Over the past couple of months I’ve moved forward with incorporating by business. There is some debate whether or not a sole proprietorship or an LLC is preferred when starting a psychotherapy practice. Because I am only working for myself (not a group or with partners), sole proprietorship seemed to be the way to go. This was fairly easy to do, just by going down to city hall to file the paperwork and get my business license. At the same time I decided to get a fictitious business name, as my “maiden name”, so that with my new married name, I can maintain my practice and identity that I have established over the years under my old name. It took some debate whether or not this was a good idea, wondering whether a fresh start is better than reputation, but I decided that the benefits of continuity outweighed any of the downsides.

I also decided to get an EIN from the IRS for tax purposes even though as a sole proprietor I can report taxes through my SSN. This feels like me staying one step ahead of the game, even though I don’t currently fully understand the future necessity of having an EIN except when I have employees.

When I fully legally change my name, I’ll write more on that process with regards to the Board of Psychology, health insurance providers and other institutions that will have to be involved with regards to my professional license. For now having a check mark next to FBN on my list of things to do for my business feels like another step towards being a successful entrepreneur.

Looking back at my “First things First” post of a few months back, I realize that I failed to motivate myself to follow my own strategic advice and go through these things in a strategic order. Writing about them here while in the process would have been helpful to processes the decision making process and help me move on to the next logical step. So let’s do a little review…

Malpractice insurance was an easy step that took me way too long to get under my belt. Just about every outside agency that you might work with requires a $1M/$3M policy, even though you could sign up for other less expensive policies. I’ve even heard about it being wise to get the $1M/$4M policy if your caseload is large enough to warrant two potential settlements in one year. However, my practice is currently small enough that I stuck with the former, which insurance companies and many contractors require.

I opted out from doing a thorough review of liability insurance providers after hearing enough positive things about about the APA’s Trust provider program to just move forward with it.

I chose the “claims made” option rather than the other option that covers all incidents that take take place during the time of the policy, regardless of when the claims are made. I decided to base this decision on my sound clinical skills and ethical principles and mostly for financial reasons. It costs about $1k less annual to go this route and right now I need that level of savings. My thought is that as my practice expands, I’ll go the other route which seems safer as I expose myself to more risk.

It has been a while and that’s due to a combination of factors, from getting distracted away from my focus on professional development to spending time celebrating getting married. But those are really just excuses. A lot of my lack of communication is due to feeling stagnant and not wanting to admit any responsibility for it.

It has been very difficult is coming to the realization that I must move towards new clients because they won’t move towards me (at least not at this stage of my practice and in a recession). The result has been a steady, yet very small practice of long term clients. Although rewarding doing this work, it has been quite difficult for me to not have the professional lifestyle I hoped for at this stage. I’ve found myself fearful of failure and preferring half-hearted attempts at success, rather than facing the possibility of nothing coming out of a full fledged attempt on a successful business.

So, how have I spending my time? It hasn’t been fruitless, but it has been dancing around living passionately and towards my professional life goals.

Since getting downsized at the beginning of the year, I began exploring possibilities and diversifying my skills working with new types of client populations and decided to focus on geriatric psychology, something that has been an interest of mine since working with addicts and the HIV+ population. The desire stemmed from enjoying previous work helping these previous clients explore the deep grief and loss they have experienced in their lifetime. This desire brought me to volunteer (while I had ample amounts of free time) with a local hospice organization while simultaneously doing contract based psychotherapy for a medical professional staffing agency that focuses on placements in nursing homes.

The strategy has been multi-fold, not only to diversify and develop my skills working with these clients, but also to keep my resume from developing holes in it and also to try and do some subtle marketing from inside these positions, getting my name out there more, and making connections to patient’s families as potential new clients.

Of course, well meaning and probably fruitful, this “strategy” and the other distractions in my life, plus my wedding didn’t help in moving strongly towards self sufficiency and entrepreneurship. So now that life is back in focus, we’ll see if these seeds I’ve planted over the past few months, plus a new cultivation strategy yield anything if I add a touch of well deserved TLC.

But I’m licensed!

So the recession is officially making its way into San Francisco community mental health. Once receiving my professional license, I figured that employment would be easy to find and secure, while developing my private practice on the side.

As a result, I’ve exercised patience over the past few months in seeking employment, waiting for the employer that felt like a good match to come my way in combination of population of clients, professionalism of the organization and of course salary. Because of this, I’ve stuck with my current employer, Walden House, despite it being time to move on, because I have been there for many years, know how things run and enjoy working with my clients.

However, the economic downturn has made its way into San Francisco’s Department of Public health as both the city and California fear huge annual deficits for the year. The SF-DPH will be cutting $26.7M, with over $.5M of those cuts affecting Walden House.

So I’m out of a job come January 1, 2009, after all of this time expecting things to be easy once I reached this stage of my career. Goes to show that you never know. I’m searching far and wide and am less picky than I have been for the past few months. We’ll see what comes my way. Hopefully my license can open up a few doors for me in these challenging times.

