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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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Music

Teacher jokingly tells 10-year-old going on a trip to England to 'find Duran Duran'—and so she kind of does.

And just like that, Simon LeBon appeared in the doorway.

Wikicommons and lakehighlandsadvocate IG

Duran Duran lead singer Simon LeBon poses with a young fan

Imagine this: you're a fourth grade language arts teacher in Dallas, and like many Gen X-ers, your obsession with Duran Duran never waned. So much so that you still have dolls of each member of the band in the classroom and, according to Austin Wood's article for the Lake Highlands Advocate, even an old telephone in case (lead singer) "Simon LeBon calls."

This describes Miriam Osborne, a fourth grade teacher at White Rock Elementary in the Lake Highlands district of Dallas, Texas. Wood shares in "White Rock E.S. student, inspired by teacher, meets Simon LeBon" that one of Osborne's students, 10-year-old Ava Meyers, was getting an early pickup for Christmas break, as her family was heading to the U.K. for a holiday wedding. As they were saying their goodbyes in the hallway, Osborne kiddingly said to Meyers, "Find Duran Duran."

gif of Duran Duran performingDuran Duran 80S GIFGiphy


Cut to: Ava and her family, including her mom Zahara, fly across the pond to find themselves in the Putney neighborhood of London. After a day of sightseeing, Zahara shares, "I was just Googling things to do in Putney, and the first thing that popped up was 'Simon Le Bon lives in Putney from Duran Duran.'”

Zahara did a little sleuthing and found Simon's house, thinking perhaps a Christmas stroll by the home would be exciting. But, according to the article, Ava felt they could do better. She and "an 83-year-old relative named Nick, who apparently has courage in droves, went to the door and tried a knock. Zahara was initially hesitant but assumed Le Bon would be away on vacation, so she figured it was harmless. Le Bon’s son-in-law answered, his wife came to the door next, and following a few moments of getting pitched the idea by Nick, agreed to get her husband 'because it was Christmas.'"

And just like that, Simon LeBon appeared in the doorway. He warmly greeted Ava and her family and even took pictures. "It was just crazy," Ava exclaimed.

But possibly more excited was Miriam Osborne, back in the States. She proudly shared the photo (which had been texted to her) with many of her friends and even encouraged Ava to recount the story to her classmates when they returned from the break. Wood shares, "Osborne’s connection to the band goes back to her childhood in El Paso in the ’80s. As the daughter of a Syrian immigrant, she says she had trouble fitting in and finding an identity. Some days, she and her brothers would travel across town to get records from a British record store."

Miriam explains she used her babysitting money to buy her first Duran Duran record. "And so I had been a fan, literally, for 43 years—my entire lifetime."

gif of Simon LeBonDuran Duran GIFGiphy

Osborne's love of Duran Duran, and many '80s bands in general, nostalgically connects her to a throughline for her life that she tries to impart onto the students as well. "Music is a connector, and it connected me to a world that I didn’t always fit in as a child. It helped me find people who I still love to this day, and it’s a big part of this classroom with me and the students I teach, because everybody has a story, and there’s something really incredible about hearing something and it taking you to a happy moment."

As for Ava? She's now taking guitar lessons. And perhaps one day, she can become so famous and inspirational, a teacher sends a student off to find her on a Christmas vacation in the future.

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This is the obituary of a 'very sick man' and it's so funny you'll wish you knew him

That said, you'd never want to date one of his daughters.

via Legacy.com

The obituary for Joe Heller

Joe Heller (1937 - 2019) of Essex, Connecticut appears to have lived a full life: he was in the Navy, worked at the Yale library, and raised three daughters. But he was also a hoarder, a hardcore napper, and loved pulling pranks that involved feces.

Well, as Abe Lincoln once said, "A man without vices is a man without virtues." His hilarious obituary, believed to be penned by one of his daughters, is going viral because it paints a loving picture of a man who clearly didn't take life too seriously — a lesson we could all use from time to time.

The obituary opens with a helluva zinger.

Joe Heller made his last undignified and largely irreverent gesture on Sept. 8, 2019, signing off on a life, in his words, 'generally well-lived and with few regrets.' When the doctors confronted his daughters with the news last week that 'your father is a very sick man,' in unison they replied, 'you have no idea.'


