The AAMFT Blog

The Private Pay 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.

The landscape of private practice has evolved rapidly since we have been coaching since 2010. We now have tech companies and directories that therapists can work for, online therapy software and companies, laws shifting for providing therapy across state lines, insurance companies that are changing how they do billing and so much more. Yet, even with these changes, the options for structuring your private practice remain to be - private pay, insurance-based, and hybrid.

Private pay practices have a cash fee and do not involve third-party payors in their practice at all. They may provide a superbill, but it is up to the client if they allow a third-party payor’s involvement. Insurance-based practices that exclusively take insurance are often working with billing companies or software to communicate with third-party payors. With many tech companies showing up in the therapy space, some of them are supporting these billing processes, negotiating fees, and managing the claw backs. Lastly, a hybrid practice is one that has a combination of both private pay and insurance provider involvement.

Is one of these options better than the other? Not necessarily. The key is choosing a structure that is profitable and sustainable for you. Profitable meaning that it provides a decent living wage for you and anyone you hire. Sustainable meaning that you can do business without it negatively impacting you, your clients, and your community. You want to look at doing this work in a way that allows for excellent outcomes, ethical practice and that doesn’t burn you out physically, emotionally, or spiritually.

There is no moral high ground for taking insurance. The variance from therapist to therapist shows us that not one single private practice is the same. We all have different circumstances and privileges at play when determining our private practice structure. What is most ethical is to choose that which is best for the client and for the therapist.

That said, many cannot afford to take insurance exclusively or in a hybrid model. If you have longed to be independent, not involving insurance companies in the therapeutic relationship, we want to explore how to make your private pay practice a possibility.

Pillar 1:  Solid Systems for Private Pay

It’s time to ditch the hustle culture and really look at how many hours you can healthily give to your business, beyond your direct client work. Working nonstop is not what will get you a private pay practice. First start with honoring your energy and time and give to the practice what is sustainable for you. Having systems in place is what will help you find flow in working in your private pay practice. Some of the key systems every private pay practice needs are a consultation and onboarding process, financial plan, business plan, marketing systems, and self-care systems. All of these systems work together to make private pay more easeful in your practice.

Websites for Therapists for a Successful 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. 

Websites are often one of the first things therapists think about when it comes to marketing their practices. If you have a website, you might remember the first time you bought a domain name or saw your website live on the internet. For me, it felt so satisfying and exciting. There is something about having a website that can make your private practice feel official. Yet, a website isn’t the thing that makes your private practice successful. At the intersection of what makes a private practice successful, you will find a private practice that is not only profitable but that is run sustainably (see you later burnout) and is consistently improving on clinical outcomes. Your website is a tool that can bring those three things together and we want to show you how.

 

 A Website That Works

Your website is how you keep the light on for your business 24/7. At any time in the day, a person searching for help can find you and reach out or get information that can truly transform their life. Your website can be the difference between someone feeling seen or motivated to take the next step toward therapy and a person giving up on the search for mental health services. Having your website do some of the work for you, lessens your burnout on running your private practice. It can hold a lot of information that otherwise would be laborious to get out into the world on your own. Your website makes your marketing plan more sustainable as it is consistently available to people searching for help. Your website also exists to attract the ideal client for your practice. The ideal client is the person you know you can help, and that you have the skills and passion to serve. This directly impacts the clinical outcomes of your practice. By working within your wheelhouse, you can continually improve on your service delivery. People are searching for the right therapist, but you are also attracting the right client for your practice. Your website serves both you and the client in making a match. When you work with your clients and get great clinical outcomes it acts as a loop, giving back to your practice. Your clients stay until they get the needed transformation, your retention improves, clients are more likely to refer to you and as you are more satisfied in your work it shows in the therapeutic relationship as well. This leads to more predictable income as well as consistent clients and clients referring to you. It’s a beautiful thing. But there are some things you need to make sure you have for a successful therapist website.

