The AAMFT Blog

The Journal of Martial and Family Therapy Celebrates 50 Years

 

2024 marks the 50th volume of the Journal of Marital and Family Therapy. It’s hard to believe it’s been half a century since the very first issue of JMFT rolled off the printing press.  

Some of you may be aware that the first article in Volume 1 in 1975 was Jay Haley’s “Why a Mental Health Clinic Should Avoid Family Therapy.” Haley’s tongue-in-cheek jab was fitting for the founders of the day, who often used humor to bring home a point. The piece begins with an editorial note suggesting that adding family therapy procedures to a health clinic might include consequences that are “likely to include disorientation of the staff, radically changed administrative procedures, and others, including service to larger numbers of people and better treatment outcome.” How appropriate for the journal to begin its life cycle with a wink and a nudge to incorporate systemic therapy into the realm of general healthcare; a reminder that so much progress has been made, but there is much left to do! 

The second article to appear in Volume 1 was written by another founder, James Framo. His “Personal Reflections of a Family Therapist” reads like a literary time capsule, painting a picture of life as an early family therapist in the 70s: covering his reflections on the politics of a systems approach in conventional settings, resistances to family and marital therapy by other professionals, whether family or marital therapy works, the satisfactions, frustrations, and stresses of being a family therapist, and how one's own personal family relationships impact and are impacted by this work. It is as much a look back in history as it is a reflection of challenges MFTs still face today. 

In the spirit of reflecting on the rich history of the journal, JMFT is pleased to offer a special 50th anniversary virtual issue. This curation highlights nearly 40 noteworthy and milestone articles from the past 50 years. Articles were selected based on the impact on the practice of family therapy, the advancement of the profession, and those that created a positive “buzz” for the practice and profession. 

JMFT editor Lenore McWey, PhD, of Florida State University commented:  

When we asked colleagues to share suggestions for papers that help shape our field, I wasn’t fully prepared for the volume, depth, and range of articles nominated for the JMFT 50th anniversary special virtual issue. The collection features early theoretical works, research that helped substantiate the legitimacy of systemic family therapy, measurement development, ideas about common factors, considerations for cultural humility, and evidence on the current state of the field. For some, this collection might feel like a walk down memory lane. For others, it may spur ideas for continued progress. Regardless, I hope this collection evokes inspiration. We hope you enjoy!  

The issue is broken into sections like Seminal Works Demonstrating the Significance of Systemic Family Therapy, featuring works including the 1995 “The Efficacy and Effectiveness of Marital and Family Therapy: A Perspective From Meta-Analysis,” by William R. Shadish, Kevin Ragsdale, Renita R. Glaser, and Linda M. Montgomery. 

The section on Historical Hot Takes: Manuscripts that Generated a Systemic Buzz, includes the 1980 article “Prescribing the Families’ Own Dysfunctional Rules as a Therapeutic Strategy” by Maurizio Andolfi. 
 
In the category of Assessment in Systemic Family Therapy: Works that Moved the Field Forward, the 1981 article “Assessing Intimacy: The Pair Inventory” by Mark T. Schaefer and David H. Olson is featured. 
 
The section covering Diversity, Equity, and Inclusion and Systemic Family Therapy includes “Different and Same: Family Therapy with Asian-American Families” by Insoo Kim Berg and Ajakai Jaya, published in 1993. 

And the final section, The Current State of the Field: Research and Clinical Implications, includes “Reducing Mental Health Disparities Among Racially and Ethnically Diverse Populations: A Review of Couple and Family Intervention Research Methods (2010–2019), published in 2022 by Lekie Dwanyen, Kendal Holtrop, and Ruben Parra-Cardona. 

The JMFT advisory council is excited to invite you to join us in celebrating the many years of high-quality content focusing on systemic therapy. All articles in the special issue are open to the public until July 2024. Please feel free to share with peers and others interested in mental health research. 
 
We hope you enjoy the selections! 

