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Mental Health

Why therapists are sounding the alarm on big box therapy companies

Why therapists are sounding the alarm on big box therapy companies
Photo by Nik Shuliahin on Unsplash

A greater demand for therapy is putting strain on therapists and creating avenues that might not be all they seem.

Given the state of the world we have all been living in for the last two-plus years, it’s no surprise that therapists are in high demand right now, and have been throughout the pandemic. Many therapists have long waiting lists and are taking on more clients than they normally would just to meet the need. New private practices are opening frequently to provide quality mental health care that people so desperately need in these (still) unprecedented times. But something else is happening simultaneously. Large tech companies have cropped up promising mental health care, and even promising to get patients in with a same-day appointments. On the surface, this seems like it should be a good thing. After all, these companies are helping to meet the growing and overwhelming demand for mental health care, so we should make room for them, right? At least that’s what most would think.

I’ve been in the mental health field since 2006, and have been in and around mental health from a professional standpoint, and therapists have been raising concerns about these large platforms for quite a while. In fact, one therapist made it his mission to show his followers on TikTok what the fine print of one mental health platform’s terms and conditions said. Viewers were shocked to hear, and read, as the therapist pulled the information from the company's actual website in real time, that clients' information was being sold to third parties for advertising purposes. This wasn’t hidden in microscopic print, it was there within the terms and conditions in plain print. But some companies bank on consumers not reading the terms of their agreement. Many people will quickly scroll through to get to the bottom of the long legal information and click the button to simply move to the next part of the process.

This therapist did the reading for you in an effort to honor his professional ethical code and protect clients. The company fought back against the claims and changed the language, all very publicly on TikTok, but it was only the language that changed, not the terms. When the therapist pointed this out, the company continued to publicly feud with the therapist on the social platform.

Now, at this point you may be wondering why I’m not using this therapist’s name, telling you where to find him and calling out this platform. It’s because when the company continued to mislead its consumers and continued to have its feet held to the fire by this ridiculously brave therapist, the mega large platform sent a cease and desist with the threat to sue this small private practice owner. It forced the therapist to remove any trace of anything unappealing he had said about this company, and he is no longer permitted to discuss the disturbing things he uncovered.

As a therapist, I feel a duty to protect this other therapist from any further threat that may come from this mega company, and to do so, allow him to remain as anonymous as possible. Nevertheless, it feels important to reveal the lengths to which one of these companies is willing to go to keep consumers in the dark about its fine print items. Therapists have an ethical obligation to protect their clients from exploitation, and it would absolutely violate ethical codes to sell client data.

When you meet with a licensed therapist your information is protected by the Health Insurance Portability and Accountability Act (HIPAA), which means we could get into trouble with our licensing boards and in some cases, depending on the level of breach, it could be criminal. Big box therapy companies seem to have found a loophole around this as the companies may not be billed as “therapy” but as lay counseling services, which is something anyone with life experience can do. A therapist who runs the YouTube account Private Practice Skills discusses this and why she was not comfortable putting her license on the line for a company that may not be bound by HIPAA. Privacy is a huge deal in the therapeutic relationship and you won’t find too many therapists willing to risk the privacy of their clients for any amount of money.

Money brings me to my next point. Many of these big box therapy companies such as Talkspace, BetterHelp, Happier Living, and so on, pay their therapists poorly. They seem to prey on therapists who have just recently earned their licenses and want to work for themselves, but may not know how to. Companies like these use the 1099 model to give therapists a sense of autonomy over their schedules, but in the case of at least one of these companies, therapists have had their pay affected by not responding to client’s texts in the middle of the night due to an arbitrary timeline the company has enforced. Let me be clear, the expectation to be readily available to your clients at all times is unrealistic and damaging to the client and the therapeutic relationship.

Bonus ranges for client retention.

TalkSpace therapist FAQ section

Therapists teach their clients skills that they are supposed to learn to utilize in between sessions with the hope that eventually they will not need a therapist to continually reinforce these skills as they will become a reflex. When a client is given access to a therapist whenever they would like between sessions it creates a reliance on the therapist to be an emotional barometer and regulator, which is not what a therapist is for. Most therapists’ ultimate goal is to work themselves out of a job. They want their clients to get to a point where they no longer need them. That’s a good thing. We welcome you back should something change, or we offer maintenance sessions on a spread-out basis like once a month or every six weeks until the client is feeling confident enough to be without a therapist.

