Independent or private: what’s in a word?

Earlier this year, with a colleague, I co-edited an edition of Context, ‘the magazine for family therapy and systemic practice’ (see this link for more information). Our edition focused on independent practice as a systemic therapist and people contributed some great articles.

In the late stages, and as we put the articles together, it struck us that some of our contributors referred to independent practice and others to private practice. Now that’s curious! We began to reflect on this and wondered about the different meanings of the two descriptors; what the different descriptors might mean to the therapists; and what the two descriptors might mean to the families/ clients they work with or who read about those therapists. We had called the edition Independent Practice, but perhaps we should have put more thought into deciding what term to use?

What thoughts does ‘private practice’ invoke? I wonder whether ‘private’ practice emphasises the confidential safe space that therapists share with clients. Or does it imply that clients have more control, more power, more autonomy (maybe) in selecting therapy that suits them? Or maybe it carries some completely different meanings.

And what about ‘independent practice’? Does this emphasise freedom, perhaps freedom from control for therapists working outside agencies? Personally, I would like to think that it conjures up a myriad of possibilities both for me and for the people I’m working with, but that may be me revealing my own ‘prejudices’.

How are our choices of descriptors (as therapists) influenced by what systemic therapists would call our social graces? I’m mis-spelling social graces here – they are really social GGRRAAACCEEESSS (and that’s the short form!) and the concept comes from the work of John Burnham and others who used the term as an acronym to represent various aspects of difference, including gender, race, age, class, employment, spirituality. (Here’s a link to an article about the social graces.) Some graces are visible at any one time and some are not. Some are voiced in therapy or supervision, and some are not. I guess the same is true across the whole of mental health. Over time different graces move into and out of view. But all are important: they inter-link with other graces and with our beliefs, our power or powerlessness, and our life-styles. As therapists and mental health practitioners we need to pay attention to them in our work, whether they are visible or not, whether they are voiced or not.

My choice of independent practice as a descriptor is undoubtedly influenced by my cultural and family background, and my training and experiences as a professional, perhaps my generation too, amongst many other influences. Our choices will carry meanings for the clients who approach us as therapists for help. It reminds me how powerful words are.

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