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Opinion: Navigating Difficult Times in the Treatment & Transition Industry

I started All Kinds of Therapy (AKoT) because I believe in the transformative experience of high-quality behavioral healthcare to save and change lives. I also believe in transparency and education, continuous improvement, and that well-informed decisions lead to better outcomes for everyone involved. I wanted the facts about treatment programs to be available to families, and as a former Independent educational and therapeutic consultant, I knew that bringing this information together in one place would be helpful for clients, families, and referring professionals. I set out to create a safe space where families could come and find facts. I wanted to begin to demystify the field and share the recipe of how successful treatment-to-transition is done.

I also had dreams of an even more dynamic platform, which would link to state websites that provide licensure, and I still hope that can one day be a reality. My vision evolved as I learned how vastly different the states are in how they license or do not license at all, or how they license state-run and adjudicated programs differently than they license private pay options.

All Kinds of Therapy is a platform that relies on you, the advertisers, to report your facts accurately and be transparent. It does that by requiring you to discuss staffing ratios, clinician ratios, licensing level, accreditation (or not), and so much more. The marketplace has responded to this transparency favorably, with over 185K visitors to AKoT in 2021, and traffic continues to grow at an alarming rate, in part due to the struggles with mental health across the country being in the toilet, especially among adolescents. This dynamic platform provides opportunities to hear from a wide range of stakeholders in, adjacent to, and in search of treatment-to-transition options for their family member or neighbor, or friend. In part, it is by analyzing site traffic details that I can determine which way the wind is blowing in the private pay behavioral healthcare industry. As I hear, and read, and digest I am also identifying what is missing, what is needed, and what families and professionals are searching for when they come to AKoT to learn about behavioral healthcare. I make tweaks and improvements to the website and, at times, require more information from the advertisers.

However, as of late, I cannot keep up with the questions, and there are some areas in which I am running out of answers.

I am writing this letter to you because you know more than I do about how your company is being attacked virtually. It is impressive how coordinated and sophisticated the effort is, added with a dash of lawsuits – some that are public and some that are not. States are regulating mental health treatment and I can smell federal regulation coming down the pike. I am not going to say if it is helpful, hurtful, or welcomed — I am not the judge of that. From my perspective, this is a crossroads and I hope, as many of you have heard me say, we make some changes together. I believe this path involves more transparency about the good work you are doing and that we can share the ways we continue to evolve as a field of reflective and proactive practitioners.

I know that the reason you do this work is because you see the positive changes in clients and family systems, and my goal is to continue to support you in this pursuit. To that end, here are 6 observations and ideas I have on how to be transparent and share how the process works.

  1. Click to Accept. I encourage programs to consider adopting “Click To Acknowledge, Click To Accept, Click To Decline” technology to ensure that all stakeholders (specifically families) are kept current on treatment and educational plans – and so that a standardized record of that engagement also exists. You have an online application and online portals. The addition of this technology will facilitate family agency in the treatment process, while also providing you with critical records of engagement and acknowledgment. I know that you have these conversations. I know that consultants have these conversations with their clients AND acknowledgment of receiving a treatment plan, assessment, and discussing the next steps with a digital footprint will assist memories, when the process changes.
  2. Links to Program Licensure and Accreditation should be transparently posted online or emailed to every family that inquires. I encourage you to also share how families can contact these organizations, as a part of the admissions process. I believe that a failure to do so gives the impression that you are hiding – either hiding information or hiding your entire existence. I know you are not. I know you are simply busy helping clients and families, and I believe that taking steps like this will help you shine a light on your own good work.
  3. National Accreditation. What we have always known is that each state is VERY different in how they license, accredit, and oversee family choice behavioral healthcare. Just because you are locally licensed or accredited, do not automatically assume that you are also operating under universal/current Best Practices. I believe that if a treatment-to-transition program does not have, or is not moving toward, a national accreditation that families should ask Why? Accreditation matters – for clients, for families, for staff, and for the health of your organization. Additionally, the amount of times people click on the ‘accreditation’ filter on AKoT is increasing at a rate of +20% or more per year. I believe that if a behavioral healthcare program or referring professional is not licensed, accredited, and/or credentialed (or working towards this) then it is out of date.
  4. Social Media. Speaking of modern professionalism, I encourage you to seriously reconsider your social media practices. Facebook is not the best place to post pictures of extravagant meals, shows, concerts, or sporting events as a part of the marketing of your program. The Ethics Agreements within all of the major membership and credentialing bodies for reputable referents set reasonable limits on gifts, and I believe that prudent professionalism dictates some evolution and restraint within the current climate of scrutiny and reasonable concern about online sabotage. We are not the equivalent of the doctors who got $ kickbacks from the big pharma companies, and I know that is not how this field operates. And to the untrained eye, we risk giving that impression.
  5. Skin in the Game. If you find that you need, or choose, to subsidize a referring professional’s travel to your program, which can be a critical step in educating the marketplace, I encourage you to also require the referents to have some skin in the game. Asking them to pay at least a portion of their travel is completely reasonable – and it is time that is the expectation, not an anomaly. Referring professionals need to absorb some of this cost should be normalized as a part of their own cost of doing business as well-educated and unbiased professional. Programs do not have to fully fund plane tickets or rental cars for tours that also get turned into spring break, summer vacation, or winter ski vacations. All referents need to pay a portion of the cost of their plane tickets, rental cars, hotels, etc., while a tour is happening – not just for their own extended days off.
  6. Continue to Share Your Good News. A recent conversation reminded me that the positive side of what is happening in your programs or in your practices is rarely seen by outside observers. When you do a staff training, send out an email to your families — just a picture of the group and a few sentences about the number of new staff or what was covered. This can help differentiate you from programs/administrations that do not invest in training. For instance, improper restraints, poor training, and the gruesome results of this intersection have recently been in the news – and for good reason. It is tragic to hear of these events in any program, and yet I fear that far too often family choice behavioral healthcare options are inappropriately lumped in with state-run or for-profit adjudicated contractors in media reports. How often are your clients deescalated by highly trained staff and provided alternative interventions to physical restraints? Do you know the amount of times a client is effectively deescalated per day, week, month, or quarter? This data will likely never fit into a neat AKoT checkbox, but this is the kind of story I hope we can begin to share about well-run and transparent family choice programs (which also serve to further differentiate you from adjudicated youth facilities).

 

I recognize that I am neither the arbiter of the field nor the final voice in these matters. I am just someone who sits at 30,000 feet, with a different vantage point on the field of family choice behavioral healthcare than you, who are doing the work, committed to clients, best practices, and running businesses. Please know I am completely committed to helping, collaborating, and shining a light on the fantastic work which is serving clients and their families. Therefore, I continue to be committed to providing education, information, honest feedback, and transparency about our field. I believe that through honest self-reflection and a commitment to continuous improvement we can both build on what is great and also continue to grow and evolve. I look forward to continuing to partner with you, and supporting you, in this endeavor.

 

As always, please feel free to reach out to me directly. I would love to discuss any of these suggested changes in further detail or speak specifically about your business.

Jenney Wilder
Owner + Producer
Allkindsoftherapy.com
202.630.2563

NOTE TO READER: This was originally an email sent to advertisers of allkindsoftherapy.com in spring 2022.