Some of these platforms build dependency and often their policies go up against a therapist's professional ethics. One of these companies offers a bonus for client retention. Meaning if the client stays longer than what may be therapeutically necessary, then the therapist gets a monetary bonus. Does this mean all clients that stay long-term with this company don’t need the therapy? No. It means that some therapists may feel pressured to retain clients who are ready to discharge in order to receive a bonus.

The pay is so low for a licensed therapist in this situation that unless you see 30 to 40 clients a week, you're not making enough to make ends meet and pay off student loans. Seeing this many clients a week doesn’t leave room for administrative tasks that are required, and in a setup like these companies it is likely to be unpaid time. For every client, you have to have a treatment plan completed at the start of therapy and progress notes after every session. If they’re only being paid for the client contact, when are therapists supposed to do these tasks? There’s also finding resources to use in sessions, looking for assessments or referral sources, and other behind-the-scenes tasks that clients know very little about.

Photo by Priscilla Du Preez on Unsplash

I interviewed with one of these companies and declined the offer after explaining the ethical dilemma it would put me in, and the inevitable burnout I would experience. This particular company wanted its therapists to see 12 clients a day with a 30-minute lunch break. The average therapist in private practice sees between five and six clients per day. Some therapists choose to see up to 8 or 9 a day, but they are few and far between. The therapists that do choose that greater load, usually do so in order to take a day or two off during the work week. Twelve clients a day averages out to 60 clients a week, which is even more than some of the other platforms require to be considered full time.

When I made the company aware of ethical concerns due to the sheer volume of clients they were expecting therapists to see, I was contacted by the VP of the company. I again explained the concern, and while at first they sounded empathetic, the tone changed to indifferent and the call ended with no resolution. I’m still listed on the site as a therapist, which I discovered recently, though I’ve never been employed by them.

There is really so much more to dive into, and I could write a book about the concerns raised by licensed therapists about these big-box therapy companies, but the key takeaway is if you need mental health care it’s best to find a therapist in private practice. When money is an issue, many therapists offer sliding scale fees to make it affordable and some even offer pro bono spots. You can find therapists offering reduced rate fees on Open Path Psychotherapy Collective.

If virtual therapy is preferable to you due to time constraints, many therapists are now offering virtual therapy as an option. If you still can’t find a therapist, there is no shame in using one of these platforms because most employ licensed therapists and your mental health is our number one priority. One can understand the appeal and affordability of these large platforms and it's important to do whatever you can to look after your well-being. Just be sure to read the fine print.

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Science

What will Earth look like if all its land ice melts? These maps show the clear answer.

Climate change isn't pretty.

via Business Insider Science/YouTube.

A map of the United States post land-ice melt.

Land ice: We got a lot of it. Considering the two largest ice sheets on earth — the one on Antarctica and the one on Greenland — extend more than 6 million square miles combined ... yeah, we're talkin' a lot of ice. But what if it was all just ... gone? Not like gone gone, but melted?

If all of earth's land ice melted, it would be nothing short of disastrous. And that's putting it lightly. This video by Business Insider Science (seen below) depicts exactly what our coastlines would look like if all the land ice melted. And spoiler alert: It isn't great. Lots of European cities like, Brussels and Venice, would be basically underwater.

I bring up the topic not just for funsies, of course, but because the maps are real possibilities.

How? Climate change.

As we continue to burn fossil fuels for energy and emit carbon into our atmosphere, the planet gets warmer and warmer. And that, ladies and gentlemen, means melted ice.

A study published this past September by researchers in the U.S., U.K., and Germany found that if we don't change our ways, there's definitely enough fossil fuel resources available for us to completely melt the Antarctic ice sheet.

Basically, the self-inflicted disaster you see above is certainly within the realm of possibility.


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In Africa and the Middle East? Dakar, Accra, Jeddah — gone.



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Millions of people in Asia, in cities like Mumbai, Beijing, and Tokyo, would be uprooted and have to move inland.



