Why are we so bad at applying therapy skills to…therapy?

For a field that is built on teaching people critical thinking about their lives, helping them develop strategies about improving their lives, encouraging personal advocacy, and fighting injustices, we do a pretty poor job of treating the workforce in our field with the same principles. This comes up when supervision is filled with narcissistic abuses, prelicensees are asked to dispense medication and conduct medical assessments without training, and the widespread business practice of having unpaid prelicensed work. We have the knowledge that this serves to disenfranchise people—why do we do it to ourselves?

A lot of our leadership didn’t develop in the current world

In writing this, I’m reminded of the stereotypical old-timey descriptions of the prices of yore. “Back in my day, a soda cost a nickel and a candy bar cost a dime.” This is the same kind of rose-colored glasses that a sizable number of therapists in leadership look at the way that we train and treat therapists. In the middle of a discussion about paying prelicensees at one recent public meeting, one therapist in a leadership position described their approach to unpaid positions as, “I was able to work in an unpaid position 30 years ago and didn’t have any problems,” implying that today’s therapists must go through the same struggles that therapists of previous generations had to go through.

But it’s not the same

As Ben Caldwell extensively points out in his book “Saving Psychotherapy”, educational costs are roughly five times higher for the same degree as they were 30 years ago. Even for those therapist positions that are paid, inflation adjusted salaries for therapists have remained roughly the same. Added to this, cost of living is roughly twice as high. We aren’t being trained in the same world and the leadership in our field is failing to recognize that the world is not the same place. Candy bars cost at least 50 cents. Sodas cost at least a dollar.

It’s easier to blame younger therapists

Therapists in leadership positions see younger therapists as entitled when they ask for money. The whole reason that our field has statements like, “I’m not in it for the income, I’m in it for the outcomes,” is to guilt those with less power into finding other values in this profession than being able to make a living wage. During the same discussion about being trained in a different era, this therapist leader described how the problems lies with therapists not working hard enough to find jobs. Paraphrasing their words, the answer lies in being able to make a couple of phone calls to find an open position. While this may work for a handful of people looking for jobs, it ignores the wider systemic problems that therapists in training face when asked to do unethical duties as part of their jobs, the lack of ongoing support for therapist development, and systems built around therapists meeting unattainable productivity quotas.

There’s also little motivation for therapists who have already achieved their status to make things easier for therapists in development. In what Caldwell describes as the “drawbridge effect”, there is little advocacy by therapists who make it through the hoops required for licensure. It’s an attitude of “I got mine” that further contributes to the degradation of our workforce.

So what’s the answer?

It may seem contradictory, but those who are making the least need to make the most noise. It costs money to advocate for change, whether it is monetarily or devoting the time to going to the public meetings at the licensing boards and professional associations. But it is impactful to show your plight to those who can do something about it.

Also, become involved enough to vote into power those who can make your position better. We need more people in leadership who get what the current workforce is like. And if you can…run for leadership. You have it in you.


*This blog has been updated to more accurately reflect the increased costs of tuition.

5 replies
  1. Diann Wingert says:

    Thought provoking post, Curt. While I totally agree that many older therapists believe younger therapists are entitled and far too focused on compensation, I would like to represent the ones who believe its time we achieved some parity with other professions that require a similar amount of education and training. It is unacceptable to me that we have the lowest-paid masters degrees on the planet. don’t think therapists should be required to take a vow of poverty to prove their commitment to service.

  2. Pascale Claus says:

    As a prelicensed person nearing the end of my hours, I could write a book about my various experiences, and I am happy to see these thoughts reflected, as I have had them on many occasions. It feels validating. With mental health being at the forefront in so many contexts in the media dealing with mass shootings, the opioid crisis and the poor situation on many of our schools, to only name a few, I am wondering what it would take for mental health professionals to unionize?

  3. Kathy McCoy says:

    I’m a bit of a hybrid therapist. That is, I am older chronologically but newer as a therapist. I got my first LMFT license (California) when I was 55. Twenty years later, I just got licensed in Arizona and am starting over with a new practice here. I welcome the changes that younger therapists are bringing to the profession. We all have a strong streak of altruism. But that doesn’t pay the bills. I am listening with wonder and great pleasure to younger therapists and their strategies for marketing, branding, and promotion of our profession as deserving professional degree level pay. I’m finding all of this very much the same in the writing profession as well (I’ve been a professional writer and author for 50 years) and accepting change instead of resisting it for the old ways is so necessary for those of us who are older. I’m looking to embrace change to thrive and endure professionally!


Trackbacks & Pingbacks


Leave a Reply

Your email address will not be published. Required fields are marked *