Lucrative Specializations in Private Practice

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I'm curious about your thoughts on private practice specializations that may be in higher demand and would presumably command a higher fee?

So far I'm thinking of eating disorders (trend toward higher SES, generally longer treatment duration) and gay couples (trend toward higher SES)...

Thoughts?

Originally Posted by jdawgg

I'm curious about your thoughts on private practice specializations that may be in higher demand and would presumably command a higher fee?

So far I'm thinking of eating disorders (trend toward higher SES, generally longer treatment duration) and gay couples (trend toward higher SES)...

Thoughts?

There are limited numbers of private detox/SA treatment facilities for the more affluent. More than just OPT but it is a lacking placement in NC.

I hear that lottery winners often suffer a lot of adjustment issues after winning several hundred million dollars. I would recommend specializing in the treatment of the suddenly rich ;-)

This is *NOT* the way to try and plan a possible career in psychology. Very very few people can successfully target high SES (cash only) patients.

The question you need to ask yourself how you will separate your practice from others as there is obviously a lot competition for high SES clients.

Originally Posted by 3rdwave

i hear that lottery winners often suffer a lot of adjustment issues after winning several hundred million dollars. I would recommend specializing in the treatment of the suddenly rich ;-)

+1!

Originally Posted by 3rdWave

I hear that lottery winners often suffer a lot of adjustment issues after winning several hundred million dollars. I would recommend specializing in the treatment of the suddenly rich ;-)

Well...

In my town - there is one practice that specializes in ED and they charge the highest fees, have a lot of private pay, they also take insurance - but generate a superbill and the client has to file the claim with their HSA or insurance. Somehow they are able to do lots of things and get reimbursed at a higher rate than other therapists. They also have created a sense of scarcity with their waiting list - and people wait to see their therapists.

That is a high risk population though - not sure I would want to specialize in that as an LPC.

In the town to the north of me - there is a senior therapist that charges double what most clinicians charge - and people pay - out of pocket. She does play therapy and she is simply the best around. She has 30+ years of experience, has been certified in attachment therapy, and she rocks. She charges the same fee to her supervisees as she does to her clients and the supervisees pay because she is connected and they network with her help.

I read some of the other replies... and yes - we are all chasing the same elusive private pay high SES clients to some degree... AND when we do what we do with skill and integrity, I think our clients find us. It does take time though and it sounds like you are wanting to lay some foundation now.

VL

She charges the same fee to her supervisees as she does to her clients and the supervisees pay because she is connected and they network with her help.

Heh. PsyDs? Who pays for that?

Originally Posted by Jon Snow

Heh. PsyDs? Who pays for that?

That was my first though as well (i.e., "who pays for that"), but I'm thinking the poster might be referring to SW/LPC students, who I believe regularly pay for supervision, or with whom paying for supervision at least isn't totally unheard of. Although charging the same rates to supervisees as to clients just seems wrong somehow. I mean, economically I see how it makes sense, since by providing supervision you're losing time to see clients, but still.

Yes - LPCs who work in agencies have their 200 hours of supervision paid for! In my setting - I pay for supervision. My clinical supervisor charges me LESS than she charges private pay and less than she would get for an ins reimb. Her philosophy is someone helped her up... and she is going to help me up.

The advantage of paying for your own supervision, is the QUALITY. In the type of work that I do - supervision is immensely useful.

I am curious - how many hours of supervision are required for the LCP?

Originally Posted by AcronymAllergy

That was my first though as well (i.e., "who pays for that"), but I'm thinking the poster might be referring to SW/LPC students, who I believe regularly pay for supervision, or with whom paying for supervision at least isn't totally unheard of. Although charging the same rates to supervisees as to clients just seems wrong somehow. I mean, economically I see how it makes sense, since by providing supervision you're losing time to see clients, but still.

In some states it is illegal to pay for supervision to complete postdoc hours, but I think people still do it "under the table"

Originally Posted by Vasa Lisa

Yes - LPCs who work in agencies have their 200 hours of supervision paid for! In my setting - I pay for supervision. My clinical supervisor charges me LESS than she charges private pay and less than she would get for an ins reimb. Her philosophy is someone helped her up... and she is going to help me up.

The advantage of paying for your own supervision, is the QUALITY. In the type of work that I do - supervision is immensely useful.