 

Post-Election, Holiday Stress and A New Year: A Systemic Look at Using Self-Compassion to Manage Our Anxiety in Stressful Times

Written by: Vanessa Bradden, LMFT

Strengthening family connections during the holiday season and in trying times is essential. Yet, it can become complicated by the pressures of gift buying, election results, and goals for the new year. Additionally, we may be coping with the loss of a loved one or loved ones and other significant life pressures like the loss of a marriage or a job. For many of us, this can cause great distress, made worse by the prospect of having to attend various holiday parties and family gatherings.

While these difficulties are real for many, hope is not lost if we take the time to understand ourselves better and the limitations of being human. As marriage and family therapists, we know that it is possible to overcome some of our stress and build better familial relationships (even if only small gains are made) by using Family Systems Theory alongside self-compassion and compassion for others. This approach helps us better understand our relationships and offers stress management tools. By focusing on kindness to ourselves and others, we can create a supportive environment for everyone during challenging moments.

Family Systems Theory is the foundation of the Marriage and Family Therapy (MFT) profession. When applied correctly, it becomes a valuable tool for therapists and clients, aiding in self-understanding, particularly during stressful situations. By utilizing systems theory, clients can develop a broader sense of compassion for themselves and others. Compassion not only fosters empathy but also encourages positivity toward those around us. Ultimately, it helps us manage the tension and anxiety often accompanying the holiday season.

Let's be honest: holidays can evoke many emotions, especially regarding our family of origin. Regardless of the complexities within your family tree—ranging from playful banter to deep-seated emotional wounds—everyone has triggers that can be activated by family members, irrespective of age or stage in life. Family gatherings can cause us to revert to unhealthy behaviors we prefer to avoid. Murray Bowen, a pioneer of family systems theory, aptly notes that families profoundly influence their members' thoughts, feelings, and actions, often making it seem like individuals live under the same "emotional skin." Family members seek each other's attention, approval, and support while reacting to needs, expectations, and upsets.

Our shared emotional history complicates the process of breaking free from established roles and negative patterns learned during childhood, yet it also connects us through shared experiences. So, what does this mean as we approach an already stressful time of year?

One approach to the season's difficulties is to cultivate self-compassion, which, in turn, allows us to have compassion for others. To do so, we need to understand our role within our family of origin, its influences, and how we contribute to its dynamics. For example, suppose you are the eldest sibling who took on a parental role. In that case, you might find it difficult to view your younger siblings as independent adults, which can lead to infantilizing behavior. Conversely, younger siblings may struggle to appreciate your support, resulting in misunderstandings and unnecessary resentment.

Engaging in sensitive discussions within family dynamics can often trigger anxiety, leading to hurt feelings and a pervasive sense of injustice that is hard to resolve. If political concerns dominate your thoughts this year, this may heighten the family's reactive tendencies. However, if we can take a step back and view these dynamics through a lens of compassion for ourselves and others, we are more likely to respond with empathy rather than contempt. At a minimum, it can prevent escalating something unlikely to be resolved. In the best-case scenario, this approach can facilitate personal growth and enhance our relationships,

Self-compassion can be a powerful tool in managing anxiety. If used properly, it will lessen the intensity of negative feelings that can come up when we are with our families over the holidays and beyond. 

Here are several ways it helps:

1. Reducing Self-Criticism: When feeling anxious, it's common to engage in harsh self-criticism. Practicing self-compassion encourages kindness toward oneself, helping to combat negative self-talk. By treating ourselves with the same understanding we would offer a friend, we can reduce feelings of inadequacy and shame.

2. Normalizing Feelings: Self-compassion allows us to recognize that anxiety is a common human experience. When we understand that others also struggle, we break the isolation that anxiety can create. This normalization can lessen our feelings of being alone in our distress.

3. Encouraging Mindfulness: Self-compassion involves being present with our feelings without judgment. This Mindfulness helps us acknowledge anxiety without becoming overwhelmed by it. Rather than suppressing or avoiding these feelings, we learn to accept them, which can reduce their intensity.

4. Promoting Emotional Resilience: We build resilience when we approach our anxiety with compassion. This resilience allows us to face challenges with greater strength and flexibility rather than feeling defeated by them.

5. Enhancing Coping Skills: Self-compassion encourages us to explore helpful coping strategies when faced with anxiety. Instead of resorting to avoidance or negative behaviors, we're more likely to engage in healthy behaviors such as seeking support, practicing relaxation techniques, or pursuing activities that bring joy.