 Therapist Websites: Make It Connecting

A therapist's website is the hub for communicating who you work with, connecting with their pain, showing that you understand as well as talking about how you uniquely help and the transformational value of working with you. While people may find you in other places, they may come to your website for that final validation that you are the right person to reach out to. From the moment someone comes to your website, they should know they are in the right place. You want your website to reflect your ideal client through the copy and images. Because it is here that the first attunement can begin in the therapeutic relationship, far before the first session. Our coaching clients often remark how referrals reach out saying that they came to their website and wept because they felt seen for the first time. That’s the power of your website messaging. The message is about attuning to their pain. It’s not really about you all that much. When you talk about what the client is going through, you demonstrate your understanding of their pain far better than if you said “I understand, you aren’t alone.” Yes, you share how you help, but first and foremost you connect. Connecting through the website leads to attracting the clients that are right for your practice, the ones who get great clinical outcomes. Taking the time to create a website that really is a home base for your practice also makes your marketing way easier. Too often therapists think fancy designs make an impression when it really is the language used to connect.

Therapist Websites: Making it Accessible

 You want your website to be easy to use. Nothing is more frustrating than wanting to connect with someone from their website and it being hard to find out how to do that. You need a clear path on your website for what a potential client needs to do. Often that is going to a contact page to book an initial consultation, but whatever you want this person to do as a next step, make sure it is clear. Also, you want anyone coming to your website to get the information they need with ease. Making your website accessible means creating a website that someone with vision impairments can read, if there is audio or video then there is a transcript or captions, and the images have descriptions. The design should never distract from the content. We would also argue for using the language that your clients use. No more technical jargon that creates a barrier between you and the client.

 Therapist Websites: Making it Visible

You can have a great website that is connecting and accessible, but it must be visible and easy to find. When someone searches for a therapist in your area, you want to pop up as an option in their search. We refer to this as SEO, Search Engine Optimization (learn more about it here). We teach how to do this in our Business School for Therapists, but essentially you want your website to tell the search engines what your website is about and why it is relevant to show your website on search results. Creating a website isn’t enough, it has to stay up to date with information. Consider it an ongoing project to get your website to be ranked and visible. You also want to share your website with others. Put it on your social media accounts, email signature, business card, or digital card and in your other marketing materials. Since it is your hub of communication, with any points of contact with others you want to bring them to your website.

 

Therapist Websites: Making It Ethical and Compliant

As a therapist, everything you do in your practice needs to be compliant with the ethics and laws of our profession. This means you need to have the proper notifications on your website, such as your terms of use, privacy policy, & disclaimers. Use tools on your website that are HIPAA compliant, even for your contact form. Your messaging should never offer false promises about what therapy can do. You can speak to the hope in the transformation, but using quotes and making guarantees about outcomes are something to avoid.

Website Perfection

It can be hard to make your website public or to promote it. You might want it to be perfect. We believe that most therapists can easily start their website with just one page. You don’t have to have all the pages, bells, and whistles together before you launch your first website. In fact, we don’t believe you have to hire a designer and pay thousands of dollars for your website. You can definitely do that if you have the budget, but in our website checklist for therapists, we cover all you need to know to get started or to revamp your website. The sooner you get yourself out there the sooner people can find you, even if it isn’t perfect.

 Website Mirage

Sometimes it can feel like all you are doing is working on your website, but you don’t know why the phone isn’t ringing. Fiddling with your website is just a marketing mirage. Your website is a piece of the marketing plan, a tool, and not necessarily the only way people find you and decide to work with you. You still need a marketing plan. When it comes to your website you do want to add pages and make updates based on the needs of your practice. You also want to keep your website fresh with new content such as through blogging. But you also want to be building relationships in the community, building your visibility with the people you serve. The website is just the start of expanding your marketing and making your message more accessible. It relies on you going out there in the world in order for it to do its job. Need more support with your website? We have a ton of resources on our website checklist for therapists here. Our hope for you is that you continue to hold your clinical outcomes as part of the foundation of a successful practice. Your website is another marketing plan cornerstone where you can make decisions that influence that foundation. It is with your website that you can find more ease, attract the right clients, and continue doing the work you love.

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! 