I am curious - how many hours of supervision are required for the LCP?

By LCP, do you mean licensed clinical psychologist? If so, most states require the equivalent of at least two full years' worth of supervised full-time practice (of which one year can be your predoctoral internship year) in addition to completion of your degree, passing the EPPP and any other state exams, etc.

Some states (I think maybe 11-ish and counting?) have done away with the required post-doctoral year, and therefore only require completion of the supervised full-time internship year (or two half-time years, again, depending on the state).

Originally Posted by AcronymAllergy

That was my first though as well (i.e., "who pays for that"), but I'm thinking the poster might be referring to SW/LPC students, who I believe regularly pay for supervision, or with whom paying for supervision at least isn't totally unheard of. Although charging the same rates to supervisees as to clients just seems wrong somehow. I mean, economically I see how it makes sense, since by providing supervision you're losing time to see clients, but still.

Most LPC's pay for their own supervision...They go through 2-3 years of supervision before being fully licensed. It is a master's degree license and they graduate with their master's degree and do their LPC-I training after graduation. Normally they have to pass the NCC exam before being eligible for LPC-I supervision. I have had my LPC license since 1986. At that time you could be supervised by a psychologist or a social worker, so I worked for five years with a Community Mental Health Center and I did not have to pay for supervision. Everything has changed and now LPC-I must be supervised by an LPC-S and they frequently charge $75 to $150 dollars per hour for supervision. In most States a LPC-S can only supervise 2-3 LPC-I at a time, but there was a time where some LPC-S were supervising 10 or more LPC-I and this was the main focus of their practice was supervising LPC-I. The LPC-S does not have to be your onsite job supervisor where you get your clinical hours, so frequently the LPC-I may work for an agency but receive their LPC-I supervision from an external person not working for the agency as their LPC-S.

People get LCP and LPC confused, but I don't believe Licensed Clinical Psychologist use abbreviation of LCP, but normally use the abbreviation of LP since most States have generic licensure of psychologists.

Originally Posted by jdawgg

I'm curious about your thoughts on private practice specializations that may be in higher demand and would presumably command a higher fee?

So far I'm thinking of eating disorders (trend toward higher SES, generally longer treatment duration) and gay couples (trend toward higher SES)...

Thoughts?

I see nothing wrong with this question. We should all know by now that SDN is a place for some regulars to knock around some screen names they disagree with.

U should be wondering how to make money; that question does not indicate any level of competency.

Originally Posted by jdawgg

I'm curious about your thoughts on private practice specializations that may be in higher demand and would presumably command a higher fee?

So far I'm thinking of eating disorders (trend toward higher SES, generally longer treatment duration) and gay couples (trend toward higher SES)...

Thoughts?

As someone with a background in and a passion for treating eating disorders, this statement is almost offensive. Eating disorders are notoriously hard to treat, with a mortality rate higher than any other mental disease and a relatively high rate of relapse. If you are only interested in the money and are basing your desire to work with this population on that alone, I would suggest looking elsewhere. And, on a side note, while patients tend to be upper middle class, I know families who went bankrupt trying to finance their loved one's recovery due to the exorbitant prices many eating disorder treatment facilities charge. The best eating disorder therapists I know charge a reasonable rate and work hard to develop more effective treatments--this is what makes them successful without having to charge an arm and a leg.

I watched THIN recently and there were a lot of people who got kicked out of Renfrew early because their insurance stopped covering their stay.

Originally Posted by aequitasveritas

I see nothing wrong with this question. We should all know by now that SDN is a place for some regulars to knock around some screen names they disagree with.

U should be wondering how to make money; that question does not indicate any level of competency.

It is not bad to know what you can expect to make in any area of the field given that an education costs money and one needs to make an informed decision. That said, it is a bit of a silly question. Psychology is not as static as medicine. There are people doing well in just about any specialization and it is more complicated than simply specializing in XYZ patient population. For example, eating disorders can be lucrative. However, most of the facilities that make money are inclusive, in-patient type, resorts that are privately paid. You are unlikely to walk out and just get a job at Passages Malibu and you are unlikely to start up such an operation just out of school.

You want a lucrative specialty...treating celebrities for sex addiction. It seems to be going around.