The following student report was submitted by Ambassador League Agent Paul P. during the 2008-2009 League.

Mission: Take Action - Interview #4

Paul: Could you give me a summary of your job position, job title, and of your organization?

Mr. Rowe: I am the co-owner, along with my wife, of Treeside Psychological Clinic P.C. We're a professional organization, and we do psychological services for the community. We're Christian based and we've been in existence for nine years now.

Paul: Could you tell me a bit about the building you own? I know there's quite a history behind it.

Mr. Rowe: It was built in 1899. We could read right off wall if you wanted to. There have been some very prominent people that have lived here, like Blanch Sims, who now has an elementary school named after her. She was a teacher in the area. A doctor, one of the original doctors of the town, lived here. I can't remember if there are six or seven people who have actually lived here since 1899. We purchased the place in 2005 from Fred and Jean Dickman, and they had lived here from either '72 or '78 up 'till July 2005. They raised their family here. The area had changed from residential to commercial; we bought it as a residence and could make it commercially compliant, so that we could run our business here. In the meantime, downtown Lake Orion has changed; they are now on the national register for historic homes, so this is a historic home in a registered historic home district of Lake Orion.

Paul: Is this one of the oldest buildings here?

Mr. Rowe: …It's one of the oldest. I don't think there are too many before 1899. I wouldn't doubt that there are one or two older buildings, but if you look at the picture of the original house, the look today is very similar to what it was when it was built in 1899. There are the same archways, the same siding, the same rooflines, everything.

Paul: It looks like you were very careful to maintain its original look.

Mr. Rowe: In fact, I give the previous owners more credit than us. Fred Dickman was on the historical society, so he was really, really conscientious of maintaining its historical integrity. Then, when we came in, even though we had to be commercially compliant, we tried to change very little. We made sure we tried to change very little as far as the structure, but we had to make some things compliant, like at the back where tucked in is a handicapped ramp, which we had to put in because we're a commercial business.

Paul: What motivated you to seek your current position?

Mr. Rowe: Well, I have two positions. One is the business owner, and the second is being a psychotherapist. A business owner or entrepreneur, and a psychotherapist, aren't necessarily congenial with each other. So, I'll talk about being a psychotherapist first.

My story is really based off of hardship back in the early 80's to middle 80's, when I had been married one time before. And when I got divorced, I was in a lot of emotional pain. So, I at the time seeked some therapeutic help, and saw a counselor. The more I got into counseling, the more I recognized I really enjoyed being in counseling and I really enjoyed learning about counseling and psychology, so I just kept learning and learning and learning, until I went back to school [for psychology]. This is the part where I feel that God kept leading me into doing counseling, because of the way that money started appearing in scholarships, and all doors were opening and other doors were closing. It felt like a God thing for me to pursue this.

The entrepreneurial part didn't come in until after I got out of school and then became a psychotherapist, and then realized that most agencies that you work for were not very healthy places to work. It was so weird to me, that, here you are trying to help people get better and yet you were working in a place that was so dysfunctional in itself, because the business end of things dictated a certain dysfunction. If you follow the traditional routes and have insurance and all of that, then you are being run by the insurance company instead of by what God wants you to do or anything else. So, that's when my wife and I decided we'd open up our own place, and it just kept blossoming until, now, nine years later, we have nine therapists, and our doors are still open.

…Would you like me to explain the difference between a psychotherapist, psychologist and psychiatrist for you?

Paul: Yes.

Mr. Rowe: There are three different disciplines that you can follow in order to do therapy. One is a psychiatrist. A psychiatrist is an actual medical doctor...a psychiatrist's form of therapy is always based upon medication. Only a psychiatrist can prescribe medication, because only a doctor can. They do very little talk therapy; some will do some, but for the most part medication management is what they do.

The second is a psychologist. A psychologist, you can get a doctorate of psychology, and become a psychologist. A psychologist, if you follow the psychology discipline, looks at standard deviations and deviations from the norm. Psychologists are actually more responsible for the bell curve, for intelligence, they do a lot of testing. They look at somebody and see, “Where do you fit in comparison to where the norm is? Are you above average, below average, in the middle?”

