Post-Grad/Externship/Residency

The Schaperow Psychology Center of CT

(Notice to post-grads: Please read this page thoroughly, and only apply if you're fully confident this is the best position for you. If accepted for an interview, we do require that you go in already knowing everything from this page.)

Post-Graduate (Extern/Resident) Position, in Waterford of New London County, CT

PLEASE CLICK HERE FOR THE POST-GRAD TESTIMONIAL(S) PAGE

At first glance, this position may seem like any random position offered to new therapists. This web page was created when I found too many applicants not recognizing why it is an exceptional position for exceptional people. Thoroughly reading and understanding this page will help you to make an informed decision about this position versus competing post-grad positions. I am confident that you will want to apply if you are the exceptional candidate I am looking for. But, if you’re still not completely sure that this position is better than the competition, you may contact me, the practice director, at (860) 447-2047 or Sam.Schaperow@gmail.com.

This page has been split into three sections (I, II, & III):

I. Our group vs. most clinics:

II. Time Allocation Chart

The following chart is based on how you will allocate your time in our group compared to most clinics.

A successful therapist must spend some time doing therapy and some time doing other work. But the question is what this "other work" consists of. At our practice the non-counseling hours are allocated to the business side of things: marketing, networking, and advertising. The goal is to train you to understand the business of therapy and generate your own clients under the support of our group. This is productive work because without clients a therapist will not get to do any therapy! This is a seemingly simple truism that turns out to be a difficult lesson for many other new therapists to learn.

On the other hand, at the typical clinic, most of your time will be spent in paperwork and administrative tasks which are not productive. Isn't the whole point of finishing your graduate school education to actually work with clients? And shouldn’t you now be treated as a respected colleague training to be an independent professional, able to have choice in what clients you see, not only relying on others’ leftovers? At most clinics, post-grads are put at the bottom of the totem pole, so to speak, and are given no responsibility or control over their own professional development or choice of clients. You won't find that kind of disrespect at our practice.

The figures in the chart are based on a random start-date, assumes the clinician takes most available cases, and follows our practice-building formula, which includes how to get his or her ideal clients, as well as how to do almost all of the paperwork within a 45-minute clinical hour, while providing excellent treatment and connecting with the client. (Please remember to view the “Totals”). Please note that this chart is based on a full-time post-grad, but figures can be adjusted for any part-timer. Lastly, note that even if someone is full-time, if they reach the number of clients seen that they want, and wish to go down to the minimum one hour per week of marketing, that post-grad can do so without needing an approval:

Summary:

Summary: Based on the most accurate estimates, the work at our practice is more challenging than at other clinics in the first one to three months, but after that, seeing clients in our group becomes an easier process. It takes a couple of months to lay the foundation at our practice before you see the results of that ground work, but the longer you are with us, the better it works for you. In contrast, for the most-part, staying longer at most clinics will not improve things much for the clinician. If it did, they would not have such a high turnover rate.

At our practice, the clinician can also increase his or her autonomy over time, while clinics typically have a rigid structure with multiple layers of management, even for the most seasoned of clinicians. The above chart also does not include the fact that even licensed therapists, with decades of experience who work at a clinic, will often earn only $38 or less per hour, while our licensed therapists (excludes associates & affiliates) on average gross $142 per hour and even more for intakes. This would mean a take-home wage of $75-$120/hour (not even including intakes). These figures are much higher than what most people earn in private practice without even a flat-rate rent/split to pay (such as when practicing out of one’s own home). This is primarily because most therapists rely on ~$69/hr. from insurers while we do not.

III. Frequently Asked Questions (FAQ):

A. Where is the practice located? We are conveniently located in Waterford, CT, immediately off of I-95 and just minutes away from 395. This allows us to serve people from a large radius.

B. How do you manage to pay externs so well? We have a low overhead. No redundant paperwork, no wasteful administrative hassle, and no useless expenses that do not help you or the client -- all this means more money for you, more client focus, not being on the verge of burnout, and results for clients! Note our system is the extern collects money directly from clients, then pays us the balance (e.g., 50%) at the end of the month as a type of variable rent. This further reduces costs to not have a secretary pay you your share, while ensuring you'll not have to hope a secretary pays you properly. But, it also means we have to be even more careful about who we take on, since we must rely on your honesty to receive proper payments.

C. What if I want to stay beyond my residency? We expect our externs to want to stay because our practice will be the best place to practice. As long as you are in good standing, becoming a permanent member of the practice is always an option. And should you do that, you can expect to do far better than most private practice, group, or clinic/hospital settings.

