Psychotherapy "Branding"

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I don't think it is wrong to market or brand yourself. But I do think that practitioners in need of referrals may not always exercise appropriate restraint when marketing their clinical skills.

I just believe that the branding should reflect your actual training and experience, and not mislead the public in any way. I do think a great example of this is neuropsychology - even through we have some pretty clear guidelines for appropriate training standards, there are tons of folks out there "branding" themselves and their services even when they don't have these qualifications. Unfortunately, there is not much one can do to limit this inappropriate type of branding outside of the ethics code (unless our profession did a better job of advocating for more specific legal regulations). But hey, more power to the master's level school neuropsychologists - right T4C? Great branding strategy.
 
It wasnt the concept of branding that induced my "ehhhhhh" so much as the further corroboration of the diminshed cultural value of pursuing psychotherapy by adequately trained professionals.

"Change? F-That, I need a 1 hour 'consult' on how to keep people off my back".
 
Interesting article. I agree, the 'problem' we face is impacted both by insurance companies support for psychopharmacology and changing cultural attitudes. When I formally decided to become a psychotherapist, I had a lot of interesting marketing ideas, kind of like what this article is talking about. It's hard to not start absorbing ideas when everywhere you click you see 'The 7 Must Know Tips To Blah Blah Blah', thanks to the ever ubiquitous presence of online 'life coaches'. But I found that the deeper I went into my studies and own psychotherapy, the more I felt aligned with the classical approach to psychotherapy that the author mentions in the article. Ideally, that is where I'd like to stay. I'm no Freudian, but I do see the benefit of not being as known to the patient as, say a life coach. But now I'm all hella confused about what to do. :scared:
 
Roth suggested to me that in addition to creating a Web site, therapists should set up Facebook and Twitter accounts (she gives instructions on how to create social-media boundaries, like whether you’ll respond to clients’ posts), blogs, real-time appointment schedulers, teletherapy that’s compliant with federal privacy rules and other features that allow potential clients, she said, “to feel personally connected to you at all times.”

I can't even fully wrap my head around this. I get that people do it, but it just feels wrong.
 
Thanks for posting this ela, as it raises a lot of interesting points.

If providers have to bend and/or abandon their training, despite research indicating the effectiveness of their training, it is a failure of the governing body of the profession (APA, ACA) to educate the public. There are really clear advantages of psychotherapy over medication and life coaching in many cases, yet very few people seem aware of this.

This article wasn't the first place that mentioned the fact that talk therapy is on the decline, while psychiatric medication use is on the rise. I think the solution is reminding the public and medication providers that therapy + medication is often the best practice for many conditions. Unfortunately, it seems that a lot of medication providers and/or insurance companies don't bother to encourage their patients to attend therapy as well, as the biological model of mental illness is receiving the most press these days.

A lot of (most?) people don't know what therapy is, and the difference between actual change and mental masturbation. There are SO MANY therapists out there, with a bazillion different approaches, etc. It is really hard to stand out from the mass, and it is very confusing for the public.
 
Thanks for posting this ela, as it raises a lot of interesting points.

If providers have to bend and/or abandon their training, despite research indicating the effectiveness of their training, it is a failure of the governing body of the profession (APA, ACA) to educate the public. There are really clear advantages of psychotherapy over medication and life coaching in many cases, yet very few people seem aware of this.

This article wasn't the first place that mentioned the fact that talk therapy is on the decline, while psychiatric medication use is on the rise. I think the solution is reminding the public and medication providers that therapy + medication is often the best practice for many conditions. Unfortunately, it seems that a lot of medication providers and/or insurance companies don't bother to encourage their patients to attend therapy as well, as the biological model of mental illness is receiving the most press these days.

A lot of (most?) people don't know what therapy is, and the difference between actual change and mental masturbation. There are SO MANY therapists out there, with a bazillion different approaches, etc. It is really hard to stand out from the mass, and it is very confusing for the public.

Completely agree. Heck, medications for psychiatric illness only really started to take off after all the direct-to-consumer marketing that the article mentions. Psychotherapy really needs at least some level of marketing as well, as uncomfortable as that idea might make some of the more-entrenched psychologists out there.

I just feel like the first session with their therapist should no longer be the first time a patient/client has ever heard the term CBT, PE, CPT, ACT, etc.
 
ela posted a thread "Psychotherapy "Branding"" with discussion of this. Clearly I'm too lazy to link right now.
 
Oops, that's what happens when I'm too busy to go on SDN for a few weeks. Sorry!
 
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Wading through the comments should be a part of PhD programs "History and Systems of Psych" component. Or Business of Practice...not that this is taught much, if at all.
 