6. Fostering a Positive Mindset: Practicing self-compassion can help shift our perspective from fear and anxiety to hope and possibility. This shift can lead to a more optimistic outlook, reducing feelings of helplessness.

7. Building Healthy Relationships: When we practice self-compassion, we're often more compassionate toward others, which can strengthen our relationships and create a supportive network, which is vital during anxious times.

In essence, self-compassion provides a powerful antidote to anxiety's harshness. It allows for a gentler, more supportive internal dialogue that fosters healing and growth. By cultivating self-compassion, we can navigate anxious moments with greater ease and grace.

MFTs are uniquely trained to work with family dynamics and are an excellent resource for those struggling with complex familial relationships. AAMFTs therapist locator is a great place to find an LMFT in your area.

Be kind to yourself this holiday season, and remember that everyone has anxious thoughts and feelings, even if we can't see them.

Sliding Scales and Accessibility in Private Practice

This content is provided by zynnyme, an affinity partner of AAMFT. This information is not necessarily the view of AAMFT and should not be interpreted as official policy.

Therapists are helpers at heart. We got into this work because we genuinely care about people and want to make a difference. We all believe in the power of therapy and its impact on not just the individual but also the family and the legacy left by each person we work with. Therapy is something that we want everyone to have access to, but how do we do that within the current context of our healthcare system?

The Truth No One Wants to Admit: Being Underpaid Can Impact Clinical Outcomes

Fees that don’t lead to a livable wage, inconsistent income, and the creeping dread of burnout don’t exactly make for a thriving private practice—or a happy, healthy therapist. And a burnt-out therapist does NOT lead to great clinical outcomes. Therapists who are struggling to live on an unlivable wage also often do not have access to consultation, training, rest, or sustainable caseloads. And yes, all of these impact clinical outcomes.

Bridging the Gap in the Healthcare System

The current landscape of mental health care in the United States is a challenging one for therapists and clients alike. Insurance companies, which are supposed to bridge the gap between care and affordability, often make it harder for both parties. Therapists are grappling with clawbacks—where insurers retroactively recoup payments for services already provided—and steadily declining reimbursement rates. These practices not only undervalue the work of mental health professionals but also discourage many from accepting insurance altogether. As a result, clients seeking affordable care are left navigating a shrinking pool of in-network providers, while therapists face increased pressure to balance accessibility with their financial and professional sustainability. This cycle perpetuates a broken system where both clients and clinicians pay the price.

For years, mental health has been underfunded and overlooked, leaving therapists to play the role of superhero—minus the cape, plus the student loans. The truth is individual therapists can’t fix systemic problems like inadequate funding or insurance barriers. Yet we’re often left holding the bag.

What’s the takeaway? We shouldn’t be the only ones patching the holes in a broken system. Advocacy and systemic change are where the real magic happens.

But what do we do at an individual level? How do we keep helping without helping ourselves into exhaustion? Let’s dig in.

Sliding Scale Fees in Private Practice

Ah, the sliding scale: the DIY solution therapists often turn to when we want to make therapy more affordable. Essentially, it’s a fee structure where clients pay based on what they can afford. Seems simple, right?

Sliding scale fees might seem like the hero we need, but they can come with some sneaky ethical dilemmas. For starters, charging different client's different rates for the same service can make things feel a little… wobbly. Imagine a client paying full price finding out someone else gets the same care for less—awkward, right? It could create feelings of unfairness or even erode trust in the therapeutic relationship.

Plus, therapists are human, and let’s be real—there’s a chance you might subconsciously invest differently in someone paying less versus someone paying your full rate (even if you don’t mean to!). Could resentment arise in the therapeutic relationship if you hear about something that infers to you that the client could pay the fee for therapy? We think it could.

This variability can conflict with the ethical principles of fairness, transparency, and maintaining the value of therapy. The result? Sliding scales can unintentionally slide right into murky territory, making it essential for therapists to tread carefully and consider alternatives that feel fair and aligned with their values. Sliding scales are not always the knight in shining armor they appear to be.

