Wendy, welcome to private practice in the WTF era. I'm Wendy Kendall, chartered psychologist and private practice designer. And if you're also waking up every morning going, WTF is happening now and then, trying to run your psychology practice on top of it, you're in the right place,
you can be completely overworked and completely under stimulated at the same time,
back to back clients all day, diary full and still this nagging feeling quiet, persistent, maybe even a little bit shameful, that your best thinking is going unused, and that's what happens when a practice is structured around selling hours rather than using what you're uniquely brilliant at.
This episode is about why the time for money model produces this, and what a differently designed working life could feel like.
Welcome to private practice in the WTF era. I'm Wendy Kendall, charter coaching and occupational psychologist, and this is episode three.
In Episode One, we looked at why the ground has shifted under private practice, that it's structural, it's not personal. In Episode Two, we got into the economics of the one to one model, the red ocean and the blue ocean. Strategy, dynamics shaping where psychological work is heading and where that redesign direction points.
This episode expands on both of those. It's about the experience of being trapped by a time for money model that is simultaneously too much, leading to burnout in some cases, and also not enough in other important ways, which leads to bore out.
And finally, I want to share with you my thoughts on why the window for doing something about that is important is open now, and why, as psychologists, we're well placed to respond to this window of opportunity. But it's a window that's not going to stay open indefinitely.
I want to start with something I think doesn't get separated out in the discussions around burnout at work and in our practices, and that's the topic of bore out. And burnout and bore out are not the same thing in everyday conversation. We use the term burnout as a catch all, whether that's for exhaustion, for overload, for the feeling of having nothing left to give. But even by psychological definitions, the burnout epidemic in psychology is real. The research is unambiguous. More than half of psychotherapists report moderate, moderate to high levels of burnout, and one in three BPS members say their work is emotionally exhausting. And those aren't small numbers,
but there's a second element sitting out alongside the burnout,
and it's something that has been showing up in the research for decades, and it's even more specific to our profession than I think most people realize.
In 19 9017,
years before the concept of bore out entered mainstream, management thinking a psychotherapist and researcher called Barry Farber, published a paper in psychotherapy and private practice identifying what he called under challenged burnout in psychotherapists specifically. And it wasn't about overload burnout. It wasn't compassion fatigue. It was under challenged burnout, the experience of being professionally depleted, not by too much, but by the wrong kind of work, by a gap between the practitioners capability and what their work actually demanded of them. Now, Farber was associate professor of psychology at the Teachers College in Columbia University, and he was writing about
an element of our professions, specifically at that time in that paper, and this was kind of research that he did through the.
80s. In that paper, he identified three distinct types of burned out therapist. The first works increasingly harder in response to frustration. They run faster. They take more cases, they try to outpace the problem. The second, burned out practitioner gives up entirely. And the third type, the one I want us to think about, performs their work. Perfunctorily
brilliant word that used in the paper, having lost interest in work they now find unchallenging. I had a hard relate when I heard about this, it reminded me, as I've spoken about, you know, the feeling that I had just doing assessment after assessment after assessment for years.
So
that is a third type of borough
named in the psychotherapy literature in 1990 36 years ago. And by the way,
Derek Mowbray's levels of psychological work model itself was also published in 1989
and he was pointing out that even then, psychologists were staying on this treadmill of Level Two work, where they could and should be delivering that more strategic work, where different theories were being integrated, where they were pushing the boundaries of work, and
it's a shame, because neither of those researchers, neither of these people got or their work, really got the attention it deserved at the time. And I find it mind blowing that decades later, I hadn't even left school when this was being published,
but
this even decades later, this is still happening in our practices, and now it's being disrupted by These platforms. So a
little bit more about bore out
in 2007
there were two Swiss business consultants, Peter weadda and Philippe Rutland, and they named the same phenomenon in the general workforce, and they called it bore out. They identified three elements, boredom, lack of challenge, lack of interest.
And their core argument was that the absence of meaningful tasks, rather than the presence of stress, is many workers' chief problem.
In addition, Ruth stock, professor of marketing, human resources management at the Technical University of Darmstadt, one of the leading researchers on borrow refined this into three components that I mean, if I think about the people that I speak to and the people that I you know, come to work with me around diversifying their practice, these are immediately recognizable For any psychologist working inside that standard time for money model,
job, boredom,
crisis of meaning and crisis of growth. Now each of these don't arise from overwork, but from a lack of challenge sufficient to use your expertise and capacity at fulfilling levels of stretch.
