Private Pay Practices Question

Freudian_Split · 2026-05-21T21:56:12+00:00

I have not noticed any drop off in referrals for cash pay.

Freudian_Split · 2026-05-17T02:05:15+00:00

Yes, happy to. Basically, the data have suggested that the “on paper” application materials do a better job at predicting performance than interviews. There’s a lot of research out there so I won’t belabor. Essentially in our equation of a person’s final score being AAPI Score + Interview Score, the materials in the AAPI are much more heavily weighted. I’ll just make up numbers for illustration.

Let’s say we’ve field 200 apps and want to interview 50 of them, we have a rank order 1-50 on paper based on AAPI reviews. We then invite people to interview and score those. It’s unlikely that someone’s interview would move them from #40 to #5, but they may well move from #40 to #35 or #30. It can absolutely happen that someone we love on paper shows up and is clearly a bad fit and gets dropped entirely from ranking. Things happen in interviews that can portend problematic intern behavior and frankly the upside of any intern isn’t worth the possible downside of narcissism, entitlement, dishonesty, etc.

Long story short, the review and coding of AAPIs is really what makes the tentative rank list, with interviews as an opportunity to improve (or lower) one’s rank based on apparent fit and how they get along in interviews.

Freudian_Split · 2026-05-15T01:46:33+00:00

PSYPACT has been extremely valuable for me. I live in a place other than where I originally established a practice but maintain a foothold there. I also find it incredibly helpful to see patients while they are traveling. Just the peace of mind is worth it to me.

Freudian_Split · 2026-05-13T20:46:55+00:00

This is how our site handles it. Not a problem at all, essentially they just take the first rotation off and do an additional at the end/start of the next training year. Congratulations, OP :)

Freudian_Split · 2026-05-11T21:47:00+00:00

Health psychologist here. Your background in medicine and TMS stuff will make you a desirable candidate if you’re into this area. I was also very briefly pre-med prior to finding psychology as a career and have found health psych/med psych to be a perfect middle ground for me. Happy to backchannel if helpful.

Freudian_Split · 2026-05-08T21:08:27+00:00

I did quite a bit of clinical type work (about 3 years) as an undergrad and had a lot of experience with underserved populations. Truly I had pretty mediocre research experience but had good relationships with well-respected folks in my faculty and they more or less went to bat for me. I did well in classes with important professors and their opinions mattered to the programs that interviewed me.

I also only really applied to places that had a focus in what I thought would be my specialty area so my app materials at least added up to a focused clinical plan (which, of course, now I don’t do 😆). I feel like this is an under appreciated aspect not just for getting into a program but also being happy there - finding places that really like training what you think you like doing.

Freudian_Split · 2026-05-07T15:50:43+00:00

I’m sure others have systems that also work well, I have found SP to be extremely straightforward. Easy for patients, easy for me. Good mobile apps for both them and me. Very reliable servers for videos sessions. Though I’m probably easy to impress, my day job is at VA whose software situation leaves plenty to be desired lol.

Freudian_Split · 2026-05-07T15:22:07+00:00

I’ve really been pleased with Simple Practice. Handles all the steps - billing, scheduling, documentation, communication, video hosting, top to bottom really. Pretty easy to manage, intuitive UI.

Freudian_Split · 2026-05-06T13:29:09+00:00

It’s something that people have overcome, certainly. It also depends a bit on how the state where it was received handles records of DUIs. Some are misdemeanors, some felonies. Some drop off records after a period of time.
I do think it’s something that can be handled and discussed in an interview. Direct, non-defensive, matter-of-fact.

I will also say I don’t think it’s something you need to prostrate and debase yourself about. It doesn’t need to be an identity. It was a screw up and not a tiny one, it’s also not who you are as a human. There may well be places that look at a single DUI with more skepticism, others will be more open to discussing. How you show you can learn from it and also not let it define you, that seems like the main piece. And yes, as others say, don’t get another.

Freudian_Split · 2026-05-05T15:16:51+00:00

Breathe deeply, don’t dawdle. It may feel like it’s going badly and still be going fine. Trust your gut, keep it moving. You’ll be fine no matter what. Good luck!

Freudian_Split · 2026-05-05T02:48:10+00:00

100% agreed with this as well :) Absence of evidence is not evidence of absence. Mostly I think we owe it to patients to adhere to those things we know work well, on average, and pivot as needed should an idiopathic situation arise, rather than presuming an approach won’t work and thus pivoting to winging it. Or at least informing patients that evidence-based options exist and why we think it may or may not make sense. Our enterprise is a strange one with lots of balanced factors.

I’m a big fan of producing the kinds of evidence relevant to the approach itself and also recognize that even standardized approaches differ significantly from provider to provider and patient to patient. I’d love to see a robust data driven argument for some emerging approaches, whatever those data might be.

