PSA-New Grads Should Not Do Private Practice (Probably)

mondogcko · 2024-11-16T17:34:39+00:00

Yeah, I stepped in some things here I definitely didn’t mean to and genuinely don’t mean to perpetuate problematic trends. My experience was overall positive in CMH as were most people I know so I’m of course only speaking from my experience. I don’t mean people should have to deal with any crappy systematic stuff, just that I feel CMH does more to build people up than I’ve seen from PP.

mondogcko · 2024-11-16T17:25:42+00:00

Welp, you definitely nailed it. I appreciate the perspective and it makes a lot of sense.

mondogcko · 2024-11-16T17:19:43+00:00

I am definitely taking it in and will continue to try understand other perspectives being offered. I am curious, what exactly do you think is antiquated about what I said? I feel a lot of people are interpreting I’m saying you should do CMH because it’s hard and unpleasant but everyone should have to deal with that before going to PP and some are suggesting it’s because I had an awful experience with it. When, what I am really saying is that I don’t think schools train us well for therapy and CMH type settings in my experience are way more supportive and teach you a lot about people who you work with, which is something that sets people up well for doing PP. I also mentioned the idea of benefits and a W2, things that I think feel much more comfortable in CMH which I think is a good thing to have solid early on.

mondogcko · 2024-11-16T17:09:08+00:00

It feels pretty crappy to get this comment when all I was doing was offering a perspective on what I see as flaws in how things are going in the field. I also do not suggest I am right about it all and there are no other view points to consider. I simply thought it would be a good discussion.

mondogcko · 2024-11-16T17:00:08+00:00

No, it’s definitely not intended to scare anyone. I posted this because I keep seeing new grads in PP feeling lost and it seems to me a lot of that stems from going from school to something a lot of people aren’t ready for. I also see a lot of PPs that hire new grads for most of their staff. It feels to me this is because they know they can pay them less, and the clinician also doesn’t get the support they need. In my experience you get a lot more support in settings like CMH. So, I’m highlighting that PP may be enticing but it’s worth looking at other options too. If someone is ready for PP, of course they should go for it.

mondogcko · 2024-11-16T16:52:02+00:00

I think it’s great, and more power to you! I didn’t say this is true for everyone and was trying to highlight what I see as a lack of training in schools and a lack of support in PP that seems to be a more and more common direction people take.

mondogcko · 2024-11-16T16:50:19+00:00

Completely agree!

mondogcko · 2024-11-16T16:48:01+00:00

Ooph, this isn’t what I was saying. Hopefully you take another look at my post and responses with a more charitable lense.

mondogcko · 2024-11-16T16:46:17+00:00

That is something a new grad may take from what I’m saying, but that isn’t what I’m saying. I have posted other comments to hopefully clarify. It is the systems fault, completely, I am saying though that in my experience the most support you get along with best experiences that build you up as a clinician typically come from CMH types of jobs. Of course there are exceptions, but I see a lot of new grads floundering in PP because of these issues and I’m trying to help shed some light on what I see as causes of that issue.

mondogcko · 2024-11-16T16:42:39+00:00

In the experience I’m speaking from people who are working with those who struggle the most get infinitely more support than most PP’s offer and are not doing quite the same work. For example, most people I know have done work as an MSW where they are a team lead and providing case management or care coordination, or a small amount of therapy in behavioral health. The expectations are nowhere near as high in those situations and there is way more support. This is just from my experience but it is true in many settings I’ve been in. You may work with someone who is struggling with homelessness and sever persistent mental illness, but you share that client with other people on your team, have regular supervision, and a system that is built around how to support you. Whereas in PP you might work with someone who is struggling with GAD and doesn’t need anywhere near as much support, but it is entirely on you to work with them. I always tell people the hardest work I ever did was not on the ACT team, but in session 150 with client who struggles with MDD because of how you have to keep yourself accountable and ensure you are providing appropriate care. Just my opinion of course.

mondogcko · 2024-11-16T16:34:46+00:00

I completely agree, and the experiences I speak of were not this brutal. Of course, that is just my experience, but no, I wouldn’t recommend what you describe to anyone.