Joe Heller, obituaries, funny, death, dying, humor, family Joe Heller's obituary photoImage via the Hartford Courant obituaries

In his youth, Heller played the role of a prankster.

Being the eldest was a dubious task but he was up for the challenge and led and tortured his siblings through a childhood of obnoxious pranks, with his brother, Bob, generally serving as his wingman. Pat, Dick and Kathy were often on the receiving end of such lessons as "Ding Dong, Dogsh*t" and thwarting lunch thieves with laxative-laced chocolate cake and excrement meatloaf sandwiches. His mother was not immune to his pranks as he named his first dog, "Fart," so she would have to scream his name to come home if he wandered off.


He met the "love of his life" at work and his daughter can't believe he fooled her into marriage.

Joe was a self-taught chemist and worked at Cheeseborough-Ponds where he developed one of their first cosmetics' lines. There he met the love of his life, Irene, who was hoodwinked into thinking he was a charming individual with decorum. Boy, was she ever wrong. Joe embarrassed her daily with his mouth and choice of clothing. To this day we do not understand how he convinced our mother, an exceedingly proper woman and a pillar in her church, to sew and create the colorful costumes and props which he used for his antics.

Heller had a knack for creatively intimidating his daughters' boyfriends.

Growing up in Joe's household was never dull. If the old adage of "You only pull the hair of those you love" holds true, his three daughters were well loved. Joe was a frequent customer of the girls' beauty shops, allowing them to "do" his hair and apply make-up liberally. He lovingly assembled doll furniture and built them a play kitchen and forts in the back yard. During their formative years, Joe made sure that their moral fibers were enriched by both Archie Bunker and Benny Hill. When they began dating, Joe would greet their dates by first running their license plates and checking for bald tires. If their vehicle passed inspection, they were invited into the house where shotguns, harpoons and sheep "nutters" were left clearly on display.


obituaries, funny, death, dying, familyStuck on you! #snoopy #woodstock #stickers #forsale #colle… | Flickrwww.flickr.com

He never met a dog he didn't like.

After retiring from running Bombaci Fuel, he was perhaps, most well-known for his role as the Essex Town "Dawg Kecher." He refused to put any of his "prisoners" down and would look for the perfect homes for them. One of them was a repeat offender who he named "A**hole" because no owner would ever keep him for very long because he was, in fact, an a**hole. My Dad would take his buddy on daily rides in his van and they'd roam around town with the breeze blowing through both of their fur. He never met a dog he didn't like, the same could not be said for the wanna-be blue bloods, snoots and summer barnacles that roamed about town.

He had a small issue with hoarding.

Joe was a frequent shopper at the Essex Dump and he left his family with a house full of crap, 300 pounds of birdseed and dead houseplants that they have no idea what to do with. If there was ever a treasure that he snatched out from under you among the mounds of junk, please wait the appropriate amount of time to contact the family to claim your loot.

Joe Heller, obituaries, death, dying, family, humor, funnyA hoarder's garageImage via Canva

Heller was born with an innate napping ability.

Joe was also a consummate napper. There wasn't a road, restaurant or friend's house in Essex that he didn't fall asleep on or in. There wasn't an occasion too formal or an event too dour that Joe didn't interrupt with his apnea and voluminous snoring.

According to the obituary, Heller will be laid to rest on Friday, September 13, at 10:00 am in Centerbrook Cemetery, but his family urges attendees to dress casually.

Joe despised formality and stuffiness and would really be ticked off if you showed up in a suit. Dress comfortably. The family encourages you to don the most inappropriate T-Shirt that you are comfortable being seen in public with as Joe often did. Everybody has a Joe story and we'd love to hear them all. Joe faced his death and his mortality, as he did with his life, face on, often telling us that when he dropped dead to dig a hole in the back yard and just roll him in.

You can read the entire obituary at Legacy.com.


This article originally appeared on 9.10.19

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Woman's rare antique turned away from 'Antique Roadshow' for heart-wrenching reason

"I just love you for bringing it in and thank you so much for making me so sad."

Photos by Murat Rahim Caglak and Antoni Shkraba via Canva

Woman's antique turned away from 'Antique Roadshow'

People come by things in all sorts of ways. Sometimes you find something while at a garage sale and sometimes it's because a family member passed away and it was left to them. After coming into possession of the item, the owner may be tempted to see how much it's worth so it can be documented for insurance purposes or sold.