A lot of psychologists will also do talk therapy, and can be relatively good at it. They spend a lot less time in school than a psychiatrist, but a lot more time in school than a psychotherapist. There is a certain amount of testing and publication that's necessary.

Then there are psychotherapists. Psychotherapists could have actually followed psychology, but are on the masters level only. Or they could be a professional counselor, who went through schooling in counseling, or mine is in social work, a masters in social work. What we do in social work is we look at the person in their environment. We work a lot with families, we work a lot with addictions, we work a lot with not how a person is deviating from the norm, but how the person is functioning in their environment. What's causing them not to be able to function in their environment? It is a lot about talk therapy, but there are also a lot of other tools available. Experiential therapy, EMPR; we can be using a whole lot of different tools depending on what we deem necessary.

For me, I really enjoy seeing the person in their environment. Therefore, you take into consideration, is the person a Christian? That's a part of their environment. Is the person an atheist?

Paul: How does one get this job? I know there's a lot of schooling involved, but do you have to get a particular license for it? Are there state tests for this?

Mr. Rowe: Again, anyone who goes into the mental health field usually has a driving factor; they usually feel compelled to do it. Otherwise, why would you? Each discipline takes a certain number of years of schooling and then there's always a licensing by the state. Now for social workers licensure here in the state of Michigan is relatively new. It's only about a year or two old, before that it was just certification. Medical licensure for psychologists and then of course medical licenses for psychiatrists has been around forever.

So you go to school for x number of years, anywhere from five to seven. You get your degree, and at that time, you apply to the state of Michigan. There may or may not be a test involved, I don't know; I was grandfathered in. I was already a certified clinical social worker so when licensure came in I just automatically got it. I honestly don't know if when you get out of school if you have to take a test to get licensed.

Paul: …What is the general purpose of this position? Where do you try to get people when you work with them?

Mr. Rowe: You try to help them to function better, whether it's function better within their family, within their job within their environment, within themselves. It's about functioning better, happier, safer, more relaxed and at ease. When someone's functioning properly, they feel more comfortable with themselves and with their environment.

Paul: What are the greatest rewards of your job?

Mr. Rowe: There is the ultimate reward of when you see somebody that you're helping actually change and get it and start feeling better, and just watch them transform. It's pretty incredible. Being part of that is just wonderful, it's rewarding. There is a reward in the sense that I'm even able to do this. I like what I do, so I get rewarded by working at a job that I like, and being able to do it all day long. One's through the client, the other one's just fun, to do something that you like to do.

Paul: What are the most enjoyable things about this job?

Mr. Rowe: Because I'm an entrepreneur, I have a lot of control over my schedule. I like that. I like scheduling people, but scheduling sometimes my own time off. You can't do that if you work for an agency. [I really enjoy] the freedom and flexibility that it gives me… There is a minor reward, in just having a business in a downtown area. There's a certain identity with it that I enjoy, there's a certain respect that comes from being a professional.

Paul: What are the biggest challenges of your job?

Mr. Rowe: The biggest challenge is taking care of myself in the midst of wallowing in dysfunction day after day. There's something in my business called secondary PTSD. PTSD is posttraumatic stress disorder. When you hear horror stories, when you hear emotional pain that people are telling you and bringing it into you, if you don't take care of yourself, you'll take it with you. That's the biggest challenge, is to not take it with you, to be able to take care of yourself in spite of listening to a lot of emotional pain… Sometimes my caseload gets so big that staying separate from it is harder. Then I have to take active steps to take care of myself.

Paul: You have active steps in place to do that?

Mr. Rowe: Yeah, and it's usually around my schedule. I usually schedule time off. We do something here called "staff" on Fridays. Staff is designed for everybody to vent, let go of, process clients so that whatever we're tending to get stuck in, we get unstuck. It's part group supervision, it's part group therapy, it's part of our way of processing and coping so we don't hold onto it all by ourselves, so that we're able to expose it and let it go.

Paul: What role does your faith play in this profession?

