Psychologists In Private Practice Research Articles

“The validation is not enough”: Australian mothers’ views and perceptions of mental health support from psychologists in private practice

ABSTRACT Objective Up to one third of adults who receive mental health services in Australia are parents. Psychologists in private practice are one of the largest groups within the Australian mental health workforce who support parents experiencing mental ill-health. Parents have specific support needs relating to their parenting role and “treatment as usual” may not address their integrated parenting and mental health concerns. The service experiences of parents in this setting have not been studied. This qualitative study addresses this knowledge gap through investigation of the experiences of Australian mothers who received support from a psychologist in private practice. Method Semi-structured interviews were conducted with 14 mothers and interviews were analysed using Interpretive Phenomenological Analysis. Results Three overarching themes were identified in relation to (i) participants’ need to feel understood and heard as a parent, (ii) their need for a nonjudgmental therapeutic space and (iii) their desire for practical parental support from psychologists. Conclusions These findings corroborate the value of family-focused practices when supporting parents with a mental health condition. The results include ways in which family-focused practices have been incorporated by clinicians in private practice settings which may have application in other mental health service contexts.

Common factors, Responsiveness and Outcome in Psychotherapy (CROP): study protocol for a naturalistic prospective cohort study of psychotherapy in Denmark

IntroductionThe aim of the Common factors, Responsiveness and Outcome in Psychotherapy (CROP) study is to identify client and psychologist characteristics and therapeutic processes associated with the outcome of psychotherapy delivered...

The impact of Covid-19 on self-employed female psychologists in the UK

This scoping study reports on the experiences of 41 female self-employed psychologists (or psychologists in private practice) during the first Covid-19 lockdown in the UK. Psychologists are more likely to be female, and unlike employed people, self-employed female psychologists were more likely to be working in lone contexts, and they were unlikely to have had broader organisational and government support available to them. Yet, self-employed female psychologists still made a significant contribution to the UK's response to the Covid-19 pandemic. In addition to supporting children and adults, they have played an important role in shaping government policy, and in the delivery of mass media campaigns and public health messaging. In view of this, the current scoping study focused on how self-employed female psychologists were fairing during the unprecedented circumstances. How were their needs being met? Responses to open-ended survey questions were qualitatively examined using a thematic analysis approach. Overall, the findings suggest that lockdown has afforded some positive opportunities for self-employed female psychologists in the UK. However, for many, it has also had a detrimental impact on their family relationships, and on their own mental health and wellbeing. The findings indicate that self-employed female psychologists may need a more nuanced approach to mitigate againstany long-termnegative effects of Covid-19.

Preparing Counselors for Potential Violence in the Workplace: Interview With Julie S. Costopoulos, PhD

Did you know that 30 to 40% of psychologists in private practice have experienced an assault by a patient in their care? Even more alarming, more than 50% of counselors in substance-use-disorder programs have or will personally experience some form of violence in the workplace. Dr. Julie Costopoulos guest stars to unpack this situation and provide vital safety information that all current and aspiring psychologists must hear.

Therapists' experiences of a brief case formulation and alliance focused pre‐treatment training session (CALL)

AbstractObjectiveA general lack of supervision outcome studies and new advancements within therapist training methods inspired us to develop a randomised controlled trial, Case formulation and ALLiance (CALL), testing the efficacy of a brief pre‐treatment training session. CALL combines generic case formulation and alliance principles with the supervision of a specific client. This qualitative study acts as a preliminary to the randomised controlled trial and aims to explore psychologists' experiences of participating in CALL.MethodSemi‐structured interviews were conducted with seven psychologists in private practice, who participated in CALL between January and May 2020. The transcribed interviews were analysed using thematic analysis.ResultsThe psychologists described CALL as a clinically useful and collegial experience but simultaneously conveyed a lack of recollection of the training session and doubts as to its enduring utilisation.ConclusionCALL has the potential to positively influence the process and outcome of therapy through the fostering of case formulation and alliance management skills, as well as a strong supervisory alliance. However, the familiar content or brief format of the session, and participants' memory bias, may have limited the utilisation and recall of the intervention.

