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COUNSELING IN A PRIVATE PRACTICE SETTING

By Derek Joyce and Tanisha Coleman

SOURCES
The information for this presentation is based on interviews with the heads of two private practice agencies
Kim Hulsey, founder and director of East Georgia Counseling Services, Statesboro, GA David Crooke, CEO of Care Partners of Georgia Inc., Swainsboro, GA

ADVANTAGES OF PRIVATE PRACTICE


Not taking orders from another superior or outside agency means that the agency has the highest potential for profitability. Able to organize and perform functions to the ideals of the director. Able to change structure, mission, or functions whenever deemed necessary. Free to use several specialties and non-mental health counseling personnel. Control over when appointments are made. Can choose to not use insurance for payment of services. Opportunity to specialize in a certain field.

DISADVANTAGES OF PRIVATE PRACTICE


Difficulty in finding and acquiring clients Full responsibility for paperwork, handling insurance, and losses. Need for strong business skills Balancing time between counseling and administrative work. Occasionally have to work pro bono.

MISSION OF PRIVATE PRACTICE


Provide high-end treatment for clients. Have multiple theorists available. Recovery of mental illness.

MISSIONS OF OUR SOURCES


EGCS: To provide mental health counseling and social services to children, adults, and families in the area. CPGI: To empower youths and their families to develop skills that promote self-sufficiency, create community partnerships and facilitate hopeful recovery for mental illness and addictive diseases.

ROLES IN THE COMMUNITY


EGCS: High collaboration with DFCS, treatment of mental disorders, prevention, counseling, and speaking on behalf of client in court. CPGI: Community support and resource linkage. Provide information to schools and juvenile facilities. Similarities: Multiple forms of services for many needs.

CLIENTS SERVED
Private Practice agencies may serve a variety of client types from those needing psychiatric help to social services. EGCS: Often works with individuals who are in need of social services, are being evaluated by DFCS, or other counseling services. CPGI: The agency treats individuals with behavioral health and addictions. Individual and family therapy are available.

ORGANIZATIONAL STRUCTURE
Often, there is one practitioner who is the director of the agency and numerous other practitioners who are of near equal hierarchy. EGCS:
Director- Kim Hulsey Full time Psychologist- Lee Ann Scott Other practitioners DFCS workers

CPGI:
CEO- David Crooke COO- Kathy Durden Behavioral Health Director- Shawna Harlin-Clifton

INTERACTIONS
EGCS: With the exception of the psychologist and the director, all of the counselors are independent, but may use this agency as a venue to access and treat patients. Some may only work with the agency when the agency requests that one of its clients be seen by the counselor. They do not interact with the community much. CPGI: Counselors fit into this organization because they are the ones who evaluate and help determine what kind of treatments are necessary. The counselors interact with the clients, their parents, their teachers and psychiatrist.

FUNDING SOURCES
EGCS: This is a state funded agency. They receive payments for their services through various insurance companies and cash. Clients without insurance may pay in cash through a sliding scale system. CPGI: This is a state funded agency. They receive payments for service from Medicaid and various major insurance companies.

OUTREACH
Outreach may not be given much importance, instead relying on clients to reach out to the agency. Advocacy may not be emphasized except where it directly relates to a specific client.

ASSESSING COMMUNITY NEEDS


Private practice agencies may assess the needs of the community by informal or formal assessments. Formal Assessments: needs assessment, asset map, community demography assessment, and market analysis. However, some private practice agencies may not assess the needs of the community at all, instead relying on the clients to go to them for services.

PROGRAM DEVELOPMENT AND EVALUATION


Intake interview of clients Gather information from those close to client. Treatment team sets up interventions. The clients set the goals and the counselors monitor progress throughout the program. The program is evaluated to see if it is meeting the needs of the clients.
Goal Attainment Scaling, Client Satisfaction Surveys, informal evaluation.

If the client is not making any improvements on a certain treatment plan, adjustments are made as needed.

SOCIOPOLITICAL CHALLENG ES
Changes in managed care policies. Reliance on other organizations for client referrals. Need to build a reputation. Competition with other mental health agencies.

SUPPORT FROM THE COMMUNITY


Agencies mainly rely on the support of other major agencies for client referrals. EGCS: Support from DFCS. CPGI: Department of Juvenile justice and from the schools.

SUMMARY
Private practice agencies have the freedom to set up appointments, have a diverse or specialized practice, and can follow formats and programs of their choosing. Some challenges occur with finding clients and an unsteady client flow. Quickly becoming the preferred form of practice for graduates of doctoral programs.