Can You Really Trust Good Therapy?

Jan
25
2012
by Tamara Suttle

Many of you have contacted me to inquire about the usefulness of online directory listings.  After hearing Kat Mindenhall’s experience with Good Therapy, I decided to invite her to write a guest post to share with you today.

_______________________

A Guest Post by Kat Mindenhall, LCSW

(If you want to guest post on this blog, check out the guidelines here.)

After signing up for four online directories six weeks ago, I began comparing how my profile shows up on each of them. I began by searching in a zip code that borders my own, and what I found on Good Therapy really surprised me.

The Issues

Zip code searches by Good Therapy take the very middle of your zip code area and use that to calculate how far you are from the very middle of another zip code. I searched in a zip code area that was 7 miles away according to Google Maps. However, my profile did not show up on Good Therapy until the seventh page. There were listings ahead of mine that were 16.83, 14.79, and 9.75 miles away.  Good No More Good Therapy For MeTherapy says that listings appear in order of proximity to the center of the chosen zip code, but this didn’t seem to really be the case.

If you search for a therapist by “browse location,” Good Therapy will only show profiles within that exact town, despite the fact that it says it’s looking within a radius of 25 miles. A search of a town that borders mine returned only 4 profiles followed by a statement that said, “There are a limited number of therapists in your area, but other distance therapy professionals are available to help.” Included within this list of “distance” therapists was a profile from someone in London! Instead of showing nearby towns, Good Therapy apparently thought that I paid them $269 per year to show my potential clients the profiles of therapists from other countries. I find this unacceptable.

I also found that they show all instances of a certain zip code at once. What this means is that if you are 7 miles away, and another highly populated area is also 7 miles away, they may show every one of the other zip’s profiles before yours (instead of mixing them up). This is why I was on the seventh page for a zip code that borders mine.

How I Addressed These Issues

I wrote to Good Therapy about these issues and received a form letter that did not address my specific concerns. They didn’t explain why their website doesn’t quite work the way they claim. I responded and restated my concerns. They simply replied with another form letter on why I would miss Good Therapy if I left.

Mental health professionals have a reputation of being technophobes that don’t understand how simple it actually is to create an intelligent search algorithm. We certainly don’t have a reputation as a community that looks out for each other and uses technology to our advantage to spread the word about an expensive and inferior product. Is Good Therapy capitalizing on this? They don’t seem to care that they are going to lose me as a customer, and Good Therapy’s impersonal response made me feel talked down to.

Good Therapy costs $269 per year, or $24.95 per month, second only to Psychology Today in price ($360/year).  On Psychology Today, Network Therapy ($149/year), and Theravive ($197/year) I had no trouble seeing my profile within the first 1-3 pages for the same nearby cities and zip codes. Part of the premium you pay for an online directory is for their “high ranking.” I’m not convinced that Good Therapy’s ranking really makes such a difference when other directories are also on Google’s first page of search results right alongside Good Therapy.

What Does this Mean for You?

So, the question is: Is it better to take your $269 and use it to get on two other “less popular listings,” or stay on a “mega directory” even if it isn’t showing your profile?

You have to research how your profile shows up in searches to make that decision. Search for yourself in many different ways. See if your listing comes up when . . .

  • you search a nearby city by name,
  • you search that same city by zip, and
  • how your profile is displayed for all nearby zip codes.

Compare how many locations or zip codes you can list with each directory. Track your referrals so that you can know what your return on investment is for each directory.

If you live in a suburb next to a heavily populated area, it may be difficult to show up in Good Therapy’s listing because of their search algorithm. If there is a chance that potential clients will search the city next to you for a therapist and not search for your specific town, beware.  You probably won’t come up in the search. I know I didn’t.

_____________________

Kat Mindenhall, LCSW, is a therapist in private practice with Image of Kat Mindenhall, LCSWA Peaceful Life Counseling Services LLC in Lakewood, CO. She specializes in helping parents enjoy their relationships with each other and their children by overcoming depression, anxiety, and relational issues.


