Sometimes such work can be more competent from the point of view of a therapeutic approach than that of a specialist who "got his hands on" and abandoned the diploma and methodology of his direction began to experiment and apply "newfangled theories" at his discretion. Never hesitate to ask a psychologist-psychotherapist about his specialized education. If he positions himself as a psychologist who works in a narrow range of issues (PTSD, psychosomatics, neuroses-depression, business, sexopathology, defectology, etc.), he always receives additional education in this direction, and receives the qualification of a sex therapist or coach. But there is also one complication here. Due to the fact that the services of novice specialists are slightly cheaper than the services of experienced colleagues, they often become an object for manipulative clients. Of course, this stimulates the psychologist-psychotherapist to develop, but he may experience various kinds of unconscious transferences to other clients. Therefore, they need more supervision, personal therapy, and accordingly, over time, the cost of their services begins to creep up. So we get to an experienced, "worked out" psychotherapist who knows his own worth;)

Psychotherapy as your own business

When it comes to the psychotherapist as an entrepreneur, his costs for attracting clients alone increase significantly. No one will pay him a salary, no one will pay for vacation or sick leave, no one will reimburse lost (stolen) work, no one will return the departed clients in case of force majeure, no one will attract new ones, while in spite of everything every month he has to pay a round the amount. Starting from all taxes and deductions to the Pension Fund, office rent or utility bills, depreciation of equipment, communications, etc., creating advertising and promoting your product, paying for your social platform (hosting sites, domains, etc.). Even if your psychologist doesn't have a staff of 10, just think about who is cleaning the floors and the toilet in his office (next door). Are you sure that this is all managed by an employee of the cleaning company, to whom the therapist simply pays money for each cleaning?

Therapist's job is not always obvious

Sometimes we think that the psychologist-psychotherapist worked an hour, got his money and went to rest. While a private practitioner works much more. Starting with the same "mental burden" that leads most entrepreneurs to pathological psychosomatics - when you constantly need to keep and plan a lot of issues in your head, ranging from accounting, law, marketing and directly maintaining the brand and improving the product. Since painstakingly building a reputation can take years, and losing trust because of one wrong step in 1 day. Ending directly with answers to failed requests, hopeless letters with a cry for help, drawing up the correct wording why he does not conduct free introductory consultations and listen to the client on the phone, answering questions on the network, writing videos, programs, articles, notes and comments, filling sites and blogs - all this work that no one sees, but it is done for a long time and for free. The fact that before the client had to explain 2-3 meetings, now can be conveyed in the form of a ready-made article, and this is real saving time and money in the first place for the client himself … At the same time, when the therapist begins to do too much "invisible" work, it is a clear sign that he needs an assistant. So boldly add at least two salaries, with taxes, etc., which will be included in the new cost of the services of a good therapist.

Here we come to the conclusion that psychotherapy is not just a profession, a specialty marked in a diploma, but the work of his whole life. His professional "brainchild", which you want to acquaint with people who are close in spirit, which you want to give to someone who understands the value of such growing up. And the more the therapist's experience and knowledge, the more one wants to direct this point help into a narrow channel, with the knowledge that the grain will sprout here, that it will be watered and fertilized here, and it is here that huge fruitful trees will grow. However, in such a situation, it is really important that the specialist does not get hung up on psychotherapy as the object of his ambitions. Therefore, the degree of his communication with other colleagues, participation in social life and projects, including charity, feedback in the form of conferences, etc. are also important elements. That only increases the momentum.

The more complex the profile, the fewer clients

Many of us forget that in most cases psychologists and psychotherapists work with problems. Very rarely come to them with a request to share their joys and successes;) In his work, a psychotherapist is always limited to a few hours a day, this business does not work outside the session. At the same time, there are psychologists who help to master communication skills, go through the path of self-determination and life choices, revise destructive attitudes and correct them, and there are psychologists who work with mental disorders, with severe traumas of violence, with death and dying, with psychosomatic pathology and others. This means that every day the mirror neurons of such specialists awaken the lowest and most unpleasant in them over and over again. Popularly referred to as "takes the trouble upon itself." Therefore, in order not to lose their mental and physical health, specialists undergo a number of preventive measures. Accordingly, the more complex the topic with which you apply to a specialist, the more resource he needs to work it out. The psychologist does not get a resource for free, he just pays money to colleagues for supervision, therapy, and in the same way needs a high-quality restoration of psychological and physical balance.

Further, of course, you can write about conferences, trainings, intensives, literature and various options for improving the qualifications of a particular psychotherapist, but I have not said a lot about this.

I said that a person who has a need and motivation, but no money, a person who is in trouble, crisis, grief, etc. - can and receives support for free in various social institutions … Always. This is a common practice, a psychologist who works for the state or a grant constantly has a job. It does not happen that one who truly needs consolation does not find a comforter, one who needs a teacher, does not receive his lesson, etc.

If we are not talking about excuses and not about the fashion to work with a psychologist, but about the need for a different kind of support and complicity, we move on to the level of financial relations. And everyone has this level. On the part of the psychotherapist, it depends on the costs incurred by the specialist in connection with the organization of his activities and the improvement of professionalism. From the client's side, it does not depend on social status or income level, but on how much the client is able to understand the level of his claims and willingness to create.