What is recovery? Views of psychologists in private practice

ABSTRACT Objective Personal recovery is a concept that emphasises an individual’s unique process of achieving a meaningful and fulfilling life, even if mental illness symptoms are ongoing. This is in contrast to clinical perspectives that focus on reducing or eliminating symptoms. The aim of this study was to examine private practice psychologists’ perceptions of recovery in the context of mental illness. Method Semi-structured interviews were completed with eight psychologists who worked in private practice in Victoria, Australia. Analysis was conducted with Interpretative Phenomenological Analysis. Results Six of the eight participants were not familiar with frameworks of recovery. Instead, their views had largely been shaped by interactions with clients. There was a view that clients undertake a unique journey towards greater functioning and reflective awareness. Symptom reduction was also considered part of this journey. The therapeutic relationship with clients was viewed as crucial to recovery. Discussion Efforts are needed to educate mental health practitioners working in private practice about recovery. Mechanisms to achieve this could be the inclusion of recovery frameworks in pre-registration courses, directing recovery-focused training and resources towards the private practice sector and establishing explicit links between recovery and commonly employed therapeutic interventions.

Youth mental health competencies in regional general practice.

General practitioners (GPs) are key health professionals for referrals to mental health specialists. Youth mental health issues are particularly challenging, requiring a competent assessment and understanding of appropriate referral pathways. We surveyed local GPs about their understanding of youth mental health problems and needs to competently look after young patients. GPs working in the Hunter region were contacted via email, fax and post over a 6-month period in 2019. Seventy-five GPs participated. They reported 577 of 1698 (34%) of young people seen 2 weeks prior to being surveyed presented with a mental health problem. Predominantly, referrals were to private practice psychologists and Headspace. Almost a third (31%) reported having limited understanding of 'at-risk mental state' and are 'not always comfortable' when facing a young person with a mental health problem. Nearly all (95%) expressed interest in attending specialised training. GPs identified treatment costs, scarce access to psychiatrists and limited patient engagement as the main obstacles to help young people. Effective treatment of a mental health problem relies on early identification. GPs are seeing young people on a regular basis but don't feel well equipped for this task and are keen to up-skill, which needs to be addressed by targeted training.

The return of the fiefdom: Are psychologists in private practice the new serfs?

A personal account, critical of a private practice business model that appears to exploit psychologists, likening it to the structure of a medieval fiefdom. This account scans the options available for practitioners, past and present, and asks for a conversation to continue, in order to explore a better way forward.

Clinical competencies and training needs of psychologists working with adults with intellectual disability and comorbid mental ill health

ObjectivesPsychologists play a pivotal role in meeting the mental health needs of people with intellectual disabilities. The aim of this study was to investigate the perceptions of Australian psychologists who work with adults with intellectual disabilities and mental ill health regarding their clinical competencies, workplace supports and training needs.MethodOne hundred and nine psychologists in Australia completed a self‐report online survey exploring clinical attitudes and practices when working with adults with intellectual disabilities and mental ill health. Provisional, generalist and clinical psychologists from a range of disability and non‐disability work settings were recruited.ResultsFindings revealed that provisional, generalist and clinical psychologists reported no significant differences in levels of agreement on self‐perceived clinical competencies in conducting mental health assessments. Psychologists in private practice and in non‐government organisations reported more adequate workplace resources to support mental health assessments for people with intellectual disabilities than did psychologists in government settings. Psychologists across work settings expressed similar views in self‐perceived clinical competencies and workplace training supports. The majority of psychologists reported limited formal academic training in intellectual disabilities and expressed a need for continual and specialised training in mental health and intellectual disabilities.ConclusionsImplications for further training in mental health and intellectual disabilities highlight the need to cater to the specific needs of psychologists in the field.

Psychological Assessment Services and Psychological Test Usage in Private Practice and in Military Settings

Ten percent random samples of psychologists in private practice as well as those in the m y , navy, and airforce settings were surveyed by mail questionnaire regarding frequency of use of 30 psychological tests and patterns of assessment services. Findings are compared with those from a similar questionnaire sent to 10 percent random samples of psychologists in psychiatric hospitals, community clinics and mental health centers, counseling centers, centers for developmental disabilities and mental retardation, and VA medical centers.

