The psychotherapy subreddit has gone Private. What are everyone’s thoughts on this?

[Groupthink]

r/psychotherapy is now Private as of about 3 months ago. In order to obtain membership, you must be a licensed and practicing professional. The application process requires you to submit a photocopy of your ID, psychotherapy license, and your graduate school transcripts in order to obtain access.

What are your thoughts about one of the major public online spaces for therapist discussion going this route?

Personally, I am quite upset. I have been licensed for 4 years now as a Clinical Psychologist, and both as a graduate student and as a licensed professional I relied on the posts in that forum. It was very helpful from a training perspective to have transparency about what it is like to work at various places in the field. One of my big criticisms of Psychology is that there is a lot of elitism and very little transparency; the subreddit offered a view I really only found there and on SDN.

I am also quite disappointed in the way their decision to go Private was handled. They took a poll of users who could post on the forum (for those unfamiliar, only licensed professionals and students were allowed to post; client posts were deleted). The overwhelming majority was against the sub going private. The moderators stated that there was a “small vocal minority” who wanted it to remain public, and said that they were speaking in a “demeaning” way towards the mods. When in actuality, the mods were locking any comments that disagreed with their view that the sub needed to go Private.

The whole thing is quite disappointing. There is already massive distrust towards mental health professionals and plenty of stigma towards the field and our services in general. Having the psychotherapy forum on one of the biggest websites on the internet go Private is not a good look. It creates more of an “us and them” image. It runs the risk of the forum becoming an echo chamber. Not to mention having to disclose your full identity to the moderation staff, some of whom from my understanding aren’t even licensed mental health professionals.

As a field, in my opinion, we have to do better regarding transparency and this decision reflects quite poorly on our image to the greater public.

Thoughts?

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[Fan_of_Meehl]

On the bright side...

Maybe that will spur a whole bunch of disaffected free-thinking professional psychologists over to this site, leaving the S&M-loving dominance-submission to authority elitists to their own heavily vetted echo chambers.

Oh well, to each her (or his) own.

 

[WisNeuro]

The f do they need transcripts? Wouldn't license be enough? Anywho, I could care less, personally. If it was anything like other therapy forums, I understand why they'd want to make it professional only.

 

[R. Matey]

As a field, in my opinion, we have to do better regarding transparency and this decision reflects quite poorly on our image to the greater public.

Broadly, I agree with your points about elitism and transparency. I do think some folks are a little too furtive about what actually happens in a therapy room in real life, but this might be going a bit far. I can understand why having some vetting is more productive to a conversation about psychotherapy without some interloper jumping in with the one outdated study they read on the benefits of primal scream therapy that devolves into a personal story about how primal scream therapy was the only treatment that worked for them, their cousin, their grandmother's dog, etc. Those accounts don't tend to last long on SDN either from what I've observed.

I'm also not sure that this is doing great harm to the profession because professionals want a space to talk with other professionals about what they do professionally.

 

[psych.meout]

I browsed it on a fairly regular basis before it went private and if it's still the same as it was when it was public, then you aren't really missing out on anything useful.

The users there frequently promoted various forms of pseudoscience, downvoted to oblivion any requests for empirical evidence for their claims, considered anecdotal experiences and opinions to be just as valid as empirical evidence, promoted or defended obvious violations of professional and/or ethical standards, etc.

There are some good psychology related subreddits, but I'd never consider r/psychotherapy to be helpful or useful in any way except as an example of what not to do.

 

[WisNeuro]

I browsed it on a fairly regular basis before it went private and if it's still the same as it was when it was public, then you aren't really missing out on anything useful.

The users there frequently promoted various forms of pseudoscience, downvoted to oblivion any requests for empirical evidence for their claims, considered anecdotal experiences and opinions to be just as valid as empirical evidence, promoted or defended obvious violations of professional and/or ethical standards, etc.

There are some good psychology related subreddits, but I'd never consider r/psychotherapy to be helpful or useful in any way except as an example of what not to do.

So, the reddit forum was just another terrible version of the psychcentral therapy forums?

