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.
Public policy
This change in California child abuse reporting took 20 years
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.
Is therapy more effective when people pay a fee for it?

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.
California’s AB5 signed. How will it impact therapists’ work as independent contractors?
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.
Why the Kaiser mental health strike matters
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.