 

Access MFTs Portability Laws Pass in Multiple States – What Does This Mean for MFTs?

 

In recent weeks, MFT licensure portability bills have been signed into law in Virginia, Maryland, Tennessee, Iowa, Arizona, and Georgia. Similar bills continue to move through the legislative process in other states.  

 

Licensure portability is the ability to take an individual’s qualifications for a license in one state and apply them for licensure in another state. There can be many barriers that cause difficulty in this process, some of which are outlined in this Family Therapy Magazine article. The Access MFTs strategic portability effort works to identify those barriers and mitigate them as much as possible to create a much easier portability process for those within the profession. 

 

As we celebrate the legislative successes in these six states, we also want to inform MFTs about what this means practically for those seeking licensure in these states. The Access MFTs model is a true licensure by endorsement model, meaning that verification of your current license is the key requirement to obtaining secondary licensure.  

 

This will simplify and streamline the process of obtaining a license by endorsement in the Access MFTs states significantly. Prior to the passage of the Access MFTs bills, some states had lengthy active years of practice requirements before an MFT could even apply for an endorsement license, or required primary verification of all education, exams, and supervised experience to establish “substantial equivalency.” These unnecessary and duplicative requirements have now been removed. 

 

Now, all an MFT must do is provide evidence of their unrestricted license to practice in another state or territory and complete an application for licensure by endorsement.  

 

While we are not always able to achieve the model law exactly, our goal is to ease the portability process as much as possible in states across the country. For example, some states might have additional state-specific requirements, such as passing a background check or a state jurisprudence exam. Ultimately, this model requires significantly less work and documentation from the MFT to obtain licensure by endorsement.  

 

For the most up-to-date news on Access MFTs, click here. The effective dates for the Access MFTs bills signed so far vary from state to state, with most going into effect this summer or fall. If you need information about a specific state, please visit accessmfts.org or contact us at [email protected].  

American Association for Marriage and Family Therapy Launches Landmark 2024 Systemic Ethics Textbook

 

 

FOR IMMEDIATE RELEASE

 

American Association for Marriage and Family Therapy Launches Landmark 2024 Systemic Ethics Textbook

AAMFT's newest publication sets a global standard for ethical practice in marriage and family therapy, offering an unparalleled resource for clinicians, educators and students worldwide 

 

Alexandria, Va. (Feb. 28, 2024) — The American Association for Marriage and Family Therapy (AAMFT), the leading professional association for marriage and family therapists, today unveiled its 2024 Systemic Ethics Textbook. This comprehensive, interactive textbook, edited by Kristina S. Brown, Ph.D., with contributions from a diverse group of chapter authors, offers an in-depth exploration of contemporary ethical issues facing marriage and family therapists around the globe.

The textbook’s release comes at a critical time when the profession is navigating the complexities of telehealth, legislative updates, and the imperative for culturally competent care. 

The 34-chapter volume addresses a wide array of topics, from the foundational aspects of ethical practice with couples and families to cutting-edge issues like using technology in clinical work, legal considerations and ethical practice with diverse populations. It features interactive components, including videos and clinical applications, as well as special chapters for educators, supervisors and researchers to manage ethics in all areas of their work.  

"As our profession continues to evolve, especially in these challenging times, it's paramount that our ethical practices do as well,” said AAMFT CEO Chris Michaels. “The 2024 Systemic Ethics Textbook is a testament to our commitment to ensuring that marriage and family therapists are equipped with the knowledge and tools to provide the highest standard of care. This textbook is not just a resource; it's a beacon for ethical practice in our profession, guiding clinicians, educators and students towards excellence in their work with clients."

Some of the chapters featured in the textbook include:

• "Navigating Client Generated Prejudice" by DeAnna Harris-McKoy, Ph.D., Racine R. Henry, Ph.D., and Taimyr Strachan-Louidor, Ph.D.
• “Family Therapy Ethics with Service Members, Veterans, and Their Families” by Meghan Lacks, Ph.D. and Jessica Goodman, Ph.D.
• “The Solid Ground of Integrated Ethical Practice” by Toni Zimmerman, Ph.D., and Marj Castronova, Ph.D.