 

[erg923]

This does not strike me as something we should really care about. I'm sorry. It's the interwebs. Whtya gonna do, right? Open access psychotherapy forum comments, and posts on "the web" are generally a mess of ridiculous nonsense or unsupported poppycock.

If you really need help, there are a several good Google groups, (billing and clinically-oriented) and list-serves that are part of the APA suborgs. If you need true, clinical peer-to-peer consultation, I would suggest joining your local state psych org or APA. Or just get to know people in your area?

Seems like maybe we should focus on other things, as a profession. And certainly, personally, I don't care about any of this.

 

[Groupthink]

I browsed it on a fairly regular basis before it went private and if it's still the same as it was when it was public, then you aren't really missing out on anything useful.

The users there frequently promoted various forms of pseudoscience, downvoted to oblivion any requests for empirical evidence for their claims, considered anecdotal experiences and opinions to be just as valid as empirical evidence, promoted or defended obvious violations of professional and/or ethical standards, etc.

There are some good psychology related subreddits, but I'd never consider r/psychotherapy to be helpful or useful in any way except as an example of what not to do.

I have to respectfully disagree. While there were plenty of posts that made me cringe at the lack of ethics, a lot of these were coming from Masters level and Social Work traditions. Rarely did I see that from our fellow Psychologists. Obviously could be selection bias on my part. But I absolutely found the sub to be validating for some of the struggles I have in the field and with the institution and systems of the profession.

In other groups I’ve belonged to, speaking up about problems of being overworked, underpaid, etc was traditionally shamed and silenced. It was nice to have a space where those aspects were validated.

At least, until the moderators of the sub decided those posts were only allowable on Wednesdays, in a moderator-created topic.

 

[Groupthink]

This does not strike me as something we should really care about. I'm sorry. It's the interwebs. Whtya gonna do, right? Open access psychotherapy forum comments, and posts on "the web" are generally a mess of ridiculous nonsense or unsupported poppycock.

If you really need help, there are a several good Google groups, (billing and clinically-oriented) and list-serves that are part of the APA suborgs. If you need true, clinical peer-to-peer consultation, I would suggest joining your local state psych org or APA. Or just get to know people in your area?

Seems like maybe we should focus on other things, as a profession. And certainly, personally, I don't care about any of this.

My post is less about professionals needing help and more the image we are sending out to the public about what we do. Reddit is a huge public forum. For the therapy-curious who want to see what is going on in the profession, being met with a closed door on a public open forum is a bad look.

And lord knows that yes, the profession has myriad problems that need to be addressed. This is a relatively small one in comparison, but perhaps relatable given that it is a fellow forum.

 

[WisNeuro]

My post is less about professionals needing help and more the image we are sending out to the public about what we do. Reddit is a huge public forum. For the therapy-curious who want to see what is going on in the profession, being met with a closed door on a public open forum is a bad look.

And lord knows that yes, the profession has myriad problems that need to be addressed. This is a relatively small one in comparison, but perhaps relatable given that it is a fellow forum.

Can't they just go to a myriad of other options related to therapy and/or psychology?

 

[erg923]

My post is less about professionals needing help and more the image we are sending out to the public about what we do. Reddit is a huge public forum. For the therapy-curious who want to see what is going on in the profession, being met with a closed door on a public open forum is a bad look.

And lord knows that yes, the profession has myriad problems that need to be addressed. This is a relatively small one in comparison, but perhaps relatable given that it is a fellow forum.

This is a futile battle. You cannot monitor all these stuffs/things...and frankly I didn't even know what "Reddit" was until last year.

There are people on the Reddit and other web forum services that are clearly mental aberrants and espouse all kinds of nonsense. We should not be engaging their self-taught or "enlighted" opinions.

 

[WisNeuro]

This is a futile battle. You cannot monitor all these stuffs/things...and frankly I didn't even know what "Reddit" was until last year.

There are people or Reddit and other web forum services that are clearly mentally aberrants and espouse all kinds of nonsense. We should not be engaging their self-taught or "enlighted" opinions.

