Editor's note: This article includes some considerations that are often neglected, and gives Dr. Kim's take on them. Seek information from a variety of sources before making decisions about your future. This article was reviewed and slightly abridged in April, 2023.

I'm going to include some practical things that don't appear in the brochures but that are important to know.

There are several different ways to qualify. You could train as a clinical psychologist, usually by obtaining a PhD. Alternatively, a Masters of Social Work in counselling, or an M.A. in psychology or occupational therapy can teach you basic counselling skills if you pick the appropriate courses, and might get you a counselling job in outlying regions (not likely Toronto or Ottawa). Some nurses also practice psychotherapy, in most cases under medical supervision. Training in a psychotherapy school approved by the College of Psychotherapists of Ontario is another option, and may give you a deeper training. Or you could train as a medical doctor and either practice as a GPP or take further training to become a psychiatrist.

As with any training you are contemplating, think about what type of work and what type of lifestyle you have in mind, and then do due diligence to find out whether you are likely to be able to find work that suits you. For employment, you could see what jobs are being advertised and try to find out how many qualified applicants are applying. Jobs have been opening up for registered psychotherapists, but the increase in people qualifying could be increasing faster.

If you are interested in private practice rather than working for an employer, be aware that except for MDs paid by OHIP, there has been an oversupply (relative to the number of people who can afford to pay for therapy, not to the need) for many years. [Editor's note: This was Dr. Kim's conclusion based on their sources. There do not seem to be any statistics that would cast light on the balance between supply and demand.]

This could mean that you spend a lot more time on marketing than on counselling--and I see a lot of money being spent by therapists on advertising and expensive offices which it is hoped will bring in clients. It has also meant that many people who train for this type of work have been unable to find it.

For example, about twenty years ago I knew a student in a very good (and very expensive) masters in counselling program at a quite prestigious university; most of the students I believe were intending to go into private practice. Two years later two were working as counsellors--one of them part time and low paid with a long commute; the rest were still (or again, after trying to start a private practice) working at what they had been doing before the course.

Since that time the numbers of people training as counsellors and psychotherapists seems to have increased considerably--for example, at the conclusion of 2016 there were 3,931 registered psychotherapists, and as of September 13, 2017, there were 4,882, and the Ontario College of Registered Psychotherapists has been processing 100 new applicants a month. (This does not include psychologists, social workers, doctors or others who practice psychotherapy.) Just recently several new schools have been set up to train RPs....

So if you want to go into private practice think about ... where you will find clients. If you train as a psychologist, you may be able to find a specialty that is currently in demand from individuals or institutions that can afford to pay. Or you might decide to train as a social worker or psychotherapist because you have a special in--for example, if your husband is a doctor in a well-to-do neighborhood, he and his friends may be able to keep you supplied with clients.... I knew one charismatic and very gregarious therapist who built a psychotherapy practice in a relatively underserviced area through friends of her many friends; many people try to do that today with social networking, with what success I don't know. Most people find they need a website--however a private website won't be found in a search; it's just to refer people to for information about you.

Another thing to remember, if you are contemplating private practice and calculating possible earnings, is that you are talking about "billable hours". You need time to plan your work with your clients, consult with colleagues, contribute to the profession, continue learning, do paperwork, and run a business, even if you ... don't need to work on marketing.

Regarding clients' ability to pay, most people with good jobs can get a few sessions provided by their EAP and/or paid for by their plan.... Plans will pay for a psychologist, and most will pay for an MSW. Payment for registered psychotherapists is in the pipeline, but at this time doesn't seem to be moving very fast. [Ed: Some plans now pay for a Registered Psychotherapist.] Some therapists lower the fee substantially after the insurance runs out, and that enables some clients to continue, for a few more sessions or longer, depending on their financial situation.

There is a way to be in private practice and never have to be concerned about marketing or finding work once you get the word around. If you become a GP Psychotherapist or psychiatrist paid by OHIP the patients will beat a path to your door. Most of the training you will get is in medicine, which is essential if you are dealing with physical problems such as dementia, but not the best preparation for doing psychotherapy; however there are courses and workshops you can take over time to build up your skills.

So choose a university program, or if you prefer to train as an RP, a psychotherapy school. Entrance to most psychotherapy schools can be obtained with a bachelor's degree. Two well-established schools with a fine reputation are the Centre for Training in Psychotherapy (in Toronto) and the Toronto Institute for Relational Psychotherapy. [A full list can be found on the website of the College of Registered Psychotherapists of Ontario.]

I have tried to fill you in on some caveats; but let me say that for those it works out for, being a therapist can be extremely satisfying. Best wishes for your very worthwhile ambition.

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More information about the nitty grits of setting up a therapy practice can be found at
https://psychcentral.com/pro/private-practice/2011/09/what-i-wish-id-known-before-starting-a-private-practice#1 The part about managed care applies to the US; thus far (as of April 2023) it is not a big player in the Canadian market. See www.psychotherapists.ca for an example of a one-page psychotherapists' website.

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