Evidently...setting boundaries is now tantamount to "white supremacy."

[texanpsychdoc]

Yup...evidently according to some folks I have interacted with, setting (and reinforcing) boundaries, especially around things like financial obligations of a patient is now tantamount to being a form of white supremacy. I guess I should I go get my bed sheets....I already have the F-150 pick up truck, so that takes care of that.

To give a larger view of the topic, a psychologist had posted on a Facebook group I belong to where people frequently offer and take referrals and also seek out and provide professional advice. Pretty standard. One psychologist had mentioned a problem they had run into with their client's credit card being declined and evidently that psychologist had allowed for a few sessions to pass by before they were going to charge, so there was a nice little sum of money needing to be collected. When the card was declined, they attempted to reach out to the client multiple times unsuccessfully, so they were concerned about how to broach the topic. Some people chimed in with their perspectives, and others, including myself chimed in with ours which basically emphasized the necessity for good informed consent up front, especially around finances and the clear path of what should happen in the event the psychologist was not getting paid (either by insurance or via credit card on file). I (and others) mentioned that being transparent (not to be confused with mean or rude) and reinforcing the practice's policies are very important in moments like this.

I will spare you the rest of the posts' details, but needless to say, another psychologist (and 1 or 2 others who agreed with that psychologist) basically said the posts speaking to "setting boundaries" reeks of "white supremacy" and counters the notion of social justice.

In moments like that...there was a STRONG inclination to respond, but I didn't. I let it be, but if this is seriously the zeitgeist and status of our field....perhaps another line of work is in order for me. I just refuse to get on board with the notion that setting boundaries, especially around finances is a form of white supremacy. everything now is being labeled as racist, white supremacy, etc. We have a new era where anything that has a hint of rules, boundaries, in-equality/inequity is being compared to gestapo, Hitler, white supremacy, etc. It's like people are just walking around with a hefty sense of dichotomous thinking.....and I'm pretty sure we try to help our patients who engage in such thinking to not do so.

Anywho...rant over. Let the flood gates open.

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[Sanman]

I think it is awesome that setting those boundaries is a form of white supremacy. If I was the psychologist not getting paid, I now have a list of referrals for all of my clients who get discharges for not paying their bills. After all, they seem to be suggesting they would put up with that.

EDIT: As a young clinician, I had a patient/parent that was unable to come up with my $80 session fee and was behind a couple of sessions payment. After not being able to come up with the fee, she brought her child in and discussed the behavioral issue of child damaging the seats in her brand new luxury SUV that she just got. I stopped feeling bad asking for payment after that.

 

[WisNeuro]

Everything is white supremacy these days. Before I resigned my state membership, for several reasons, people were claiming that CBT was White Supremacy in practice and theory. The people who take things this far are no different than the delusion level of QAnoners.

 

[texanpsychdoc]

I actually have resigned my memberships with APA, TPA, and OPA for similar reasons.

 

[Mama Bear]

I sometimes consider how our various systems have been made for and benefit certain groups. But… that doesn’t change the fact that you need to get paid. You can consider how policies affect disenfranchised groups while still having boundaries.

 

[texanpsychdoc]

Awareness is one thing....considering I have a whole degree in sociology, I am very well aware of the various theories on social stratification as applied to various macro level systems. It was basically a degree that if you are a white, heterosexual, Christian, male....you best keep that to yourself in class.

We can have an appreciation of said challenges a person who differs from me faces, but for me, as a business owner, I am running a for-profit company, not a charity. If that person is wanting to work with someone who is going to "validate and encourage" the plight of their struggles due to whatever socio-politico-economic factors they identify with, I am not their person. In fact, I would likely disagree with many of the clinicians I see out there pandering to certain clients. For example, one psychologist posted "ISO of an anti-capitalist, BIPOC, gender-fluid, Southeast Asian female who accept Cigna".....and I was in disbelief. I was shaking my head and thinking to myself, maybe we don't have to validate every radical belief that is situated with various economic and political factors that person struggles with in society.

My goal is to work with them to function in the environment they live in. I am not there to be "there there, those pesky white capitalists are wrong, let's spend 50 minutes validating that thought so hopefully you can go out there and hold down a job to pay your bills." I'd like to think it comes from a good place when I see psychologists say this, but I think it can be to the client's detriment. I think in an era where professional psychology has had a nasty history of doing some obscene things in the name of "science," we are trying to back pedal and project a new "socially inclusive" image to people, but going off to the deep end on the other side of the spectrum is equally as bad IMO. We need some middle ground here. We need to pump the brakes before we start throwing the baby out with the bath water each time some novel isolated study comes out drawing lofty conclusions about various social constructs and psychological functioning.