Did they reimburse telegraph-assisted therapy back in your day? Could you pay for sessions with your original Diner's Club card?

 

[erg923]

Did they reimburse telegraph-assisted therapy back in your day? Could you pay for sessions with your original Diner's Club card?

I am a member of the Lions Club and the Knight's of Columbus. If that is what you are getting at? Otherwise, no, I don't get into alot of the modern social media stuff.

 

[WisNeuro]

I was just calling you old. But now we all know you are a member of a bunch of organizations with 40+ white dudes wearing mom jeans and polos.

 

[PsyDr]

I am a member of the Lions Club and the Knight's of Columbus. If that is what you are getting at? Otherwise, no, I don't get into alot of the modern social media stuff.

LOL

Diner's Club was the original charge card, which was started in the 1940s. How old are you?! Because, that's not exactly modern.

 

[erg923]

LOL

Diner's Club was the original charge card, which was started in the 1940s. How old are you?! Because, that's not exactly modern.

Forty-two

 

[PsyDr]

Forty-two

don't you mean, "....- ..---"? Or however it's written in morse code.

 

[cara susanna]

That seems like... a lot. I don't want to send my school transcripts or other identifying information to randos on Reddit.

 

[chicandtoughness]

I used to be VERY active on /r/psychotherapy up until I quit reddit last year. I generally found it a pretty accepting place and personally used it as a soapbox for why CACREP sucks and EMDR is a scam. I don't mind it going private, but asking for license and transcripts makes me uncomfortable. The loss of anonymity is concerning, especially for a subreddit where folks regularly go to rant about supervisors/coworkers or get broad case consults. Obviously I don't feel it's a huge loss (as I purposefully extracted myself from reddit ages ago), but going private and requiring a lot of personal info to gain access means it will become a close-minded sounding box. Not something we want to engage in anyways.

 

[borne_before]

Why would anyone potentially dox themselves to randos online? Like, I'm pretty sure I could be doxed from stuff I post here, but I'm not trying to make it easy peasy - and there is always plausible deniability.

I feel like reddit used to be good, but now its like a weird mob mentality website. I do use it for a couple of niche hobbies and local/state subreddits tho. Shout out to the coffee subreddit for turning me onto the aeropress. I also like the trader joes/costco subs, there's a cool one about arrowheads, and the college basketball subs.

 

[cara susanna]

Why would anyone potentially dox themselves to randos online? Like, I'm pretty sure I could be doxed from stuff I post here, but I'm not trying to make it easy peasy - and there is always plausible deniability.

I feel like reddit used to be good, but now its like a weird mob mentality website. I do use it for a couple of niche hobbies and local/state subreddits tho. Shout out to the coffee subreddit for turning me onto the aeropress. I also like the trader joes/costco subs, there's a cool one about arrowheads, and the college basketball subs.

I love Reddit for some niche hobbies/interests of mine as well as support around a personal issue I'm going through. The latter is why I DEFINITELY do not want to be identifiable.

 

[ClinicalABA]

I must admit that I have no idea what a "subreddit" (or "main" reddit, for that matter, is). I've seen the term, as well as (i think) the little logo thing that looks like a teletubby. In all seriousness, do you all think my life would be better if I used/looked at/subscribed to/otherwise did what you do with a "reddit"? I'm not averse to the use of novel social media platforms for the dissemination and acquisition of useful information. I am, however, averse to ignorant fools spreading nonsense (as opposed to the relatively intelligent fools who spread nonsense around here).

I most definitely would not send off trancripts to a social media site, more because I don't want to be bothered to do that than any fear that someone would use my participation in that advances fear conditioning and anxiety course against me.

 

[Justanothergrad]

The f do they need transcripts?

"While we're at it, if you could kindly send us copies of your syllabi in case we need it for anything."

 

[WisNeuro]

"While we're at it, if you could kindly send us copies of your syllabi in case we need it for anything."

Maybe also a SSN to verify, possibly some routing and account numbers while we're at it?

