In Search of the Perfect Private Practitioner By Howard Rosenthal, EdD on 2/4/15 - 9:58 AM

It all began in my undergraduate abnormal psychology class after I made the curious observation that our faithful professor was absent for each and every one of our exams. The professor's pattern of behavior struck me as odd. I leaned over and asked a fellow student who worked as a teacher's aide what he knew about this since I figured he might just have the inside scoop.

My cohort whispered, "You really don't know. The guy is in private practice and he charges $50 an hour, man."


I nearly choked on my Adam's Apple. I didn't know a single soul who commanded $50 for an hour back then. I decided at that very moment that since I wanted to devote my life to helping others, I might as well do it with a bank account that rivaled the worth of US Bullion Depository at Fort Knox. I was going to be a private practice therapist. Yes indeed, a private practitioner, the most noble profession on the planet.
Soon after snaring my master's degree I set up shop in a plush psychotherapeutic district of the city. I wanted to be on the strip where all the other greatest local minds in the field of psychotherapy practiced their craft.

I was able to afford the raised gold leaf lettered ink business cards (okay barely), but renting an office in this venue was a whole different story. The rent was extremely expensive and was way out of my league. But I knew I was living right when I spied an ad for a choice office location for under $100 a month. It had to be a mistake. Nope, I contacted the real estate office and it was for real. Some guys just have all the luck.

But it didn't take long to see why I landed this lead airplane of an office for less than a C-note every 30 days. The office was heated by radiators and the temperature was controlled by the real estate company. When the radiators kicked in they generated a banging noise that sounded like a steel drum band. Try to do a little creative visualization here. I am attempting to perform hypnosis, systematic desensitization, or relaxation therapy, and it sounded like Gene Krupa, or perhaps the lead drummer from Led Zeppelin, had set up shop in the suite next door. Worse yet, the office temperature soared to Death Valley levels, to the point that it was wilting my books and artwork. I coped by showing up for some of my clients' sessions wearing a light short sleeve golf shirt on days when the thermometer was hovering near zero and the streets were covered in ice and snow.

To fight off the intense heat I installed two window AC units that raised the already high decibel level to a fever pitch. In case you are missing the point, this was not turning out to be the private practice made it heaven.

But an even bigger problem emerged. The slick business cards and the cool custom white lettering I personally purchased and mounted on the office suite door did nothing to bring in clients. What in the world was I thinking when I opened the practice? Was I pondering that somebody would be strolling down the street and just happen to mosey into the building for no special reason, and make the sojourn to the second floor? Then, while on the second floor, spy my compelling sign replete with my degree and think, "Awesome. I'll march right in and see this Rosenthal guy. Now would be a great time to do something about that anxiety problem of mine."

Actually, that's exactly what I was thinking would occur.

Then came the dawn. I needed a role model, a hero, someone to pump me up and make me optimistic. While spending time in my, ahem, comfortable cubby-hole excuse for a private practice, I read numerous books on psychotherapy since the office wasn't exactly brimming with clients.

Enter my savior, Dr. Karen Asch. Luckily, the neighborhood had a free community newspaper replete with a column called "Ask the Counselor," penned by a therapist named Dr. Karen Asch. Her distinguished confident mug shot graced every issue.

Each week she would take clients' questions and answer them. Her answers were solid and beyond insightful. I loved it. I finally knew there was psychotherapeutic light at the end of the tunnel.

In my mind Dr. Asch had it all. Here was a practitioner who was so well liked that clients were writing the newspaper weekly just to correspond with her. I imagined she had the perfect private practice. I didn't know how big it really was, but I knew it was big!

I made up my mind right then and there that one day I would be like Karen Asch. Indeed, I too would live the good life. I would write my own "Ask the Counselor" newspaper column and head up a mega private practice, packed with clients, just like hers.

I had never met Dr. Asch, but it is safe to say that I admired her from afar.

Fast forward approximately five years into the future. Although I was still running a part-time private practice (several miles down the road from my old office where the radiators and the twin window boxes kept things jumping), I had acquired a day job working for a nonprofit agency, where I gave numerous mental health lectures to the corporate world, schools, community groups, and organizations.

One evening I presented to a burgeoning mental health center. The lecture went well. But it was what occurred immediately after the talk that was significant.

As I was packing up my handouts to leave I froze. There she was. In the flesh. My hero, Dr. Karen Asch was standing in front of the coffee pot adding a dash of cream to her brew. She looked just as confident and successful as her picture in the throw-away paper made her out to be. She had not attended my lecture, but then again, who could blame her? Would you expect Albert Pujols to come to a beginning course on baseball for little leaguers or Martin E.P. Seligman to sit in on an introductory lecture on positive psychology? Well would you?

I nervously approached her. I didn't want to blow it. This was a seminal point in my career. "Dr. Asch."
She turned to face me. "Yes, may I help you?"

Me, behaving like a ten-year-old kid who just ran into Taylor Swift at a yogurt bar, "Are you the Dr. Karen Asch?"

"What do you mean the Dr. Karen Asch? Why do you say it like that?"

In sixty seconds or less, I encapsulated the saga of my anemic private practice and how she had been my much needed role model and hero. I described to her precisely how in my mind she had become the poster child for running a successful private practice.

What came next was totally unexpected.

Dr. Asch, the open, honest, and candid person that she was, revealed she could honestly never remember a single question submitted for her "Ask the Counselor Column." She created (translation: made up) the questions herself. She added that she just couldn't make it in private practice, because it was too darn difficult to get clients. Her dream private practice, I so vividly had created in my mind, didn't exist. She was now working full time at the agency where I had just given my speech as an administrator.

The next day my first call was from Dr. Asch. She candidly admitted that she was not happy at the agency where I had run into her the evening before and wondered if I could give her a few viable job leads. I did.
So in the end, the moral of the story is that the carpet is not always greener in your neighbor's private practice, though to be sure, their heating and cooling system might be a hairline quieter than your own. Or perhaps that we shouldn't judge a fellow private practitioner's business by our insides . . . or something like that.

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