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Therapy for Sale


I’m not sure if a buy two get one free special is going to connect anyone with a good therapist, but companies are trying.

The move toward quick, cheap and easy online therapy has accelerated now that so many people have had experiences with teletherapy during the coronavirus shutdown. Startups are offering clients subscription services for reduced rates as they contact every therapist with a private practice and try to lure them onto their aggressively marketed, data scouring platforms.

I don’t begrudge therapists making money. They change lives, they deserve to live good ones themselves. But when every encounter becomes a business transaction facilitated by a for-profit technology aggregator promising price before experience I get a very bad taste in my mouth.

Southern California therapist Jon Smith described some of his interactions with these companies as they try to sell their services and promises of vast databases of clients just waiting to be linked with anyone with credentials and an open appointment book. His experience with teletherapy has been mixed, and he looks forward to meeting in-person with every client soon.

Of course, he’s not about to join one of these internet shops. Smith writes:

I recognize the value in meeting over Zoom when necessary but I refuse to stand silent as our field and our potential clients are convinced by non-clinicians that remote sessions are just as good as meeting in person. Anyone who’s ever spent any time on the couch or in the chair (ideally both) knows that subtle intersubjective dynamics occur in shared physical proximity. Attunement to these dynamics is an essential component of effective psychotherapy, even if this is never explicitly discussed. The most enduring therapy is that in which right-brain, preverbal wounding gets integrated into awareness through left-brain processes. What’s experienced by laypeople as the feeling which precedes the statement, “It all makes sense now.”  

We are relational beings after all. Secure attachment could never be established over Facetime, though I’m sure somebody North of here with a surfeit of time and money has been set to work on that thorny problem. Attachment wounds can never be healed “virtually”. At least not in my clinical and personal opinion. Again, I’m all for Zoom when meeting in person is not possible, but we might as well get on board with teledentistry if we don’t firm up a consensus here.

Psychotherapy holds great promise for people struggling with trauma, abuse and personality challenges. It requires a relationship between the therapist and the client that is trusting and gentle, with possibly a little bit of tough prodding toward realizations when required. This takes time. Silence and introspection are punctuated by occasional breakthroughs, and this process is full of nonverbal cues and benefits from a therapist with a lot of experience – experience full of training, mentorship, life experience including, possibly, sessions in therapy working on themselves, and tests from clients.

This doesn’t work well virtually, and I predict a significant backlash against this tele-whatever technology as soon as we can get out and see, relate to and be with each other again.

These market-cornering online platforms are betting on people like Smith and I being wrong.

Smith continues:

I believe a fragmented field that employs behaviorist methodology to induce or retain clients will be populated primarily by mediocre clinicians offering possibly ineffective but likely harmful therapy. The whole point of relational work is to assist clients in throwing off the virtual shackles which bind them to unevolved versions of themselves. These platforms are likely to recreate the very problems which bring clients to therapy in the first place. Or which used to, in the before.

In addition, a subscription model limits access to therapy to those who can afford the subscription and limits the right of therapists to set their own fees, to work with court-mandated clients and to serve low-income and other underserved populations as most private practitioners did on the way to building their own businesses.  

There are myriad confidentiality, mandated reporting and ethical issues as well here which don’t appear to have been considered. If you go fast you might break things. In our field this is a bug, not a feature, just as bingeing is not a healthy behavior. Be careful. 

Any therapist who relies on coercion to keep people coming should probably get some coaching or something in order to find a line of work more suited to his/her/their talents. Maybe coaching, actually. It’s ideal for people who like to tell other people what to do and who are ready to get down to business. 

I hope therapists like Smith hang in there and resist the pull toward subscription model, computer matched online therapy. We’ve all had to meet virtually for a while now. It facilitates nothing but convenience.

Let’s meet in-person with therapists who we find through referrals from doctors, other therapists, friends or family members we trust. Beats an algorithm any day.

George Hofmann’s book Resilience: Handling Anxiety in a Time of Crisis is available now.

Therapy for Sale


George Hofmann

George is the author of Resilience: Handling Anxiety in a Time of Crisis, from Changemakers Books. Visit George's site www.practicingmentalillness.com or join the Facebook group Practicing Mental Illness


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APA Reference
Hofmann, G. (2020). Therapy for Sale. Psych Central. Retrieved on September 28, 2020, from https://blogs.psychcentral.com/older-bipolar/2020/08/therapy-for-sale/

 

Last updated: 7 Aug 2020
Statement of review: Psych Central does not review the content that appears in our blog network (blogs.psychcentral.com) prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on PsychCentral.com. All rights reserved.