 

[Fan_of_Meehl]

I must admit that I have no idea what a "subreddit" (or "main" reddit, for that matter, is). I've seen the term, as well as (i think) the little logo thing that looks like a teletubby. In all seriousness, do you all think my life would be better if I used/looked at/subscribed to/otherwise did what you do with a "reddit"? I'm not averse to the use of novel social media platforms for the dissemination and acquisition of useful information. I am, however, averse to ignorant fools spreading nonsense (as opposed to the relatively intelligent fools who spread nonsense around here).

I most definitely would not send off trancripts to a social media site, more because I don't want to be bothered to do that than any fear that someone would use my participation in that advances fear conditioning and anxiety course against me.

Kind of depends on the forum. I frequent one that lets people offer advice, ideas, and experiences around home improvement/maintenance issues. It's been pretty useful as a 'bulletin board' type resource.

 

[R. Matey]

"While we're at it, if you could kindly send us copies of your syllabi in case we need it for anything."

Also make sure to sign in with your facebook, google, and apple account.

 

[futureapppsy2]

I love Reddit for some niche hobbies/interests of mine as well as support around a personal issue I'm going through. The latter is why I DEFINITELY do not want to be identifiable.

Reddit is an A+ location for posting about why Taylor Swift is queer, and that is it primary function for me, ngl.

 

[foreverbull]

Reddit is an A+ location for posting about why Taylor Swift is queer, and that is it primary function for me, ngl.

For a hot second I believed that Ms. Swift would out herself in 2018. I lost a bet with friends on that, sadly, but where there’s smoke….

 

[foreverbull]

Can someone explain what the psychotherapy Reddit provided that would require such a high level of vetting?

What topics were discussed in there?

 

[cara susanna]

The clinical psych subreddit just asks that you set flair with your location and degree.

 

[borne_before]

You know what online psychology space really grinds my gears? The Testing Psychologist community facebook. Here the typical posts: "Oh hai, I'm getting into testing because it's really lucrative and am sick of working with adults, what tests to do I need to diagnose (insert basic neurodevelopmental disorder) without having to learn about that condition or its treatment?" and "Did you know that everything is trauma or a combination of female autism, but that's not a big deal because autism isn't impairing at all and literally everyone has it."

 

[WisNeuro]

You know what online psychology space really grinds my gears? The Testing Psychologist community facebook. Here the typical posts: "Oh hai, I'm getting into testing because it's really lucrative and am sick of working with adults, what tests to do I need to diagnose (insert basic neurodevelopmental disorder) without having to learn about that condition or its treatment?" and "Did you know that everything is trauma or a combination of female autism, but that's not a big deal because autism isn't impairing at all and literally everyone has it."

I'm conflicted. Obviously incompetent providers are bad for the field and bad for patients. On the other hand they make my legal work so very easy and so very entertaining.

 

[borne_before]

I'm conflicted. Obviously incompetent providers are bad for the field and bad for patients. On the other hand they make my legal work so very easy and so very entertaining.

Ugh, I just saw a question about ID and diagnosing SLD in kids with low IQs. Thank god I have a personal policy to never post anything on facebook- I should make a troll account to post what I really think...

 

[ClinicalABA]

I'd be concerned that with a site that is vetting licensure and training, there might be an expectation of some provision of direct clinical advice (in other words, practicising therapy without a license in the jurisdiction in which the client is located). If I'm not performing the role of a licensed psychologist, why do you need to verify whether or not I am one? By default, anyone giving clinical advice on such a forum should not be trusted, as it's probably not legal to do so! Just participating in a thread where someone is doing so could be seen as an ethical or regulatory violation. Are the subreddits moderated like here, where any posts asking for clinical advice are quickly removed?

 

[AcronymAllergy]

I'd be concerned that with a site that is vetting licensure and training, there might be an expectation of some provision of direct clinical advice (in other words, practicising therapy without a license in the jurisdiction in which the client is located). If I'm not performing the role of a licensed psychologist, why do you need to verify whether or not I am one? By default, anyone giving clinical advice on such a forum should not be trusted, as it's probably not legal to do so! Just participating in a thread where someone is doing so could be seen as an ethical or regulatory violation. Are the subreddits moderated like here, where any posts asking for clinical advice are quickly removed?

