What single-payer health care would mean for California therapists

California flagThe Healthy California Act — California’s single-payer bill — continues to make progress through the state legislature. If signed into law, it would make California the first state to have a statewide single-payer health care system, even as the federal Affordable Care Act may be scaled back. How would single-payer health care impact therapists, counselors, and related mental health providers?

Here, I’ll do a quick review of what we know so far. It’s broken down into three questions providers rightly ask about the bill: How would it impact my client load? How would it impact my rates? And, How would it impact how I run my practice?

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The problem with life coaching

wooden-chestBecoming a therapist isn’t the only way you can put a psychology or counseling degree to work. You can also become a “life coach,” a growing profession that involves helping people come closer to reaching their life goals. Some clients who would resist going to therapy will happily visit with a life coach, as receiving coaching does not carry the same implications that going to therapy might. And some therapists see coaching as a way to diversify their practice, allowing them to market to clients who simply wouldn’t attend counseling or therapy.

Life coaching is a perfectly respectable and well-defined profession. The problem with life coaching isn’t the work itself, for which there clearly is a market. It’s with the people providing it.

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A therapists’ union is not the answer

USCurrency_Federal_ReserveFirst thing, to be clear: I am pro-union. If there is any possible way that employees at your workplace can unionize, you probably should. Union workers have significantly better pay and working conditions than their non-union counterparts, and the notion that union dues will outweigh the gains you make as part of a union is typically false. Unions are good.

Psychotherapists often decry the current state of the field. Education and training costs continue to rise. Reimbursement rates are not rising. Salaries aren’t keeping up with inflation. The list goes on. (I discuss each of these issues at some length in Saving Psychotherapy.) It makes sense to wonder why there isn’t something like a therapists’ union to protect the interests of psychotherapy professionals.

However, the idea that a union of therapists will fix the problems in the field is largely wrong. A union for psychotherapists is not the solution we’re looking for. Here’s why.

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California looks to change MFT and PCC interns to associates

California flagAt its November 2015 meeting, the California Board of Behavioral Sciences (BBS) voted to pursue legislation in 2016 that would change the titles of post-degree, pre-license professional clinical counselors (PCCs) and marriage and family therapists (MFTs) from “interns” to “associates.”

There are a lot of “ifs” here, but if they are able to find an author, and if the bill gets through the Legislature and if it is then signed by the Governor, it would not take effect until 2018. This would give individuals and employers ample time during 2017 to plan changes to their marketing materials.

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Why you should read Saving Psychotherapy, in two charts

Saving psychotherapy cover image (c) Copyright 2015 Benjamin E. Caldwell.My new book, Saving Psychotherapy, will be officially released September 22 [Update: Here it is!]. An edited excerpt about licensing exams is available here. Another excerpt focused on student debt appeared in the January/February 2015 issue of AAMFT’s Family Therapy Magazine (it starts on page 26).

I could spend a lot of time convincing you why you should read the book, but I think these two charts will be sufficient.

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