[above: the back of my new business cards!]

So today my new business cards arrived! I’m really excited. They say “Licensed Psychologist” on them, how could I not be.

I’m not the most traditional psychologist out there, so in putting together my business cards, I decided to take some risks and show that off in the style of the card (see image above). I also decided that i needed to make cards that are those hip new “skinny” business cards. Also, they’re green, not white. I can’t show you the front, but all I decided to put on there way my name, title, phone number, email addy and license number.

I’m not sure how my approach to business cards will turn out. I’ll guess I’ll end up getting boring cards if it seems be working against me down the road.

Below are the first things (well, at least profession-oriented) things that I officially became a License Psychologist. Who knows if this is the best order or if I’m missing anything. During some professional transition phases mentorship is highly valuable. This seems to be one of those phases.

1) Get new business cards
2) Learn about malpractice insurance and sign up for it
3) Learn more about HMO panels and apply
4) Examine new employment opportunities
5) Take Clinical Supervision class (online)
4) Find private practice location
5) Take next steps into private practice entrepreneurship

So that’s my list in no particular order (of course some things are better to do before others). #5 is my biggest challenge. I’ll be discussing that more here in the weeks and months to come.

So I’ve never been in a fraternity (and to clarify, nor have I ever wanted to be in one) but as a friend has pointed out, going through the licensing process is largely like being hazed into the greek system back in college. I guess this isn’t only for psychologists/therapists, but for most professionals who have governing institutions and license procedures. One may argue that there is some level of testing competency involved in the EPPP and CPSE testing process, but from my point of view, its mostly a test of determination, test-taking ability and ego strength, and not so much a test of knowledge and skill. Much of that material I learned through the studying process. I’m grateful for the odd psych-trivia I now have embedded in the depths of my memory reserves, but I’m not sure how useful it is. I’m a big fan of the internet, journals and books as sources of information, and could see clinicians using these resources rather than cramming (and probably not retaining) a bunch of useful (and largely useless) information into their heads when they could be learning about applied clinical psychology best practices.

But, regardless of how both silly and important that test of stamina and determination can be, I’m now in the club. Being in the club gives you access to all sorts of great things – you can practice psychology on your own, you qualify for all those jobs that say “licensed” in the listings, you can ask for higher salary, you can supervise interns (once you take the supervision CE class) and most of all, you are recognized by the elder members as one of the ones who has made it through all the hoops.

It feels really good reaching this milestone and sharing this space with all the other psychologists who have reached this place. Now we’re finally colleagues. Its not like this is close to the end of the road. There are so many more challenges to take on and things to learn and grow from. Now I can take them on with a new sense of pride and sense of belonging.

Now, I’m eagerly waiting to be assigned my license number!

After one month of constant studying (thanks to Quia for its help with its good study guide, practice exams, lessons on cd, etc) and feeling really confident I scheduled my CPSE last week for today, Friday Aug 29, 2008.

This morning, I woke up at 6am and drove down to Santa Clara. For some unknown reason, the CA Board of Psychology doesn’t contract with a test giver that has an office in San Francisco, Oakland or Berkeley, so I had to make the 1hr journey down into the Peninsula during morning rush hour.

And at 11:30am this morning, I completed my exam and passed the California Psychology Supplemental Exam (CPSE).
I rushed home, completed the application, paid the licensing fee, stuffed it into an envelope and rushed it to the post office.
Of course, the BoP doesn’t have a straightforward process, but I’m pretty sure everything is complete with the “T”’s crossed and “I”’s dotted as wished.
$400 isn’t really something I can afford right now, but the investment is so worth it.

What a relief! The final major obstacle to getting my Psychologist License is complete.

Next up, I’ll do a little analysis of this whole initial licensing processes. And I can’t see what’s next around the corner.

I just stumbled on a website created by Dr. Raymond Lloyd Richmond, a fellow psychologist here in the Bay Area. It’s pretty comprehensive, and seems good for both clinicians and clients. I think the most noteworthy section is on how to become a psychologist.

Yesterday I got my letter from the EPPP and I passed! Wa-hoo!

Now that I passed, I’m comfortable writing about it. It was really challenging and I didn’t confident that I passed either while i was taking the exam or when I left. Many of the questions I had never seen before and I had to just use deductive reasoning to try and find the best answer. I also changed probably 10% of my answers when I went back through the exam. Thank god I took many practice exams and studied through a study guide. Probably 10% of the material on the test I only knew because of the study guide. I’m also really surprised that the scores came back so quick. Supposedly they only report scores twice a month. I must have gotten lucky and ended up on the right side of the mid-month cutoff.

Next up is the California Psychology Supplemental Examination (CPSE)

This looks like it might be helpful in studying for it:
http://www.quia.com/pages/cpsepretest.html

I’m really trying to avoid spending a few hundred on a course, but that may be necessary. Although the information is all very relevant to practicing psychotherapy (unlike the EPPP), the questions are pretty tricky.

I can’t wait for all this to be over with.