I could be wrong, as I've never been to that particular subreddit, but I think it may be (or at least is now) geared solely toward licensed professionals, thus the new vetting. So basically a place to "talk shop."

 

[PsyDr]

You know what online psychology space really grinds my gears? The Testing Psychologist community facebook. Here the typical posts: "Oh hai, I'm getting into testing because it's really lucrative and am sick of working with adults, what tests to do I need to diagnose (insert basic neurodevelopmental disorder) without having to learn about that condition or its treatment?" and "Did you know that everything is trauma or a combination of female autism, but that's not a big deal because autism isn't impairing at all and literally everyone has it."

There's a what?! And they say what? Didn't everyone get trained in testing? And learn that abreactive and cathartic methods are not empirically supported?

 

[Justanothergrad]

There's a what?! And they say what? Didn't everyone get trained in testing? And learn that abreactive and cathartic methods are not empirically supported?

Its sad what portion of graduating students/faculty will openly state that they are not competent in assessment.

 

[WisNeuro]

Its sad what portion of graduating students/faculty will openly state that they are not competent in assessment.

Can confirm. After reviewing hundreds of general track internship applications, our field is doing an absolute disservice in training what is one of the unique scope aspects of our field.

 

[foreverbull]

Can confirm. After reviewing hundreds of general track internship applications, our field is doing an absolute disservice in training what is one of the unique scope aspects of our field.

My program provided 3 assessment-based courses (required) but did not necessarily emphasize the practica experiences to match the fairly extensive education. We had a long list of available practicum sites but with only a few assessment practicum sites out of that long list. Certainly not enough spots for everyone in the program to do an assessment practicum, and 1 of the few assessment practica offered very limited hours (10 hours/week max), which meant far fewer direct hours if you chose that route, because we didn’t have the time to do full clinical + assessment practica concurrently.

I gave my program feedback that assessment needed more emphasis. It’s a pity to have 3 courses worth of assessment practice and education and not use it at any point when it is one of the more unique offerings, as you say, and also one that compensates for report writing time, which is a bonus compared to unpaid notetaking/intakes/termination summaries in psychotherapy.

I’m wondering how common my experience was in terms of the program’s lack of emphasis on the assessment practica side?

 

[WisNeuro]

My program provided 3 assessment-based courses (required) but did not necessarily emphasize the practica experiences to match the fairly extensive education. We had a long list of available practicum sites but with only a few assessment practicum sites out of that long list. Certainly not enough spots for everyone in the program to do an assessment practicum, and 1 of the few assessment practica offered very limited hours (10 hours/week max), which meant far fewer direct hours if you chose that route, because we didn’t have the time to do full clinical + assessment practica concurrently.

I gave my program feedback that assessment needed more emphasis. It’s a pity to have 3 courses worth of assessment practice and education and not use it at any point when it is one of the more unique offerings, as you say, and also one that compensates for report writing time, which is a bonus compared to unpaid notetaking/intakes/termination summaries in psychotherapy.

I’m wondering how common my experience was in terms of the program’s lack of emphasis on the assessment practica side?

It's a wide gamut, but most programs should give students ~100 assessment hours minimum (psych and neuro assessment combined) even for generalists. My program probably tended on the higher side as everyone in the program learned assessment in our in-house LD/ADHD assessment clinic, and between that and other assessment opportunities in-house, most people had at least 10 integrated reports and a decent number of hours even without external practica. Nowadays, we can commonly see people with 1-2 integrated reports when applying to internship. Sad to see what's happening.

 

[Skye18]

It's a wide gamut, but most programs should give students ~100 assessment hours minimum (psych and neuro assessment combined) even for generalists. My program probably tended on the higher side as everyone in the program learned assessment in our in-house LD/ADHD assessment clinic, and between that and other assessment opportunities in-house, most people had at least 10 integrated reports and a decent number of hours even without external practica. Nowadays, we can commonly see people with 1-2 integrated reports when applying to internship. Sad to see what's happening.