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South America would say goodbye to cities like Rio de Janeiro and Buenos Aires.


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And in the U.S., we'd watch places like Houston, San Francisco, and New York City — not to mention the entire state of Florida — slowly disappear into the sea.


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All GIFs via Business Insider Science/YouTube.

Business Insider based these visuals off National Geographic's estimation that sea levels will rise 216 feet (!) if all of earth's land ice melted into our oceans.

There's even a tool where you can take a detailed look at how your community could be affected by rising seas, for better or worse.

Although ... looking at these maps, it's hard to imagine "for better" is a likely outcome for many of us.

Much of America's most populated regions would be severely affected by rising sea levels, as you'll notice exploring the map, created by Alex Tingle using data provided by NASA.

Take, for instance, the West Coast. (Goodbye, San Fran!)



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Or the East Coast. (See ya, Philly!)


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And the Gulf Coast. (RIP, Bourbon Street!)

"This would not happen overnight, but the mind-boggling point is that our actions today are changing the face of planet Earth as we know it and will continue to do so for tens of thousands of years to come," said lead author of the study Ricarda Winkelmann, of the Potsdam Institute for Climate Impact Research.

If we want to stop this from happening," she says, "we need to keep coal, gas, and oil in the ground."

The good news? Most of our coastlines are still intact! And they can stay that way, too — if we act now.

World leaders are finallystarting to treat climate change like the global crisis that it is — and you can help get the point across to them, too.

Check out Business Insider's video below:


- YouTubewww.youtube.com


This article originally appeared eleven years ago.

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Health

Science confirms ‘Move in Silence’ trend might be the smartest way to achieve your goals

“I promise you things always work out better when you keep them to yourself.”

TikTok: @wemiopakunle, @_alliechen, @mandanazarfhami,

Science confirms ‘Move in Silence’ trend might be the smartest way to achieve your goals.

TikTok's latest viral wisdom is backed by hard data—and it's making people rethink their communication habits. We live in a world of chronic oversharing. We post everything, from the routes we run (including screenshots as proof of all that hard work), to the pale-green iced matcha latte sitting at our desks or a present from a boyfriend (who will be tagged prominently, not secretly off screen). Who knows when, but our brains became wired for sharing: to record, to curate, and to post every second of our lives, then consume that of others to a disturbing degree. So, here's a radical idea: when it comes to goals and plans, try keeping them to yourself. It could be the key to making them a reality.

That's the message behind TikTok's massively popular "Move in Silence" trend, where creators like @noemoneyyy have cracked the contradictory code to success: Instead of broadcasting every big idea or project that runs through your head, if you actually want it to come to fruition, keep your plans to yourself until they're executed. And it's not just a trend; surprisingly, science also supports this muted approach.


@noemoneyyy Work in private and let the results speak! #privatelife #privatelifehappylife #workinprivate #creatorsearchinsights ♬ sonido original - Luis Jonathan

"As a former oversharer who used to tell every single friend, every single family member, or a partner everything I was doing, I promise you things always work out better when you keep them to yourself," explains creator @noemoneyyy in a video that's garnered millions of views.

On a different video by @mandanazarfhami, she says, “I don’t care what you’ve got going on in your life: that dream job, that city that you want to move to, that dream person, that dream life, that dream anything. Literally keep it to yourself until it’s done.”

Commentors were quick to agree, with one person writing: “From a young age, I never told anyone my next steps. I also taught my husband and son to keep our private matters to themselves and just do things 💯Not many people like it, but who cares🌝🙌🏼🫶🏼”

Another chimed in, “This concept has changed my life for the better.” Others replied, “100 agree 💕” and “100%🙌🏼people can’t ruin what is silent, show results.”


@mandanazarghami monitoring spirits are a real thing - move in silence and watch how much your life changes #fypシ ♬ Jacob and the Stone - Emile Mosseri


What's going on here

In a study done by New York University, researchers found that people who kept their goals private worked on tasks for an average of 45 minutes, compared to the 33 minutes of work completed by those who announced their plans in advance. The twist? The people who shared their goals expressed feeling closer to finishing, despite doing approximately 25% less work.

