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Ethical Questions s/o from how much do you earn
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amother
Pearl


 

Post Fri, Nov 01 2019, 2:43 am
giselle wrote:
If we’re talking about a social work degree, you need two years of internship. After that you can get a job earning hours toward your clinical license. At least in NY and NJ. I’ve never heard of anyone working for free for 5 years. Once you graduate it’s no longer called an internship. Or are you talking about psychology?


As I wrote on another post, NOT social work. And the 2 year thing is only in certain states for certain degrees. Nothing is that universal in the USA. Each state has different requirements. I don't want to out myself as I might have said some things on this thread that can identify myself if I name my field. Especially if I would say my specialization.

But...
1. Not everything is social work or Ph.D. There are other degrees. I personally don't think social work schools always prepare for therapy practice- they are two totally different skill sets. Social workers can do therapy but that is not a definite guarantee. Unlike say a Marriage and Family Therapist (who can see individuals too) or an LPCC- they mostly do therapy.
2. Not everyone lives in NY/NJ.
3. Not everyone is licensed in NY/NJ.
4. The word internship was used for practical terminology. Some fields call in internship while in school (social work), other fields call it internship after and practicum while in school (LPCC, LMFT, LMHC I believe). It also depends on your state. The field is slowly moving from the term internship post graduation but it's not across the board and it also depends on when you got licensed and where...
5. Many fields in many states it is not a set number of years but a set number of clinical hours in certain categories. I know someone who has almost managed to get the total number in less than 2 years post graduation but is missing a crucial number of required hours in a specific category. So unless they get a different internship quickly, they will take a lot longer to meet all the intense requirements for licensure.

And apparently you don't know me IRL. Or some of my friends, coworkers and colleagues. Why would I make this up?
This is ridiculous. I came on to explain that it isn't some quick and easy degree and some put in years of training (excluding specialization, certificates etc). And for those therapists it is understandable they don't want to take home 40 an hour. Especially with the burn out and emotional toll it takes on us. And now you are saying that what I did doesn't happen. Ok. Whatever.
Bottom line:
Be a mindful consumer, decide if you feel you are getting results after putting in effort, and make an educated decision where to go. No one is forcing you to spend hundreds on a session. I don't think it makes sense to spend hundreds unless you have tried cheaper options or the situation is so dire you can't mess around and try something else (heart surgery 2nd opinion vs finding a pediatrician on your insurance plan. One you might may OOP for the 2nd opinion. One should just be from your insurance.)
Ask where they got their degree from- Sara Schneirer, Bulka or other quick program? Or a SUNY or other mainstream competitive school that took slightly more effort into getting accepted and graduating? (Sorry, knew people who went to frum programs like that and complained about 2 page papers. I had 20-30 or more pages due for my program.)
No one forces you to go to therapy anywhere.
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amother
cornflower


 

Post Fri, Nov 01 2019, 2:58 am
ora_43 wrote:
The problem is that this isn't entirely true.

If someone wants a therapist, they need a qualified therapist.

And the number of qualified therapists is artificially low. This isn't a free market where any person smart and kind enough to be a therapist can decide the salary looks good to them, and make the transition.

In Israel, they'd have to compete for one of a limited number of spots in university.

In America, they'd have to come up with a mind-boggling (to many people) amount of money to pay for not only undergrad and graduate, but years of unpaid/underpaid internships. It might not officially weed people out, but unofficially, it's not a process most people can afford.

I'm not saying that therapists don't need training, but you can't expect supply/demand to work in the same way that it does with, say, content writing, or website design, or translation, or any one of hundreds of other professions that anyone can join just by declaring themselves a member. If you want a content writer, you can choose from anywhere on the spectrum, anything from an expert with a portfolio full of beautiful work who charges accordingly, down to someone who just started advertising as a content writer on Wednesday because hey, anyone can write, right?

If you desperately need help from a psychologist, you can choose anything from a highly trained expert who charged $350 an hour, to a highly trained non-expert who charges $150/hour.

Add to that the fact that access to psychological treatment is literally a question of life or death for many people, and of course there's frustration.


You are 100% right. I have $70,000 of student loans (I put myself through school) plus a lot of other credit card debt accrued when working for too little money and not making ends meet as I got more and more training.

So having put in an enormous investment of time, effort, and money, it makes sense that professionals with extensive training should be able to charge higher fees.

I get that it’s extremely difficult for people to pay. I really do. But in general, if you are getting a higher caliber, you have to pay for it.

Psychotherapy is more problematic because it is a matter of life and death at times. But so are many other situations, in a sense. The specialist who doesn’t take any insurance. But he is the one who can best help your medical condition. The PT who specializes in women’s health and can help you heal after a traumatic birth but who takes no insurance. The top reading specialist who can get your dyslexic child to read. The list goes on and on.

At the end of the day, if someone has a niche and went through a lot to get there, they ought to be able to charge their worth.