I realize this is hijacking the thread a bit, but since the topic has been raised, I would love to hear experienced opinions on how to vet programs/look for opportunities that will prepare me well to specialize in assessment and to be competitive for later assessment-heavy internships. (I'm interested in neuro and forensic evals if that matters). On the flip side, I'd be curious to hear about red flags to look for in this area as well. Interview season is coming up! Thanks.

 

[R. Matey]

It's a wide gamut, but most programs should give students ~100 assessment hours minimum (psych and neuro assessment combined) even for generalists. My program probably tended on the higher side as everyone in the program learned assessment in our in-house LD/ADHD assessment clinic, and between that and other assessment opportunities in-house, most people had at least 10 integrated reports and a decent number of hours even without external practica. Nowadays, we can commonly see people with 1-2 integrated reports when applying to internship. Sad to see what's happening.

Yeah, I think assessment also has that "math is scary" facade that can be off-putting to folks who are primarily interested in being a well-paid psychotherapist. I was very well north of those figures when I applied to internship a few years ago, but I intentionally sought out a generalist assessment prac.

 

[WisNeuro]

I realize this is hijacking the thread a bit, but since the topic has been raised, I would love to hear experienced opinions on how to vet programs/look for opportunities that will prepare me well to specialize in assessment and to be competitive for later assessment-heavy internships. (I'm interested in neuro and forensic evals if that matters). On the flip side, I'd be curious to hear about red flags to look for in this area as well. Interview season is coming up! Thanks.

I'd suggest starting a new thread to keep it separate if you want some comprehensive responses.

Yeah, I think assessment also has that "math is scary" facade that can be off-putting to folks who are primarily interested in being a well-paid psychotherapist. I was very well north of those figures when I applied to internship a few years ago, but I intentionally sought out a generalist assessment prac.

Yeah, especially when you get to Sp/Sn/NPV/PPV/etc. Just seems like you wouldn't want to limit your earning potential. Lot of money out there for people skilled in various assessments. Ceiling is much higher in assessment than it is in therapy only.

 

[Ollie123]

Always enjoyed assessment far more than therapy, but sadly afraid I now belong in the category of faculty members who aren't competent in it. Its been probably 6+ years since I've administered anything besides some self-report surveys or a SCID/MINI. Have a strong enough foundation that right now I think I could probably self-study my way to get back up to speed, but in 10 more years without doing one? Who knows. Even as someone who enjoyed assessment, I would have needed to go far out of my way to find opportunities to do it once I finished grad school. It was kind of a zero-sum game of time and the things that paid the bills always ended up taking priority. I imagine its similar to how many clinical folks lose contact with the research world even when they have the best of intentions for staying involved.

Not sure I'm ever likely to return to a clinical role (not even licensed in my current state), but if I do I'd seriously consider rebooting by doing an assessment-focused post-doc.

 

[WisNeuro]

Always enjoyed assessment far more than therapy, but sadly afraid I now belong in the category of faculty members who aren't competent in it. Its been probably 6+ years since I've administered anything besides some self-report surveys or a SCID/MINI. Have a strong enough foundation that right now I think I could probably self-study my way to get back up to speed, but in 10 more years without doing one? Who knows. Even as someone who enjoyed assessment, I would have needed to go far out of my way to find opportunities to do it once I finished grad school. It was kind of a zero-sum game of time and the things that paid the bills always ended up taking priority. I imagine its similar to how many clinical folks lose contact with the research world even when they have the best of intentions for staying involved.

Not sure I'm ever likely to return to a clinical role (not even licensed in my current state), but if I do I'd seriously consider rebooting by doing an assessment-focused post-doc.

If you licensed up, are there any opportunities where you are to do some? May be worth it to stay fresh if you want the possibility down the road. Even opens up the chance of a side gig.