Honestly, I can understand some of the ethical issues out there, but a lot what the article had to say was that the specialty niches are the trend as there are many therapists and people want experts in their problem. The generalist model just is not as workable nowadays The trick is finding a niche that can be sustained and is common enough to fill a practice. Based on my own experiences, I also wonder if full-time private practice in psychotherapy will be a sustainable trend. Outside of a small percentage of professionals, being on insurance panels is a requirement to fill a practice full-time and declining reimbursements mean there will be a point where the net income will simply not make it viable. Granted, things may change in the future with changes to healthcare, but it does not seem to be reversing course any time soon.

I often feel as if therapy is much like exercise. The best option that nobody wants to go for because it is not quick and requires effort. We are like personal trainers...the monetarily successful often end up catering to those that really do not NEED the help, but want it as part of their life.
 
From one of the comments:
My pre-doctoral internship consisted of 50-hour weeks with a provocative array of patients, excellent supervision, and psychodynamic seminars alongside budding psychiatrists. The psychiatry residents were paid roundabout 30K, the psychology interns nothing, with the exception of a 50% discount on the parking garage..

Sounds like this person's internship wasn't APA-accredited.
 
From one of the comments:

Sounds like this person's internship wasn't APA-accredited.

It also sounds as if that person has no problem that said experience does not give him/her a way to feed/clothe/shelter themselves as it does with the psychiatrists. Sometimes, I feel like the only person around concerned with providing for myself and my family and wanting to provide proper care to patients. I tend to run into people that have become jaded mercenaries or people who think this is some sort of calling and that mentioning being able to eat is a crime. At least out in practice settings. Hospitals, VA ctrs, and Academic medicine seem more insulated and a bit more balanced.
 
It also sounds as if that person has no problem that said experience does not give him/her a way to feed/clothe/shelter themselves as it does with the psychiatrists. Sometimes, I feel like the only person around concerned with providing for myself and my family and wanting to provide proper care to patients. I tend to run into people that have become jaded mercenaries or people who think this is some sort of calling and that mentioning being able to eat is a crime. At least out in practice settings. Hospitals, VA ctrs, and Academic medicine seem more insulated and a bit more balanced.

I'd like to think of myself as only somewhat jaded ;), but hopefully I'm still in touch with the value of the services I provide. Some clinicians confuse the practice of psychology with some odd sense of martyrdom, as if proper compensation is at odds with providing quality services and helping people. A vow of poverty is not needed, though it seems to tag along in far too many cases.
 
I'd like to think of myself as only somewhat jaded ;), but hopefully I'm still in touch with the value of the services I provide. Some clinicians confuse the practice of psychology with some odd sense of martyrdom, as if proper compensation is at odds with providing quality services and helping people. A vow of poverty is not needed, though it seems to tag along in far too many cases.

On the mercenary end, I often question the ethics of some colleagues I see at my job. It is not uncommon to see colleagues not to want to do one thing beyond the requirements with an eye on getting paid. That often means that real therapy for patients go by the wayside as initial evaluations and 20 minute 90804 check-ins make more financial sense than actual therapy.
 
On the mercenary end, I often question the ethics of some colleagues I see at my job. It is not uncommon to see colleagues not to want to do one thing beyond the requirements with an eye on getting paid. That often means that real therapy for patients go by the wayside as initial evaluations and 20 minute 90804 check-ins make more financial sense than actual therapy.

(Speaking only to in-patient work....)

The implementation of an RVU system really has thrown a wrench into how MH services are measured within a medical setting. A 90801 tends to translate well to RVUs, but the follow-up therapy session....not so much. Group therapy is horrendously bad (in regard to translated RVUs). It makes far more "productivity" sense to focus on the initial evals and punt to out-patient for any individual follow-up or group support. I'm not saying this is clinically indicated or even ethically viable, but some/many productivity standards are not in line with actual clinical care. Sadly, it makes sense on some level, as most of our medical colleagues only do the initial consult and then sign off. The "re-consult if needed" keeps patient load more manageable and billing more straight forward.
 
(Speaking only to in-patient work....)

The implementation of an RVU system really has thrown a wrench into how MH services are measured within a medical setting. A 90801 tends to translate well to RVUs, but the follow-up therapy session....not so much. Group therapy is horrendously bad (in regard to translated RVUs). It makes far more "productivity" sense to focus on the initial evals and punt to out-patient for any individual follow-up or group support. I'm not saying this is clinically indicated or even ethically viable, but some/many productivity standards are not in line with actual clinical care. Sadly, it makes sense on some level, as most of our medical colleagues only do the initial consult and then sign off. The "re-consult if needed" keeps patient load more manageable and billing more straight forward.