On a recent episode of BBC One's Antique Roadshow, a woman brought an ivory bracelet to be appraised. Interestingly enough, the expert didn't meet this rare find with excitement, but appeared somber. The antique expert, Ronnie Archer-Morgan carefully explains the purpose of the bracelet in what appears to be a tense emotional exchange.

There would be no appraisal of this antique ivory bracelet adorned with beautiful script around the circumference. Archer-Morgan gives a brief disclaimer that he and the Antique Roadshow disapprove of the trade of ivory, though that was not his reason for refusing the ivory bangle.

"This ivory bangle here is not about trading in ivory, it’s about trading in human life, and it’s probably one of the most difficult things that I’ve ever had to talk about. But talk about it we must," Archer-Morgan says.

Ronnie Archer-Morgan, Antiques Roadshow, BBC, antiques, ivoryRonnie Archer-Morgan on an episode of the BBC's Antiques RoadshowImage via Antqiues Roadshow


Turns out the woman had no idea what she had in her possession as she purchased it from an estate sale over 30 years before. One of the elderly residents she cared for passed away and the woman found the ivory bracelet among the things being sold. Finding the bangle particularly intriguing with the fancy inscription around it, she decided to purchase the unique piece of jewelry.

After explaining that his great-grandmother was once enslaved in Nova Scotia, Canada before being returned to Sierra Leone, Archer-Morgan concluded he could not price the item.

Antiques Roadshow, BBC, Ronnie Archer MorganRonnie Archer-Morgan holds the ivory bracelet he refused to valueImage via Antiques Roadshow/BBC

"I just don’t want to value it. I do not want to put a price on something that signifies such an awful business. But the value is in the lessons that this can tell people," he tells the woman.

In the end the woman leaves without knowing the monetary value of the item but with a wealth of knowledge she didn't have before visiting. Now she can continue to share the significance of the antique with others. Watch the full explanation below:


- YouTubewww.youtube.com

This article originally appeared last year.

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Motherhood

Mom points out the unspoken, 'unfair' part of having kids who travel for sports

Parents whose children participate in elite travel ball leagues can spend up to $12,000 annually on fees, equipment, hotel rooms and gas.

via Casey Kelley (used with permission) and Vince Fleming/Unsplash

Casey Kelley shares her thoughts on kids in travel sports.

Parents whose children participate in elite travel ball leagues can spend up to $12,000 annually on fees, equipment, hotel rooms and gas. One mother, Casey Kelley, from Alabama, has spoken out, saying that if parents spend all of that money and time, their children should get to play in games. Kelley's daughter plays on a club volleyball team.

According to the latest Aspen Institute survey, the average American family spends $883 per year for a single child to play one primary sport. Project Play also points out that the cost of playing various youth sports can fluctuate great. For example, their 2022 report reveals that it costs an average $1,188 per year for a child to play soccer and $714 for baseball. As Jersey Watch writes, those numbers have come down a bit since the pandemic but are still cost prohibitive for many American families trying to make ends meet. What's even more frustrating is that those high prices don't even guarantee participation in games for children. A family can literally spend thousands of dollars all for the experience of having their child sit on a bench watching their peers actually get to participate.

The topic was inspired by a conversation she had with other volleyball parents who agreed that every kid should get a decent amount of playing time. “I’ll tell you what I think. I think, if you’re paying to be there, so it's not like high school sports, I think everyone should have the opportunity to play because this is a developmental league ... and they’re there to develop and to learn,” she explained in a TikTok video.

“Especially if these parents are paying thousands of dollars for them to be in the league and then traveling, spending money on hotels for their kid to sit there and maybe play a minute or two the whole weekend. I think it’s unfair,” she continued.



@caseyjkelley

What do you think? #travelball #clubsport #athlete #kids #mom #question


It's reasonable for Kelley to believe that spending a lot of money and traveling all over the map only to watch your kid play for a few minutes feels pointless. However, a lot of parents disagreed with her in the comments.

"You pay for practice. Playing time is earned," Nathan Sullins wrote.