 

[Ollie123]

Yeah that's the thing. If I wanted to, I'm sure I could find opportunities, but it would be a huge hassle (find a clinic, convince hospital to credential me to do something I'm probably not qualified to do anymore and/or create some weird "fully licensed/independent but still trainee" role, likely find a supervisor to mitigate that, convince my bosses they should let me do stuff of absolutely no relevance to my job because "reasons" and depending on funds flow potentially eat that cost). Going outside the systems means potential conflict of commitment issues that necessitate a boatload of paperwork. I could make all that happen, its just never seemed worth it....

 

[PsyDr]

I think the assessment phase is the sign psychologists are screwed. The average assessment is what? 7 hrs? If you’re just doing EBTs for strict diagnosis based treatment, you’re billing 13hrs. That’s a net loss of billable hours. So why are people flocking to assessment?

I believe it’s because there are cheaper options for psychotherapy, and that pills, or some form of excuse for responsibility, are a preferable option. That should tell you something about the general narcissistic character structures of society. That should be terrifying for us. People see us as less valuable. Questions of “what’s wrong with me?”; are responded to, and perceived to reflect, “there’s no changing me!”. That’s bad news from a business sense.

And I lost interest in reddit when they banned the peerage subreddit…. Because narcissistic observations are reciprocal.

 

[WisNeuro]

I think the assessment phase is the sign psychologists are screwed. The average assessment is what? 7 hrs? If you’re just doing EBTs for strict diagnosis based treatment, you’re billing 13hrs. That’s a net loss of billable hours. So why are people flocking to assessment?

I believe it’s because there are cheaper options for psychotherapy, and that pills, or some form of excuse for responsibility, are a preferable option. That should tell you something about the general narcissistic character structures of society. That should be terrifying for us. People see us as less valuable. Questions of “what’s wrong with me?”; are responded to, and perceived to reflect, “there’s no changing me!”. That’s bad news from a business sense.

And I lost interest in reddit when they banned the peerage subreddit…. Because narcissistic observations are reciprocal.

Different story for IME work, though. Our area could use some good psych assessment, particularly in the PTSD area. The plaintiff shills are pretty locked in, but there's a shortage of people who will do a real objective eval for civil work.

 

[borne_before]

I think the assessment phase is the sign psychologists are screwed. The average assessment is what? 7 hrs? If you’re just doing EBTs for strict diagnosis based treatment, you’re billing 13hrs. That’s a net loss of billable hours. So why are people flocking to assessment?

I believe it’s because there are cheaper options for psychotherapy, and that pills, or some form of excuse for responsibility, are a preferable option. That should tell you something about the general narcissistic character structures of society. That should be terrifying for us. People see us as less valuable. Questions of “what’s wrong with me?”; are responded to, and perceived to reflect, “there’s no changing me!”. That’s bad news from a business sense.

And I lost interest in reddit when they banned the peerage subreddit…. Because narcissistic observations are reciprocal.

I don’t think people are flocking to assessment for adults. I think most disability evaluations for adults are done in house of a treatment program ensure a good pipeline to make them more financially worth it. Neuropsychology is a different beast - and those evals are more profitable under insurance. Documenting impairment is huge.

But for kids, the testing world is different beast - and I think the trend is for most pediatric testing psychologists to stop taking insurance, unless they are part of hospital system or the in house tester of an ABA outfit to bring in patients for the much more lucrative from insurance ABA services.

Autism and ADHD evals are pretty big right now in the pediatricians office and autism is huge for the hopeful imaginations of parents with kids who are weird or difficult.

Schooling is another one that is huge. Parents can request and independent educational eval - you can bill like 2200 for a basic psychoed sometimes with those. I hate doing those though. Uninteresting, usually the school psych was right, requesting an IEE is like the first move any special Ed advocate makes though.

I also think people are flocking to assessment with kids because it’s pretty low risk and you can make a decent living doing part time work.

 

[Fan_of_Meehl]

Different story for IME work, though. Our area could use some good psych assessment, particularly in the PTSD area. The plaintiff shills are pretty locked in, but there's a shortage of people who will do a real objective eval for civil work.

How does one get into that area, though? Cold contacting health insurance companies? Are there websites, tutorials? Over the holidays I tried to do some online searches and came up empty.