Let's assume that the setting of psychological consultation clinic and individual consultation (consultation setting-in short, the basic rules that psychologists, consultants and visitors should abide by) is the same: face-to-face consultation is the main one, and each session lasts 45-60 minutes.
In this case, the working hours of the psychotherapist/counselor in a week are actually limited: 20-30 hours per week and 800- 1200 hours per year. This is basically the total workload of a mature practitioner with sufficient support system (supervision, systematic training and good vacation habits). If this figure is exceeded, practitioners will face a higher risk of psychological exhaustion.
With this foundation, let's look at outpatient service and private practice.
The first is the charge.
With the same training level and case experience, the fees for outpatient service are much cheaper than those for private practice.
Then there are problem areas that can be treated and solved.
Outpatients, like private clinics, cannot receive serious cases such as mental disorders alone. Patients with mental disorders in clinical work will be recommended to be referred to psychiatric clinics or even inpatient departments.
Article 76
Under any of the following circumstances, the health administrative department and the industrial and commercial administrative department of the people's government at or above the county level shall, according to their respective duties, order it to make corrections, give it a warning and impose a fine of more than 5,000 yuan 1 10,000 yuan. Illegal income, confiscate the illegal income; If serious consequences are caused, it shall be ordered to suspend its practice activities for more than six months and less than one year until its practice certificate or business license is revoked:
(a) psychological counselors engaged in psychotherapy or diagnosis and treatment of mental disorders;
(2) Persons engaged in psychotherapy carry out psychotherapy activities outside medical institutions;
(3) Persons who specialize in psychotherapy are engaged in the diagnosis of mental disorders;
(4) Persons who specialize in psychotherapy prescribe or provide surgical treatment for patients with mental disorders.
(The quotation is from the Mental Health Law. )
The real difference between them lies in the treatment of personality disorder and neurosis.
The treatment of patients with personality disorder usually needs a treatment team and a complete treatment system, such as TFP (Empathy Focus Therapy), schema therapy and dialectical behavior therapy. Neurosis patients have good effects in many treatment paradigms. In fact, experienced therapists and psychological counselors have rich experience in the diagnosis and treatment of neurosis (psychotherapy of personality disorder is a relatively specialized field, and the treatment process and strategies adopted are unique). According to the Ministry of Health's interpretation of the Mental Health Law, psychotherapists can accept patients with personality disorders and neurosis, but psychological counselors can't. Judging from the current demand of the display market, except for the help-seeking groups of teenagers' growth problems, most of them are cases from mental disorders to neurosis in outpatient clinics and private institutions, because the proportion of "general psychological problems" coming for help is actually very small. The boundary between personality disorder, neurosis and normal people is actually very vague, and the social function and career achievements of many cases are even much higher than those of most normal people. The clinical definition of psychological problems is also a difficult thing to distinguish.
Aside from the legal level, there is actually little difference between psychotherapy and psychological counseling in clinical work. However, due to the interests and safety of visitors and counselors, most counselors will consider referral more in the face of possible personality disorders and suicide threats.
After discussing special cases, let's talk about the difference between general cases. Contrary to most people's impression, some cases that require long-term work (more than half a year) are more suitable for consulting in personal practice or consulting institutions. Psychological outpatient service has a certain nature of public health service, and the low price determines a large number of help. In this case, short-term and medium-term work strategies will be the first choice, and the focus of work may be more focused on solving problems, alleviating specific symptoms, better adapting to the life and work of drug treatment, and restoring social functions. Personal growth, intimate relationship and life planning in psychological work are relatively lacking.
summary
Compared with private practice, the former is cheaper, which means that more people see a doctor and it is more difficult to obtain resources, while the latter is more expensive and easier to make an appointment. In the field of treatment, there is considerable overlap between the two, while the former is more closely related to psychiatry, and the nature of public health services determines that it tends to be problem-oriented, while the latter tends to be growth-oriented because of legal and support system problems. Note that the orientation mentioned here is more of a tendency than an obvious difference. More commonly, the individual differences in practitioners' styles are greater than the overall differences in the two fields.
Note: The general training of practitioners, the evaluation of practitioners' level and the matching degree with help seekers are not discussed here. Relevant parties can search for "psychologist, how to choose the one that suits you?" Find the answer in the article.