California Governor Gavin Newsom on Sunday signed Assembly Bill 1759, making a couple of key changes in continuing education (CE) requirements for California MFTs, clinical counselors, and clinical social workers. There’s a new one-time Telehealth CE requirement for everyone, and a new annual Law and Ethics CE requirement for Associates.
The bill was tagged as urgency legislation, meaning it took effect immediately upon the Governor’s signature. In addition to making video supervision legal across all work settings, it also newly requires supervisors (in all work settings, not just private practice) to assess a supervisee’s appropriateness for video supervision. I’ve created a form for that, modeled after the specific requirements in the bill. It’s available on my Resources page at the Ben Caldwell Labs site.
On Tuesday, mental health clinicians for Kaiser Permanente in Northern California went on strike. While Kaiser and the union representing the therapists appear to have reached agreement on wages, the sides remain in dispute on issues related to staffing, working conditions, and client access to care. Kaiser reps have responded by calling the strike itself “unethical.” They have said that union leaders were asking therapists to “walk away from people who need help.” Suggesting that your own employees are unethical when they are striking to force Kaiser to improve patient access to mental health care is, as they say, a choice. It’s one that would seem destined to only worsen Kaiser’s ability to recruit and retain therapists in the future.
On Friday, the Association of Social Work Boards (ASWB) released a report detailing four years of data on its various exams. The report shows that white examinees were almost twice as likely as Black examinees to pass the ASWB Clinical Exam on their first attempt. This data supports the notion that license exams are more than passive recipients of existing inequities in training, and instead actively heighten racial disparities in the mental health work force.
Emotional support animals (ESAs), and therapists writing ESA letters for clients, are frequent topics around here. After years of overuse, the FAA allowed airlines to ban ESAs from passenger cabins early this year, and every major domestic airline has done so. Now California has developed new rules for therapists wanting to write ESA letters, most commonly for clients who want an ESA in a housing situation that does not allow pets.
Almost eight years ago, I wrote about how California’s Child Abuse and Neglect Reporting Act was naive and discriminatory. By applying one set of child abuse reporting mandates to consensual heterosexual intercourse, and a very different, stricter set of reporting mandates to other forms of consensual sexual activity, the law plainly discriminated against LGBT adolescents in same-sex relationships. It also failed to address typical adolescent sexual development, making intercourse non-reportable in many instances where other activities adolescents would engage in during the run-up to intercourse were mandated reports.
That law has finally changed.
The idea that clients should pay at least a small fee for therapy in order for therapy to be effective has been around for a long time. But it doesn’t hold up as well as you might think.
This is one of those things that I learned in grad school and simply accepted as truth for a long time. And then I was startled when I actually looked into it. Not only does forcing clients to pay even a small amount for therapy not help outcomes, some evidence suggests it makes outcomes worse.
Despite what you may have heard, the passage of AB5 will not cause the sky to fall.
California’s independent contractor bill, Assembly Bill 5, was described in media reports as an effort to regulate the gig economy, more specifically Uber and Lyft drivers. It actually impacts many, many more workers than that. But it doesn’t change anything for master’s-level mental health professionals in the state. The change that matters for us happened more than a year ago, and most employers have already adapted to it.
Thousands of California mental health professionals working for Kaiser plan to begin an open-ended strike on June 11. They are protesting the company’s ongoing failure to staff up their mental health operations, resulting in Kaiser patients waiting several weeks between appointments. More than 700 stories of the human impacts of these wait times can be found at kaiserdontdeny.com.
I initially posted about Kaiser’s mental health labor force struggles late last year, when therapists staged a five-day walkout. Kaiser has told its workforce that they believe progress has been made since then on a new contract, but Kaiser’s NUHW workers have been working without a contract since September, and are clearly tired of waiting. The dispute hasn’t fundamentally changed since the December walkout. In April, NUHW workers staged a one-day work stoppage in Pasadena.
My original post, published December 12, 2018, follows:
On Monday, roughly 4,000 mental health professionals employed by Kaiser Permanente in California began a planned five-day strike. The therapists (and nurses, who also walked out in solidarity) say they are protesting the massive and continued failure on Kaiser’s part to provide adequate mental health care to its own patients.
This strike is, in some ways, like other strikes you’ve heard about. While the therapists are highlighting client care issues, Kaiser itself notes that those therapists also are demanding better pay and working conditions — common demands to strike over. But this strike is also deeply unusual in the mental health world. Even when therapists are in a union, strikes are very rare. For that reason, this strike is uniquely important.
When the Public Service Loan Forgiveness program (PSLF) started in 2007, mental health professionals all over the country expressed optimism and relief. Student debt is crushing younger mental health professionals — hear two stories, in their own words, here. The PSLF program promised those working in nonprofit agencies and in public service that if they just stuck it out for 10 years, the remainder of their direct student loans would be forgiven.
Any kind of mental health work is challenging, but nonprofit clinics and public systems are notoriously difficult to work in. They offer low pay, low-functioning clients, a ton of paperwork, and often, little support. It’s no wonder that many counties struggle to fill those jobs at all.
For those clinicians who experience the work as a calling, though, the PSLF program offered a lifeline. It would be a reward for staying put in positions that most therapists understandably leave. For those who otherwise faced a possible lifetime of debt, PSLF suggested a way out.
It’s not going well so far.