The Future of Psychotherapy

http://www.npr.org/blogs/health/2013/10/24/234737302/therapists-explore-dropping-solo-practices-to-join-groups?goback=%2Egde_4267431_member_5799134027814297601#%21

So, this is what the therapy practice of the future will look like, essentially.  It has good and bad things.

First off, therapy practices that align with primary care offices will do really, really well.  Secondly, therapy practices that have medication providers (psychiatrists, psychiatric nurse practitioners, and possibly physician assistants and some psychologists in some states) will get insurance contracts, whereas solo practitioners, except in extremely rural areas, will not.  Psych Choices, where I work, is one of these offices.  Due to increased coordination between medication providers and therapists, people will get better quicker.

On the other hand, your local solo provider who is not aligned with a therapy equivalent of Walmart or Home Depot will gradually find themselves pushed out of the market.  Also, as the super centers start to form and push out competition, they will do salary fixing for psychotherapists and bring salaries down to maximize profits for owners and stockholders in an environment where reimbursement rates have already been stagnant or declining for the past two decades, because they are the monopoly, just as Walmart does when it hits a town.  This will mean that therapists will still be available, but there will be a lot of turnover as they seek better paying jobs in and out of the field, so the focus for the client needs to be on owning their own psychotherapy and taking the best from their therapists and leaving the rest.  If you live in a rural area, transportation to treatment will be important, as the number of places to get it will decline.  Finally, in offices where medical professionals abound, there will most likely be a cultural shift towards an orientation around the medical model because medical practitioners bring in more money and because they have culturally been the people of most authority in practices like that.  Too give you an idea of what this means, you can expect to hear more of:  “It’s not your problems with your spouse, it’s your depression!  Let me refer you to get pills.” perspective.  This has real pros and cons which will need to be figured out in the field.

It is what it is, folks.  If you don’t like it, fight it.  If you like it, fight for it.  But prepare for it.

About Nate Prentice, MSW, LCSW, CAS-PC

Nate Prentice, MSW, LCSW is a Licensed Clinical Social Worker and Pastoral Counselor who maintains a private psychotherapy practice in Drexel Hill, PA.
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