Impact of managed care on private practice psychologists : Florida study

A modified version of a questionnaire previously distributed to New Jersey psychologists was used to survey Florida licensed psychologists to determine how managed care has affected their practices. Overall, 60% of respondents claimed practice income had increased over the past three years, 21% reported a decrease, and 19% indicated no change. Only 27% denied any managed care affiliation. Managed care affiliated psychologists (MCs) reported on average that 18% of referrals and 27% of annual practice income came from managed care systems. Although practice income was higher (p <.02) among MCs than non-affiliated practitioners, this finding was strongly confounded since MCs were more commonly (p <.01) in full time practice (69%) than non-affiliated clinicians (42%). No significant differences were found between MCs and other practitioners in proportions reporting an increase, decrease, or no change in practice income over the past three years. Discussion of findings highlights the possible implications of differential practice patterns observed between MC and NMC psychologists. [Article copies available from The Haworth Document Delivery Service : 1-800-342-9678.]

Fortigenic qualities of psychotherapists in practice

This brief report presents preliminary findings on the exploration of strengths (fortigenic) qualities of psychotherapists which can buffer them against compassion fatigue. Participants were seven South African psychologists in private practice. Data were collected using qualitative interviews and thematically analysed using narrative analysis. Findings suggest fortigenic qualities such as resilience, acceptance, appreciation and passion, humour, philosophy of life and a higher level of logic act as buffers against compassion fatigue.

Utilisation of psychiatrists and psychologists in private practice among non-Western labour immigrants, immigrants from refugee-generating countries and ethnic Danes: the role of mental health status.

The stressful migration process has been associated with higher vulnerability for mental health problems, implying a greater need for mental healthcare among immigrants compared with native-born. Our objective was to investigate whether potential differences in the use of psychiatrists and psychologists in labour immigrants, immigrants from refugee-generating countries (RGC), and ethnic Danes could be fully explained by mental health status. We conducted a nationwide survey in 2007 with 3,573 individuals aged 18-66 comprising ethnic Danes, labour immigrants (Pakistan and Turkey), and immigrants from RGC (Iran, Iraq, Lebanon, and Somalia). Survey data was linked to healthcare utilisation registries. Using Poisson regression, contacts with private practising psychiatrists and psychologists were estimated. Analyses were adjusted for socioeconomic factors and mental health status. Overall, 2.2 % among ethnic Danes, 1.4 % among labour immigrants and 6.5 % among immigrants from RGC consulted a psychiatrist or psychologist. In adjusted analyses, for psychiatrists, compared with ethnic Danes, labour-immigrant women (multiplicative effect = 1.78), and immigrant women from RGC (multiplicative effect = 2.49) had increased use, while labour-immigrant men had decreased use (multiplicative effect = 0.03). For psychologists, immigrant men from RGC had increased use (multiplicative effect = 2.96), while labour-immigrant women had decreased use (multiplicative effect = 0.27) compared with ethnic Danes. Mental health status had a somewhat explanatory effect on the use of psychiatrists and psychologists. These selected parts of the Danish mental healthcare system seem responsive to health needs across different population groups, particularly for immigrants from RGC. Yet more attention should be given to non-Western labour immigrants to meet their mental health needs.

Burnout in Australian psychologists: Correlations with work-setting, mindfulness and self-care behaviours

Burnout is an inherent risk for those working as mental health professionals, given the nature of their work. Due to recent Medicare changes in Australia, private practice psychologists were suspected to face similar burnout risks as non-private practitioners. The aim of the present study was to investigate the relationships among burnout in Australian psychologists, work-setting and years of experience in that setting, mindfulness and career-sustaining behaviours (CSBs). 145 Females and 22 male Australian registered psychologists, with a mean age of 42.47 years (SD = 11.64, range 24–68), were surveyed to determine work-setting, mindfulness, burnout and preferences for CSBs. High levels of burnout were reported among Australian psychologists. No significant difference in burnout between psychologists working in private-practice and non-private-practice settings was found. There was a strong negative relationship between mindfulness and burnout and there was a low but significant negative relationship between years of experience in current work-setting and burnout levels. CSB preferences only had weak relationships with burnout, which decreased after controlling for mindfulness. Several CSBs that had a detrimental relationship with burnout were identified and may be worthy of further investigation. Developing strategies to increase mindfulness may prevent burnout in Australian psychologists.