I can tell you that most RVUs setup like this translate into money and not ethical care. In nursing home settings, I will get paid 2/3 of a full-session for a 20-30 min 90804. It is no secret that it pays better to see 2-3 90804/90816 than one 90806/90818 in the same time. First hand, I can tell you that seeing a number of these check-ins for pts with mild depression, anxiety, and adjustment issues makes for a much easier and monetarily healthy career than helping the severely ill that need more care than anyone will pay for. Being the FNG at work, I usually get the latter from my colleagues.
 
Reading the comments, Does Lori Gottlieb even have a PhD? The only credentials I can find are a masters in Clinical Psychology with an emphasis in Marriage & Family counseling.
 
The comments are reporting that she does not have a PhD.
 
Reading the comments, Does Lori Gottlieb even have a PhD? The only credentials I can find are a masters in Clinical Psychology with an emphasis in Marriage & Family counseling.

Is she a big name in some area? The name sounds realllly familiar, but I can't quite place it.
 
Is she a big name in some area? The name sounds realllly familiar, but I can't quite place it.

Her website lists her has a Masters in clinical, working under the supervision of a Psy.D.

She has bulleted list of areas on her webpage, which looks like an implicit statement of "this is what I focus on" containing:

• Parenting Solutions
• Couples Counseling
• Fertility
• Third-Party Family Building
• Post-Partum Adjustment
• Eating Disorders & Body Image
• Overcoming Creative Blocks
• Career & Life Transitions
• Child & Adolescent Therapy
• Autism Spectrum Disorder
• Life Balance
• Stress Management
• Depression, Anxiety & OCD
• Relationship Roadblocks
• Collaborative Divorce
• Co-parenting
• Blended Families

This type of psychotherapy branding seems to be about broadcasting the message that focusing on one area you are truly expert in is hamstringing yourself. I mean each bullet point on that list could be someone's entire focus in graduate school. Granted, some of those areas like "Life Balance" and "Stress Management" could be addressed by most any psychologist, there are still many specialty areas there all under one roof.
 
That list seems to go counter to the message of her piece to specialize specialize specialize. Unless you take it to mean specialize in anything and everything that might have a large client base.
 
If you follow politics you may recognize Gottlieb (former GOP guy who worked w. Scott Walker in Wisconsin). There is also a Gottlieb in FL, though she is a Dem. BOOO! :D


Nope, it's a psych association--something to do with eating disorders, IIRC. But I could just be making it up or confusing it with something else. :confused:

Ugh. I hate those huge lists of having every specialty under the sun. And often fresh out of grad school, too. ;) I do think it has the potential to become an ethics issue, tbh.
 
Is she a big name in some area? The name sounds realllly familiar, but I can't quite place it.

Possible you are thinking of Ian Gotlib? Different spelling, gender, etc. but many people are only known by last name anyways. Certainly qualifies as a big name (Chair of Stanford, leading depression researcher), and was the first one that sprung to my mind when I saw your post.
 
Nope, it's a psych association--something to do with eating disorders, IIRC. But I could just be making it up or confusing it with something else. :confused:

Good memory...."Stick Figure", a book/memoir about struggling with an ED (I cheated and Googled it because when you said ED it stuck out). I vaguely remember hearing about it 2000-2001ish, as that was when I first read Pipher's "Reviving Ophelia", which is/was a very popular book about the struggles of adolescent women that came out in the mid-90s.

Ugh. I hate those huge lists of having every specialty under the sun. And often fresh out of grad school, too. ;) I do think it has the potential to become an ethics issue, tbh.

EDs...to autism....to fertility. Those are pretty diverse areas.
 
Overcoming creative blocks? Is there an EBT for that? ;)
 
When I develop such a list I want to start it thusly:

- Men's Issues
- Women's Issues
 
Is she a big name in some area? The name sounds realllly familiar, but I can't quite place it.

She has written a number of books, Articles for The Atlantic, NY Times, etc. I first heard of her after she wrote and article/book called "The Case for Settling" about settling for imperfect men to marry.
 
• Parenting Solutions
• Couples Counseling
• Fertility
• Third-Party Family Building
• Post-Partum Adjustment
• Eating Disorders & Body Image
• Overcoming Creative Blocks
• Career & Life Transitions
• Child & Adolescent Therapy
• Autism Spectrum Disorder
• Life Balance
• Stress Management
• Depression, Anxiety & OCD
Relationship Roadblocks
• Collaborative Divorce
• Co-parenting

• Blended Families

Why would anyone go to a woman who wrote a book about how she never found a successful relationship or got married and should have settled for some of the men she dated for relationship therapy? Maybe that is why she cannot fill a practice.
 