NYU psychologist Peter Gollwitzer, who led the research, concluded that "once you've told other people your intentions, it gives you a 'premature sense of completeness.'" He also found that the brain is made up of "identity symbols," which create one's self-image. Interestingly, both action and talking about action create symbols in your brain, so simply speaking about a future plan or something you want to do satisfies that part of your brain. When we make our goals public, especially ones that matter to us and deal with our identity, our ability to achieve said goal is significantly reduced. As the old adage goes, "actions speak louder than words."

Stranger still, in his paper "Does Social Reality Widen the Intention-Behavior Gap," Gollwitzer notes that in order for this phenomenon to happen, one must truly care about their goals. "Ironically, this effect was only found for participants who are very committed to their goal!" PsychologyToday notes. "The lesson learned is that the more passionate you are about your goals, the more secretive you should be about them."

Quiet, silence, peace, shhh, no speaking, secret The more passionate you are about your goals, the more secretive you should be. Photo credit: Canva

Another reason to keep quiet: If you're a beginner trying something new, sharing your plans could potentially open you up to criticism and negative feedback, which could deter you from even starting. At the University of Chicago, professor Ayelet Fishbach conducted studies to determine how positive and negative feedback affects the pursuit of one's goal. According to Atlassian, she and her team found:

  • When positive feedback signals commitment to a goal, it increases motivation.
  • When positive feedback signals progress, it actually decreases motivation.
"One example the researchers give is a math student who gets a good grade on a test. If she perceives it to mean she likes math, she will study harder. If, however, she sees the high score as a sign she is making progress in the class, she may ease up and study less." - Atlassian


@_alliechen I used to be such an open book but now im a lot more reserved on my goals and plans so ppl dont judge #moveinsilence #relateablecontent #girlies #viral #success ♬ suara asli - astrooo🪐

We've all been there: excitedly telling everyone about your grand plans to backpack through Europe, the year you'll finally learn Spanish, or joining the group lesson at the tennis courts you always pass by… only to mysteriously lose all motivation a week later. Turns out, those lovely dopamine bursts that accompany every enthusiastic "That sounds great!" or "You should totally do it!" response might be precisely what's holding you back.

The good news? You don't need to become closed-off and secretive, a hermit on the top of a mountain who's afraid to share any part of themselves with the world. Research suggests that sharing your goals with one or two selected friends who can be trusted to provide meaningful support is still a good idea. Just hold off on the Instagram Live announcement until you've actually accomplished something substantial.

So, the next time you sit down to write your goals, whether they be a new year's resolution, the day's to-do list, or a five-year plan, think twice about sharing it with others. Give it time and you might have something better to share soon: the results.

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Science

8th grader's award-winning experiment tested if dogs' tongues are really cleaner than ours

Here's what science says about letting your dog lick your face.

Photo credit: Canva

Should you let a dog lick your face?

With nearly half of the households in American having at least one dog, there's a lot people need to know about them. Our furry friends come in wide variety of breeds, each with their own unique traits and needs. "Man's best friend" can be a guardian, a helpful worker, a loyal friend, and a snuggly companion, but there's one thing almost all dogs have in common: Licking.

Some dogs lick way more than others, but it's rare to find a dog who never licks anyone or anything. Many dogs communicate and show affection by licking, which is sweet—if a little gross—depending on how slobbery they are. There's a common saying that dogs' mouths are cleaner than humans', which is a bit hard to believe when you see what some dogs put in their mouths, but it is true? What does science say about dog tongues and saliva? Is a dog licking our face something we should worry about?

dogs, dog mouths clean, dog tongues, dog licking, should you let a dog lick your facePooch smooches are sweet if they're not too slobbery.Photo credit: Canva

It turns out, the answer to whether a dog's mouth is cleaner than ours isn't super straightforward.

An 8th grader named Abby tackled this question in a science experiment that won her a Young Naturalists Award from the American Museum of Natural History in 2011. Her family had gotten a dog and her mom kept telling her not to let the dog lick her face because dog mouths are full of bacteria. Instead of arguing, Abby decided to find out herself if this was true.

"I hypothesized that human tongues would be cleaner than dog tongues," she wrote. "I thought this because humans brush their teeth at least once a day. I hypothesized that dogs' tongues would be dirty because they were always licking dirty things like garbage."