Food for thought: Enabling and constraining factors for effective rural eating disorder service delivery

This study examined the effectiveness of an assessment and referral model of eating disorder service delivery in the Northern Rivers of New South Wales and its potential as a model for rural service delivery. A qualitative evaluative research design used brief and extended semistructured interviews with clients, and surveys and semistructured extended interviews with service providers who either referred clients to the service or to whom clients were referred. A sole practitioner service based in a small non-government women's health service in rural New South Wales. Clients of the service, all but one of whom was woman; service providers including general practitioners, private practice psychologists and social workers, dietitians, mental health service workers. Participant identified enabling and constraining factors which contributed to the effectiveness of the service model. Whilst all service providers and most clients found the assessment process to be beneficial, they identified a number of constraining factors in the referral part of the service which undermined the effectiveness of the model of service delivery, especially for those with more complex or severe presentations. For a rural ED service to be effective, a number of enabling factors must be present including the capacity to provide: treatment services as well as assessment; a multidisciplinary team approach to assessment and treatment; and expert consultation and training to generalist practitioners, counsellors, hospital wards and other service providers.

Psychologists' Experiences with the Better Access Initiative: A Pilot Study

The Australian Government's Better Access initiative was introduced in late 2006 to increase treatment rates for people with mental disorders. It provides for reimbursement of psychologists' services through Medicare. The current pilot study examines the experiences of psychologists with this initiative. A random sample of 204 of 4,235 psychologists in private practice was approached and 73 psychologists (36%) were interviewed. The current study suggests that psychologists have had positive experiences with Better Access. They have appreciated the greater security of income and greater variety of work afforded by the initiative, and they have observed flow‐on benefits in terms of increased access and reduced stigma for their clients. Additional research is required to corroborate these findings with a larger sample of psychologists, but the current findings provide indicative evidence that Better Access is assisting psychologists to meet a previously unmet community need for mental health care.

The Australian Psychology Workforce 4: An analysis of psychologists in private practice providing Medicare-funded services

There have always been independent private psychology practitioners in Australia, yet in the past payment of their services was largely by a user-pays model. The introduction of Medicare Benefits for patients, under the Enhanced Primary Care program in 1999, and Better Access in Mental Health Care in 2006, along with Government-funded mental health initiatives such as Better Outcomes in Mental Health Care introduced in 2001, has provided an alternative funding model for independent private psychological services. Introduction of these and other Government-funded programs has raised questions about the responsiveness of the psychology workforce to meet the changing demands for psychological services created by these reforms. This study aimed to profile the characteristics of 3,587 independent private psychologists who provide services to clients under these schemes by analysing their responses to the Australian Psychology Workforce Survey. Of the 44% of psychologists completing the survey who indicated that they had a Medicare Provider Number, only 61% were in private practice as their main job. The remainder conducted services for Medicare-funded clients as part of a private practice in a second job. The demographic characteristics, work roles, client groups and income of psychologists with Medicare provider numbers are reported.

Interesting practitioners in training in empirically supported treatments: research reviews versus case studies.

It has been repeatedly demonstrated that clinicians rely more on clinical judgment than on research findings. We hypothesized that psychologists in practice might be more open to adopting empirically supported treatments (ESTs) if outcome results were presented with a case study. Psychologists in private practice (N=742) were randomly assigned to receive a research review of data from randomized controlled trials of cognitive-behavioral treatment (CBT) and medication for bulimia, a case study of CBT for a fictional patient with bulimia, or both. Results indicated that the inclusion of case examples renders ESTs more compelling and interests clinicians in gaining training. Despite these participants' training in statistics, the inclusion of the statistical information had no influence on attitudes or training willingness beyond that of the anecdotal case information.

The Association of Child Psychologists in Private Practice (AChiPPP) is born

The Association of Child Psychologists in Private Practice (AChiPPP) is born

Continuing Professional Development in School Psychology

A questionnaire survey was conducted in Hong Kong to investigate the types, frequency, popularity and quality of continuing professional development (CPD) in school psychology. The results indicated that 60 percent of the 32 respondents received regular supervision, however, the majority met their supervisors less than once a month. The characteristics of their supervisors also suggested that the supervision tended to be administrative instead of professional in nature. The most popular CPD activities were attending conferences/seminars, self-study and individual supervision. Large variation was found among the school psychologists from different work settings. The few school psychologists in private practice reported the least amount of CPD activities. The results are discussed with reference to the need to establish regulatory systems with mandatory CPD.