That list seems to go counter to the message of her piece to specialize specialize specialize. Unless you take it to mean specialize in anything and everything that might have a large client base.

I didn't really get that. I thought that her article provided a first person narrative about her ambivalence towards branding and specialization.

Regarding the numerous "specializations": I see that more often than not at both masters level and doc level (therapist websites, business cards, etc.). Not defending the practice or saying that Gottleib doesn't appear to be spreading herself a bit too thin, just stating that it's far from uncommon.

And (@ whoever commented that she doesn't even have a doctorate): why is that a problem? I didn't notice her misrepresenting herself anywhere as a "psychologist" or doctoral level provider. Isn't the official sdn line that if you "just want to do therapy" you should stop at the masters because doc training is overkill? :confused:
 
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And (@ whoever commented that she doesn't even have a doctorate): why is that a problem? I didn't notice her misrepresenting herself anywhere as a "psychologist" or doctoral level provider. Isn't the official sdn line that if you "just want to do therapy" you should stop at the masters because doc training is overkill? :confused:


The first line of the piece states she finished 6 years of graduate school. Hence, there is the suggestion that she has doctoral training. This is not true. I am still not sure what she did for 6 years in graduate school.
 
The first line of the piece states she finished 6 years of graduate school. Hence, there is the suggestion that she has doctoral training. This is not true. I am still not sure what she did for 6 years in graduate school.

Ah, this:

"after I completed six years of graduate school and internship training and was about to start my psychotherapy practice, I sat down with my clinical supervisor in the Los Angeles office we'd be sharing. It had been a rigorous six years,"

I think you've provided an "insider" reading. I don't think it's intended to mislead. Check out the school website--you can attend part time in the evenings, and in an oversaturated CA metro center market, it can take years and years to complete the post-masters hours to sit for licensure. 6 years from start to finish (licensure) isn't outlandish, which is why the "masters = a shorter path than the doctorate" conventional wisdom doesn't readily map onto this region. Additionally, the state schools (although she attended private) are so screwed financially that their programs, many of which already take >=2.5 years, are taking even longer due to unit caps, cancelled classes and the like. She's providing journalistic detail: It was a long arduous journey to get the license. Now she needs clients. Should she stoop to "branding"?
 
Even if it wasn't intentional, the comments (mostly by mental health professionals who would know the distinction between a PhD and a Masters) have many people calling her "Dr." So the article was misleading, and that's an ethical problem.
 
Even if it wasn't intentional, the comments (mostly by mental health professionals who would know the distinction between a PhD and a Masters) have many people calling her "Dr." So the article was misleading, and that's an ethical problem.

I don't know. I'm kind of inclined to believe that it means that a lot of folks (clinicians and non-clinicians) just aren't very accomplished close readers. She refers to herself as a "therapist" with a "psychotherapy" practice. In this region of the country, "psychotherapy" = masters level. How many licensed psychologists complete doctoral study only to go on to promote themselves as mere "therapists"?
 
Even if it wasn't intentional, the comments (mostly by mental health professionals who would know the distinction between a PhD and a Masters) have many people calling her "Dr." So the article was misleading, and that's an ethical problem.

Her credentials are clearly stated on her therapy website, though that is not the case on her media/consulting website. The lack of specificity is what bothers me in these instances of fluff/covert advertising pieces that get published in widely circulated mediums. The clinician should always state their credentials when opining on a subject in a public forum. We cannot educate every last reader on the nuances of training differences, but there is a large gap between that and leaving a person to dig for credentials 2 degrees away (article--> media website--> therapy website). I also have significant reservations about having someone be an "expert" when they are not even practicing independently in the area being discussed.
 
I don't know. I'm kind of inclined to believe that it means that a lot of folks (clinicians and non-clinicians) just aren't very accomplished close readers. She refers to herself as a "therapist" with a "psychotherapy" practice. In this region of the country, "psychotherapy" = masters level. How many licensed psychologists complete doctoral study only to go on to promote themselves as mere "therapists"?

There is still a difference between implicit and explicit statements about training and scope of practice. SoP and limited v. independent practice are two areas of significant ethical concern when interacting with the public. The ethics code speaks to how a person portrays themselves to the public and they need to take reasonable steps to ensure how they are presented in the media.