Mr. Rowe: A big role. There's so many times, Paul, that there is such a horrendous amount, or enough abuse or dysfunction or pain, that only God can cure them. And if I didn't have faith that God could heal, I really don't know how I would handle it. There's a lot of secular psychiatrists and psychologists and even secular social workers, psychotherapists, who rely on their own techniques or their own this, their own that… and I don't know how they do it, because to me, ultimately, God's doing the healing, no matter what. I'm just helping facilitate it sometimes. Without God, I don't honestly don't know how people would ever get better.

Paul: That must be another really nice reason to own your business; you no doubt have a lot more freedom to explain that to people and to help them out in that way.

Mr. Rowe: Yes. We had to become entrepreneurs to do that. The benefit is that because I don't have to be accountable to an insurance company, I can pray with somebody and it's ok.

Paul: So insurance companies would actually restrict you from doing that?

Mr. Rowe: Yes. If you're dealing with an insurance company, there's certain ways you have to write your case notes. They would not acknowledge or reimburse for praying. They reimburse for cognitive therapy, or doing a certain technique or a certain theory… so to write down on your case notes, “Prayed with client. Client felt better.” They wouldn't do it. So what happens is if you're doing it, which some places do do, they have to get real creative about how they write their notes. Well, that's a lot of work, to not be genuine. So now you're creating this whole set of notes for the insurance company, if they ever audit you, and it's just a lot of work. However, because some people like to use their insurance, because it costs them less out of pocket, there's a certain amount of business we lose, because people aren't looking at the bigger picture of the flexibility and stuff, they're looking at the dollars coming out of their pocket.

Paul: Could there even be certain methods of therapy that don't fall into any distinct category or technique that you wouldn't be able to do under an insurance company?

Mr. Rowe: …Theophostic [therapy] is a prayer ministry, and it really is designed specifically to help people heal around specific issues. A minister, Ed Smith, came up with it (he was also a psychologist), but it is basically praying with somebody. To my knowledge, there's not an insurance company out there that would, if you put that down on your notes, reimburse you. The ones they will reimburse you for are the ones and the things that you learned in school, that there's certain documentation for, there's certain codes for, there's certain words that you have to use.

You put all these theories down on paper, but honestly, when you're working with somebody, it's not just about the theory, it's about the relationship, it's about the setting… there's a whole multitude of things that are going on. Insurance says it's medically necessary, and well, how do you even put down sometimes the relationship that's being built. Is that medically necessary? It is, technically… So, that's why we don't deal with them.

Paul: There are some things that schooling just doesn't teach you.

Mr. Rowe: Absolutely doesn't, because it's an art and a science. There's the science of it, the psychology of it, but then there's an art in performing it, and disseminating information, or listening to information, or whatever goes on. There are all sorts of things that are more artful, skillful, than just the intellectual training of what the book says.

Paul: That covers all of my questions. Is there anything else you'd like to add?

Mr. Rowe: …One of the biggest difficulties is like I said, the two different roles I have to play, what I was just talking to you about the insurance and about being a psychotherapist. The insurance is what I call the business end of things. On the business end of things, you have to go with what's going to work, numbers-wise. There's a real black and white about running a business, and how to develop that business, and things that they don't teach you unless you go to business school, which I didn't; I went to therapy school, not business school. And the business end has been a challenge because websites, marketing, all of that takes a lot of work and energy in addition to being a psychotherapist, which is my main function, but if I can't get people to come in my door, then I can't be a psychotherapist. So it's just a challenge being an entrepreneur in this field, because this is a field about feelings and about connection, whereas business a lot of times is strictly a numbers thing. We don't care how you feel about it, the numbers say this, or the numbers say that.

…There's a lot of good therapists out there that wouldn't be able work for themselves, and there's a lot of entrepreneurs out there that when you're trying to learn about business stuff, can't really adapt it very well to the therapeutic part, because it doesn't make any sense to them. Again, if nothing else, it's just the challenge of it, but I've enjoyed the challenge. It is what it is.

Paul: Looks like you've done pretty well facing it.

Mr. Rowe: Well, our doors are still open.