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.