APA Ethics Code said:
5.02 Statements by Others
(a) Psychologists who engage others to create or place public statements that promote their professional practice, products, or activities retain professional responsibility for such statements.

5.04 Media Presentations
When psychologists provide public advice or comment via print, Internet or other electronic transmission, they take precautions to ensure that statements (1) are based on their professional knowledge, training or experience in accord with appropriate psychological literature and practice; (2) are otherwise consistent with this Ethics Code; and (3) do not indicate that a professional relationship has been established with the recipient. (See also Standard 2.04, Bases for Scientific and Professional Judgments.)

My emphasis added above.
 
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Her credentials are clearly stated on her therapy website, though that is not the case on her media/consulting website. The lack of specificity is what bothers me in these instances of fluff/covert advertising pieces that get published in widely circulated mediums. The clinician should always state their credentials when opining on a subject in a public forum. We cannot educate every last reader on the nuances of training differences, but there is a large gap between that and leaving a person to dig for credentials 2 degrees away (article--> media website--> therapy website). I also have significant reservations about having someone be an "expert" when they are not even practicing independently in the area being discussed.

Yeah, when people's credentials are unclear it annoys me too, but I think this really only bothers us because we are in "the biz." Average Joe client doesn't really care (or understand) if you have a PhD or MA. And how many times a day do you have to explain the difference between a psychologist and a psychiatrist to patients? To the general public a therapist is a therapist. This article was about therapists in general and not psychologists.

Best,
Dr. E
 
Yeah, when people's credentials are unclear it annoys me too, but I think this really only bothers us because we are in "the biz." Average Joe client doesn't really care (or understand) if you have a PhD or MA. And how many times a day do you have to explain the difference between a psychologist and a psychiatrist to patients? To the general public a therapist is a therapist. This article was about therapists in general and not psychologists.

Best,
Dr. E

Those are very fair points, though I think there is a certain amount of responsibility on the part of the professional to not only clearly state credentials, but to also put the credentials in context. This is a common complaint when dealing with the media, because many clinicians responsibility report this information, though they do not have control over the final printed piece. In this case the clinician wrote the article, so I have a more stringent expectation of transparency and disclosure when it comes to credentials.

Maybe this is just repressed Dr. Laura and Dr. Phil backlash. :laugh:
 
The most interesting part of the article for me was the claim that as a result of cultural shifts, contemporary "therapy" clients have different expectations than they might have had several decades ago (and therefore branding is responsive to client demand). I'd be interested in hearing reflections on that point if anyone cares to go there...
 
I got the impression that she is ABD.

She got a masters from Pepperdine. She's an MFT, not a doc student. It took her six years to complete coursework and internship. In CA you can work for free for literally years to accrue enough hours for licensing at the masters level. 6 years, especially for someone with a day job doing something else (journalism, her first career), is not an unusual amount of time to invest in achieving masters level licensure, especially in a major metro center like LA.
 
I think the bigger honesty issue is a question of what her legal and business constraints are within the scope the article. For example, I could write about similar struggles in my PP (though I have more than her 3 clients), but a big part of my issue is being unable to bill insurance in many cases. My colleagues a 1-5 yrs ahead of me are licensed, on panels, and filling their slots fine. My complaint then is specifically about what clients want that are paying out of pocket rather than clients in general. The clients that are want therapy may simply choose to deal with a provider that accepts their insurance and those that want to deal out of pocket may have different goals. Without that piece of knowledge being made transparent to others, they are getting an inaccurate picture of the landscape for therapy providers.
 
I think the bigger honesty issue is a question of what her legal and business constraints are within the scope the article. For example, I could write about similar struggles in my PP (though I have more than her 3 clients), but a big part of my issue is being unable to bill insurance in many cases. My colleagues a 1-5 yrs ahead of me are licensed, on panels, and filling their slots fine. My complaint then is specifically about what clients want that are paying out of pocket rather than clients in general. The clients that are want therapy may simply choose to deal with a provider that accepts their insurance and those that want to deal out of pocket may have different goals. Without that piece of knowledge being made transparent to others, they are getting an inaccurate picture of the landscape for therapy providers.

To clarify, are you saying you think she doesn't accept insurance? There are differences between the out of pocket folks and insurance folks, but I still think her points are well-taken. Even if a therapist is on insurance panels, there are lots of other therapists on panel too. Why should a client pick you? You need to do set yourself apart in some way (unless you are in a part of the country in desperate need of therapists). Around me, it is pretty easy to get a same-week appt with a therapist on your insurance. I take that as a sign that people who are in PP are not so over-whelmed by clients that they don't need to think about these issues.

Best,
Dr. E
 
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