Discussions about value-based care among therapists are often confusing and unproductive. In my experience, that seems to be because a lot of us simply don’t know what the term means. So it gets either dismissed as just a new term for things many of us already do (like measuring outcomes), or it gets framed as the boogeyman intent on destroying therapy as we know it.
insurance
AI therapy is about to make therapy a lot cheaper
“I’m in L.A. We have a lot of therapists,” Angelle Haney Gullett told the Washington Post in 2022. “So it’s just kind of wild to me that that many people are at capacity.” She had contacted 25 different therapists after her father passed away, knowing that she needed help. Even though she was willing to pay cash, not one would take her. No one would even put her on a waiting list.
She’s not alone. Tens of thousands of Americans struggle to access mental health care even when they know they need it, and even when their health insurance covers it. But for clients like Angelle, mental health care is about to get much easier to access. It’s about to get a lot less expensive, too. This will happen thanks to artificial intelligence. AI therapy is already here, and it’s about to upend US mental health care.
Package pricing comes with risks for therapists
Therapists and counselors in private practice find all kinds of creative ways to keep clients coming back. Some therapists offer clients package pricing, which they might also call a prepayment discount. For example, a therapist who charges $100 per session might offer five sessions for $450 if the client agrees to pay up front. Under either name, the therapist agrees to a price cut in exchange for a commitment to a certain number of sessions.
At first glance, everyone wins with such an arrangement. The therapist has cash in hand, the client saves money, and the client’s commitment to therapy may reduce dropouts and missed sessions. But such arrangements carry meaningful risks for therapists. These discounts can wind up costing therapists much more than they are worth.
HIPAA compliance: Three great resources under $35
The Health Insurance Portability and Accountability Act, also known as HIPAA, confuses a lot of therapists. Parts of the law are flexible based on the size and type of entity involved. Other parts apply equally to every covered entity. It’s a big and complex law, one that sometimes scares therapists and counselors away from using technology in their work.
Thankfully, there are a number of good and inexpensive resources for psychotherapists who want to comply with the law. Each of the ones listed below is less than $35.
A therapists’ union is not the answer
First 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.