Let Volunteers in Psychotherapy Help You

(This is one of the most interesting public service programs we have seen in some time. We encourage you and Div. 42 to think about how they can further this fantastic outreach program – Eds.)

You’re a psychologist providing psychotherapy in private practice. Depending on your perspective on therapy, you might be eager to provide therapy that is:

Completely private, with no reports required by insurers, government, nor documentation that goes to employers – so that your clients can speak openly about difficult intimate topics.
Client-controlled, with no rationing by a third-party payer who profits by denying people access to therapy.
Accessible to any client, regardless of their ability to pay, or possession of insurance.
Attuned to the subtleties of what the client talks about, both directly and indirectly – rather than focused on topics a payer tells you they’ll reimburse.
Separate from any secondary agendas clients may have: such as seeking disability payments, attaining a favorable legal judgment or educational placement or custody arrangement, etc., so that it is
Only focused on the agenda of truthful exploration and resolution of difficult personal or familial problems which couldn’t easily be discussed in a less private setting.
Earned or paid for by the client themselves, so that they contribute something meaningful in the exchange and are invested in their own progress; and take ultimate responsibility for their own life.
With clients paying for any irresponsibly cancelled or “no show” sessions.

If this list describes many of your therapy preferences, you might be interested to know of Volunteers in Psychotherapy (VIP), a nonprofit organization developed by psychologists and nonprofit experts in Hartford, CT. It is a program, functioning (since 1999) that you could bring to your own community, and participate in through your own practice – thereby institutionalizing therapy framework guidelines which could be maximally conducive for productive therapy relationships.

Volunteers in Psychotherapy is an innovative nonprofit organization where people, regardless of finances or health insurance status, can earn therapy for themselves or their families. VIP provides psychotherapy that is strictly private and of duration determined by the client, for no-fee or a low-fee, to clients who agree to privately provide ongoing independent volunteer work elsewhere, to the community nonprofit, charity or government agency of their choice. Four [4] hours of volunteering is required to earn each therapy session. For example, in exchange for substantial hours of documented volunteering at a hospital, soup kitchen, nursing home or youth program, people can earn strictly private therapy with one of VIP’s licensed practitioners. (If a VIP client volunteers at a soup kitchen, that agency doesn’t know of the volunteer’s involvement in VIP – the volunteer just gets some written documentation of their work hours, which they forward to us independently. This preserves the client’s privacy.)

VIP’s service is desperately needed at a time when managed care insurance severely limits access to psychotherapy, or strictly rations a brief number of sessions. In the decade leading to 1998, insurance-based mental health funding decreased by 54% (Hay Group, 1998), and access to psychotherapy was severely cut in particular. Also, roughly 45 million Americans have no insurance.

Funding cuts and financial pressures have influenced many public clinics to provide much less private psychotherapy, and to focus on short-term educational groups and especially provision of medication. VIP has recently seen an increase in self-referrals from clients who initially sought therapy through prominent public clinics in Hartford; only to be told that they could not get private therapy at those institutions. In many settings, people are commonly denied access to private psychotherapy of reasonable duration, where they can discuss the hidden personal issues which often can be the source of emotional confusion or distress.

VIP is a nonprofit dedicated to preserving and providing truly private psychotherapy for those in the community who can’t afford to pay for therapy out of their own pockets, since that is the only way to ensure real privacy and client control. Working independently of insurance, we aren’t required to send reports to insurers which undermine privacy, nor to provide documentation which may become available to employers.

VIP also promotes increased volunteer work in the community, which multiplies benefits to all involved. Clients’ private and independent volunteer work, at the community charity of their choice, demonstrates their commitment to helping others and themselves. Their volunteer work promotes the benefits all volunteers derive: greater confidence and autonomy, recognition of their value to others, enjoyment of a job well done in contributing to others, and increased involvement with the common good of the community. Clients pick volunteer work that helps others in a form that is meaningful to them.

