Psychologists in independent practice (PIs) have never been fully independent. Practice occurs in the context of multiple systems, and interdependence is a fact of successful practice life. Often understood in terms of local practice contexts such as patients/client groups and referrers, other systems in which PIs are embedded are relatively hidden. Some are potentially more malleable, some are relatively fixed, and some will disrupt "practice as we know it." Unseen contexts affect current practice and must be taken into account for future practice development and health. This article identifies some of the more influential, potentially less obvious but unavoidable contexts, provides a glimpse into how these came to be, attempts to illuminate current and likely future disruptions, and offers suggestions for proaction. Systems and contexts addressed include how prices for psychological services are established both for and by PIs, the health care insurance industrial complex, and legal guardrails that support health care delivery and appear to limit PIs' freedom of group action. Recommendations are offered for thriving in the context of disruptions to service delivery, practice, and payment structures.
Clinical Impact StatementIndependent psychology practice is embedded in many systems, some of which may be less obvious and relatively stable. Economic factors, population needs, reduced stigma, technology, cost transparency, and other major influences will force substantial changes in practice. This article describes some of the foreseeable risks and identifies opportunities for independently practicing psychologists to adapt and thrive in the future.