The complete textbook is now available for purchase on Amazon. 

 

About AAMFT

The American Association for Marriage and Family Therapy (AAMFT) is the professional association for the field of marriage and family therapy. We represent the professional interests of more than 72,000 marriage and family therapists throughout the United States, Canada and abroad.

Media Contact 

Keaveny Hewitt
[email protected]
919.622.5276

 

Recession Proof Your 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. 

As therapists, our job is often to sit with people’s fears and anxieties. But what happens when WE are anxious? With growing uncertainty about the economy and global crisis happening many therapists are asking themselves whether owning a private practice is truly sustainable during a recession. Today, we want to talk about some real data, and real options to recession proof your private practice as a therapist.

"Wait, does that mean you think we are going into a recession?" Whether we go into a recession next month or in the next decade, we want to share what every therapist who plans to grow, launch, or maintain a private practice should do to recession proof their private practice. Ultimately, we aren’t financial analysts, and even they can’t always agree!

So, why do you get to talk about recession proofing private practices?

In 2008, Miranda over at zynnyme launched her cash-pay private practice during the recession in one of the worst-hit cities in the United States. And guess what? It flourished. Kelly built her practice during the recession in a city saturated with therapists.

We know every recession is different, but we think there are lessons we can bring forward from our pasts that help us to navigate our futures.

Defining a Recession

A recession, by definition, is “a period of temporary economic decline during which trade and industrial activity are reduced, generally identified by a fall in GDP in two successive quarters.” Effects of a recession often include high unemployment rates, defaults on loans and mortgages, and a flurry of public policy decisions related to managing the change in cash-flow AND attempts to stimulate the economy.

Worst Jobs During a Recession

According to Yahoo Finance and their analysis of employment data from the downturns in 1990-91, 2008-2009, and 2013, the following were the worst jobs to hold during the recession: tradesmen (plumbers, construction, etc.), manufacturing workers, CEOs, drivers, farmers, and finance workers. While many therapists “feel” like mental health and helping professions are the first to go and the least needed, this actually doesn’t align with the data.

A Recession-Proof Business

In fact, every list of recession-proof industries we could find (like this one) included healthcare. Some lumped mental health in with physical health; other lists listed psychologists, social workers, and others as the jobs least impacted by previous downturns and recessions.

Statistics Are Great, But What Happens in Real Life?

Here’s a bit of Miranda’s story: I quit my county job with amazing benefits in the spring of the height of the 2007 recession after receiving a clear message from my higher power that it was what I was supposed to do (it was literally written down on a slip of paper!). I was already teaching and had jobs at a local junior college and at a local university. In October, I started a cash-pay private practice. People thought I had lost my mind.

I hadn’t been licensed long enough to get on insurance panels. I knew VERY little about how to run a business. And I had a child that I was nursing at home. I built my business, designed my website, and learned online marketing during my child’s two naps during the day. He didn’t sleep well at night (and if he skipped a nap during the day, the nighttime restlessness got even worse).

I knew what I was supposed to be doing, so I kept my blinders on and just took one small step at time, day-by-day and week-by-week. I had a great clinical reputation at the local psychiatric hospital and with agencies, but people I respected said they’d only start referring to me once I was on insurance panels… you know, the ones I couldn’t get on because I hadn’t been licensed long enough.

I figured once I was eligible for insurance panels, I’d consider them if my practice wasn’t full or growing. Then, guess what? It grew! People hired me, they came to see me. Couples on unemployment budgeted for couples counseling while living with their parents because their relationship was EXTRA important during the recession.

That cushy county position with the great benefits that I left? They started doing furloughs and reducing benefits, and my old coworkers had to manage with decreased income while I was able to adjust my income. In fact, my spouse’s industry was eventually impacted by the Great Recession, he was laid off, and I was able to adjust my business plan and hours to ensure that we could pay our mortgage while he went back to school.

Meditations for Marriage and Family Therapists

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 know you’ve likely found or created great meditations for your clients. But, what about for you, what about meditations for therapists?

