CLINICIAN'S DIGEST: Chasing Dollars
Cooper, Garry, Family Therapy Networker
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In its annual survey of therapists' incomes, the monthly newsletter Psychotherapy Finances has some heartening news for marriage and family therapists. The median income of MFTs in private practice rose a little more than 7 percent last year, to $57,119. This figure represents total professional income--from private practice, consulting, teaching and contracts with social agencies and hospitals--after expenses and before tax. If that doesn't sound like great news, consider the alternative: the median total professional income in every other psychotherapy discipline dropped. Psychiatrists took the biggest hit, decreasing 16.7 percent to $96,666, followed by social workers, who decreased 2.4 percent to $57,570. Psychologists and professional counselors each dropped 2 percent or less, to $80,531 and $48,022 respectively.
To those feeling caught in the managed care squeeze, the survey reveals some surprises. The percentage of income from managed care (as opposed to direct pay and other third-party payments) dropped slightly from 1995 to 1996 (31 to 29 percent)--not a revolution, but perhaps the beginning of a trend. This may explain why the average number of sessions per client rose slightly last year, suggesting some freedom from the restrictions of utilization reviewers. MFTs showed the greatest increase, from 16 sessions to 20, followed by professional counselors (16 to 19). Only psychiatrists showed a drop in the average number of sessions (24 to 20), which may account for their drop in income and may also result from an increasing reliance on medications and decreasing emphasis on psychotherapy--a trend that many psychiatrists decry.
If you're wondering what kind of deal you're getting from your managed care company, the survey reports the mean (mathematically speaking) payments, based upon therapists' reported payments. Psychiatrists, despite their gross-income woes, head the list at $85 per hour, followed by psychologists ($75), professional counselors ($61), social workers ($60) and MFTs ($58). In contrast, in the fee-for-service market, psychiatrists command $105, followed by psychologists ($92), MFTs ($75), social workers ($74) and professional counselors ($67).
Recently publicized court cases in which lesbian mothers were denied adoption rights or lost custody of their children primarily because of their sexual orientation have helped focus attention on the effects on children of having lesbian mothers. The sheer number of lesbian mothers in the United States, estimated at between 1.5 million and 5 million, suggests that arguing whether children ought to be raised by lesbian mothers is pretty much beside the point. Research indicates that lesbian mothers--both single and with their partners--do at least as good a job raising emotionally healthy children as heterosexual singles and couples--and sometimes better.
Three studies presented this April at the Society for Research on Child Development comparing children of lesbian mothers from the United States, Britain and the Netherlands with those raised by heterosexual parents found no significant differences among the children. The only significant differences concerned the coparents' roles. In a study of 15 lesbian and 41 heterosexual couples, British social psychologist Fiona Tasker found that 90 percent of the lesbian coparents took an active role in raising the children, while only about 37 percent of the heterosexual fathers did the same. …