03/31/2000

No-fee Psychotherapy for Community Volunteers

Volunteers in Psychotherapy (VIP), a new non-profit organization in West Hartford, is taking the meaning of community service to heart by offering no-fee psychotherapy sessions in exchange for volunteer work clients provide to local charitable organizations. People who are unemployed or uninsured, can't afford to pay, who are dissatisfied with their insurance coverage or its lack of confidentiality, or who worry about documentation of their therapy being available to their employers, are welcome to participate. VIP provides truly private therapy for adults and families, including children.

Clinical psychologists and nonprofit specialists provide this no-fee service. VIP is supported by charitable donations and grant awards. The aim of VIP is to provide psychotherapy that is truly confidential and under the control of the client.

VIP aims to reverse problematic therapy practices brought on by managed care. Current insurance approaches require therapists to submit reports of personal information that violate the privacy of therapy clients. Those "third party payers" are also in charge of decisions about how many sessions of therapy will be paid for and have increasingly limited access to psychotherapy based on determinations of what is "medically necessary." But many psychotherapists believe that it is a distortion to describe people's personal, emotional or family difficulties as diseases, because such problems rarely have identifiable medical pathology. And insurance companies can profit by denying access to therapy of reasonable length.

VIP has recently been awarded substantial charitable grants, in addition to private donations, so that funds are now established to modestly reimburse therapists for working in this way. Everyone involved with VIP is asked to contribute to the common good, including psychotherapists, who work for well below average fees. Compensation for therapy is less than half the local average private practice fees.

"This approach puts clients back in charge of their therapy, even if they might otherwise find the fees for therapy prohibitive," said Dr. Richard Shulman, Licensed Psychologist and Director of VIP. "It will protect their privacy, and let them determine whether continued therapy is of value to them. It also requires some commitment from clients that benefits the community and should increase peoples' motivation and self-determination. This approach encourages voluntarism in the community by requiring our therapy clients to independently and privately provide ongoing volunteer work to the charity of their choice in order to receive our services. Clients should also derive all the benefits that volunteers receive from their volunteer work helping others in the community."

Many therapists are uncomfortable with all the compromises they must make in order to receive referrals in managed care systems. They recognize that sending required reports on the private lives of their clients breaches the privacy people need in order to speak openly in therapy. Even the Supreme Court recognized the need for strict privacy in a recent ruling about psychotherapy. Volunteers In Psychotherapy will permit the benefits of responsibility, commitment and privacy in therapy in a way that many therapy practices, clinics and hospitals don't. The honesty and effectiveness of therapy discussions requires that the privacy and control of clients not be compromised.

How VIP Works:

1. You choose a community charity or nonprofit organization where you independently and privately volunteer your time.

2. Your work as a volunteer "pays" for some or all of your psychotherapy with VIP.

3. VIP's experienced professionals provide you therapy that is private, with no reports to insurance companies.

4. You help others in the community through your independent volunteer work.

5. Your volunteer work is also likely to benefit you, as you see your value to others.

6. Charitable donations to VIP modestly reimburse participating psychotherapists at significantly below market rates.

Please send questions or comments to bbruno@snet.net.