Therapists Talk


Therapists Talk 
Shrink Rap 


    Michael E. Holtby, LCSW, BCD

Therapists Talk to Each Other


Now offering a workshop for professional healthcare groups:  

Compassion Without Fatigue

I am the founding member of the Private Practice Network, whose mission is professional networking with other psychotherapists in the Denver area. Our email distribution list is close to 300 people, and we have just launched a new directory -- which only about 40% of the members have thusfar joined. The URL for the Directory is:

We meet every month for the purpose of networking. Its human nature that we don't refer to people we don't know!

Since originally beginning this web site in the Spring of this year ('98), I have gotten an encouraging response. Among those who have surfed through have been a number of therapists, and I regularly get e-mail from them. The mail has been almost exclusively queries about private practice, and curiosity about how my practice his survived without being a preferred provider. I must say that since I quit in May of 1996 I am not only surviving, but thriving. Unlike many of my colleagues, who remain primarily in a managed health care based practice, I don't have my time squandered on the phone trying to collect my fees, or get more sessions authorized; nor do I labor with bureaucratic paperwork. At the end of the month, with most of my clients paying at the time of service, I bill perhaps three to six clients. I rarely do a HCFA form! I'm not sure I could do this as successfully if I didn't have twenty-one years of getting a reputation in one community, or if I didn't have a niche in some specializations that are somewhat unique. As a generalist, who is new to private practice I shudder at the daunting prospect of making a private practice solvent.

I am also concerned with the future of our profession, and fear that I am like the old country doctor -- a relic of the past who may not be around in another ten or twenty years. This is only compounded by the relative lack of value our society puts on our respective professions. After accumulating a debt commensurate to a home mortgage, the new graduate is faced with agency salaries no better than I made over twenty years ago, a fraction of the new MBA's income. In fact, my hourly fee is now comparable to my car mechanic.

In spite of all this, I still enjoy the work -- as I know many of you do as well. I know that it has meaning and purpose with intrinsic "soul" satisfaction that goes beyond what I could accomplish in the corporate world. Having been in clinical practice since 1973, I figure I have worked with well over three thousand people. I know that at the end of my life, I can look back on my career and say that I touched a lot of lives in a way they value.

I am also counting on the impersonal, stingy way in which my competitors mete out their benefits. I get a lot of clients who are tired of having to wait three weeks between sessions, or who are concerned about the fast and lose way in which the most intimate details of their lives are handled. I believe there will always be a place for an alternative to therapy packaged like fast food, with about as much nutritional value. I believe there will always be a place for therapists who develop solid, lasting relationships with their clients; mentoring them through the rough spots of their lives, and challenging them to grow into better people. I'm betting the rest of my career on it!

Read my original article about leaving the preferred provider lists: "I Quit!"
Check out my article on a one year follow-up: "My Recovery from Managed Health Care"

Networking With Other Therapists


Clinical Social Work on Line
Psychotherapy Finances
Anti-managed health care organization with a good article on unethical practices by HMO's:
National Coalition of Mental Health Professionals & Consumers, Inc

Please send me e-mail about your own practice experience:



Last messed with February 23, 2016

Copyright(c) 2001 Michael E. Holtby, LCSW. All rights reserved.