After diving into the research about bacteria that live in and on humans and dogs, Abby decided she had a testable hypothesis. But this wasn't any old middle school science experiment. She applied for and got a grant to the State Hygienic Lab at the University of Iowa, where she was assigned a mentor to work with her.

You can read the nitty gritty details of her experiment here, but here was her conclusion:

dogs, dog mouths clean, dog tongues, dog licking, should you let a dog lick your faceMany dogs will lick you if you give them the chance. Photo credit: Canva

"I concluded that dog and human mouth flora are very different. (Flora means the bacteria found in a mouth or anywhere else.) The bacteria found in human mouths are more similar to another human's oral bacteria than the bacteria found in a dog's mouth.

I also concluded that dogs' mouths are cleaner than humans' in some ways, and dirtier in other ways. Humans have more bacteria in their mouths than dogs do, based on the total number of bacteria. Most of the humans had a 'moderate' number of bacteria, and most of the dogs had 'few' bacteria. A possible explanation of this might be that dogs pant a lot, and maybe while panting, bacteria falls off their tongues along with their saliva. But dogs had more types of bacteria. The average number of different bacterial colonies in a dog's mouth was about 5.7. The average number of different bacterial colonies in a human's mouth was about 4.1. I think this is so because dogs sniff and lick a variety of things, like carpets, floors, chairs, grass, etc., so they pick up bacteria from many places."

But what about the licking of our faces? That's a bit of a subjective call, but Abby's results gave her some peace of mind:

"In conclusion, will I let my dog continue to lick me? The answer to the question is yes!" she wrote. "I will feel guiltless about letting my dog lick me because I found out that human and dog oral bacteria are different, so my dog's oral bacteria present no harm to me."

lick, licking, face, dogs, dogpuppy love kiss GIF by Pickler & BenGiphy

What do the experts say?

According to Colin Harvey, professor at the University of Pennsylvania’s School of Veterinary Medicine and executive secretary at the American Veterinary Dental College, comparing dogs' mouths to humans' mouth is "like comparing apples to oranges." As Abby found, the microbes in a dog's mouth are very different than those in a human's.

The American Kennel Club elaborates:

"Most of the bacteria in your dog’s mouth aren’t zoonotic, which means you probably won’t get a disease from a big old doggy kiss. There are exceptions to this. Dogs that eat a raw diet are at an increased risk of contracting salmonella, which can be spread to humans. You also probably shouldn’t share kisses with a dog that regularly raids the litter box.

In other words, kissing your dog is less risky than kissing another human, but that doesn’t mean that your dog’s mouth is necessarily cleaner than a human’s—they just have a mostly incompatible set of germs."

dogs, dog mouths, dog kisses, dog teeth cleaningKeep your dog's mouth clean with regular teeth brushing.Photo credit: Canva

Keeping your dog's mouth healthy through regular teeth cleaning and dental check-ups can also help prevent issues that could potentially come from dog licks.

So there you have it. If your dog doesn't eat a raw diet and doesn't go snacking in the cat box (or some other equally fecal-bacteria-ridden place), their kisses are probably not going to hurt you. Guilt-free pooch smooches for the win!

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Sustainability

How Kamikatsu became the first zero-waste town in Japan, and what we can learn from them

Meet the tiny town that's radicalizing the ways we recycle.

Photo credit: Canva

Anyone can transform their relationship with waste.

In Japan, one of the first things you notice is how intense they are about recycling. Bins are guarded by two to three uniformed protectors who are quick to tell you if you’re doing things wrong. For a novice—especially one from America—that seems to be almost everything. The plastic plate wasn’t washed clean enough, you’re headed to the wrong bin (there are many, all with varying purposes), etc.. It can feel quite exhausting until you realize that Japan is a global leader in plastic bottle and e-waste recycling, with an impressive 86% and 70%, respectively. Compare that to the global recycling numbers: according to the Ellen MacArthur Foundation, about 30% of plastic water bottles (PET) are recycled globally and only 22% of all e-waste is formally recycled globally.