D. What if I need benefits, and if I have to pay for them, wouldn’t that make your position not as much better than others as it seems? Our group receives benefits from providers who give us excellent benefits with great rates. Many people who are used to receiving benefits from an employer are unaware of the multitude of better options available elsewhere with just a little research. (You'll find that I'm an excellent researcher and negotiator, and these are just a few of the skills you'll be learning from me, which will be useful in all aspects of the therapy business that you can't learn anywhere else). Because you’ll be earning such a nice wage here, you will end more than making up for the difference. Clinic positions with benefits are typically those that will pay a person a salary, which often comes out to ~$18-20/hr. Remember: those benefits are always simply paid out of wages that would otherwise go to you! They are not "free." These benefits also typically have high co-pays. And if choosing your own provider, rather than going to those who are still on the insurance panels, you will often have a very high deductible, and then the benefits will still be quite limited in what they cover. The bottom line is that our higher wages and great deals on health insurance and other such benefits win out over full-time clinic positions hands-down.

E. Your practice isn't near my home, so I should just find something local, right? It depends on how far away you are. It can be worthwhile to commute if you can consolidate your schedule into two or three days, rather than seeing a few clients per day spread out over five or six days. However, you need to be sure that you'll be completely comfortable to travel here for years to come, with an intention to stay well into licensure.

F. I’m impressed with your supervision options, but is it really worth the investment? Is any education really worth the investment? Even our director, an LMFT, continues to get supervision. This is despite frequent compliments from his patients, as well as many measurable successes. We do believe, however, that supervision is only as good as the supervisor and the supervisee’s use of it (plus the compatibility of the two). Our options are flexible, unlike clinics with “free” (you still pay the supervisor through lower wages and/or extensive grant-supporting paperwork, so it is not any more free than the "free alarm systems" offers you see in malls) supervision (clinics typically tell their clinicians who will be doing the supervising, and there is little to no room for negotiation).

G. This position sounds too good to be true. The information here is highly accurate. Perhaps the biggest downside that has not been stated already is that we sift through many resumes without a single candidate being accepted/joining. We don't usually say "you can't join", but rather will increase our scrutiny as we see anything of concern, leading all but the most dedicated people to opt to withdraw. You see, we are dedicated to adding people, but not just any random candidate. After the initial screening email/phone call, we may move on to an interview. If that goes well, we will do a second interview. If that also goes well, we draw up the paperwork for joining after final checks are done (reference check, credit check [score & report], discussion about our concerns, etc.), and set a date for signatures after the prospective post-grad has had a chance to review it. This process can take weeks, and again only those who are the most dedicated to joining will end up joining our practice.

H. I saw that if I stay beyond my externship, that I can make much more money per client seen than almost anywhere, but how is this possible? We have a low overhead relative to the location and benefits we offer that combined lead to greater case-load growth and diversity of clients. We are respected by the medical community & schools, and devoted to advancing the profession, which leads to more full-fee clients. We focus on giving clients premium therapy & counseling (partially due to not having huge case-loads and investing in supervision and colleague consultations), which makes clients happy, then spreads the word about our practice further. It is an upward spiral that we take pride in. Also, our co-director has been an avid activist in the fight against the insurers that treat licensed therapists worse than psychiatrists. While most insurers will pay only $~69 per session, he has received much more. One of his records was in ~2005 to persuade two insurers (IE Shaffer as primary & Anthem Blue Cross as secondary) to fully cover sessions with a very difficult case at $225/hr., while the patient had to pay nothing. Most therapists would have received about 1/3 of this fee. This also allowed our co-director to not have to take a bunch more cases, which let him focus more on the cases he had in order to provide the high-quality service that patients have grown to expect from us. For this benefit, it is worth getting supervision directly from our co-director even if cheap supervision can be found outside our practice to be used while here. You will earn more money in the long-run from this kind of supervision. You'll also gain the kind of clinical supervision that will maximize your success with clients, which then leads to more cases from client-referrals, and more confidence by your clients in you.

I. How is your no-show and late cancellation rate so low? We have researched and developed the most effective strategies to decrease it, starting with the initial phone call, followed by a verbal and written explanation during the first session. We also use deterrents, such as a no-show or late cancellation fees, to keep clients serious about keeping appointments. Those who do not attend will typically have to give at least 48-hours of notice. This is enough time for that client to reschedule on that week, or for the clinician to be able to fill in that week’s time slot with another client. This also works well for other patients who are in need of an urgent appointment.

J. How available is your staff/director for me if I need to learn more now, or if I join & then need help? We are here to support you. We’ll either be on-site, or available by phone/email/IM. Even if it is midnight, if there is an emergency, you can call the co-director’s cell phone, which he'll typically either answer or quickly get back to you (this is not an exaggeration).

K. I’d like to join part-time. Would that really work for me? Yes, a part-timer, even one who can only devote six or seven hours per week can find this a fulfilling and rewarding externship. To calculate how the position would work for you, simply go to the “Time Allocation Chart”, and plug in new numbers. For example, if practicing half-time, just cut all numbers in half, or if only quarter time, just cut all numbers into quarters.