"Absolutely not. If you want fair playing time you play rec ball. Travel ball playing time is performance based," another user wrote.

travel ball, volleyball, youth sports, travelball, parenting, finance, sportsYoung girls line up to play volleyballImage via Canva

But these parents haven’t changed Kelley’s mind.

“I’m not opposed to kids earning their spot or the best kids playing more, but I feel that every kid who makes the team should at least have some playing time,” she told Upworthy. “I know it’s not a popular opinion, but it’s how I currently see it.”

Kelley further explained the story in a follow-up video.



@caseyjkelley

Clarification post and the last one on this topic #travelball #athlete #travelballparents #clubsport #parenting


What do you think?

This article originally appeared last

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The things we carry

The most poignant moments are honoring those who carried and still carry us.

Image courtesy Tara Roth

Tara Roth with her family

Editor's Note: This essay originally appeared on LinkedIn, you can read it here. It was republished here with permission from Tara Roth.

Today is the two-month anniversary of our evacuation from the Palisades Fire. Although we still don't know when we can return, we have learned - and are grateful for - so much.

It’s funny what the mind latches onto when under duress. One of my first thoughts amidst the surreal encroaching flames, circling smoke, debris and dust in the choking orange air, I noticed what people carried. What they brought with them as they rolled their suitcases down to Pacific Coast Highway, what was strapped to their backs, what they carried in their hands—no one really knowing what they were leaving behind or what, if anything, they may return to. And I thought of Tim O’Brien’s powerful piece about the Vietnam War, The Things They Carried, and reflected on what his wisdom could, with hindsight, eventually teach us. I’ve aggregated his words (with poetic license) below:

“For the most part they carried themselves with poise, a kind of dignity. They shared the weight of memory….the world would take on the old logic—absolute silence, then the wind, then sunlight, then voices… despite the unknowns, they made their legs move. They endured. They took up what others could no longer bear. Often they carried each other.”

Perhaps primed by the memory of this piece, my senses heightened by the chaos around me and the COVID that wracked my body, I observed what we carried. While the LA fires do not compare to the ravages of war, they evoked the same primal instincts. We were under siege. We needed to survive. The fires were redefining what we knew as familiar, as home—snatching safety and seizing the comfort of our quotidian lives that we took for granted—that so many of us long for again.

We carry the grief and loss and devastation and desolation of communities. We carry the memories constructed lovingly into homes and structures that now stand only in our mind’s eye—the library where families got their children's first library card, the beauty salon started by a young woman who immigrated from Russia, now no longer a young woman, and passed down to her daughter. Whole communities and identities carved and scrimped for, then lost, with debris and dust that settles in the wind, smattered by the rains—schools, restaurants, churches, businesses, the bench of a first kiss, the home where the couple brought their newborn from the hospital for the first time.

And even when houses stand, like mine, there’s something else we carry—after the initial elation of the news that our homes remain, a sort of survivor’s guilt sets in realizing how much we have when others have lost everything. We have homes to return to yet never could have imagined how it feels to drive past scarred earth and scorched chimneys, the thundering absence of a neighborhood, the empty lots of ashes of memories—a chronic reminder of all that was lost and the toll of our good luck. We carry this too.

And we, innocent children of the developed world, didn’t consider that even if a structure is standing, that we need power lines, sanitation, safe running water, and neighbors to look out for each other. That we will need countless months of waste removal and remediation. That we will continue to don masks and gloves to enter these standing, yet uninhabitable, structures.

The most poignant moments are honoring those who carried and still carry us. The first responders, the countless volunteers, those who prepared hot meals and donated clothes and comforts. Those who opened their homes so generously to my and myriad other families. The hundreds of people who reached out—from the oldest of friends to people I haven't talked to in decades to those with whom I shared maybe just a professional moment in the last few months. The care and love and generosity and grace, extended by so many.

When I reflect on this time, still living displaced in the homes of various warm-hearted friends, I think about the universality of human suffering and joy, wretchedness and wonder. And how, at our best, we come together in crisis. We know that we are a part of something greater, and we act without hesitation to lend a hand to carry each other. We carry hope about the resilience we have already witnessed as communities come together and pledge to reimagine and rebuild. And, this is what I want us to carry forward.


Tara Roth is the president of the Goldhirsh Foundation

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