We are a nonprofit organization that doesn’t believe in giving “something for nothing”. Clients “pay for” their therapy with their community volunteer work, which is done independently and privately. And clients ration their use of VIP services since the high work requirement puts them in the position of being a consumer, making their own autonomous decisions about the worth, to them, of their therapy.

In the five years of VIP’s existence, we have worked with over 200 individuals and families who have earned about 1600 therapy sessions through roughly 6400 hours of independent volunteering. Most VIP clients lack full time employment, and are financially strapped. But VIP services are open to people from all walks of life, with no “means testing” necessary, since there is such a substantial work requirement. Clients also have the option of paying a partial fee and doing proportionally less volunteering, should that suit them. However, in more than 95% of VIP sessions to date, clients chose to pay nothing (and earned their sessions strictly through volunteering).

You may have heard of VIP: Division 42 and the American Psychological Association highlighted us through a Symposium at an APA national convention. The Monitor on Psychology wrote an article about VIP, and we have been featured by National Public Radio. VIP was granted the Award for Distinguished Psychological Contribution in the Public Interest by the Connecticut Psychological Association and we recently received award recognition from the American Institute of Medical Education. In 2002 there was a feature article about VIP in the New York Times.

As a tax-exempt, charitable nonprofit entity, approved by the IRS, VIP is supported by many community-minded individuals who have made donations which underwrite our service. VIP is also eligible for grant support from charitable foundations. Psychologists who provide therapy for VIP through their private practices are paid (per session) from these funds.

Would you like to adapt a program like this to your own community?

You could create a similar, but independent, nonprofit organization in your own area. You could shape the framework of therapy in a way which seemed best for you or a group of similarly committed professionals, perhaps tailoring it to your community needs and your own particular interests in serving them.

Why reinvent the wheel when you could borrow from our experience? We can help you based on the lessons we have learned, guiding you to avoid potential pitfalls, and easing your way into developing your own nonprofit program. We can point you toward resources – some of which probably already exist in your own community – which could help you to develop an adjunct to your own practice which could help people of limited means to access your services. And you may already have resources available to you – obvious or hidden – which could put you in an even better position to develop and implement your own local program than we were when we developed VIP.

Towards the goal consulting with other psychologists, VIP has begun investigating relevant charitable funding for such work. VIP recently applied for seed funding from the American Psychological Foundation and the Blue Cross Blue Shield of Massachusetts Foundation. We are eager to learn of other funders who might want to underwrite our “export” of this model. Previously we have successfully applied for and been granted 37 modest grants to provide our therapy services locally. Now we intend to provide inexpensive consultation with incipient community groups (comprised of psychologists and perhaps other psychotherapists, as well as people with nonprofit experience in your community) who could easily comprise a developing Board of Directors for your organization. We also have experience in helping existing groups to conceptualize ways in which they could adapt our model to their interests. We will help you to identify individuals and organizations who could provide ongoing oversight and resources for growth in your own community.

In 1998 we developed VIP without any particular prospective funding. But having functioned well over these last 5+ years, we can help you to find, recruit and cultivate resources which could lead to a thriving autonomous nonprofit program. You may already have, in your own community, resources of committed and talented personnel, potential partnerships with academic, philanthropic and business resources, who could already be motivated to aid you in this charitable cause, or might be inspired to do so. There may already be professional organizations comprised of attorneys, accountants, retired nonprofit executives, etc., who are offering their pro bono consultation to start-up nonprofit organizations in your locale. Your nonprofit can access free publicity and collaborations with other community groups which will help to market your service and make it visible, and could also help connect you to potential local sources of funding.

These collaborative resources and your efforts with other like-minded and committed colleagues could help you to establish a psychotherapeutic community service. Your program could simultaneously help you to control your own professional life and your provision of therapy under optimal conditions of privacy and client-control; and allow you to establish a reasonable reimbursement to you for a job well done: A job helping other people who are earning your services by helping still other people.

Let us help you to investigate this possibility.

Learn more about Volunteers in Psychotherapy at the VIP website (www.CTVIP.org) or by calling (860) 233-5115.

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