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Found a practical, thirty-year-old guide to all this called The Business of Psychotherapy by Robert L. Barker. It looks like it was intended as a text book for a class on setting up a private practice. And by the way has anyone ever seen a school offer that? It’s rare to hear about CE courses on the topic. Anyway, this book includes chapters on setting up the therapy office, building up a therapy client load, etc. and he makes it a lively read with illustrative anecdotes. Not a lot of surprises here, but I was interested to note that only one factor correlated with success in passing the LCSW licensing exam at the time. Not training, not age, not years of experience… If a therapist had been in personal therapy herself, she was significantly more likely to pass the exam. Of course, in those days they were still using oral examinations as part of the licensure process, which ended when lawsuits ensued charging that they were overly subjective and subject to bias.

His sample contract (page 102) includes a statement of the agreed upon therapy goals, which I haven’t seen in the others I’ve been reviewing.

Comparing the therapy market of the times to the pre-1929 crash, Barker warns that their heady days of relatively unchecked insurance reimbursement for therapy were endangered, and that the “bubble” may pop. “It can happen when there are very many more therapists than there is demand for them, when many therapists find they must leave the work for which they were trained and which they struggled to enter. It will happen if the insurance companies decide they can no longer pay for therapy services that aren’t proved effective and if government funding is cut back to cover only treatment of the seriously disturbed (page 280).”

Ahem. Duly noted.

Here’s a link if you’re interested:

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