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How to Get Mind-Body Tools Reimbursed By Insurance Companies

Dec
27
2011
by Tamara Suttle

In addition to being licensed as a Professional Counselor, I am also a Certified Clinical Hypnotherapist soHow to Get Reimbursed by Insurance for Mind-Body Tools it should not surprise you to know that I was reading Belleruth Naparstek’s blog, Health Journeys today and stumbled across an excellent post she wrote (back in August) on getting reimbursement from insurance companies for the use of mind-body tools.  Here is what I took away from her post . . . .

Don’t make things harder than they need to be. It reminds me of what my first partner, a scrub tech, used to tell me . . . . A surgeon can call a mass “a mass” or  “a cyst” or “cancer.”  And, for some masses more than one of those words may be accurate.  However, the rate of reimbursement was / is contingent upon what s/he chooses to call it.  The same is true for your services.  Sometimes you have choices . . . and it benefits both you and your client to make both accurate and informed choices when it comes to the services you provide.

Persuasion is simply “applied empathy.” It is a skill that you have either developed or you have not.  Don’t psych yourself out when talking with managed care.  If you have the ability to apply your empathy to your client, you also have that same ability to apply your empathy to those who work in managed care.  Put yourself in their seats so that you can speak to their unique concerns – those of balancing health care and restricting costs.  And, if you are unable to apply your empathy there, then check yourself.  That may be a skill that needs polishing . . . as it would benefit both you and your client.

Language matters. I know I’ve written about this before.  Belleruth’s references to both managed care and the military are excellent examples of why this is so important.  Different cultures speak different languages.  If you are choosing to work within the culture of managed care, learn the language.

You need a Supporting Data File. Belleruth refers to this as “robust research data.”  Whatever you call it . . . for whatever you do . . . keep your research data file current and easily accessible.  It may be what gives you the upper hand in securing a contract to provide your services.  (And, if a portion of what you offer falls under Complimentary / Alternative Medicine, then you need to double your efforts here.)

Doing your homework on each insurance company goes hand in hand with strategic networking. You’ll need both in order to find and persuade those with the influence necessary to approve of your mind-body services.

If you have additional tips that have helped you secure reimbursement for your services, I hope you’ll take a moment to share them below with our readers.

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8 Reasons To Work In A Community Agency BEFORE You Go Into Private Practice – Part 2

Nov
2
2011
by Tamara Suttle

This is the 2nd part of a 3 -part series.Image of Number 8
To see the previous post in this series, click here.

The Clinical Experience Will Be Invaluable

By working in a community mental health agency, nonprofit organization, or psychiatric hospital after graduation, new mental health professionals can learn to work with a wide variety of clients and issues.  This strengthens your clinical and diagnostic skills.    Oftentimes, the clients you see in these settings will have fewer resources and a greater number of social and clinical challenges.  That’s an experience that is unique to these community settings and will help prepare you to competently work with a variety of presenting issues.

Professional Development is Usually FREE

Every mental health professional is ethically obligated to continue their professional development throughout their careers.  Even Colorado has finally stepped up to this standard!  One of the best things about working in community settings is that continuing education is typically provided for employees on the job at no additional expense. Consider that the typical workshop or conference that I attend may cost me at least $15-20 per hour without counting transportation and lodging.  That’s a a great deal and a huge incentive for the new professional!  Think about it – If your state requires that you attend 24 hours / 2 year cycle like Texas does, that equates to $480 / 2 year cycle plus transportation and lodging. If that training does not come as a perk from your employers, then it’s coming out of your paycheck!

Peer Consultation is Right Down the Hall

Most mental health professionals in private practice are sole proprietors who work in offices isolated from their peers.  The number one complaint I hear from them is “It’s lonely in private practice!”  By working in a community setting, you have an opportunity to work with and learn from your colleagues right down the hall from you.  When you have a clinical or administrative question, you will have peers an arms’ length away to staff a case or help you find resources.  Once you are out on your own, that immediate availability is likely to be much more difficult to find.

Shared Liability Reduces Your Risk

When you work as a therapist in a community mental health agency, it’s likely that you will make your share of mistakes just like the rest of us humans do while we are learning new skills.  The benefit of making them there is that should you encounter a disgruntled client that decides to sue for malpractice, your entire agency can rally to your defense.  Once you are in private practice, you are all on your own!

