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by Rona L. LoPresti and Edward L. Zuckerman
Guilford, 2003
Review by Ruth E. Nieuwenhuis-Mark on Sep 28th 2005

Rewarding Specialties for Mental Health Clinicians

LoPresti and Zuckerman's book, Rewarding Specialties for Mental Health Clinicians: Developing Your Practice Niche (henceforth referred to as Rewarding Specialties) should be in every University career office and psychology department in the world. It would also serve not only psychologists working in diverse workplaces but also business people wanting a refresher course on how to market their services. There are lots of tips here aimed at starting up a private business. Despite the fact that it is clearly written for an American audience (Medicare, Medicaid and other U.S. legal/insurance issues are discussed in detail throughout) it can nevertheless be applied to psychologists from diverse cultures, training backgrounds and interests.

Written in clear, relatively jargon-free language, the authors set out their stall in the Introduction. They advocate a positive future for generally-trained psychologists (although their emphasis is on those from the clinical specialties) as long as we are prepared to move with the times. All professions must evolve and psychology as a discipline perhaps more than most, as we try to help people adapt to ever-changing societal mores.

The authors' message is above all a positive one, stressing that:

"We psychologists learn skills that have universal applicability" and they ask "Does any human activity not have psychological aspects?" (p2)

They also clearly state what the central goal of Rewarding Specialties is in the first few pages:

"We must specialize to continue our mission of helping people and to survive as a profession. This book is simply about some of those specializations." (p2)

The authors go on to give suggestions of possible niches or specializations we might consider developing in a comprehensive, non-preachy way. Above all, this is a book to get your imaginative juices flowing. LoPresti and Zuckerman make it clear that the specialties discussed here are only suggestions, and that:

"Trends are opportunities. In this book we offer information on viable, currently unfilled, or underfilled niches, but society is dynamic; it continually generates opportunities for those who are looking." (p232)

The gift this book has to offer is the fact that it will open your eyes to the possibilities waiting for you out there. It breaks the barriers suggested by such traditional terms as Occupational Psychology, Developmental Psychology and the like, suggesting that clinical psychologists have a wealth of talents to offer both within and without their profession's gates.

To recap, LoPresti and Zuckerman have written this book for trained clinical psychologists, especially those who regularly use psychotherapy, Cognitive Behavior Therapy (CBT), and other such treatments. The emphasis is on making a living utilizing the skills (both professional and personal) we clinicians possess. The authors also recommend thinking outside the box, learning how to effectively market ourselves and they show us ways to build both private clinics and/or collaborate with other professionals on our way to career fulfillment.

The lay-out of this book is excellent. Following the Introduction there are five main sections: The Psychological Sides of Medical Illness; Couples, Families, Children, and Schools; The World of Work; Forensics; and Underserved Populations and Developing Needs. Within each section they begin with an Introduction, Overview and Commonalities, then go on to discuss the various niches they have chosen to represent.

How they selected the specialties portrayed in this book is detailed in the Overall Introduction. This included answering the following questions (pp6-8):

1.)    Is There a Knowledge Base for This Specialty Area?

2.)    Are Learning Opportunities, Training, and Supervision Obtainable?

3.)    Does the Specialization Provide Autonomy?

4.)    Does the Specialization Provide Satisfactions for Clinicians?

5.)    Does the Specialization Offer a Real Opportunity?

In each section the authors focus very much on helping their readers decide which niche might be for them. I particularly found the paragraphs on "Your Potential Satisfactions" throughout the book to be very enlightening.

Other paragraphs which are common to all sections and subsections are: Nature of the Work (including practice models which exist or which are currently being developed, financial considerations and cautions); and Prospects (including Where is the Need? how to reach client populations, how to market and who your competition is likely to be). There is also cross-sectioning and overlap is highlighted in a very useful, easy-to-follow way throughout.

This might be all very well but how do we go about specializing? The authors suggest three steps can be sought on our path to becoming experts in a niche:

a.)    Recycling (where we use the same skills we currently use and thus there is less need to retrain)

b.)    Retreading (where we need to acquire some specific skills and credentials via reading, continued education, finding a mentor - especially one who is already an expert, and workshop attendance, for example)

c.)    Retooling ("acquiring a whole set of new tools and mastering them", p13)

This book focuses mainly on Recycling with some suggestions for Retreading. Many clinicians will be as relieved as I was to discover that major retraining (or, in the authors' words, retooling) is often not required.

The sections on marketing are also particularly useful. I'd suggest that most psychologists rarely think about selling their services and yet Rewarding Specialties motivates us and offers multiple suggestions on how to do just that. The fact that it focuses on the practicalities makes this book a special one -- it's not just full of empty promises with no direction. It actually shows us how to go about making a career out of helping often forgotten populations.

Of the five sections covered in Rewarding Specialties I found two to be the most relevant for my own particular background (Section 1 with its information on sleep disturbances, working with chronic illnesses etc. and those covering various aspects of Gerontology, especially working with the elderly and their caregivers). All the sections were interesting however, especially (for me) Section 4 on Forensics and also that on working with gifted children (see Section 2).

This is a fabulous book, one in which the authors have clearly done their homework. They talk a lot of sense; most of their suggestions are supported by relevant, empirical research. I found their pointers, further reading and resources at the end of subsections particularly useful and impressive. At times, in their enthusiasm the authors are guilty of overgeneralization (e.g. surely not all stepfamilies are dysfunctional "highly stressed family systems" p235), and only once (as far as I could see) did they succumb to pop psychology in their cheesy statement on p 234:

"Select a few books for careful study that appeal to your YEARNings, from which you could LEARN some things of value, and whose activities could be a source of EARNings for you." (capitals and layout -- authors' own)

I'd also have liked them to provide the website addresses for the professional journals they quote but that's only a minor grumble and probably the reflections of a busy psychologist wondering when they will find the time to read all these interesting papers! On the whole their chatty writing style and personal asides throughout serve to make this a very accessible, very human-friendly book. That can definitely not be said for the vast majority of psychology texts that appears on the shelves these days.

In conclusion, Rewarding Specialties impressed me so much that I'm going to recommend it to my colleagues and students. Everyone who is interested in the direction psychology as a profession is taking should make the time to read it whether they are living on the North American continent or not. Perhaps someone will be inspired to write a European equivalent some day in the near future. Above all, Rewarding Specialties is the book to motivate any psychologists out there who think opportunities in the workplace are shrinking. LoPresti and Zuckerman refute this wholeheartedly and give us hope for a bright, fruitful (financially, professionally and personally) future. Rewarding Specialties is both a practical how to towards finding your niche and should be an inspiration to all who read it.


© 2005 Ruth Mark




Ruth E. Nieuwenhuis-Mark is lecturer of neuropsychology at the University of Tilburg in the Netherlands. She specializes in Alzheimer's disease, stroke, epilepsy and other neurological disorders. Her personal website can be viewed at: www.remark.be