Regulatory expectations and requirements or "paperwork."

Dear Michael:

In response to your concerns about all the insurance regulations which must be followed to bill for services I jotted down some of my thoughts.

We can get caught up in the regulations, expectations, and requirements of running a business and practicing a profession when we manage a career in psychotherapy. This obsession with the trees precludes us from seeing the forest. The more basic questions that we overlook are:

What ultimately is the purpose of psychotherapy? 

Who are we ultimately working for?

One of the foundational concepts in TQM (Total quality management) is to know your customer. Who is your customer? There usually are many stakeholders in the business being managed. So these stakeholders can be put in priority.

The managed care model was built on a three legged stool. The model intended three things: good outcomes, achieved cost competitively, with customer satisfaction. Or as the bumper sticker says "Good, cheap, fast pick two."

At the end of the day I am on a mission from God and the client's needs and wishes are my ultimate concerns.

I went to a conference once presented by Michael White, the father of Narrative Therapy. He was asked a question by somebody in the audience who probably was a graduate student "Is Narrative Therapy research based?" Michael paused for a moment and then said, "Well, I am not a researcher. I am a practitioner. I don't know if Narrative Therapy is research based or not and it isn't my biggest concern. My concern is that it be ethically based."

Obviously, I have never forgotten this very important principle. We can worship at the altar of data or we can do the right thing. Hopefully these will usually be the same thing, but sometimes they are not and at the end of the world I'd rather be on the side of the ethical.

There is a line in A Course In Miracles, "Would you rather be right or be happy?" The need to be right may ultimately miss the point, right?