Her background was business and HR management, not clinical psychology,
but and the application of this framework to private practice psychologists is mine, not hers. It's not showing up in her book, but when I listen to psychologists describe what's happening inside that time for money model where they're experiencing that flatness, sometimes a sense of going through the motions, a feeling that their best thinking is sitting unused for years. It maps on to stocks, crisis of meaning and crisis of growth, kind of word for word.
And it's not that psychologists find their work with people meaningless.
Everyone's an individual, and they bring something new to the work that we do with them. I mean, I would always say this about working in assessment and development centers, there's a joy and a deep sense of fulfillment in seeing people's transformation when we work with them, one to one, whatever kind of psychologist or therapist we are,
but there can definitely come.
Time when delivering this work over and over wears thin
Stark. Described burnout as a largely neglected phenomenon, and I think that's interesting. And she said it's because workers are ashamed to admit it. Well,
in contrast to burnout, she said burnout was something where, you know, it kind of fits with the ascribed values of overwork. I'm not saying that's a good thing, right, but I'm saying that a person who is performing so much, who's so well appreciated in society
ends up being held in some kind of esteem in hyper capitalist societies. In those driven contexts, in contrast, people often hide their bore out. You see it positioned differently if we think about
people talking, you know, post pandemic lockdowns, around the whole topic of quiet, quitting, well, you know what level of bore out was coming along with that, where people were just kind of feeling disconnected with the level of challenge in their jobs.
Werder and ratlin, the two Swiss management consultants, said the same thing bore outs systematically under reported because revealing it exposes workers to social stigma. So admitting that you're profoundly bored in a profession where the narrative is always about being overwhelmed
feels like a confession. Somehow, you know, people don't want to say it. They say burnout instead, because burnout is at least understandable.
Bore out kind of stays as one of the known unspoken problems,
and that's where I also hear it about. As I mentioned to you know about one in four psychologists, kind of straw poll, who book a coffee chat with me, say something in that register. They rarely come out and say it straight. You know, usually it comes out alongside a lot of qualification, a lot of self criticism and encouragement. For me that it's fine to say this like this is not the first time I've heard people say I feel terrible saying this, but
I can't continue to do that. It's I am so bored from doing it.
It's what I hear again and again, exhausted. Yes, life is
flipping demanding, but chronically under stimulated at the same time.
You know that combination feels kind of at odds, right? If you're exhausted, surely being used, but we know the reality of the treadmill, the time for money. Treadmill produces exactly this because the diary is filled with volume, and volume isn't necessarily fulfilling. It's not stretch, it's not growth, at least not qualitatively and even quantitative. Growth tops out, because there's only so many hours in a day, that's what happens when a practice is structured around selling hours rather than what you are uniquely brilliant at. It's a model that extracts energy, by definition, it doesn't necessarily develop and stretch your capacity to deliver that fulfilling, inspiring, unique, distinctive work that you can you can deliver that you have the capacity for, if Only you have the time and space.
Now I'm going to geek out again here, because I got really excited looking into
some of the economic principles that explain this. Would you believe it? And there is an economic principle that explains a lot of what's happening, not just at the kind of micro level of, you know, our experience of delivering within this time for money model, but also thinking about, you know, setting that in the context of what's happening in that commoditized market for.
Or our time for money or for our time within our practices.
So
this is an economic
model or an economic paradox called Jevons paradox.
William Stanley Jevons, little bit of storytelling here. William Stanley Jevons was a 19th century economist who noticed something counterintuitive about coal. Hmm, interesting that that's an extractive industry, so
when steam engines became more efficient and coal became cheaper to use.
There was a lot of worry in the world because industrialists and economists expected consumption to fall, and instead it went up dramatically because efficiency and accessibility didn't lead to a saturated market. They created new uses, new demand and new markets. And so the economy grew more efficiency, more access to that efficiency led to more use, not less
so some while some parts of the market will get saturated, that doesn't mean that all activity will fall away.
What happens instead is new forms of demand emerge. Now the eagle eyed among you, should I? Should that be Eagle eared on a podcast?
