The Big Picture
The following paragraph isn't something we talked about in our clinical training programs, but it's important:
In the last 50 years or so, worker power in every sector has decreased as neoliberal capitalism became the global economic order. Over this same period, mental health problems have worsened for just about everyone, and demand for mental health services have skyrocketed. Meanwhile, the gap of pay between CEOs and their workers has become more extreme; many CEOs in America now make 674 times more than their median-paid workers. If every workplace in America were a worker cooperative, these disparities would dissolve and a society-wide healing process would begin. Why aren't we as therapists yet engaged in this transformative healing process within our own therapy practices?
Our healing work usually happens on the "micro" scale of society unless we're social workers engaged in policy change work. The field has arguably broadened in recent years in that we now consider how our social location and identities impact clinical treatment and relationships, and this is surely progress. But some larger questions in our field remain unaddressed: what is our role as mental health workers within this exploitative capitalist system?
One common experience many of us have had is that Community Mental Health (CMH) is a kind of "burnout factory" due to high caseload, lack of autonomy, low pay. Whether pre-licensed or licensed in CMH settings, our voices carry little weight and we feel we're worked to the bone. Some look toward climbing the managerial ladder for better pay (and for some, more power) as a way to improve things. For others, leaving CMH as soon as possible is the dream.
Solo practice can feel like a refreshing alternative once you're licensed and ready to leave CMH, because now you have full autonomy and higher pay. But this can be isolating and unfulfilling, and being a business owner comes with it a variety of challenges. Some solo practice therapists go on to form group practices where they hire pre-licensed therapists and pay them a little (or a lot) less than they could, because 60-80k/yr didn't seem as rewarding as 200-500k/yr is if you really expand the business and help those associates get their hours! Such practices usually aren't extremely exploitative, but they're not built on workplace democracy in the way worker cooperatives are.
The Better Alternative
Some therapists are already pushing into new frontiers with the worker cooperative model, and so the alternative doesn't need to be created from scratch. Go to Existing Models for more info.