 

[cara susanna]

Everything is white supremacy these days. Before I resigned my state membership, for several reasons, people were claiming that CBT was White Supremacy in practice and theory. The people who take things this far are no different than the delusion level of QAnoners.

CBT is white supremacy AND capitalist.

 

[deleted1038433]

CBT is white supremacy AND capitalist.

Meep meep ☹

 

[texanpsychdoc]

Well then.....my Ford F-150 fits a lot of folks then.

 

[WisNeuro]

CBT is white supremacy AND capitalist.

Correction, "Late-stage capitalist."

 

[PsyDr]

So they wanted the poster to send their patients to collections instead?

 

[MCParent]

My experience has been that those fb referral groups are cesspools.
My fav was the same person posting in response to every referral requests that everything imaginable was a “perfect fit” for them, no matter presenting client concerns or demographics. Only for full private pay patients tho, of course.

 

[Sanman]

My experience has been that those fb referral groups are cesspools.
My fav was the same person posting in response to every referral requests that everything imaginable was a “perfect fit” for them, no matter presenting client concerns or demographics. Only for full private pay patients tho, of course.

To be fair, anyone willing to pay me $300/hr+ is a perfect fit for my practice because I want $300/hr. People who hit their credit limit are a poor fit for for my practice. That's how it works, right?

 

[WisNeuro]

To be fair, anyone willing to pay me $300/hr+ is a perfect fit for my practice because I want $300/hr. People who hit their credit limit are a poor fit for for my practice. That's how it works, right?

If you want $300+/hr, come to the dark side. It's warm here, we have cookies.

 

[texanpsychdoc]

If you want $300+/hr, come to the dark side. It's warm here, we have cookies.

I'd love to do $300+ an hour.....maybe in a few years once my practice has been in the area for a bit I could do that. Right now I charge $125 for therapy...$150 for a 90791.

 

[Sanman]

If you want $300+/hr, come to the dark side. It's warm here, we have cookies.

The problem with going to the dark side is the cookies are always oatmeal raisin

 

[BuckeyeLove]

I remember in grad school i had a few professors (tenured, been there forever, not really producing anything but making a solid 150-200k/year) spouting off similar nonsense. I remember asking "Aren't we supposed to get paid for our time?" And getting looks.

 

[WisNeuro]

The problem with going to the dark side is the cookies are always oatmeal raisin

You and your white privilege...

 

[Grenth]

Suppose the person not getting paid is not white and the person failing to pay is white is that still white supremacy? I mean it's probably the internalized white supremacy of the minority psychologist that makes them not want to be forced to work without a pay a condition sometimes known by the shorthand term slavery but I suppose we could still blame capitalism here.

On a serious note this exact situation was spelled out in all my ethics training and was even a common EPPP question so why are people struggling so much with the idea that psychologists are entitled to collect agreed payments for services, they can stop services for consistent non-payment, and they can even use a debt collection service if needed.

 

[WisNeuro]

Suppose the person not getting paid is not white and the person failing to pay is white is that still white supremacy? I mean it's probably the internalized white supremacy of the minority psychologist that makes them not want to be forced to work without a pay a condition sometimes known by the shorthand term slavery but I suppose we could still blame capitalism here.

On a serious note this exact situation was spelled out in all my ethics training and was even a common EPPP question so why are people struggling so much with the idea that psychologists are entitled to collect agreed payments for services, they can stop services for consistent non-payment, and they can even use a debt collection service if needed.

I think it's less to do with the facts of the situation as opposed to taking every opportunity to throw out some misguided and delusional virtue signaling, even better if you can try and shame an oppressor in the attempt.

 

[Ollie123]

Genuinely curious the background of the folks making that argument. Wondering how profitable their practice happens to be. Wondering how they handle non-payment for services. Wondering how many are the primary wage earner for their family.

 

[medium rare]

The problem with going to the dark side is the cookies are always oatmeal raisin

Them’s fightin’ words. Oatmeal raisin cookies are the bomb!

 

[ThatPsyGuy]

Is making sure you get your pockets filled important? Hell yes.

Is it an aspect of white supremacy to charge for services you deliver? Hell no. That's dumb. That's probably why only 2-3 people held that opinion in that Facebook group thread lol.

Is this the direction of the field? Doubt it, just look back up to the previous paragraph. It's a loud minority.

Nonetheless, it's still important to recognize the systems that are in place that affect marginalized communities. White supremacy is part of that, but it's not everything.

 

[futureapppsy2]

CBT is white supremacy AND capitalist.

Gaslighting and victim-blaming too!

 

[borne_before]

Yup...evidently according to some folks I have interacted with, setting (and reinforcing) boundaries, especially around things like financial obligations of a patient is now tantamount to being a form of white supremacy. I guess I should I go get my bed sheets....I already have the F-150 pick up truck, so that takes care of that.