However, nestled in the lush mountains of Shikoku Island—the smallest of Japan’s four islands—is a tiny town that’s revolutionizing the trash and recycling industry. Welcome to Kamikatsu. All 1,400 residents here are so committed to zero-waste, they sort their garbage into 45 different categories and don’t even use garbage trucks. And their efforts have paid off: Kamikatsu received a remarkable 81% recycling rate—the highest in the world, thus far.

Recyling, reusing, environment, Japan, environmentKamikatusu's recycling techniques are well worth the effort. Kamikatsu Zero Waste Center

For perspective, Japan’s national average (for overall solid waste recycling) is only 20%. Germany is considered as the global leader in recycling household and municipal waste, with a recycling rate of 67%. Following Germany are Austria (58%), South Korea (59%) Slovenia (58%), and Belgium (54%). The United States rests at 32%, although it aims for 50% by 2030. In short, Kamikatsu isn’t just lapping the world’s global leaders: it’s redefining what’s possible.

Which wasn’t always the case. In the 1970s, there was nothing exceptional about Kamikatsu, in terms of recycling. According to ReasonsToBeCheerful: “The roots of Kamikatsu’s reuse revolution go back decades. During Japan’s postwar economic boom, the expansion of mass industry created huge amounts of waste, which increased from 6.2 million tons in 1955 to 43.9 million tons in 1980. In response, municipalities across Japan, including Kamikatsu, began to build incinerators to dispose of it all. But over time, concern grew about the pollution being created.”

Recycling, Japan, zero-waste, trash, environmentThe inside of Kamikatsu's Zero Waste Center. KAMIKATSU ZERO WASTE CENTER

The town’s transformation took years, beginning in 1991, when officials first tackled food waste by providing composters to every household. By 1997, they’d created nine categories for recycling:

  1. Newspapers
  2. Magazines and flyers
  3. Cardboard
  4. Milk cartons
  5. Other paper
  6. Aluminum cans
  7. Steel cans
  8. Glass bottles
  9. PET bottles

This was the moment that changed everything for Kamikatsu, a significant cultural and logistical shift that laid the foundation for years to come. "It was tough because it changed their day-to-day duties," admits Akira Sakano, founder and director of Zero Waste Japan, "but people got used to it."


Recycling, Japan, zero-waste, trash, environmentHow to recycle boxes and other cardboard goods. KAMIKATSU ZERO WASTE CENTER

Today, Kamikatsu continues its goal to become fully zero-waste. The town closed down their incinerators, removed all garbage trucks, and now boasts a radical 45 categories for recycling.

But do you really need a 45-category system to cut back on waste? Of course not. Here are five practices anyone can adopt at home:

  1. Compost your food waste. According to Kamikatsu’s garbage guide (which was helpfully translated by Core77), “Compost food scraps [is] the only resource you can recycle yourself.” By using compost bins, electric composters, and bamboo composters, residents are able to transform food scraps into valuable fertilizer.
  2. Embrace second-hand. The town has a “Kuru-kuru” shop, which translates to “come and go,” and offers free second-hand items to anyone who wants them. Each product is weighed and tracked, to account for exactly how much waste is avoided. To do this locally, try joining your neighborhood’s Buy Nothing group, or donate to a Tiny Free Library.
  3. Get creative with upcycling. Local artisans in Kamikatsu transform old clothes, like kimonos, and koinobori (fish-shaped streamers) into bags, jackets, and toys. So, ask yourself: Do I really need to throw away that jar, or could it become a treasured container? Old t-shirts could become lovely, braided rugs. Egg cartons make wonderful painted art projects or storage bins.
  4. Reuse your own containers. Places like The Refill Shoppe, Common Good, and Clean Cult offer green alternatives to single-use cleaning solutions and soaps. Their wide variety of refillable products also use less packaging and contain non-toxic ingredients.
  5. Question consumption. The Kamikatsu Zero Waste Center is shaped in a giant question mark, urging people to ask why they must spend money on something. Their website reads: “Why do you buy it? Why do you throw it away?” It’s a reset, an invitation to rethink your relationship with constant consumption.

As we face mounting environmental challenges, Kamikatsu offers a powerful reminder: with community commitment and creative thinking, we can transform our relationship with waste. Are you ready to try?

Recycling, Japan, zero-waste, trash, environmentGive radical recycling a try. KAMIKATSU ZERO WASTE CENTER

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