The Ethics of Using a Sliding Scale

AAMFT emphasizes fairness and transparency. If you’re using a sliding scale, it better be clear, consistent, and above all, ethical. This means that if you choose to use a sliding scale you need to remove bias from your process, so that every person that comes through your door gets the same access based on the same factors.

In a CPH Insurance Avoiding Liability Bulletin it was mentioned by Richard Leslie, “My view is that a "sliding fee scale” is unnecessary, unwise and problematic." Most sliding fee scales used by nonprofits and other entities base the fee on the financial condition of the patient. In order to properly implement such a policy, entities must ask for certain information and perhaps supporting documentation, like tax returns. Most private practitioners do not want to get into that kind of detail in their practices. Psychotherapists usually establish fees that they are comfortable charging and stay with those fees until they decide to raise their fees. Physicians and other practitioners likewise establish a “usual and customary fee” and typically do not change their fee for different patients. If the patient can’t afford the fee, he or she can be referred elsewhere."

Sliding scales aren’t a no-no, but they’re not exactly a “yes-yes” either.

Let’s think outside the sliding-scale box and explore some fresh alternatives that keep therapy accessible without leaving therapists feeling like overworked superheroes.

First up, there’s the Privilege-Based Sliding Scale. An example of this would be the Green Bottle Method created by Alex J. Cunningfolk. This spin on the traditional sliding scale puts the power in your clients’ hands. Instead of awkward financial disclosures, clients self-select their fee based on their resources, privilege, and ability to pay. It’s judgment-free, transparent, and as a bonus—way less paperwork for you! This approach empowers clients while taking the emotional and administrative weight off your shoulders. Yet, what will you do if you find that this process doesn’t lead to a sustainable wage? Or, if clients that appear to have more financial privilege are consistently self-selecting for a sliding scale, while clients who are struggling do not?

Then there’s Group Therapy, the ultimate win-win solution. Group therapy gives clients a built-in support system, reducing feelings of isolation while being budget friendly. For therapists, it’s a great way to maximize impact without burning out. Pro tip? Market it as a unique, collaborative feature of your practice—because group therapy is seriously underrated and underutilized.

Another option is Tiered Service Models, which are like a buffet of therapy offerings. You can create a range of options: lower-cost services such as workshops, self-guided programs, or one-off consultations for budget-conscious clients, while reserving your one-on-one sessions for full-fee clients. This approach not only protects your time and energy but also gives clients more ways to access your expertise.

You can also choose to Give Back, as our AAMFT ethics mention, and improve accessibility, changing the system from within through lobbying, advocacy and volunteering at a government level to affect change.

And sometimes, you just have to pass the baton. Build Advocacy and Referral Networks by connecting with nonprofits or other clinicians who offer sliding scale or low-cost options. It’s okay to acknowledge when a client’s needs fall outside your financial or professional capacity. Bonus points for getting involved in advocacy efforts to push for systemic changes like better insurance reimbursements and increased mental health funding—because real change happens when we shift the system, not just our individual practices.

Finally, there’s the all-in strategy of Lower Fees Across the Board. While it might sound like an easy fix, it comes with a big red flag: burnout. If you decide to reduce rates for all clients, make sure you’ve got a rock-solid self-care plan and a realistic client load. Remember, being a therapist isn’t about self-sacrifice—it’s about sustainable care for both you and your clients.

Redefining Accessibility and Sustainability

Sliding scales aren’t inherently bad, but they’re not the only (or always the best) solution. Whether it’s privilege-based models, group therapy, or tiered services, there are plenty of creative ways to balance accessibility with sustainability.

And let’s not forget the bigger picture: systemic change is the real game-changer. So, while you’re doing the amazing work of supporting your clients, don’t forget to advocate for a system that supports you, too.

because at the end of the day, the best therapy happens when both client and therapist are thriving.

Celebrating Pioneers - LGBTQ+ Advocates in Family Therapy

Written by Ivonne Harting (She/Her) LAC, LPCC, MFTC, NCC

Diversity has always existed; it’s an intrinsic part of the human condition. Why is understanding diversity crucial in today's society? There isn’t a single person on Earth who is exactly like another. Yet, we often choose to rival our differences instead of rejoicing in them. Although we recognize the importance of support and acceptance as a society, hesitation still exists. Fortunately, we have made significant strides in celebrating diversity, particularly within the LGBTQIA+ community, which has relied on brave pioneers to advocate for our rights and illuminate the battles we face.