You'll spot where I'm going with this, because there's a through line from the red ocean of commoditized psychological services and the burnout and bore out that we've been experiencing running on this treadmill, which itself is now being kind of eaten Up in this red red ocean
through Jevons paradox to the creation of new blue ocean markets beyond. So that's the paradox that explains what's happening. So I started to think about what's happening to psychological services in the 21st century with the platforms, the AI tools, the Uber therapy model and Jevons paradox made the whole thing make sense. Platform therapy, AI assisted pseudo therapy, or whatever it is that people are doing on chat, GPT and Claude and other AI chat bots, they've made psychological support in inverted commas, cheaper and more accessible that it than at any point in the history of those services being available.
The logic should be
more access, same or less demand on individual practitioners. But that is not happening across the board,
as Jevons paradox implies cheap and accessible support is also expanding the total total market for psychological services, though, what we don't want to do as private practitioners is to keep swimming in that red ocean of commoditized services, where the price is forever decreasing is being where there is competing
competition for ever decreasing rates. But these new technologies are themselves creating new demand in two distinct directions, and I think understanding both of these directions is where the real opportunity sits for us.
The first source of that new demand, the direction of this newly emerging blue ocean
is systemic challenges that are including, but not limited to new forms of harm. So these platforms and AI systems rolling out across society are creating new challenges for people,
as well as failing to solve existing ones, by the way, new demands on people navigating.
AI managed workplaces, new forms of isolation in organizations that are moving to digital. First models, new risks to child and adult mental mental health from systems that are designed for extracting value, not promoting human flourishing. New harm from therapeutic ruptures, in that for people experiencing therapy through those platform models themselves, the expansion of the technology is generating its own psychological challenges. We we've seen it right. I've seen this as an occupational and coaching psychologist. I know my clinical counseling, educational colleagues, etc,
are also seeing this forensic sports and exercise and beyond.
So the expansion of that technology is generating its own psychological challenges in the workforce, in education, in communities that itself will need to be healed, avoided, managed, maybe even harnessed.
That's new demand, and it's real demand
the platforms themselves, whether it's AI, whether it's commoditized, services are structurally incapable of addressing these because they're hyper specific or hyper local, or just intricate demands in ways that machines and platforms can't address.
The second source of new demand is, in my opinion, psychological curiosity that is growing when more people have access to psychological language, psychological frameworks, even low level psychological support, even when that support is not as good as that provided by psychologists,
something shifts. Psychological literacy rises. People become more aware of what they're carrying, more curious about what could be possible, more able to name things they previously couldn't name.
And that curiosity itself creates appetite, real, growing appetite for something that is more sophisticated than what they've been used to for, maybe complex co created even systems level work that requires our professional judgment, a distinctive human perspective and a genuine relationship over time. So we're already seeing different kinds of practitioners moving into these spaces to me, to meet that appetite, and I think that's precisely where we as psychologists, should also be exploring,
let's be really honest and really realistic here, unless We adapt and grow into these new blue oceans.
The financial upside of that expanded demand will continue to accrue in two places.
It will accrue to the platforms and it will accrue to the other kinds of practitioners who will move to meet the new demands.
So you're not imagining it. The economics are designed to produce exactly the situation we find ourselves in,
run faster, earn the same or less or adapt.
In Episode Two, we talked about that red ocean and blue ocean strategy, you know, Kim and more bonds, framework for understanding contested versus uncontested market space,
the commoditization of psychological services. It's not just therapy. I've seen it across other, you know, divisions and types of psychology that's happening at that level two of psychological work, and it is a red ocean dynamic, more players, compressed margins, competing on price in a race where platforms are positioned to win more easily.
Jevons paradox adds to that picture
the idea that the same forces driving commoditized.
At Level Two are also creating something that platforms can't deliver.
It's cheap, accessible therapy or coaching increases psychological literacy. It raises people's awareness of what they're carrying. It expands their sense of what's possible. It creates new challenges, it creates new appetite. So Jevons paradox explains why the whole market is expanding, including and especially parts that resist commoditization by their very nature.
So moving into the blue ocean isn't just attractive,
I would argue it's necessary, because that red ocean space is going to keep experiencing compression of rates.
But here's the part that's also worth considering
the psychological work that can be done upstream or downstream of therapy or coaching, the prevention work, the growth work, the restoration, the transformation, the full range of what psychological work can do
when it's not only positioned as a response to suffering, those spaces are not sitting empty waiting for us to arrive.