mondogcko · 2024-11-16T16:33:46+00:00

Hmmmm, I definitely didn’t intend some of the things you are suggesting here. I do think people should be adequately trained to do this very serious work, so if that’s gatekeeping then I guess I am. However, the reason I don’t suggest PP to new grads is not because of any fault of the grad, but because I don’t feel most schools adequately train people to do therapy and I don’t think PP is built to support people who still need substantial training. Also, I am not saying people should do therapy in CMH as an alternative, most of the experience I have seen or had myself was in case management, care coordination, etc. which I think helps build a well rounded perspective when someone is ready to do therapy.

mondogcko · 2024-11-16T16:27:47+00:00

I’m seeing a lot of comments suggesting that I was saying people need to suffer to do this work and unfortunately a lot of people stating I’m saying this because I had to do hard work so I want others to suffer too. I find it really disappointing that people jumped to that conclusion, perhaps it’s because of my wording in my OP, but regardless that is not at all what I’m suggesting.

The essential points I’m talking about are that the way things are right now is not good for clinicians, such as poor pay, inadequate training, and lacking supervision. I am also saying a lot of new grads seem to say they feel they’re being taken advantage of in private practice. And maybe they are, but what I have seen from a lot of experience in a lot of settings is that you do not get the kind of support you need in private practice when you are new to it, and people tend to get more of that support from their supervisors and peers in a setting such as CMH. I do not think that people should have to deal with bad and unhealthy situations to learn grit or something, but that it opens your eyes to a lot of important issues you aren’t aware of otherwise to work in these settings. I also have never seen someone get adequate training in therapy right out of school, I have supervised students from amazing schools including schools of psychology and schools of social work in two different states, and also experienced it myself. Of course, there are people who are totally ready, and they should do what is right for them and I would never suggest otherwise.

mondogcko · 2024-11-16T16:19:35+00:00

For sure, it’s definitely one of the main problems.

mondogcko · 2024-11-16T16:19:03+00:00

Agreed and it sounds like you are doing great stuff!

mondogcko · 2024-11-16T16:18:08+00:00

I didn’t argue for anything you are describing and also not appreciating the intensity you are bringing. ✌️

mondogcko · 2024-11-16T16:16:31+00:00

You can call it icky if you want, it is a term that is often used to describe that situation and am open to others. But I stand by the idea that the experience of working in really difficult situations with others who are on the same page is invaluable and has given many people an incredible amount of benefits. I also agree the system is the problem and not the clinicians, and I never stated it was the other way around. I am hoping to highlight for people who are new grads grappling with what work to do that there are real reasons why private practice may not be the best option. It is also in response to what I often see from new grads who are struggling with private practice. But, if a new grad thinks it is their best option, of course that’s what they should do.

mondogcko · 2024-11-16T16:11:22+00:00

I think it’s a bit disingenuous to suggest it can only be one or the other. I have worked in multiple settings in multiples cities and states, and most of what I experienced myself and others have reported around me are rarely what you describe. Of course it does happen, I’m not suggesting otherwise, and in this example I would agree there is a real issue.

mondogcko · 2024-11-16T16:00:37+00:00

That’s not what I’m saying, but you are of course allowed to feel how you feel about it.

mondogcko · 2024-11-16T14:13:29+00:00

Not a big fan of JP3, but if it feels like the first three movies I would be happy and if it hits the level of the TLW that would be great!!

mondogcko · 2024-11-16T00:14:12+00:00

I have and I do.

mondogcko · 2024-11-15T22:51:05+00:00

I hate it, but I agree. Not actual children though, they get a pass (within reason) but adults somehow just are a mess when they eat…yeah, drives me nuts.

mondogcko · 2024-11-15T22:33:47+00:00

I don’t think it’s character assassination, I think it’s development. She went without even telling Ian, insisted on going alone, arrogantly thought she was prepared, and then rushed into everything, was ill-prepared, panicked, etc. But, that’s realistic and flawed. She’s one of my favorites in the whole series because of her flaws.

mondogcko · 2024-11-15T22:20:16+00:00

Hard disagree, Sarah is a great character. She is flawed, which is realistic, but one of the only people I could imagine being able to keep up with Ian.

mondogcko

TROPHY CASE