Respect
In addition to the formal authority associated with the title “Doctor,” there is the informal power that comes with Respect. In many ways, the respect associated with this title holds greater, consistent weight than does the formal authority, especially given the blizzard of roles and regulations found in the contemporary world of American human services.
Title and Costume
The most tangible manifestation of respect for the title of “Doctor” comes in the use of this title when addressing a person who has earned this esteemed degree. While the title is automatically assigned to a physician when they are operating in a medical center (rather than on the golf course or at home), the title of “Doctor” is usually embraced by psychologists when they are operating in a clinical role. While these traditional clinical psychologists have abandoned the white coats of their medical colleagues, and of course have no stereoscopes to drape around their necks. The male clinicians do tend to wear coat and tie, while their female counterparts will dress in an understated dress or slacks.
Those clinical psychologists who seek to reduce the hierarchy associated with quasi-medical engagements may abandon this title. They ask their clients to call them by their first name, just as they rarely identify the person they are serving as a “patient.” Beginning with the “democratization” of psychotherapy by those following the practices of Carl Rogers, the psychotherapists who steer away from psychodynamic (psychoanalytic) perspectives on therapy are likely to go by their first name and wear more informal attire than their psychodynamic colleagues – though they still tend to abide by the 50 minutes therapy “hour” and the private therapy office. We find more informality regarding the use of title among those therapists engaged in behaviorally focused approaches (e.g., cognitive-emotional therapy) and among those inclined toward humanistic approaches (e.g., narrative therapy).
Most importantly, those without a doctorate will never (or very rarely) use their awarded degree as a title. Shirley Smith, who has earned a Masters Degree and has practiced as an MFT for many years, would never call herself “Master Smith.” It would be even less likely that David Johnson, with his Bachelors Degree and license as a Mental Health Service provider, would call himself “Bachelor Johnson.” The only indication of degree earned is to be found in the initials that follow their name, such as “Shirley Smith, M.A., MFT” or “David Johnson, B.S., LMH”.
Fees
There is another salient way in which Respect is manifest. This concerns the fees that can be charged. Those with a “Doctorate” are likely to earn at least 1/3 more and often twice as much as their clinical colleagues without doctorates. The current fees range from $100 to $200 per hour. The rate that is charged depends in part on location (related to local cost-of-living) and available options for reimbursement of client/patient’s payment. For those who offered psychoanalytic services, the fees tend to start at about $150 per hour and rise to at least $250 per hour in major urban areas and when therapy is being offered by prestigious psychoanalysts. The costs are even higher when consideration is given to the frequent scheduling of multiple sessions each week by traditional analysts.