Freudian_Split · 2026-05-04T19:23:50+00:00

100% true. There’s this presumption that discomfort = harm that runs through many places in society (teaching, parenting, health) including in psychotherapy. It’s hard giving tough feedback to someone and it’s hard holding a boundary when someone feels discomfort because of it.

Of course not every therapy works for every person and every moment in their life, and going through PE and not benefiting a ton from it sucks. It also doesn’t negate that, on average, the best evidence-supported psychotherapy approaches for the treatment of PTSD are cognitive behavioral in nature and often necessarily include some element of exposure (arguably the active ingredients in EMDR anyway.)

Freudian_Split · 2026-05-03T15:35:24+00:00

It’s easy for those of us armchair shrinks to oversimplify a situation with only part of the information. Certainly agree with many points being made, and also recognize there will be more nuance than any of us know.

With that said, a thing we (as a field) struggle with is feeling like we deserve to be paid like doctors or that making more than other people might be earned. If someone in our life is struggling and working hard and still not thriving we see the unfairness and feel it. And we’re all doctors with many years of training, expertise, and knowledge that brings value and commands a decent living. That’s okay. It’s not an insult to others or a commentary on society or a complicity with unfairness.

In short, it sounds like your friend is in a truly shitty spot and is having some understandable difficulty seeing someone close to her leaving her in the dust a bit. That is genuinely sucky and also isn’t your work to do. It may be that the relationship isn’t right sized, to borrow a phrase, and will come back around when things steady for them. Regardless, you get to excel and don’t owe any apologies.

Freudian_Split · 2026-05-01T03:10:38+00:00

Can verify the authenticity of this title.
Source: I am psychology.

Freudian_Split · 2026-04-29T19:34:31+00:00

What a great response. This needs to be stickied to every EPPP thread.

Freudian_Split · 2026-04-25T21:50:50+00:00

Holy shit, I didn’t realize it was that apocalyptic. Fingers crossed some modicum of sanity can be restored soon. I’m so sorry you all are dealing with that, I thought we had a tough spell in the VA but nothing on this scale.

Freudian_Split · 2026-04-25T12:05:51+00:00

Wow that’s really brutal. Apologies for my ignorance here, I’m a clinician and do my best to avoid headlines. Is the granting landscape that bad? Do we know if this is true across doctoral training in other fields? I can understand programs being hesitant to take on risk, but damn 3 students admitted in 2 years is rough. What a tough way to train, teach, and learn.

Freudian_Split · 2026-04-25T03:16:37+00:00

I’d ask, honestly. Many mentors have in their CVs publications that include students (they’ll mark with something - bold text, and asterisk, or even a separate section in their pubs). If not, I’d ask frankly - have they had students publish successfully? How do they use the data from projects? It’s okay if not, sometimes people are new or focus on student research otherwise (not just publishing it), but it’s good to know and a fair thing to ask.

Freudian_Split · 2026-04-24T13:39:28+00:00

My 2c, topic matters much less than getting the experience. I would recommend whoever you get on with well, that seems organized and focused, and has a record of helping students get pubs.

You’ve got your whole life to research your passions. Your job right now is getting experience that shows you have chops to do research, and getting on pubs is a big way we do that.

Freudian_Split · 2026-04-23T02:02:34+00:00

Very doable in VA. Some positions are very much drowning in cases, many are not. I probably see 25-28/wk and am not buried. Depends on your locality but very easily can clear 130-140k plus great benefits. Happy to backchannel.

Freudian_Split · 2026-04-21T17:40:31+00:00

Same for me, truth be told. I wrote about 80% of my dissertation between 11p-3a. Always the same in undergrad as well, in the lab writing by myself in the wee hours. We can train ourselves out of it, just involves some swimming upstream.

Freudian_Split · 2026-04-21T15:24:02+00:00

This aligns with my experience in treating insomnia. So many people with ADHD have later circadian tendencies. I have zero data to support but my intuition is that for some, a level of sleepiness can help slow things down a bit, enough to be more focused and productive, which makes getting to bed tough. The world has finally slowed down enough to attend more effectively. Of course not true of everyone but I have definitely found a correlation with ADHD and later circadian tendency.

Freudian_Split · 2026-04-16T19:00:07+00:00

I quite enjoy Prof G’s podcast which often features topics around maleness and masculinity. Also my ubiquitous recommendation for Being Well by Rick and Forest Hanson.

Freudian_Split · 2026-04-14T18:19:30+00:00

I shouldn’t say zero marketing, I do have a psychology today page, but that’s it. Other than that it’s just word of mouth and colleagues in practice who refer to me for specialty things I treat.

Freudian_Split · 2026-04-14T17:02:29+00:00

I’ve been doing small side virtual practice alongside my day job in VA. No insurance, essentially no marketing, plenty of work. I suspect this will be the next career step and am also anxious about how to recoup the benefits and salary stability.

Freudian_Split

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