[Originally published May 2014.] Last week in Isla Vista, California, Elliot Rodger killed six people before taking his own life. His family says he was seeing multiple therapists. Meanwhile, in the California legislature, discussion of a bill that would mandate additional suicide prevention training for therapists has focused on research showing that more than 30% of those who commit suicide had seen a mental health professional within the past year. Why can’t therapists do more to stop violence among our own clients?
Ben Caldwell
How did we get here? Part 1: 3,000 hours
In every state, and for every psychotherapist license, there is a supervised experience requirement. Those requirements differ a bit from state to state and between license types, but they all hover around the same place: two years of full-time experience or the equivalent, typically operationalized as 3,000 hours. Where did that standard come from, and how has it changed over time? You may be surprised.
It’s nearly 100 years old.
Graham-Cassidy health care bill would be disastrous for US mental health care
The US Senate may take action this week on the Graham-Cassidy health care bill, a last-ditch effort by Senate Republicans to repeal and replace the Affordable Care Act. If Graham-Cassidy becomes law, the consequences for US mental health providers and their clients would be disastrous.
The nonpartisan Congressional Budget Office will not score the bill before a September 30 deadline for Senators to vote on it. But estimates suggest that under the bill, at least 16 million Americans would lose health insurance entirely after 10 years, given the bill’s similarity to prior Republican health care bills. This would leave millions paying out of pocket for mental health care that is currently covered by insurance.
Talkspace forces therapists to break rules. The rules may be the problem.
App-based therapy platforms may well represent the next evolution of psychotherapy practice. I praised Talkspace a few years ago for offering access to mental health care for many who otherwise would never find their way to a therapist’s office. But the platforms — Talkspace, Betterhelp, and the like — have run into controversy over their confidentiality policies. Therapists using these apps may have little to no ready access to the client’s full name, address, or other information necessary in an emergency.
Every excuse for California’s MFT Clinical Exam pass rate, debunked
At the August meeting of the California Board of Behavioral Sciences, I had a tense exchange with representatives from the state’s Office of Professional Examination Services about pass rates for the California MFT Clinical Exam. That pass rate has fallen off a cliff. For the first six months of the year, just 56% of those taking the test for the first time passed.
At the meeting, OPES presented about their exam development process, and argued that nothing meaningful had changed on their end. They and the BBS raised several hypotheses about both the current low pass rate and the drop in pass rate at the start of the year.
Over the past week, I investigated every one of the hypotheses offered. Not one of those hypotheses stands up to scrutiny.