In honor of LGBTQIA+ History Month, I want to highlight one such pioneer: Dr. Deborah Coolhart. She is a prominent voice in family therapy, especially known for her work with trans and gender-expansive youth. Dr. Coolhart has made significant contributions to gender-affirmative therapy, centering the needs and voices of LGBTQIA+ youth in family therapy practices.

Dr. Coolhart emphasizes the critical importance of support—especially family support—in fostering positive mental health outcomes for LGBTQIA+ individuals. In her work, she discusses how dysphoria affects not just the mental health of trans masculine individuals, but also their physical and relational well-being. She states, “Because your dysphoria gets in the way of you…it affects everything.” This highlights the profound impact body dysphoria can have on a person’s identity and daily functioning. Addressing dysphoria through gender-affirming practices in therapy is essential, as it not only validates the experiences of trans individuals but also creates an environment where families can learn to support their loved ones effectively.

Dr. Coolhart’s work resonates deeply with me, especially as I reflect on my own experiences as a queer therapist. I remember the fear I felt when contemplating coming out to my family. Growing up in Venezuela—a society that lacks inclusivity regarding anything outside of heteronormativity—having a safe space that normalized discussions about gender and sexuality would have been life-changing. Such an environment would have allowed my family to understand my experiences from a different perspective and receive psychoeducation on how to support and accept me. This is what I believe our current society needs more of: education—not just about tolerance and acceptance, but about love and empathy. Community workshops and educational programs can play a vital role in fostering this understanding.

The progress we have seen in our field is monumental! We have transitioned from homosexuality being classified as a disorder in the DSM-I in 1952, to professionals like Dr. Coolhart advocating for and researching gender-affirming care, driving positive change in family therapy. It is clear that there is nothing we need to change about gender-diverse individuals. Conversion therapy is not the answer. Inclusion is. Let history be a reminder of how far we’ve come and where we are yet to go. Let’s continue to find ways to contribute as professionals, fostering environments that celebrate diversity and support all individuals in their journeys.

With love and pride,

Ivonne

Disaster Resources

Millions of people are reeling from the heartbreak left behind by Hurricanes Helene and Milton. In the Carolinas, Helene left entire communities submerged by floodwaters and cut off from aid with people waiting to be rescued with no access to food, power, or fuel. In Georgia and Tennessee, damage from downed trees and flooding have left neighborhoods unrecognizable. In Florida, cars are buried in sand and homes have been gutted by the massive storm surge. Rescues are underway in Florida as the extent of damage and deaths from Milton are still unfolding. Hurricane Milton knocked out power to more than 3 million customers, flooded barrier islands, tore the roof off a baseball stadium and toppled a construction crane. Many are missing, possibly unable to leave their location or unable to contact family where communications infrastructure is inoperable. AAMFT will shortly release information on its partnership with the Red Cross letting AAMFT members know how they can help by volunteering in the impacted areas.

Following are ways for you to donate, volunteer, or get resources on helping families navigate this challenging and life-changing time.

• Make a donation to the Red Cross here for hurricane relief.

Resources and Information

Disastershock: How to Cope with the Emotional Stress of a Major Disaster has a systemic, trauma-informed, and evidence-based foundation, making the manual an excellent resource for MFTs. This resource was produced by AAMFT members who serve on the board for the Institute for School-based Family Counseling and are part of the Disastershock Global Volunteer Team, which has members from 16 countries.