Meditations for Marriage and Family Therapists

As a marriage and family therapist, you help clients reconnect with their mind, body, and spirit. But when you’re not serving your community, how much time do you take for YOU?

It’s easy to dismiss your own needs when you’re prioritizing those of others, though we encourage you to push back against the narrative that you have to neglect yourself to truly support your clients. And that starts with integrating self-care into your regular routine.

Below, we’ve included some meditations for marriage and family therapists.

They’ll encourage you to slow down and reconnect with yourself at a pace that works for you, covering topics of gratitude, self-love, detachment, and money.

Give yourself permission this week to move away from the doing and embrace the simply being. Then, check out one or more of the powerful meditations below, led by Kelly Higdon, LMFT. We can’t wait to hear how they’ve impacted your life and business!

Gratitude Meditation

Without a clear, sustainable vision and plan, the day-to-day experience of running a marriage and family therapy practice can feel like it leaves no space for other areas of your life. That’s when you begin to focus more on the routine and all of your to-dos, losing sight of what matters most.

It’s time to remind yourself of all the people and things that contribute to your well-being. Maybe it’s as simple as the last meal you had. Or it can be about a relationship you value that brings a lot of joy into your life. Whatever it is, pause for a moment to really reflect on it and feel the appreciation for the role it’s played in your life, bringing you more energy and inspiration.

Take a moment to experience gratitude for your life and how it’s connected to others. How even the most seemingly “mundane” things are a gift and made possible by the communities that surround you — even if you might not always realize it in the moment.

Check out the gratitude meditation here!

Self-Love Meditation

After you’ve taken some time to reflect on the things you’re grateful for — as a marriage and family therapist AND as a human being with the power to influence the lives of others — it’s time to experience that power by sending some love out into the world (and to yourself).

There’s love within you, and it can be accessed at any time.

Shift your focus from what hasn’t been done and what needs to be done and start replacing all that built-up negative self-talk and shame with the grounding feelings of love.

You have a lot to offer as a healing professional, but don’t limit your strengths to the transformational work you do with clients. Because you’re deserving of love regardless of whether you serve the people in your life.

The simple truth is that each and every one of us has value.

Sometimes, it’s a matter of giving yourself the same love that you give to others — and deeply feeling and knowing you deserve that love just as much as them.

Check out the self-love meditation here!

Detachment Meditation

As much as we value gratitude and self-love, we also recognize there’s a time and place for detachment and untangling from the barrage of thoughts that can show up in your mind.

Whether it’s thinking back to a recent session with one of your marriage and family therapy clients that didn’t go as well as you’d hoped or ruminating on the difficulties you’re experiencing in your personal life, practicing detachment allows you to distance yourself from those thoughts.

Instead of being stuck in a cycle of anxiety, considering all the “what-ifs” and things you could do differently, the practice of detachment lets you observe each of your thoughts like they’re flowing down a river, acknowledging their presence and letting them go.

Remember: It’s not about judging your thoughts.

Even if your thoughts bring up feelings of discomfort, allowing them to be there and accepting them for what they are is what allows you to process them — and ultimately let each one of them go through their natural flow until they pass and plateau in intensity.

Check out the detachment meditation here!

Money Meditation

Your journey toward wealth as a marriage and family therapist happens at your own pace. It’s one-of-a-kind, based on your experiences, and it’s okay if you don’t have it all figured out yet. But don’t forget to recognize the progress you’ve made along the journey.

Think about your solo or group practice as a seed. From an outsider’s perspective, it doesn’t look like much is happening. And yet, as someone who’s constantly giving it the attention it needs to grow and flourish, you recognize its expanding potential. Then, one day — maybe when you’re starting to question if it’s all worth it — you see the positive outcomes of your efforts.

Your life and business may be growing without you even realizing it. The process may be slow, and sometimes even a bit frustrating (we totally get it!) but know that there’s value in your efforts. Maybe it’s a few months, or maybe it’s a few years. Eventually, though, as the income from your values-aligned practice reaches new levels, you’ll realize it was all worth it.

For now, it’s all about celebrating where you’re at and where you’re going.