L. How long can I stay with you? Starting ~1.5 decades ago I (Sam Schaperow) was at Catholic Charities (Catholic Family Services), where I stayed for quite some time, breaking productivity records as well as clinical review scores and no-show rates, however when I became licensed I was not offered more money than the $17/hr. they offered. They said being licensed doesn't affect pay-rate. I'm very loyal, sometimes to a fault, and would have stayed part-time if they offered something more, but as they did not, I started the practice that has now expanded into what it is today. This practice is devoted to being up-front about its benefits, which are put into your contract. Contracts lengths are determined based on factors like if you're full or part-time, and if you have other hours being earned toward licensure from an alternate location. Further, your contract converts to a licensed contract (see our licensed page) to take effect the month following handing us the physical license certificate the state issues you to give to a contractor/employer. The total length between the post-grad and licensed contracts should ultimately range from 1.5-4 years, so please only apply if you are interested in a commitment, as we are not well set up to have people only do their post-grads here, nor do we feel that is in the best interest of the clients to have high turnover rates.

M. Hypothetically speaking, if someone were to work here and not follow-through on requests, then would the clinical director list "yes" or "no" on the form for the state for hours worked where it asks about any concerns? Its a matter of degree of concern. Please keep in mind that if minor concerns were listed, the state should have minor to no concern about those concerns.

N. I’m a detailed person who likes to have as much information as possible on hand before making a decision. Please provide me with a “Time Allocation Chart” that is broken down into each month? No problem. See below (note: this FAQ is continued after the below info.):

Additional information for those who like lots of details (this is the Time Allocation Chart, broken down into individual months):

This section is an abridged reply to someone's seeking more clarification:

"Thank you for clarifying. I'll try to answer your question:

Everything about the post-grad position is on the post-grad page. The externship is a lot of hard work, but also some of the most financially and clinically productive in the long-term. Truly, it is an investment that will also earn you your hours toward licensure. The supervision, at the discounted cost described on the site, is more about practice building at first, but later is more and more clinical as you get more clients, but toward the end it gets more about practice building as you prepare to become licensed and will get help toward that transition.

We do have referrals to give out ... (but not random people from waiting lists like many clinics, as we immediately refer out based on the needs of the client and clinician; but how can we have waiting lists when people ready for therapy are ready to start, not ready for a month long waiting list?), typically, but this varies a lot depending on the market and other factors (presently, the average number of referrals sent to a post-grad is ~4 per week). The primary focus of the extern is to learn how to get her own clients through marketing (includes phone calls, mailings, doing lectures on mental health at local organizations, meeting potential referral sources, etc.). I, as someone who has built a thriving cash and out-of-network practice from scratch, making an excellent living with 15 client-hours per week for me, (20 or more is too many to give my full attention and intersession case preparation to each person), if you choose me for supervision, I would be able to provide you with the entire spectrum of practice building and clinical knowledge.

So, basically, you'll spend a lot of time at first investing in yourself as you learn how to establish a practice, and as the chart shows, over time you should gain more and more clients, spending less time investing in yourself, and more time just seeing clients. Then, when you become licensed, you should be able to stay where you are with your current clients and have a full-time private practice [that should not rely on insurance panels] already established. You may also find our licensed positions page interesting, if you are considering coming on board and staying beyond licensure: Licensed Positions."

O. I'd like to work there for only about 4-8 hours per week, and possibly at odd hours; is that okay and can I build a case-load that way?

Yes, you'll be your own boss here and can determine your hours. As for your case-load, as you know, you can divide your hours by the full-time hours from the chart. On the one hand, it is possible w/o as much momentum, you'll do worse than those figures after dividing, however it is possible you'll exceed the chart because the number of referrals to you from us will not be diminished by the # of hrs. you're avail. (the times you're avail. could have an impact, however), and because any ads you have for yourself should generate the same # of referrals even if you're very part-time.

P. Is there any monthly flat fee I must pay on top paying the practice my share of what I earn, and supervision/consultation fees? Other than with delinquencies, there's no regular fee to pay, however if any exceptions ever exist, they'll be listed in your contract.

Q. Can I still apply if I don't have good or excellent credit? We may consider someone with fair credit, depending on how their credit report looks. If someone has poor or bad credit, we'd rarely take such a person. Please let us know if you have anything less than good credit on or before the 1st interview.

Q. Is there anything else I should do or know before applying?

1. It is important to know that applicants who will work out here are highly motivated, have good boundaries, good references, good credit, are honest, and are logical thinkers. We've seen people apply after saying they've read this page thoroughly and are sure this is the right position for them, only to get back to us after an interview admitting they didn't calculate how many hours they would get clinically, vs. what they already had, in order to meet their own deadline on when to get licensed. That is despite this webpage having all the info. needed to assess their situation. They then back out, but much time could have been saved if they had figured things out ahead of time, instead of after going through the interview process and then doing the calculations. We've also had applicants who's boundaries were no better than many of the clients they hope to help. This, too, didn't work out.