Administrative Supervision is Free and Abundant, Too

OK, so I’ll admit it . . . .  I rarely appreciated administrative supervision when I had it. Mostly, it seemed like a lot of red tape i.e. a pain in the butt.  Nevertheless, after 30 years of working in the field of mental health, now I get it.  I get how critical it really is to learn early on how to write a strong progress note and treatment plan, how to deal with money matters and cancellations, and how to set an appointment, and how to be a team player in an organization.  And, equally important, I get why someone needs to make sure that an agency continues to meet their own goals just to survive.  Administrative supervision is critical – to the agency, yes, but also to you as a new professional.  Administrative supervision teaches you to put foundational habits and practices in place that will support you in the field of mental health for decades to come.

Clinical Supervision at No Additional Cost

No one told me when I entered graduate school that I would need clinical supervision post-graduation in order to get licensed and practice ethically and competently.  And, when the topic eventually came up . . . in my Practicum class, no one bothered to spell out that in all likelihood it would be ME paying for every minute of that supervision unless I had an employer or tooth fairy that was willing to provide it to me at their own expense!

If you were as clueless as me, let me clue you in now . . . . The customary fee for clinical supervision post graduation can easily cost you an additional $30,000. Here are some more thoughts about fees for clinical supervision.  However, for now, let me just say that if that’s coming out of your wallet right out of graduate school, it’s going to hurt! Many employers will provide individual and / or group clinical supervision at no additional cost to you.

Community Resources Abound in Agency Settings

One of the challenges to any new mental health professional is a general lack of knowledge about the community resources.  Yes, many communities have a “Blue Book” of community resources but that is not sufficient to support your clients and minimize your liability in private practice.  By spending time in an agency, you will have time and experiences that allow you to develop a knowledge and understanding of specific agencies’ strengths and challenges.  For example, if you were in private practice today, would you know

  • How to support and keep safe a suicidal client who has phoned you? (Check out ASIST through LivingWorks.)
  • Where to send a client who is struggling with staying sober? (Inpatient treatment if detox is needed; Alcoholics Anonymous for ongoing peer support.)
  • Who provides group therapy to court-ordered domestic violence offenders? (Here in Colorado, providers must be approved through the Domestic Violence Offender Management Board.)
  • Who to call first when you’ve been threatened with a lawsuit? (Yes, call a mental health attorney.)
  • Where to turn when your client needs resources to help her adult son who is soon to be homeless? (For me, it’s the Douglas County Youth Initiative’s resource guide.)

Of course, those questions are just a fraction of the resources that you will need to know in private practice.  And, working in an agency for a few years will build up your knowledge of community resources faster than anything else!

Opportunity Foster Community Relationships Will Pay Dividends Down the Road

And, while you are building up that knowledge of community resources, you will also be building up your address book as you continue to meet and problems solve with other agencies and professionals in your community.  You may see this initially as simply “doing your job.”  But, the truth is, you are planting seeds!  Once you leave the agency and move into private practice, you will see that you have fostered many relationships with individuals and organizations.  If you’ve done this right, you will know many who can and will be eager to send clients to you for counseling and support!

Here, in Colorado, many new therapists eschew agency work and opt to immediately hang out their shingles only to find that they struggle.  I can’t say that I’m really surprised. If you haven’t planted the seeds to help clients find their way to you, it’s not likely that you will have great success in private practice.  There are many paths to building a successful and vibrant practice, but working in an agency is definitely one that can pay off in dividends if you have the wisdom to pursue it!

Have you worked in a non-profit or agency of some type?  What has been the benefits for you?  Are you now in private practice and didn’t take this route?  I hope regardless of your path, you’ll take a moment to drop in here to chat and let us learn from your journey, too!  I look forward to chatting with you!

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The Language Of Managed Care – What To Say And How To Say It

Oct
13
2011
by Tamara Suttle

If you have chosen to work directly with managed care companies and now find yourself struggling to work effectively with them, you may not be speaking their language.  Theirs is the language of behavioral health care.  As such, it focuses on impairments.

Impairments are behavioral dysfunctions.  They are quantifiable and measurable.

Biopsychological impairments address both the biological and psychological spheres of a client’s life and include such things as altered sleep, learning disabilities, and psychotic thought.

Family / significant other impairments are those Image of Speech Bubblesthat reference a client’s difficulty in relating to significant others such as family or marital dysfunction, emotional / physical trauma as a victim or perpetrator, and even running away from home.

