"Mental Health Consulting"

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If somebody says they do "Mental Health Consulting," what does that mean to you?

To me, it is very close to "therapy," but I wanted to see if other people had the same impression or if it was just my take on it...

Originally Posted by BlackSkirtTetra

If somebody says they do "Mental Health Consulting," what does that mean to you?

What's the context?

Who supplies their malpractice insurance?

Sounds like personal coaching to me. It also sounds like it crosses the crap-you-can-do-without-qualifications boundary.

Lots if liability. Little protection. Alas it seems to be thriving as residencies become more scarce.

I was at a seminar and at lunch (we all ate together in the dining hall) a woman whose background is in Nursing (I forget her exact degree) said she does "mental health consulting" one day a week and charges $90 per hour, cash-only. I asked what that entailed (I pictured somebody meeting with lawyers or the court system and giving information about mental health diagnoses), and she described what sounded to me like therapy, with individual clients. I don't know her from any other person on the street so I can't follow up, but that struck me as a weird phrase to use, "mental health consulting." I should have followed up right there, but my head was in another place.

Edit: In response to the question of insurance, I obviously don't know. But I wonder even if she is insured as a nurse if this covers her, since nurses can't go into private practice all by themselves (where I live, at least).

Originally Posted by BlackSkirtTetra

$90 per hour, cash-only

Hoo boy.

Based on what you describe, this sounds waaaaay outside her scope of practice, no matter whether she called it "consulting," "therapy," or "voodoo." (Unless she's a PMHNP in private practice, which you said was impossible in your state.)

Originally Posted by Qwerk

Sounds like personal coaching to me. It also sounds like it crosses the crap-you-can-do-without-qualifications boundary.

Originally Posted by BlackSkirtTetra

I was at a seminar and at lunch (we all ate together in the dining hall) a woman whose background is in Nursing (I forget her exact degree) said she does "mental health consulting" one day a week and charges $90 per hour, cash-only. I asked what that entailed (I pictured somebody meeting with lawyers or the court system and giving information about mental health diagnoses), and she described what sounded to me like therapy, with individual clients. I don't know her from any other person on the street so I can't follow up, but that struck me as a weird phrase to use, "mental health consulting." I should have followed up right there, but my head was in another place.

Ugh. I don't do therapy, but the thought of a random, untrained, unregulated, and seemingly (by the current description) unethical person doing anything related to individual therapy makes my blood boil. The problem with these types of situations is that it is a hassle to figure out what board to notify, how to bring a formal complaint, get someone to actually review it, etc.

I'm kicking myself for not asking more questions, but I was so busy and scatter-brained. As I've thought more about it, what's also weird to me is that the other professionals at the table also didn't ask her any questions. I was the only student there, as far as I know. I know at least one person was an LPC. We were discussing our backgrounds, which brought on the discussion.

Originally Posted by Therapist4Chnge

Ugh. I don't do therapy, but the thought of a random, untrained, unregulated, and seemingly (by the current description) unethical person doing anything related to individual therapy makes my blood boil. The problem with these types of situations is that it is a hassle to figure out what board to notify, how to bring a formal complaint, get someone to actually review it, etc.

Even if I knew her name, I wouldn't know to report it to the board of nursing, psychological boards, social work boards, or what. And I currently work in this field! So I can't imagine how a mentally ill client would even begin to report her...I don't know if anything she is doing is actually illegal.

Can the boards of Social Work/Psychology/Marriage and Family Therapy fine somebody who isn't even operating within their profession?

Originally Posted by BlackSkirtTetra

I don't know if anything she is doing is actually illegal.

Can the boards of Social Work/Psychology/Marriage and Family Therapy fine somebody who isn't even operating within their profession?

Might this depend in part on your state? I thought there were some places where anyone could legally hang out a shingle* (Colorado?), but I'm perfectly happy to be wrong about that.

*I'm not quibbling with the ethics issue and am in agreement with other posters. Just noting that legality and ethics might not coincide perfectly...

In my state "counseling" is defined by statute. The statute states the educational requirements, licensure, etc. I would assume - and could be totally wrong - but this could fall in theory under the same scenario as practicing "x" without a license where x is engineering, medicine, counseling etc.

In practice, i don't think anything happens unless a client is "hurt." then the practitioner is unprotected if the client complains, or files suit. Hence my liability insurance comment.

I bet her liability insurance doesn't cover her when she us outside her scope if practice.

AND I think this happens pretty frequently.

Originally Posted by Vasa Lisa

AND I think this happens pretty frequently.

Really? I was talking to my supervisor at work today (she is an LICSW) and she didn't seemed too bothered by it. She seems to be of the opinion that this happens a lot, too.

I asked her why I am even in school for my Masters if I could just charge people for therapy without having a degree at all! She laughed, but I was only about 90% joking!!

Originally Posted by BlackSkirtTetra

Really? I was talking to my supervisor at work today (she is an LICSW) and she didn't seemed too bothered by it. She seems to be of the opinion that this happens a lot, too.

I asked her why I am even in school for my Masters if I could just charge people for therapy without having a degree at all! She laughed, but I was only about 90% joking!!

It being legal and it being ethical are two different things. That being said, your education will allow you to be billable for 3rd party reimbursement. I can't remember the study, but I was told the American Psychological Society sponsored research said that there were no measurable difference between the outcomes of counseling provided by skilled listeners and that provided by licensed therapists (I'm assuming this was counseling done on a non-clinical population). I'm personally somewhat skeptical that this is true, but I also see some reason why someone may want to see an unlicensed therapist... Though certainly not for $90/hr. Still, many clergy receive little to no formal training in counseling, but still offer spiritual counseling.

When you reference a study, you have to post that study. Thanks!

Originally Posted by BlackSkirtTetra

When you reference a study, you have to post that study. Thanks!

I just sent a request to the person who referenced it. Hopefully they will respond (and soon).

Originally Posted by MBellows

It being legal and it being ethical are two different things. That being said, your education will allow you to be billable for 3rd party reimbursement. I can't remember the study, but I was told the American Psychological Society sponsored research said that there were no measurable difference between the outcomes of counseling provided by skilled listeners and that provided by licensed therapists (I'm assuming this was counseling done on a non-clinical population). I'm personally somewhat skeptical that this is true, but I also see some reason why someone may want to see an unlicensed therapist... Though certainly not for $90/hr. Still, many clergy receive little to no formal training in counseling, but still offer spiritual counseling.

I'll say for the purpose of this board that this is likely bunk.

I heard about the study on treatment of depression in a lecture by a
Harvard psych professor. I can't remember any more details.

**a few hours later**

The only additional details that I recall about the study are that the
lay therapists had been selected by neighbors as "good listeners" and
that they had received (I think) 20 hours of training prior to being
turned loose on patients. I think that it was for depression.

The source that I saw the quotation from was Philip Greenspun, a law professor at MIT, but the above was his response for further information. The only way to my knowledge that this may be somewhat plausible is if the depression was subclinical/minor and if the efficacy measurements didn't include long-term follow-up.

But yeah. Probably crap or mostly crap. Thanks for pushing me to follow up on that one. =)