Consult a Psychologist

When a potential client picks up the Yellow Pages seeking a psychotherapist, or asks a friend for a recommendation, why should that potential client see a psychologist? That is a question that we, as a profession, had better answer or we shall soon be extinct. Masters level practitioners are numerous, their numbers are rapidly growing, and their fees are typically lower than ours. Why should the marketplace allow us to continue to exist?
We psychologists are like the full fare airlines, say United or Delta, while the masters level practitioners are like Southwest. A substantial portion of the flying public will forego movies, meals, seat assignments and classes of service in exchange for low fares. Hence, the problems faced by United and Delta: They can lower their prices, but, at a certain price point, it becomes useless for them to remain in business. The old airlines can imitate Southwest, as United tried with Ted, but even that doesn’t work because United has expensive Union workers to pay and just loses money even as business increases.

This is our problem, too. We can lower our fees to compete with the masters level people. We can develop huge caseloads of people paying us too little. But then we ask ourselves, why are we doing this? There is no point in agreeing to work for the lowest going rate if it means far more work for far less money—coupled with the offense of allowing ourselves to become indistinguishable from the masters level competition. Why did we bother to get doctorate degrees? Was it only to be greeted with the title “doctor” when we next check into a hotel? We must conclude we will not compete based on price. Instead, we must engage in an expensive and pervasive campaign to set ourselves apart from masters level counselors in the marketplace.

We are psychologists, we are entitled to better reimbursement, yet we are not getting that. What has gone wrong? The market has not been convinced that psychologists are different or better than masters level counselors. Our Division once had an advertising campaign to try to imprint the term “psychologist” in the minds of the therapy-shopping public. It didn’t go very far because we exhausted the advertising budget. Even if we had spent the entire Division’s reserves of over $ 200,000, it would have been a drop in the bucket compared to what we needed and still need.

We are running out of time quickly. Now is the time to expend all our resources to save our profession. That means we need to advertise to create, in effect, a psychologist brand name in the marketplace. The term “psychologist” has got to be exploited as something of value, much as the term Rolex is associated with a fine timepiece. We need to make the consumer feel that we are the gold standard for psychotherapeutic care and that masters level practitioners are not. We must persuade the public to view masters level practitioners as akin to Timex watches. They may work, they may get the job done, but, if you can afford better, you probably want to purchase something better. You do not want to purchase the Timex level of care when your family’s mental health is at stake.

We have shied away from doing this because too many psychologists are of the “we’re all the same, I’m not better than you, academic degrees don’t matter” school of thought. We practice in interdisciplinary groups, we belong to interdisciplinary organizations, and so on. We want to be kind to our masters level friends. But then we have to consider the law-of-the-jungle. The lion doesn’t survive by hesitating when it comes time to kill the gazelle. If the lion thinks to himself, “Well, gazelles have their rights, too,” then that’s one starving lion.

We cannot love the masters level practitioner as we love ourselves unless we are ready to erase the marketplace distinction between them and us and accept their level of reimbursement, which will only continue to plummet as they continue to replicate themselves. Remember, many people are seeking counseling degrees because “I have always wanted to be a therapist,” and they want to practice with such passion that they will do it pretty much for free. How can we possibly compete financially when our competitors are not driven by the profit motive?

I find Division 42 to be rather indifferent to the impending end of clinical psychology as a profession. The average age of the Division 42 member is close to 60. Most of us have figured out how to make a living, most of us are doing well and will continue to do well until we retire. After that, when younger generations of psychologists are trying to make a living, the term “psychologist” will come to equal generic therapist and reimbursement will level-out at the masters level/managed care rate.

I think we can stop this trend, but it would mean going on a war footing, accepting that it’s an eat or be eaten world, and aggressively setting out to establish psychological treatment by psychologists as the Cadillac, Rolex or Neiman-Marcus of behavioral health care.

This is a job for the Practice Directorate/APA Practice Organization, and it needs to be spearheaded by our Division. It might involve brief advertising spots on the Dr. Phil show, the Oprah show, or anywhere else where psychotherapy seekers might be found. We have got to adopt the use of sloganeering and jingles—Madison Avenue style. This is not like presenting a poster session at APA. This is about manipulating public opinion. We do not need to say much, just a slogan: “When your family’s well-being is at stake, talk to a licensed psychologist.” We do not need to explain what is different about our training and experience that sets us apart from the masters people. This is about advertising; it is not a debate. But we need our slogans to be everywhere, so people memorize them and come to believe that psychologists are better/non-psychologists are worse—even if they do not know why.

Keep in mind that the Rolex keeps worse time than any watch you can buy at a drugstore for $5. Advertising and public opinion are not necessarily rational. We do not need to launch complex diatribes setting forth the differences between ourselves and masters practitioners. Instead, we need to capitalize on the name “psychologist.” This is a name that has cache, and nobody owns it but us. We must spend the money to make the public feel bad every time they chose to get care from a non-psychological provider. Remember, you don’t see pictures in magazines of Yo Yo Ma and Diana Krall sporting their new Timexes. They wear a Rolex, you want a Rolex, and the public must be made to want a psychologist. When your family’s mental health is at stake, you don’t want to pinch pennies and get cheap care. You want the best: You want a psychologist!

Martin H. Williams, Ph.D., is Past Editor of the Independent Practitioner and current chair the Interdivisional Task Force on Licensing Board Issues for Divisions 42 and 31. He practices clinical psychology in Santa Clara, California and testifies nationwide in psychotherapy malpractice cases. Dr. Williams can be reached at mw@drmwilliams.com or www.drmwilliams.com .

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