The Heart of the Collective:

Why We Need It, and Why I'm Acting Now

Written by Lindsay Sherman, LCPC

When I created Resilience Counseling about 5 years ago; I had no idea the intensity to which practical information was withheld in private practice, or the amount of money it's commonly sold for. Even when I later did pay hundreds for a single insurance/billing consultation, some of the information I paid for was inaccurate. This, too, I figured out the hard way. Starting out in my garden unit apartment where I initially saw clients pre-pandemic, I had no money to pay for consultation on the various areas of private practice that I'd find myself stuck in or stumped by. Through sheer stubbornness and determination, I figured out the many problems I faced by working extra longs hours, a long, painful series of trial and error, and the generosity of one clinician who showed me a few things out of pure kindness. This experience should not be common or necessary. While the details are still being worked out, it is my goal to make the tiered monthly membership fees to join Resilience Collective as affordable as possible. Every business needs revenue to run, and a lot needs to happen behind the scenes before we can go live; but profit is not my motivation for building this.

When united in community and grounded in similar values, I know that we hold the power to make private practice a more equitable place. In addition, entry into independent practice is possible without signing over to a corporate group/therapy platform. These companies regularly mislead both clients and clinicians to grow enrollment; are often funded by venture capital, who invest large sums of money for a profit (in this case, from mental health care) and the insurance companies themselves. Insurance companies have invested upwards of hundreds of millions of dollars into large therapy platform(s) citing a provider shortage. Yet they offer way higher compensation through these platform(s), while stalling or (recently) even drastically decreasing compensation rates over the past decade for those of us paneled independently. 

If there is really a provider shortage in their networks, there's a much easier solution. Raise the rates of contracted providers to the rate they pay providers on these platform(s) they're discreetly funding, and they'd be flooded with applications to be in-network. Are we really supposed to believe that they can "negotiate" better insurance rates because they're so big, the story we're told- when insurance companies are actually major investors funding the platform(s)? What the return on investment that insurance companies are anticipating remains unclear. What is clear however, is that large-scale deception is at play and client privacy in serious danger. Client geolocation is collected, not for therapists, but the platform itself. Cookies are placed on client computers to track websites visited when not in a telehealth session, biometric client data collected (video, voice and photo), and permission granted to give client information over to the police, outside of a subpoena, by corporate attorney authored privacy practices.

Yet it is the people within our field who perpetuate(d) the gate-keeping of information for personal profit, that eventually paved the way for this to one day happen. Once telehealth took off, the stage had already been set for corporations to swoop in and begin collecting large databases of therapists from every state in the US; all billing under a single tax ID number. This is not private practice; this is the takeover of private practice from corporate America. Spun to the media as a diversity & inclusion success story; large percentages of clinicians enrolled on specific platform(s) are BIPOC and/or part of the LGBTQIA+ community. It is marginalized communities who are left out the most from accessing the information and resources required to work for themselves, and start their own business/practice. This is no success. Targeting clinicians impacted by systemic oppression is the same predatory behavior we see corporations play on the general public, over and over again.

There is tangible hope for change, because the options currently available are not the only way to enter independent practice. Join me in building an alternative that benefits all of us. We can open the door to entrepreneurship for skilled clinicians who experience systemic oppression; and/or lack start-up funds to pay hundreds of dollars an hour in consultation fees simply to understand the basics of solo or small group practice. Capitalism and consequently business owners who've already built significant personal wealth in our field, both profit from our isolation. The gate-keeping of information to enter private practice is both a symptom and a function of Capitalism; a system of oppression embedded within the very structure of our society. While we can't "opt-out" from Capitalism (though I'd love to have the option!)- we do not need to continue upholding professional practices that do not serve us, nor should we fall for the illusion that corporations have come to save us. It's up to us to come together, preserve the integrity of our field post-2020, and ultimately save ourselves.