Social / interpersonal impairments are those that address a client’s destructive, chaotic, or unmanageable chaotic world.  These impairments may include manipulativeness, uncommunicativeness, egocentricity, or oppositionalism.

Future / achievement impairments refer to a client’s ability to hope and plan for the future.  These impairments include hopelessness, inadequate survival or health care skills, and educational performance deficits.

Some managed care companies refer to this list of impairments as a Patient Impairment Profile or PIP.  When I have worked with managed care in the past, I have used the PIP to structure my reviews and negotiations for authorization of care. It is an efficient and professional way to address your concerns in the language that best reflects managed care’s concerns.

Here are some recommendations for you to consider when communicating with professionals within the managed care industry about your clients.

  • Do not provide a lengthy problem list of every concern that you have.
  • Do provide a list of impairments that you intend to successfully treat.
  • Start with biopsychological impairments because they carry the most weight with managed care.
  • Impairments should be consistent with DSM-IV symptomology.
  • Include any impairment that has the potential to directly impact treatment.
  • Avoid the use of Axis II diagnoses and V codes whenever possible.

In the world of managed care, clinical / medical necessity is defined by these impairments. It’s important for you to know that by the industry standards of managed care, impairments  (and not diagnoses) are the reasons that a client requires treatment. And, it is impairments that are used to determine reimbursements for your fees.  You will not foster good will or bridge the culture gaps with managed care by addressing clinical “issues” that do not easily lend themselves to your treatment or repair. Keep this in mind when you are going back to them to request extending their authorization for your client to continue working with you.

If you are finding this post useful, let me know and I’ll share a bit more with you about working with managed care.  And, if I don’t hear from you, I’ll happily revert back to my managed-care free emphasis in this blog!


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How To Get On Insurance Panels As A Preferred Provider – Part 2

Oct
6
2011
by Tamara Suttle

This is the second of a 3-part series to help ease your way to getting approved as a preferred provider with insurance companies. The series began here.How to Get on Insurance Panels - Part 2

Managed care companies receive hundreds of applications from licensed mental health professionals every year who are wanting to become preferred providers.  That’s why it’s important to make your application stand out in a positive way to the professionals in Provider Relations that will be evaluating your credentials and experience.  Here’s a few tips that I’ve learned over the years that may help you rise to the top of the pile.

Tip #1 – Focus on your own efficiency and your ability to save on costs. Managed care came into existence as a reaction to offset the rampant financial abuses in health care.  As such, the primary goal of these companies is to reduce costs of health care.  The care of clients comes second. Make sure that your application speaks to managed care’s concerns and not just your own.

Tip #2 – Location makes a difference. (And, not just for the reasons I stated here.) If you can provide services in an under-served area, you are more likely to be admitted to a preferred provider list.  If you currently provide services in a therapist-saturated market, you may want to consider adding a second site to your practice.  By indicating that you are available to provide services in an under-served area for just a few hours each week, you make yourself much more desirable to managed care companies.  (And, the good news is that once your are “in” on the panel, you can typically relocate your services without losing your place on the provider lists – even across state lines!)

Tip #3 – Highlight second languages that you are fluent in. Your unique expertise is what will get you on the list so don’t forget to highlight an ability to speak a foreign language every chance you get.

Tip #4 – Special hours can set your practice apart. Most therapists work 8 a.m. – 5 p.m.  If you can offer late or early hours or are willing to work on weekends, mention them on your application. Those “special” hours can be a way to expedite your entrance into the world of preferred providers.

Tip #5 – Special populations require special knowledge. Don’t indicate that you “work with everybody.”  That’s not what managed care is looking for.  Instead, if you have advanced training and experience working with a specific population or two, emphasize this. Populations such as geriatrics, children, GLBT, deaf clients, etc. can open doors for you with managed care.

Tip #6 – Advanced training and credentials count. Although experience definitely counts, proof of skills via advanced training and credentialing make you much less of a risk to insurance companies and much more desirable to them, too.  Track your professional development and flaunt it in your application.

Do you have other tips that can help other licensed mental health professionals get on insurance panels?  If so, I hope you will leave them below.

And, on Monday, I’ll wrap up this series by sharing a couple of thoughts for those who have had their applications denied. 


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