Early-Career Psychology

According to psychologist Tammy Martin-Causey, PhD, president-elect of APA's Div. 42 (Psychologists in Independent Practice), many beginning practitioners do things backwards: They develop a set of skills or a specialty, then hope people will need them.

"If you want to be successful, you have to always keep your finger on the pulse of the community and know what people are interested in and what the current problems are locally," says Martin-Causey, who launched a private practice called PsychArizona in Scottsdale in 2002. "Then you can design services as much as you can around what people want."

Uncovering what kind of help people need means connecting with your community, say Martin-Causey and other practitioners. And they have all sorts of strategies for finding the people who need their help, including befriending other psychologists, educating health-care professionals, volunteering with groups they believe in and embracing their own cultural heritage.

"In the not so distant past, it may have been enough to hang out a shingle advertising your services as a psychologist, but today, there is more competition for services," says Gary Hawley, PsyD, chair of APA's Committee on Early Career Psychologists. "New practitioners must be willing to diversify their practices to meet the demands of the community to be successful."

The Monitor asked Hawley, Martin-Causey and other early career practitioners for their advice. They say:

  • Get out of your office. "Do anything that gets you out there with a diverse group of people," recommends Martin-Causey.

Volunteering "with any organization that appeals to you" is an especially good way to connect with your community, says Debbie Klingender, PhD, the student and early career psychologist representative on Div. 42's board. Klingender, who established Wellspring Psychological Services in Brevard, N.C., in 2006, supports a music center for young people, serves on the board of an organization that provides housing for adults with developmental disabilities and recently joined her local American Association of University Women chapter. Having her picture in the local paper as a result helps destigmatize psychology, she adds. "I'm seen as someone who cares about the community and who's trying to make it better," she explains.

Giving talks on psychological topics is another route. Be sure to interact with the audience when you do, adds Martin-Causey. Ask the audience what they're concerned about and what services they need, she suggests. "You start to get a flavor of what people are concerned about right now," she says.

Another way to connect to the community is to become a local expert via the media, says Hawley. "Contacting the local print, radio or television news media and letting them know that you are available for comment or information on psychologically relevant news stories can also be a great way for the community to come to know you as a trusted professional," he says.

  • Learn your community's concerns. "Read the local news so you know what's important," suggests Martin-Causey. Her community got alarmed about drunken-driving statistic, for example. The result was new legislation increasing the penalties—and a rush of new clients seeking help for drinking problems.

It's not just particular subject matters that your community may care about, adds Martin-Causey. Facing economic hard times, her clients now have different needs when it comes to paying for services. She has responded by expanding service options, such as bringing couples together in less expensive group therapy so they can save their individual sessions for more specific concerns. She also changed her pricing structure, so that clients don't have to pay for a whole hour unless they need it. "For some situations, 30 minutes is all you need," she explains.

  • Meet your colleagues. Klingender has gone out of her way to meet other local therapists.

When Klingender first arrived in town, she sent out a letter of introduction to every therapist she could find. "It wasn't just to say, 'I'm the new kid on the block,' but was framed more in terms of wanting to get to know them and their interests," she explains. Now a group of psychotherapists meets for lunch every quarter.

Joining state or regional psychological associations is another way to network. "And attending continuing-ed workshops in your town is a terrific way to meet fellow psychologists," says Klingender.

  • Connect with the APA Public Education Campaign, says Hawley. "There are slides, handouts and talking points ready to go on the mind-body health campaign, which is a great way to connect with many community groups, such as churches or organizations like health departments or the YMCA that may provide a great base for referrals." For more information, visit our Psychology Help Center.

  • Educate physicians and other health-care providers. The stigma that still surrounds mental health care, especially in rural areas, can keep people from getting the help they need, says Klingender. That's why it's especially important to educate the health-care providers people are already going to, she explains. "I suggest that MDs make psychotherapy referrals looking people in the eye and using the same tone of voice as they would if they were making a physical therapy referral," she says.

When she launched her practice, Klingender and the counselor she shares office space with hosted an open house for physicians, physician assistants, nurse practitioners, clergy and staff from the local counseling center and womenís shelter. Held just after business hours, the event featured good food and drink plus an opportunity to chat with each other. The goal? To give practitioners another way to serve their patients.

"If a physician sends someone to you because they can't provide what the person needs, you work effectively with that person and the physician sees how much better the person is, you've just taught the physician a really important lesson about what psychologists can do," she says.

It's also important to reach out to psychiatrists, emphasizes Martin-Causey. "That helps me provide better quality services," she says, explaining that she keeps a list of psychiatrists who can offer appointments to her clients on short notice.

  • Reach for your roots. Racial and ethnic groups may have their own specific concerns, says Ritu Trivedi-Purohit, PsyD, who created the Center for Behavioral Health & Wellness in Park Ridge, Ill., last year. Immigrants from India, Pakistan and neighboring countries are very underserved when it comes to mental health, for example, says Trivedi-Purohit, an Indian-American.

At home, she explains, families typically care for individuals with chronic mental illnesses. That changes when families migrate to the United States and are geographically separated from their family support systems. "Oftentimes family members are at a loss for how to help manage an individual with mental health issues," she says. They don't necessarily get help from physicians either, since they often turn to professionals from their own ethnic backgrounds who share the same cultural beliefs about mental illness.

To help meet the community's needs, Trivedi-Purohit educates health-care providers whenever she can. "That can be done formally at office visits or informally during social gatherings," she says. She's also planning to give talks, provide screenings and do other outreach activities at health fairs targeting the Chicago area's Indo-Pakistani community.

  • Tap into your community's diversity. Diversity doesn't just mean racial and ethnic characteristics, emphasizes Shreya Patel Hessler, PsyD, a private practitioner in Bel Air, Md., who specializes in children, adolescents and families. "If I only saw Asian-Indians, I would be out of work," says Hessler, an Indian-American.

Study the demographic shifts in your community, she suggests. Military families are a new minority group in her community, for instance. "We're in the middle of a two- to three-year population increase because of military relocation from another state," Hessler explains. "There are obviously needs there." Hessler has met with Veterans Affairs offices and civilian organizations to learn more about what soldiers, veterans and family members need and how she can help.

Your own friends represent another source of diversity, says Hessler, urging her colleagues to look beyond fellow psychologists. "You're also friends with a lot of other people with lots of different backgrounds—not just ethnic backgrounds but sexual orientation and so on," she says. Don't take for granted that they know what you do, she recommends. Instead, ask them what they think about the mental health profession and what would get them—or their own acquaintances—through the door if they needed help. By having those kinds of conversations, she says, "you're learning more about the diversity around you."

  • Work the Web. Hawley says the Web is very effective in attracting potential clients. "Web sites offer much more than a simple listing in a phonebook," he says. "They offer potential clients the ability to get to know you, what you offer and what to expect from treatment with you."

Martin-Causey says most of her new clients come via the Web. In fact, that the number of hits on her site has recently doubled. Advertising on Google helps, she says. "If someone wants treatment for obsessive-compulsive disorder in Scottsdale, for instance, I pay so that my site will be on the first page," she explains.

The APA Practice Organization's psychologist locator at http://locator.apa.org and the state, provincial and territorial psychological associations' referral services are other options.

Rebecca A. Clay is a writer in Washington, D.C.