And yes, it does work by supply and demand. There is a demand for their services and not enough supply so the prices go up.

And yes, when there are fields where anyone can hang out a shingle, people have numerous options so it’s a free country. They can charge what they want and people don’t have to use them.

But just to keep things in perspective, I live in a big Jewish community, and there are HUNDREDS of licensed social workers, speech therapists, OTs, etc.
so if you can’t afford one, there is always someone else to use...don’t know how good they are, but there ARE options...people are not limited to one or two professionals.
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amother
Bisque


 

Post Fri, Nov 01 2019, 7:56 am
amother [ cornflower ] wrote:
I just wanted to weigh in:

I am a speech therapist in private practice. I charge $80 for a 1/2 hour session, which amounts to $160 an hour so it’s way less than a social worker in private practice, but some would consider that very expensive and think I’m ‘raking it in’.

I also have a very specific specialization and bH see a lot of hatzlacha with my clients, which is why I have a very long waiting list.

I worked for several years at very low-paying clinics to gain experience (after my 4 year bachelor’s and nearly 3 year’s Master’s, and after my CFY year where I worked also for practically nothing). I have many years’ experience and spend HOURS researching each month and collaborating with other professionals. I take courses all the time and constantly develop new programs. For every session I do, there is preparation, note-taking, other paperwork, and often speaking to parents/teachers/other therapists, etc.
The numerous extra hours are, for the most part, not reimbursed. So when you’re paying for your sessions you’re really getting much more.

Aside from that, I am in a solidly middle class position, and not eligible for government programs. With my ‘high’ salary, we often don’t make ends meet. I love how people count others’ money when they really have no clue...

There are therapists who take Medicaid and/or other insurances, and there are therapists who charge lower rates. Some might be wonderful, and some are not.

It is a free country and people can go wherever they want. No one is being forced to use my (or any other therapists’) services.

I think after my schooling (with loads of student loan debt to boot), experience, research, and dedication, I have earned the right to charge what I feel I am worth. It is up to the client to use my services or to seek cheaper services elsewhere.

It is also important to note that there are many, many overhead expenses of which your average client is simply unaware. Liability and malpractice insurance, billing system, bookkeeper, materials (and especially testing materials which I keep updating and upgrading), technology when appropriate, credit card fees, etc. The expenses cost waaay more than you could ever be aware of if you don’t run your own private practice.

With that being said, I think it is up to each and every client to be an educated consumer, whether they are seeing a psychotherapist, speech therapist, or any other kind of professional. Always ask about their training, experience, etc. and have a clear idea of the goals and why those were chosen. Question the therapist if you don’t feel you’re seeing progress.

There will always be those who are either unscrupulous or just really not aware of how mediocre their services are.

But for the most part, I find that you get what you pay for (though not always). Unless someone is seriously off the charts with regard to what they charge (as compared to similar professionals around them) I wouldn’t bash them or accuse them of price gouging. They have a right to charge it. You have a right to seek services elsewhere.


With all due respect, there is a huge difference between 80/session and $350/session. It doesn't really make sense to compare your situation and field to the psychotherapy field where the prices are astronomical. And all for services and training and effort required similar to your own. In fact, it sounds like you put in a lot more effort and work than most in the psychotherapy field I have encountered.
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giselle




 
 
    
 

Post Fri, Nov 01 2019, 8:28 am
amother [ Pearl ] wrote:


And apparently you don't know me IRL. Or some of my friends, coworkers and colleagues. Why would I make this up?
This is ridiculous. I came on to explain that it isn't some quick and easy degree and some put in years of training (excluding specialization, certificates etc). And for those therapists it is understandable they don't want to take home 40 an hour. Especially with the burn out and emotional toll it takes on us. And now you are saying that what I did doesn't happen. Ok. Whatever.

Why are you getting so worked up? I never heard of this and now you explained. Great.

I know therapists don’t want to take home $40 an hour. I know about the burn out and emotional toll. I’m a therapist. Still don’t think it’s ok to charge exorbitant prices btw.
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ora_43




 
 
    
 

Post Sun, Nov 03 2019, 1:04 am
amother [ cornflower ] wrote:
And yes, it does work by supply and demand. There is a demand for their services and not enough supply so the prices go up.

I misspoke. I didn't mean that supply and demand isn't the rule behind the prices (even though that's what I said), I meant that this isn't a situation where we can trust that the market will balance itself out.

Previous posters were saying "supply and demand" as if that's some kind of natural phenomenon, and the prices are out of anyone's hands. When really, we as a society (and more specifically, universities and professional licensing boards) have made this a situation where supply is low.

I also think my point about professional training wasn't clear. A professional writer - just for example - has also spent many, many years getting better at their craft, often at their own expense. The point isn't that writers in general are less trained/qualified, it's that the openness of the field means that your average writer can't charge super-high prices. Because there's always someone just a little less qualified willing to do the work for less, and also because more people get the chance to become good to become good in the first place.
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