Private mental health providers in the US are pretty unsupervised and have a conflict of interest in that they make more money by keeping their patients/clients unwell, which can lead to negligence and abuse. The only thing keeping in line is the possibility of someone informed and insightful enough to report them to the licensing board or pressing a lawsuit.
For example, if a provider has poor integrity, it is in their best interest to not treat depression, but rather help the patient/client feel good for the moment. What the patient/client experiences is that they feel better when they see their provider, so they become dependent on their provider. This ensures the provider a reliable source of revenue.
Another issue is that masters level therapists, while capable of providing treatment for simple cases such as a clear depressive episode, are not properly trained to conduct thorough assessments for complex cases, meaning they can misdiagnose quite easily. Complex cases would be better treated by a well-trained psychologist that can conduct thorough psychometric assessments that are quite sophisticated and take lots of time to analyze. These services are costly and the vast majority of insurance policies won’t cover them.
Relevantly, yet another issue is insurance for mental health. Most insurance policies that pay for mental health services pay low, so the care you receive can be substandard since the more effective providers are charging what they’re worth in a market economy. One example that comes to mind is Better Help. They pay providers insultingly low, like around $30/hour, while effective providers are charging ~$150/hr out-of-pocket. That means that when someone uses Better Help to obtain care, they’re getting the bottom of the barrel therapist.
Lastly, the majority of family and marriage therapists aren’t properly trained in narcissistic emotional abuse. This can mean that therapy would not only be a waste of time, but can make things much worse as they can help the narcissist abuse the victim even further. Narcissistic abuse is quite complicated and requires a relationship therapist that specializes in that to properly assess and help the victim escape.
Tips: If you have been seeing a therapist for 12 sessions, and you haven’t realized any considerable long-term changes, find another therapist. Also, if your therapist doesn’t call you out on your bullshit, let’s you ramble about tangential matters, or focuses on helping you overcome specific weekly struggles, rather than helping you develop skills and restructure deep cognitive matters to address them yourself, find another therapist. An effective therapist would develop a clear treatment plan with you that aims to meet objectively measurable goals within a certain time frame.
Note: I am not a therapist. I have just worked in the mental health field and have friends that are therapists.
An effective therapist would develop a clear treatment plan with you that aims to meet objectively measurable goals within a certain time frame.
This is a great point and true for non-therapists as well. A good measure of whether or not someone helping you is providing you value is if you are progressively improving in measurable ways.
True for doctors, meds, physical therapists, coaches, you name it
During the pandemic, this company was heavily advertised across Twitch. Not surprised they pay shit wages. Wonder if they originally paid 2-3X market rate during the hype, but slowly clawed back the teaser rates in favor of the dog shit rates.
I heard all the bad shit about better help. But I had been interested in therapy so I tried to find a therapist from a local person instead. Found out my bill was nearly $200 a session. And since therapy isn’t something like an annual doctor visit or a twice a year dentist visit, I noped out of that.
So I more than understand why people choose Better Help. It’s often actually affordable.
This is very accurate. I worked 5 years in a BH Insurance company. We saw shitty providers all the time, and we were constantly having to play the game of deciding how much we (and our members) could tolerate before cutting the providers out of the network. Cutting too many providers doesn’t correct bad actors or replace providers for people who need them and can cause backlogs if other providers aren’t available to take on their patients.
The only thing we were able to do to correct many providers by changing their pay to a value based model, so providers would get paid more for better outcomes (and sometimes only paid when patients improve). It would increase pay a lot over standard rates. But providers fought that big time. They just wanted to do things their way and cash a check of a set amount with little or no oversight.
Better help is used by providers as a way to supplement their income, and they typically pay a bit less than conventional appointments because of the digital channels. However, Ive heard they have some issues with data security on their platform and their matching system is pretty flawed due to their network being somewhat ephemeral.
If you do want to seek therapy, remember you have multiple ways to get it covered. Your health insurance probably has some coverage, and your employer (in the US) likely has an EAP program which will have coverage for therapy for at least a few sessions (typically 3-12) sessions. It’s worth looking into that before paying out of pocket.
I get that Better Help isn’t necessarily that great of a service, but therapy without Better Help is so ungodly expensive.
I was interested in therapy so I found a local provider that takes my insurance. Found out that even with insurance, it was going to cost me nearly $200 per session. So I passed on it because I’m not exactly in dire straits. I don’t understand how average Joes afford regular therapy. Better Help’s main advantage seems to be that it’s actually affordable. Though granted, I’ve never used them so maybe it would still end up being that much with my particular insurance.
