sending the food back

The family of a colleague of mine enjoys dining out, but an elderly family member had a habit of sending her food back to the kitchen. The family would become concerned–worried that she was upset. However, my colleague suggested to them that perhaps she enjoyed sending the food back. Perhaps this was when she was most happy–after all, she was getting special attention during the process. Once the family came to realize this, they began to view her complaints in a new light. They could relax in the knowledge that she was doing what she enjoyed. No longer did it ruin the meal.

the psychotherapist in 2010

I want to briefly discuss three important issues to the psychotherapist: Avoiding burn-out, adapting to the current consumer culture, and leveraging time.

Avoiding burn-out. Psychotherapists have one of the best professions, helping people find peace and meaning in their lives. Therapists start out valuing their profession, but may become cynical. I remember in training hearing an experienced therapist say he was not sure if he could stand to hear one more complaining client. I thought about his comment for quite a while, because as a naïve beginning therapist it caught me by surprise. How could I avoid becoming him? Other therapists seemed to focus on continuing to hone their abilities to interpret client problems and select therapeutic responses. Could a key to avoiding burn-out be to continue to look for opportunity for improvement in skills? In Malcolm Gladwell’s Outliers: The Story of Success, he makes a good case for 10,000 hours of experience being a prerequisite to becoming great at something. I feel like I am just starting to get a handle on being a good psychotherapist.

Adapting to current culture. Old-school therapists have fixed schedules and answering services, and an implicit medical model, in which the client shows up at the appointed time and place and humbly accepts advice. Today’s society is of course an on-demand culture of digital video recordings in lieu of scheduled broadcasting, instant information from search engines, every product and service imaginable at our finger-tips, instant communication with anyone: all accessible from a personal digital assistant. Tomorrow’s successful therapist will likely be available via messaging and even web cam when needed. I suspect that people will come to increasingly expect egalitarian relationships between clients and therapists as they do between employees and managers or in the meritocracy of the web.

There is good evidence that the relationship between the client and the therapist is the key to retaining clients, and working in a collaborative manner enhances therapy.

Leveraging time. Being available on-demand in an information-rich culture with lots of user-determined content available dovetails with providing services in a more efficient way, allowing the therapist to do more in less time. One example of this is providing a place for users to exchange information in a moderated blog and other group-interaction settings. Although business models are lacking for much of the new egalitarian culture, therapist reputation, especially within a specialty niche, can be greatly enhanced with the greater degree of exposure that new media allow. Other options include creating residual income from the production of books and testing products, or conducting scalable groups and seminars. Finally, consider service activities as a way to enhance reputation in a personally meaningful and interesting way. Getting more out of your time does not necessarily mean working less. For example, it may make sense to fill therapy hours with selected pro bono cases, Medi-Cal (Medicaid) clients, and lower-paying managed care members prior to being able to fill all slots with better insured and self-paying clients within your preferred specialty area. Having a busy practice is a reputation builder, as is becoming known as the go-to person for a particular issue or disorder.

Viewing psychotherapy as an important and meaningful career should provide the incentive to become a master therapist, to build more responsive relationships with clients, and to adapt to current culture. Success should follow.