There are different kinds of people practitioners already moving into those spaces. So every year we stay on this treadmill is another year that territory gets more established without psychologists being mainstream within it,
every person who goes to a coach instead of finding a psychologist. Working upstream is evidence of the gap. Coaches are visible, accessible,
and they're not carrying the institutionalized norms that can feel alienating when you're not yet in crisis. So when maybe you've experienced something working with a psychologist that's been a rupture with that formal system,
maybe you don't want to go back to therapy.
So to be clear, coaches and other people, practitioners aren't the so called competition or the problem, they're the signal.
They're pointing directly at the blue ocean. And to be fair to them, they're filling it while we are still debating whether it's appropriate to have both therapy and coaching on our website,
the ocean, where psychologists can credibly claim those upstream and downstream spaces is opening up and it's big and blue, but other people are paddling in that direction already.
So let's think about this more, because the implications go beyond practice design too. If we stay inside our professional silos, if we stay behind those referral pathways, presenting only in the ways that have been prescribed, or the, you know, the well trodden roots, we could remain invisible to the people who most need a different kind of access.
Maybe the person who tried platform therapy felt worse, concluded it wasn't for them, that therapy itself wasn't for them. The people who went to a coach instead, not because the coach was better placed, but because the coach was there.
Maybe the person who knows that westernized therapy models don't feel aligned with their spirituality or their intergenerational trauma.
So Jevons paradox also means that diversifying our offers and showing up more expansively in public creates multiple pathways in for people who wouldn't otherwise work with us,
ways for people to encounter us before they're in a crisis.
Maybe they're coming to connect for services at the level of growth, transformation and restoration, not just treatment. Maybe they're coming for healing that goes beyond.
And diagnosis and treatment
and those expanded pathways do something else,
they contribute to reducing overall levels of distress in a society, not as a side effect, but as the point
when psychologists are working in prevention, in communities, in organizations, in schools, in the informal relational spaces where people are actually living their lives. We're not just filling a blue ocean or a market gap. We're helping to shift the system,
and that's what a more de institutionalized practice makes possible. It's not about abandoning professional rigor. It's about expanding where and how that shows up more of us in more spaces, working across the full range of what we can actually do.
And I think back to those papers that came out in the 90s about bore out, and I think
maybe they were just 30 odd years before their time. And now's really the time. Now is really the time to move into that level three and four work
a well designed practice for the WTF era.
The time we're in isn't just a service transaction, it is community infrastructure that actively builds the psychological capacity of the people and places and communities around it.
So back to where we started, you can be completely overworked and completely under stimulated at the same time. That's what the treadmill produces,
burnout and bore out alongside each other.
Farmers under challenge, burnout stocks, crisis of meaning of crisis of growth. Mowbray's getting stuck at level two work, and it makes sense, because that model is structured around selling hours, not using what you're uniquely brilliant at.
There's a level three and level four mind sitting quietly in the corner, and it isn't going away. It's just waiting for your practices design to catch up.
A differently designed working life isn't necessarily one where you work less hard, unless you design it in
it may be one where you work just as hard, but where the work uses more of you in more fulfilling ways,
and therefore creates more value for you, more value for society,
where your thinking builds something the way that you see a name and work with the world shows up in those offers, in public, maybe upstream, maybe downstream, not Just in the consulting room
where your practice is infrastructure.
It's not only about your income, but it's also infrastructure for the people in the communities around you. And that's the redesign direction
that blue ocean, those different blue oceans that are emerging are real, and demand is moving there.
The way ahead is open, but other people practitioners are already moving in.
So I would say the time to redesign and design toward that blue ocean, whatever that is for you, is now not when the wheels finally fall off the treadmill.
In the next episode, we're going to look at another
clear feature of this WTF era of private practice, which I call the split screen chasm, and that's the contextual reality of our practices, be they red or blue ocean,
with the daily whiplash between business as usual
and the reality that we're working.
Inside, why there is this sense of disconnect,
and why it's real, and how we can move forward in our practices in a way that feels more integrated and more hopeful, rather than feels like it's demanding more and more avoidance or dissociation.
Thank you for being here. If this is resonating, share it with a colleague who needs to hear it. Details for the WTF era, practice redesigned sprint in March are in the show notes. See you next time you.