Check out the money meditation here!

Share Your Thoughts on The Marriage and Family Therapist Meditations

How did these meditations for marriage and family therapists help you and your practice? Let us know your experiences below and whether you’re interested in us creating more meditations for you in the future! In the meantime, click here to learn all about our Starting a Counseling Practice Success Stories and Starting a Private Practice podcasts + where to subscribe for more!

P.S. If you’ve found any of these meditations to be valuable, know they don’t have to be a one-time listen. Incorporate space for reconnecting with your mind, body, and spirit on a regular basis — even if it’s outside of the context of your private practice business hours.

Resources for MFTs: War, Conflict, & Trauma

AAMFT is aware is that many of our members have clients going through a range of difficulties at this time. Some are distressed and fearful of yet another war erupting on our planet, while others are more directly impacted; perhaps Jewish or Palestinian families living in the US who are concerned about their loved ones in the Middle East; or perhaps families who have generational trauma lingering from the Holocaust who now face old wounds being reopened unexpectedly and horrifically. AAMFT is currently reaching out to systemic therapists in the Middle East, or those with experience working in the region, to obtain more information and resources for working with clients suffering the impacts of war and trauma in the region.

Below are some resources for clinicians related to the impact of war, conflict, trauma, and treatment approaches.

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. The guide can be used alone or with the accompanying audio exercises. Available in multiple languages. Informed by evidence and extensive field testing, the guide is for anyone who experiences stress, wherever they live and whatever their circumstances.

Mental Health Innovation Network (MHIN)

Many great resources are included on this site. Search for “war” or “conflict” in the search bar for a variety of resources and information. One recommended resource is PFA-Psychological First Aid. Psychological first aid has been recommended by many international and national expert groups, including the Inter-Agency Standing Committee (IASC) and the Sphere Project. Psychological first aid is an alternative to psychological debriefing. In 2009, the World Health Organization’s mhGAP Guidelines Development Group evaluated the evidence for psychological first aid and psychological debriefing. They concluded that psychological first aid, rather than psychological debriefing, should be offered to people in severe distress after being recently exposed to a traumatic event."

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. These effects can also threaten peace, human rights, and development. Protecting and improving people's mental health and psychosocial well-being is therefore a priority in emergencies. To achieve this goal, coordinated action is needed among humanitarian assistance providers, including governmental agencies, non-governmental organizations and civil society groups involved in Mental Health and Psychosocial Support (MHPSS).

The Mental Health & Psychosocial Support Network

This online platform enables members to share resources, join groups, and interact with others, based on their work and interests. The platform also plays an important role in mobilizing capacities, resources, and supporting coordination around MHPSS response during emergencies. Scroll down to the "Latest Resources" section for resources on hostilities in the Gaza Strip and Israel.

Thank you to AAMFT Professional Member Dr. Laurie L. Charlés for her resource suggestions. Dr. Charlés has extensive experience working in regions experiencing conflict and war around the world.

Additional resources:

War Anxiety: How EMDR Therapists Can Help

Statement on Mental Health in Light of Global Conflict, with resources on Jewish and Muslim communities

Healing Circles

‘I Love You. I Am Sorry’: One Jew, One Muslim and a Friendship Tested by War
A Los Angeles program that connects Muslims and Jews has been strained by the war in Israel. But the group’s leaders found that it has strengthened their bond.

Family Therapy Magazine articles related to trauma:

Trauma-informed Family Therapy: Systemic Treatment of Trauma of Child Refugees
Charity Somo, PhD, and Laurie L. Charlés, PhD

Transgenerational Trauma: A Memory of a Therapist to Be

Ronald W. Lawrence, MS

Children’s Reactions to Death

Sarah Bauer, MMFT

Supporting Children Through Their Grief Journey

Nancy L. Kriseman, MSW and Lane Pease Hendricks, MS

Family Evacuation After the Collapse of Afghanistan

Laurie L Charlés, PhD and Florence J. Lewis, PhD

Helping Families Cope with Disasters

Michael Ungar, PhD

Journal of Marital and Family Therapy:
JMFT Special Section on Mass Trauma

Family Interventions for Populations Exposed to Traumatic Stress Related to War and Violence

Elizabeth Wieling

Experiencing Couple Relationships in the Line of Fire

Michal Shamai, Saray Fogel, and Dvorit Gilad

 

Costs for Starting a Marriage and Family Therapist 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. 

