Academic journal article Journal of Psychology and Christianity

Developing and Marketing a Faith-Based Practice: Mission and Business

Academic journal article Journal of Psychology and Christianity

Developing and Marketing a Faith-Based Practice: Mission and Business

Article excerpt

Providing faith oriented services to the psychotherapy consumer presents challenges for the integration of faith with the business of managing a clinical practice. Using both American and Canadian experience, we are proposing that a faith based clinical practice is a viable model for providing professional clinical services. As clinicians interested in integrating their spirituality in the therapeutic relationship, we will address some of the practical issues confronting those who offer spiritual resources in clinical settings.

The Economic Climate

Clinicians are not used to thinking that in economic terms, psychotherapy is a discretionary service. It is our experience that there is a strong correlation between the availability of discretionary household income and the choice to enter psychotherapy. In a tight economy people will choose to spend their income on meeting basic needs rather than on luxury products and services. Canadian studies have estimated that nearly one in five Canadian adults will personally experience a mental illness during a 1 year period (Health Canada, 2002). People in the United States with low incomes and no insurance are nearly twice as likely as the general population to be diagnosed with mental illness (Mauksch et al., 2001). Governments and insurance or managed care companies make similar economic decisions. When money is tight, mental health needs receive lower priority even though the tight economy puts more pressure and stress on the part of the population that is vulnerable.

According to the Psychotherapy Finances' 2000 survey, income from psychotherapy was very stable in the 1990's, but the income of psychotherapists has dropped by 22% since 2000. Three reasons for the change in the economics of clinical practice were identified. First is the introduction of managed care in the United States. Managed care treats psychotherapy as a commodity. Based on diagnosis, a specific therapeutic regime is prescribed and a length of treatment is expected without regard to either the specific circumstances of the patient or the unique qualifications of the therapist. In a mature market place where overall product quality is high and where there is an abundance of trained clinicians, product differentiation is determined by price and psychotherapy becomes a commodity. Managed care companies are paying between $00 to $75 per session and capping the number of treatment sessions. The therapist's credentials and qualifications are secondary in an empirically based treatment approach.

The second economic factor is the erosion of self paying clients. According to the Psychotherapy Finances data, self paying clients were averaging 44% of a clinical practice in the 1990's but have declined to about 20% of a clinical practice at present. The specific economic circumstances of the geographic area of your practice may make a difference; your practice economics will be different depending on whether your local economy is growing or in distress.

Third, the overhead costs of maintaining a practice have not gone down. About 30% to 45% of the income from your practice goes to keeping the lights on. The costs of insurance, professional accreditation and ongoing training are not going down. Clinical practice is a business, as well as mission driven, and the economics of psychotherapy matter.

Developing a clinical practice that provides a living wage has been a challenge since professional psychotherapy first began. Freud acknowledged the challenges of economic fluctuations in his practice. In a letter to Wilhelm Fliess in 1899, Freud wrote:

My mood also depends very strongly on my earnings. Money is a laughing gas for me. I know from my youth that once the wild horses of the pampas have been lassoed, they retain a certain anxiousness for life. Thus I came to know the helplessness of poverty and continually fear it. You will see that my style will improve and my ideas will be more correct if this city provides me with an ample livelihood. …

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