From AAMFT’s Family Therapy Magazine

Helping Families Cope with Disasters

An Overview of the Red Cross and Disaster Mental Health

Systemic Therapists on the Frontlines of Climate Change

Attending to the Whole System: Eco-Informed Family Therapy

Tips for Parenting During Times of Crisis

• Model calm and control. Reassure children that they are safe and so are the other important adults in their lives.
• Talk with your children about crisis events. Take some time and determine what you wish to say. This is especially true since new information will unfold each day. Provide brief, accurate, and age-appropriate information. Don’t dwell on the scale or scope of the tragedy, particularly with young children.
• Keep your explanations developmentally appropriate. Early elementary school children need brief, simple information that should be balanced with reassurances that their lives will not change. Upper elementary school children will be more vocal in asking questions about their safety and what is being done. They may need assistance separating reality from fantasy.
• Understand what your child is asking. Difficult questions that children ask may be spurred by curiosity or feelings. Rather than plunging into an immediate answer, learn what motivates the question. Ask, “What made you think of that?” or “What ideas do you have?” Once the meaning of a question is known, it is easier to answer effectively.
• There may be questions we cannot answer. Rather than invent a response, it is more helpful to say, “I don’t know,” or “I’ll try to find out.”
• Acknowledge, validate, and accept your child’s feelings. He or she may be feeling confused, frightened, or even excited. Listen calmly and reassuringly as they express their thoughts and feelings.
• Limit the amount of your child’s television viewing of these events. If they must watch, watch with them for a brief time; then turn the set off. Young children should not be allowed to watch TV coverage of the event, as they are too young to process what they are seeing and hearing.
• Maintain a “normal” routine. To the extent possible, stick to your family’s normal routine for dinner, homework, chores, bedtime, etc. Children feel secure when routines are calmly followed.
• Spend extra time reading or playing quiet games with your children before bed without the television or news radio on. These activities are calming, foster a sense of closeness and security, and reinforce a sense of normalcy.

First Responder Toolkit: A free app for those deployed to emergency response events

Red Cross Disaster Mental Health Volunteers

From AAMFT: MFT Volunteer Opportunities with the American Red Cross

Red Cross Volunteers

Trauma Informed Care: A downloadable, comprehensive, and free guide to TIC

Psychological First Aid: A downloadable, comprehensive, and free guide to PFA

SAMHSA Resources by Disaster Type

SAMHSA Disaster Response Helpline (call or text): 1-800-985-5990

SAMHSA Disaster Response Overview

Doing What Matters in Times of Stress: An Illustrated Guide (from the World Health Organization). A stress management guide for coping with adversity. The guide aims to equip people with practical skills to help cope with stress. A few minutes each day is enough to practice the self-help techniques. Informed by evidence and extensive field testing, the guide is for anyone who experiences stress, wherever they live and whatever their circumstances.

Pan American Health Organization: Mental Health and Psychosocial Support in Emergencies (MHPSS). Health emergencies, natural and socio-environmental disasters, armed conflicts, and various migratory phenomena may cause severe suffering in affected populations. The psychological and social effects of emergencies can be severe in the short term, but they can also affect people in the long term. Protecting and improving people's mental health and psychosocial well-being is therefore a priority in emergencies.

Disaster Preparation

AARP offers tips on how to protect your important papers and property:

Protect Your Important Papers and Property

Information on preparing your office for an emergency:

8 Tips on Preparing your Office for an Emergency

Be prepared before the next storm. The Red Cross offers tips on “How to Prepare for a Hurricane”

Tips for a flooded office

Ways to donate and help

How to help those impacted by Hurricane Helene: Charities, organizations to support relief efforts

Pet Rescue

For those interested in helping pets impacted by the hurricane, a Virginia-based pet rescue organization is receiving cats and dogs from flood-impacted states and is in need of donations to care for the influx of arriving pets. Learn more in “Cats and dogs from flood-ravaged North Carolina find hope in Fairfax”

Homeward Trails: Donate

Hiring for Group Practice

This content is provided by zynnyme, an affinity partner of AAMFT. This information is not necessarily the view of AAMFT and should not be interpreted as official policy.

We recently received a question from a group practice owner in practice since 2013. They are known in their community as one of the top private practices in their county and in the past never had an issue with finding and retaining great clinicians. Yet recently they have noticed a change in the landscape for employment options for therapists and they asked “Since you are in the of the ‘business’ of mental health, am I the only one seeing this or are other brick and mortar therapy offices struggling as well? I fear that if places like mine go out of business what will there be for therapists to return to if they tire of the online platforms?”