To give a larger view of the topic, a psychologist had posted on a Facebook group I belong to where people frequently offer and take referrals and also seek out and provide professional advice. Pretty standard. One psychologist had mentioned a problem they had run into with their client's credit card being declined and evidently that psychologist had allowed for a few sessions to pass by before they were going to charge, so there was a nice little sum of money needing to be collected. When the card was declined, they attempted to reach out to the client multiple times unsuccessfully, so they were concerned about how to broach the topic. Some people chimed in with their perspectives, and others, including myself chimed in with ours which basically emphasized the necessity for good informed consent up front, especially around finances and the clear path of what should happen in the event the psychologist was not getting paid (either by insurance or via credit card on file). I (and others) mentioned that being transparent (not to be confused with mean or rude) and reinforcing the practice's policies are very important in moments like this.

I will spare you the rest of the posts' details, but needless to say, another psychologist (and 1 or 2 others who agreed with that psychologist) basically said the posts speaking to "setting boundaries" reeks of "white supremacy" and counters the notion of social justice.

In moments like that...there was a STRONG inclination to respond, but I didn't. I let it be, but if this is seriously the zeitgeist and status of our field....perhaps another line of work is in order for me. I just refuse to get on board with the notion that setting boundaries, especially around finances is a form of white supremacy. everything now is being labeled as racist, white supremacy, etc. We have a new era where anything that has a hint of rules, boundaries, in-equality/inequity is being compared to gestapo, Hitler, white supremacy, etc. It's like people are just walking around with a hefty sense of dichotomous thinking.....and I'm pretty sure we try to help our patients who engage in such thinking to not do so.

Anywho...rant over. Let the flood gates open.

Do you have a Texas edition f-150?

 

[borne_before]

Genuinely curious the background of the folks making that argument. Wondering how profitable their practice happens to be. Wondering how they handle non-payment for services. Wondering how many are the primary wage earner for their family.

Hint: most ppl spouting this nonsense are trust fund babies who did undergrad at as a legacy at a private school.

 

[PsyDr]

1) This is exactly how the death spiral of our profession occurs. Either the services have value or not. The value of our services is determined through a complex system of price, availability, demand and average charges. And Notice how insurance doesn’t pay for academic testing, because there is a free option through schools?

2) While I am one of the more prolific providers of pro bono services, this is a violation of most insurance contracts. Medicare says it is a federal crime.

3) At this point, I’m just curious about this F150. Can we see it? Does it have the big tires? One of those decals where Calvin is urinating on things?

 

[Sanman]

Not sure what @texanpsychdoc F150 looks like, but it needs to look more like this:

 

[texanpsychdoc]

1) This is exactly how the death spiral of our profession occurs. Either the services have value or not. The value of our services is determined through a complex system of price, availability, demand and average charges. And Notice how insurance doesn’t pay for academic testing, because there is a free option through schools?

2) While I am one of the more prolific providers of pro bono services, this is a violation of most insurance contracts. Medicare says it is a federal crime.

3) At this point, I’m just curious about this F150. Can we see it? Does it have the big tires? One of those decals where Calvin is urinating on things?

 

[foreverbull]

Every PP should have something in the consent form stating that if clients are unable to pay or become unable to pay for services, they will be referred to low cost or no cost services and services with the clinician will terminate. APA ethics don’t require us to provide services to clients pro bono when they can’t pay. Of course, taking context and situational factors into consideration.

Credit cards on file are great because one can charge immediately at the time of session. I actually charge just before session so of the payment is rejected, I bring it up at that day’s session (tip from a colleague). Payment talk is awkward at first, but I’ve done it for years and it’s not as big of a deal over time.

I think we can be sensitive to legitimate issues of white supremacy/privilege without taking it to a meaningless extreme, such as meaning we shouldn’t be paid commensurate with our experience and education. In my opinion, needing to support my family is not exploitation (and I’m not talking buying luxury cars or annual first class trips to Europe as part of that support, but a fair standard of living). What I do see as exploitative is charging extremely high rates for the area with very limited education or training, or charging exorbitant rates for “life experience.”

 

[smalltownpsych]

Different cultures have different values. Not all aspects of European culture that have been brought into American culture are racist. Many immigrants from Asia value education more so than other groups. Anglican Protestants had an emphasis on a strong work ethic,. Latin American cultures tend to emphasize strong family structure and support. All of these cultures “work” because only cultural traits and perspectives that benefit groups will last. In this country we saw the systematic attempt to eradicate and sever specifically two groups of people from their culture and this has led to generational problems that are ongoing. Current perspectives seem to ignore this.