Private mental health providers in the US are pretty unsupervised and have a conflict of interest in that they make more money by keeping their patients/clients unwell, which can lead to negligence and abuse. The only thing keeping in line is the possibility of someone informed and insightful enough to report them to the licensing board or pressing a lawsuit.
For example, if a provider has poor integrity, it is in their best interest to not treat depression, but rather help the patient/client feel good for the moment. What the patient/client experiences is that they feel better when they see their provider, so they become dependent on their provider. This ensures the provider a reliable source of revenue.
Another issue is that masters level therapists, while capable of providing treatment for simple cases such as a clear depressive episode, are not properly trained to conduct thorough assessments for complex cases, meaning they can misdiagnose quite easily. Complex cases would be better treated by a well-trained psychologist that can conduct thorough psychometric assessments that are quite sophisticated and take lots of time to analyze. These services are costly and the vast majority of insurance policies won’t cover them.
Relevantly, yet another issue is insurance for mental health. Most insurance policies that pay for mental health services pay low, so the care you receive can be substandard since the more effective providers are charging what they’re worth in a market economy. One example that comes to mind is Better Help. They pay providers insultingly low, like around $30/hour, while effective providers are charging ~$150/hr out-of-pocket. That means that when someone uses Better Help to obtain care, they’re getting the bottom of the barrel therapist.
Lastly, the majority of family and marriage therapists aren’t properly trained in narcissistic emotional abuse. This can mean that therapy would not only be a waste of time, but can make things much worse as they can help the narcissist abuse the victim even further. Narcissistic abuse is quite complicated and requires a relationship therapist that specializes in that to properly assess and help the victim escape.
Tips: If you have been seeing a therapist for 12 sessions, and you haven’t realized any considerable long-term changes, find another therapist. Also, if your therapist doesn’t call you out on your bullshit, let’s you ramble about tangential matters, or focuses on helping you overcome specific weekly struggles, rather than helping you develop skills and restructure deep cognitive matters to address them yourself, find another therapist. An effective therapist would develop a clear treatment plan with you that aims to meet objectively measurable goals within a certain time frame.
Note: I am not a therapist. I have just worked in the mental health field and have friends that are therapists.
This is a great point and true for non-therapists as well. A good measure of whether or not someone helping you is providing you value is if you are progressively improving in measurable ways.
True for doctors, meds, physical therapists, coaches, you name it
During the pandemic, this company was heavily advertised across Twitch. Not surprised they pay shit wages. Wonder if they originally paid 2-3X market rate during the hype, but slowly clawed back the teaser rates in favor of the dog shit rates.
I heard all the bad shit about better help. But I had been interested in therapy so I tried to find a therapist from a local person instead. Found out my bill was nearly $200 a session. And since therapy isn’t something like an annual doctor visit or a twice a year dentist visit, I noped out of that.
So I more than understand why people choose Better Help. It’s often actually affordable.
This is very accurate. I worked 5 years in a BH Insurance company. We saw shitty providers all the time, and we were constantly having to play the game of deciding how much we (and our members) could tolerate before cutting the providers out of the network. Cutting too many providers doesn’t correct bad actors or replace providers for people who need them and can cause backlogs if other providers aren’t available to take on their patients.
The only thing we were able to do to correct many providers by changing their pay to a value based model, so providers would get paid more for better outcomes (and sometimes only paid when patients improve). It would increase pay a lot over standard rates. But providers fought that big time. They just wanted to do things their way and cash a check of a set amount with little or no oversight.
Better help is used by providers as a way to supplement their income, and they typically pay a bit less than conventional appointments because of the digital channels. However, Ive heard they have some issues with data security on their platform and their matching system is pretty flawed due to their network being somewhat ephemeral.
If you do want to seek therapy, remember you have multiple ways to get it covered. Your health insurance probably has some coverage, and your employer (in the US) likely has an EAP program which will have coverage for therapy for at least a few sessions (typically 3-12) sessions. It’s worth looking into that before paying out of pocket.
I get that Better Help isn’t necessarily that great of a service, but therapy without Better Help is so ungodly expensive.
I was interested in therapy so I found a local provider that takes my insurance. Found out that even with insurance, it was going to cost me nearly $200 per session. So I passed on it because I’m not exactly in dire straits. I don’t understand how average Joes afford regular therapy. Better Help’s main advantage seems to be that it’s actually affordable. Though granted, I’ve never used them so maybe it would still end up being that much with my particular insurance.
You nailed it. 💯
This is why I hate that “get therapy” has become a common meme. Most therapy is a scam in the US.