Many years ago, therapists who wanted to work in private practice settings had the option of either starting a private practice themselves or joining one. Fast forward to today where therapists can now work for online mental health tech companies, creating a work-from-home option usually as a contractor but sometimes as a W2 employee. To acquire therapist labor, they offer sign-on bonuses, promises of providing clients and working as little or as much as you would like, and do some of the administrative work of being on insurance panels.

So now that there are more options than ever before, how do you as a group practice owner stand out, hire and retain great staff so you can continue to provide great clinical outcomes to your clients?

First, we want to say that this group practice owner is not alone. Many group practice owners have found hiring to be more challenging because of the landscape of multiple options for clinicians. We want you, the group practice owner to be more agile so you can continue serving your community, clients, and staff. Being a group practice that offers clients to a clinician is no longer enough of a draw for hiring. Let’s look at what you want to be clear about when showing what you offer to potential new hires so you can create a private practice that truly thrives.

Stand out In WHO you serve

Many tech companies take a serve-all approach. We believe that group practices that serve within their scope and expertise, will find they get better clinical outcomes, reduce the burnout of their staff, and be known for the good work they do. Group practices that stand out in who they serve have not only a great benefit to the client but also to the clinician.

The focus on who you serve will influence trainings, supervision, and overall culture of the group practice. For example, one of our coaching clients is highly specialized in divorce and mediation. They focus on hiring therapists interested in working with couples and those who want to gain special training in divorce and mediation. Their therapists benefit from the specialization and can really hone their skills in this area.

Stand out in HOW you serve

Some group practices choose to stand out in how they serve their communities. Again, this is a benefit to the clinicians they hire because the clinicians get a more specialized approach in their supervision and trainings. We know of practices that focus exclusively on IFS or EMDR. You appeal to clinicians who want to really develop their skills with the modalities that are of focus in the group practice. Other options for clinicians don’t typically offer this kind of focus. They provide the clients, but not necessarily expert case consultation or training.

Stand out in WHAT you offer to your staff

To run a group practice, you need to pay your staff well. As one of the lowest-paid master's degrees, group practice owners have an opportunity to shift the narrative and value their staff’s well-being. When you take care of your clinicians, you are also taking care of their clients. We would much rather see a well-rested, low-stressed therapist than one that is overrun with clients and burning out.

So, what are some things to consider offering clinicians who you want to hire beyond just paying them? Let us help you stand out even more as the best option for therapists when it comes to choosing their private practice setting options.

Health Insurance - This is beyond what many tech employers offer clinicians, but it is necessary for your clinician’s well-being that they have access to health care.

W2 vs 1099 - By the federal definition of what constitutes a 1099, it is very rare that group practices can hire a 1099. If you do hire a 1099 contractor, you are outsourcing your business to another business. What does this mean for you? It means you have no say in how the therapist provides treatment. You cannot provide anything for them to do their job either, think about laptops or office space. As a 1099 contractor, the therapist is responsible for using their own resources to take on the work you provide. But with a W2 you do have more control, and not in a sense of abusing power, but to work together to create better clinical outcomes for clients. W2 status protects the therapist with labor laws and is in that therapist’s best interest.

Vacation & PTO - We all need breaks, but often if you are a therapist, taking a break means you don’t get paid. If you aren’t saving up for vacation or sick leave, it can be financially disastrous for many. This is why so many therapists never take time off even though that leads to massive burnout. As the group practice owner, you can support your staff by setting aside part of their pay for vacation and sick leave. It can be such a relief for clinicians to not have to worry about how they will cover this expense. This means your clinicians are more likely to take time off and your clients benefit too, because again, we love a well-rested therapist.

Supervision and Training - In other private practice settings you will not find this offered to clinicians. Clinicians are expected to seek out these things on their own. Value your knowledge and the collective knowledge of your team by offering supervision and training. Not only does this improve clinical outcomes, but it can improve group practice culture, clinician confidence, and satisfaction as well.

As a group practice owner, you aren’t here to create a practice that just churns people through the therapy door. You genuinely care about the outcomes of the clients and the satisfaction and joy of your clinicians. It may take some financial planning and support, but standing out from other options is your best bet to attract the right kind of clinicians who value the work that you do.

Need more support on your group practice? Check out our free training library where we have training exclusively on group practice financials.