You have your degree, supervision hours, training experience, and licensure… but what about a Marriage and Family Therapy private practice? Even though you’ve already invested a LOT of money into your education to become the kind of therapist who makes a real impact on clients, you feel completely out of your element when it comes to the business side of things.

And then there’s the dreaded question:

How much is a Marriage and Family Therapy practice actually going to cost!?

The good news: Much less than you might expect. In fact, all of the money spent on getting you to where you are today in your profession is the greatest expense you’ll need as a therapist. Yes, it’s true that you’ll need to invest some money into private practice, but it’s totally doable.

In fact…

Your Marriage and Family Therapist practice costs LESS than most businesses.

That’s right — you don’t need hundreds (or even tens) of thousands of dollars to start a successful, values-aligned private practice. It’s all about starting for a low cost and growing as you build a steady caseload of ideal clients to learn from and serve.

So, let’s get right to it!

Here’s how much starting a Marriage and Family Therapist practice really costs…

Checklist: Cost of Starting a Marriage and Family Therapist Private Practice

To make this easy for you, we’re going to cover things one at a time. You’ll be able to check off each of these items once you have what you need, so you can avoid confusion and overwhelm.

Alright, here we go…

1. A Physical or Virtual Marriage and Family Therapist Office

Whether you prefer to see clients in person or with secure, HIPAA-compliant telehealth software for online sessions, you need some kind of private space to practice therapy.

If you choose to go the in-office (or hybrid) route, look into subletting an office for $100-200 or less per month. The specific number depends on the area you’re practicing in, of course, but you’ll likely find it’s a lot more affordable than you might’ve expected!

Plus, you won’t have to pay for expensive furniture and may even negotiate a deal where you only start paying for office space after you start seeing clients. My personal experience as a Marriage and Family Therapist was that I only paid for the space when I had clients, and there was an hourly fee that only went up to a max of $75 for a couple night’s worth of rent per month.

Investment: $200/month
> Download our free Office Space Checklist for your private practice 

 

90 Day Business Plan for Private Practice Therapists

Guest Blog: by AAMFT affinity partner zynnyme

As a private practice therapist, you need a business plan.

But not just any plan. You want to create one that grows with your business and reconnects with those deep parts of you that give you the energy to make your plan a reality. Because private practice success looks different for everyone, and you want to be in genuine alignment with who you currently are — NOT the “you” from months (or even years) ago who had different goals.

Many therapists in private practice who develop an initial business plan, focus on a business plan that outlines broadly what they’ll do over the next 3-5 years. Then, that business plan collects physical or virtual dust as they start actually running their business. Often, the business plan and the day-to-day operations are completely disconnected from each other.

That is why we recommend starting with a 90-day business plan. It keeps things focused on things you can achieve and implement over the next 3 months. It helps reduce the overwhelm. And finally, it turns it from a dusty document to a game plan, so you know what you’re doing and WHY -- week by week and month by month. 

An effective 90-day business plan involves eight key elements:

• Your vision for life and practice.
• Your schedule and organization.
• Your documentation.
• Your processes.
• Your financial plan.
• Your niche and messaging.
• Your private practice website.
• And your marketing plan.

Let’s cover each of these areas in more detail…

Private Practice Vision

This is the foundation of your business.

As a reminder, it’s okay to change. In fact, depending on how long you’ve been in solo or group private practice, that might be exactly what your business needs to reach that next level!

When you’re creating your ideal vision, you want to include not just time for your practice but also time for your life. Journal about your one-of-a-kind strengths as a therapist — or, if you have some people in your life you can ask, share a survey with them (even if it’s anonymous).

It’s all about identifying (or reconnecting) with your core values.