In another example from the 2010s (perhaps around 2015), someone impressive in many ways applied who had poor credit, despite having read this webpage that says we're looking for people with good credit. This person stated confidence and assurance in their interest in joining us. We discussed in detail the concerns about the poor credit, since we wanted to see if there was a reasonable explanation (plus it wasn't "bad" credit). There remained some concerns after that discussion and they may have understandably felt less comfortable with us after having that conversation, but we still did not deny their application. W/in the same discussion was a question about the supervision fees. They expected it was simply $75 (our rate last decade), despite the website at the time saying "as low as $75". We explained we would accept any amount they can afford up to the then actual rate of $150 or as low as the lowest rate of $75. Yet, even knowing of the potential to pay $75, and our website saying one can use outside supervision (this does require approval and we still would have some minimum on-site supervision requirements), we heard uncertainty in their voice despite their words stating certainty about joining. Honestly, there remained hope that things would work out, but we didn't expect it, and asked them to take a day or two to think more about if this is the right place for them at this time. Sure enough, the applicant withdrew w/in a couple days of that conversation. We nevertheless would be willing to reconsider this and many other applicants for the future once they understand this webpage and know this is the right position for them, such that we can start fresh and have an interview more about how we can meet each others' needs than about various concerns and points of confusion.

A good candidate not only possesses the qualities explained in this webpage, but will not come into the application process with confusion about what was stated here, such that the process will go smoothly (it has gone very smoothly with people who are with us now many years later). So, please be sure to fully understand this webpage before applying and interviewing, such that those who do not like all they see will save much time and effort by not applying, and those who are truly sure this would be a good position for them will be able to apply and have a smooth process toward joining us. In summary, a smooth application process occurs when there is true understanding both ways, honest discussion, and confidence based on the aforementioned understanding.

2. Also note that we have a lot of referrals coming in, and we often referred prospective clients out of the practice because of how much demand there is vs. what we can supply. We very much hope to find the right post-grad, who plans to work here for years to come, so that we can entrust that person with referrals as they also grow their private practice.

3. Post-grads in a private practice setting can't take insurance, even through their supervisor, though we've seen exceptions that have worked well for post-grads. The charts on this page show what to expect regarding clients, and that you can expect to average keeping about a minimum of $25/session, & more for assessments. It is vital that you do the math to determine if a post-grad position here will be feasible for your budget. In '16 we had someone join, only to leave after signing the contract, which was problematic in many respects. It appears he had anxiety about the potential to not support himself, even though he claimed to have done the calculations ahead of time. He instead joined w/every assurance, then talked to other therapists who knew far less about building a case-load in a busy practice like ours who were nay-sayers, and then he ultimately ignored the charts on this page and left (he claimed it was because he thought he could take insurance as a post-grad through his supervisor, yet we never said he could do so...). The point here is the charts on this page have already shown what you need to know about if this will be a good position for you or not, but when people ignore parts of it or make assumptions, they may not be successful. Successful post-grads here are planners, thoughtful, not controlled by their own anxiety, are highly motivated, and place their trust in us instead of those who know little about building a successful fee-for-service practice. We hope to not have a repeat of the situation we had w/him, and to gain people who will meet or, as some have done, exceed the stats shown the above charts.

4. The style of our clinical director is to be up-front and follow-through on what he says he'll do, even if it becomes costly to do so. He expects nothing less from post-grads, therefore if you have excellent follow-through, expect to learn a lot and be very successful. If, however, you let emotions get in the way and don't resolve it through your own therapy, then you'd likely not be a good fit here, especially as a post-grad.

5. Any post-grad therapist who's advocating people be in therapy, and yet are not in therapy, may be at a disadvantage compared to other clinicians who can utilize the benefit of therapy and then advocate from a point of knowing 1st-hand how helpful it is. Please note that we may recommend being in therapy if a post-grad appears to struggle in ways that may affect their practice. Examples include anxiety, hypocrisy, depression, extensive numbers of discomforts or lack of confidence that appears to interfere with successful practice formation, or a pattern of lack of follow-through. The latter two may be applicable if in-practice consultation meetings don't successfully overcome those difficulties.

6. Note that if you’re looking to go on the externship journey with another post-grad, we often have just one to two post-grads at a time. Given you will do most of your work independently, if you’re looking to extern with another, an agency would probably be a better place for you.

P.S. If you saw any typos or unclear statements on this page, please let us know. This page continues to evolve, and so is more prone to typos than the rest of our website.

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