Schedule and Organization

Just like your vision — you’ll notice a trend here! — you want to create a schedule that includes time for the impactful work you do AND your personal life. Figure out a way to organize your plan and tasks that works for YOUR brain and learning style. This isn’t one-size-fits-all!

And don’t forget to get your calendar organized. If you have multiple calendars, ensure they’re all in sync with each other. We personally recommend software like Google Calendar where you can have a virtual record of everything you need (and want) to do and easily make updates.

Private Practice Documentation

Do you have a way of doing your notes that allows you to finish in 5 minutes or less? Do you have a clear informed consent with a clear cancellation policy?

We recommend a 48-hour cancellation policy at minimum, but feel free to set up something like 72 hours in advance if that works better for you. The goal here, like with all the other parts of your 90-day business plan for private practice, is to create something sustainable.

And speaking of sustainable… we recommend a paperless office.

The less you have to lock away in filing cabinets, the more ease of access (and, for many private practice therapists, peace of mind) to your business and clinical documents.

Breaking News on MFTs in Medicare!

AAMFT is thrilled to announce that the Mental Health Access Improvement Act (S. 828/H.R. 432), legislation that would allow MFTs, as well as MHCs, to serve as Medicare-eligible providers, has been included in the proposed omnibus package currently making its way through Congress. It is heavily anticipated that both houses of Congress will take action on this proposed legislation within the coming days.

As stated in the AAMFT Blog post from December 15, AAMFT and its allies have been advocating that Congress include the language from the Mental Health Access Improvement Act into the end of year omnibus spending package that Congress has been developing. We are pleased to report that the language from the Mental Health Access Improvement Act was included in the omnibus bill!

At over 4,100 pages, this massive omnibus bill will fund the federal government through the end of the current fiscal year, which ends on September 30, 2023. In addition to funding the federal government, this legislation also includes many policy provisions that change federal law. One of several changes to Medicare would finally allow MFTs and MHCs to serve as recognized providers under Medicare. This legislation would allow MFTs in private practice or other settings to become Medicare-eligible providers. The effective date for allowing MFTs to start serving as Medicare providers is a year from now – January 1, 2024.

 Below are a few FAQs concerning this legislation:

• Has this omnibus package been signed into law? - No, it has not. The Senate will first vote on this legislation. If it passes the Senate, the House of Representatives must vote on it, then it would be presented to President Biden for his signature.

• When should Congress pass this omnibus package? - Congress is expected to vote and send this legislation to the President by Friday, December 23. As of Tuesday afternoon, the Senate is expected to vote on this legislation on Wednesday, with the House voting on the legislation about a day after the Senate approves the package. Funding for the federal government will end on Friday evening if Congress does not act. Therefore, there is some pressure on Congress to act this week to prevent a government shutdown.

• Is passage of this omnibus package guaranteed?  -  No. Although a majority of Members of Congress are believed to support the omnibus package as it is now, passage of any legislation is not guaranteed.

• If this legislation is signed into law, when can I enroll as a Medicare provider and start providing services to Medicare beneficiaries? - Under this legislation, MFTs and MHCs would not be able to serve as Medicare-eligible providers and bill Medicare until January 1, 2024.  This delay is needed so that the federal government can make arrangements for MFTs and MHCs to serve as Medicare providers.

Please follow AAMFT through our social media pages and the AAMFT Blog to stay informed of the progress of this legislation. Please also consider sending a grassroots message to your Members of Congress urging them to pass the omnibus package as introduced.

Thank you in advance for advocating for MFTs as Medicare providers. Your messages and outreach to Congress in support of the Mental Health Improvement Act made the difference! Please contact us at [email protected] if you have any questions. 

Additional information:

Statement of Support from Finance Committee Chair Senator Ron Wyden (D-OR) for Mental Health Provisions in Omnibus Package

Statement from Energy and Commerce Committee Chair Frank Pallone, Jr. (D-NJ) and Health Subcommittee Chair Anna G. Eshoo (D-CA)  in Support of Healthcare Provisions in Omnibus Package

Description of Medicare Policy Changes in the Omnibus Package