Stands We Take: Position Papers & Publications
PsiAN issues position papers and other public-facing statements that promote high-quality mental health treatments. We aim to promote therapies of depth, insight and relationship to policy makers, the general public and mental health professionals and organizations.
PsiAN’s Position on Mental Health Apps
PsiAN supports tools and technologies when they increase access to quality care of lasting benefit. However, we are concerned with profit-driven apps, websites and platforms seeking revenue by discarding the therapeutic relationship, violating standards of professional practice ethics, and putting their commercial interests ahead of the best interests of patients. In addition, current technologies too often increase the stigma around seeking effective care, flood the marketplace with misleading claims, and make it more difficult for people to get the help they need. This position paper outlines PsiAN's position on these emerging mental health tools and technologies, including a list of red flags to identify problematic versions.
To push back on the near-ubiquitous advertising for these products, we've also developed a template for contacting businesses that accept advertising from app/tech companies.
Insurance and Parity Advocacy Toolkit
Along with a webinar sponsored by the Austen Riggs Center, PsiAN has created this toolkit to educate and assist therapists and patients in protecting provision of and insurance payment for mental health services. This guide helps therapists address insurance denials, violations of parity, and other treatment limitations that impact providing optimal care for our patients. It explains the significance of the landmark Wit v UBH class action lawsuit, generally accepted standards of care, examples of parity violations, and new state laws that protect patient care and parity. Also included are instructions for filing complaints and appeals, as well as templates for appeal letters and medical necessity evaluations. There are examples of how to advocate with the media for greater access and coverage of therapy, and a resource list of articles and links to other toolkits.
Medicare and impacts on therapy
Many rely on Medicare, but we increasingly see the government turning Medicare over to private insurance companies. Here's our paper outlining the privatization of Medicare - its historical roots and potential implications.
And here's the PsiAN Guide on Choosing a Medicare Plan to understanding traditional Medicare and newer Medicare Advantage plans. PsiAN offers this unbiased resource to counter the misleading advertising that makes Medicare Advantage plans look appealing, while downplaying their longer-term costs and features. Specifically, we are concerned that Medicare Advantage plans may have more restricted networks that limit access to therapists and result in higher costs for therapy.
PsiAN's Guide to Choosing a Therapist
Connecting with a therapist can be an overwhelming and daunting process, whether you’ve done it before or not. Here’s our roadmap to help you find a therapist who values depth, insight, and relationship.
Cost Effectiveness of Psychotherapy
Intensive, longer-term treatment is needed by many, and not only is it highly effective -- it's cost effective. People use extended psychotherapy because they need it, and they should have access to it when necessary. Such critical care decisions should be in the hands of the patient and their clinician, not the insurance company or other third party. Depriving people of care when they need it results in greatly increased medical costs, as well as increases in disability, lost lives and suffering.
Why PsiAN Supports Therapies of Depth, Insight and Relationship
You’ve probably been hearing a lot about “evidence-based” treatments these days. And maybe you’re unsure what that means. Here’s our short take on that term – and how it’s being used. In fact, all mainstream therapies are evidence-based. And therapies of depth, insight and relationship offer even more – a caring therapist who sees each individual as a unique person with unique needs.
Constituent Advocacy Toolkit
PsiAN created a toolkit as a source of both information and inspiration for members as they take on the very important task of advocating for therapies of depth, insight and relationship. With input from experienced advocates, former lobbyists and individuals who have run political campaigns, this toolkit will provide professional guidance in advocating with elected officials in seeking your advocacy goals! Be sure to attend one of our webinars to learn about the Toolkit and being the best advocate you can for therapies of depth, insight and relationship.
Evolution of Psychotherapy
Psychotherapy has grown and evolved over the past 130 years. Building on decades of clinical experience, academic research and ever-growing evidence base, psychotherapy today is a modern, relevant and highly effective treatment for people suffering from all sorts of emotional and psychological problems. While many mistakenly believe that CBT and similar approaches are more “evidence based” than therapies of depth, insight, and relationship; this is just an artifact of the way CBTs are studied and promoted. All mainstream therapy is supported by scientific evidence, and therapies have been around the longest, building on the origins of psychotherapy, which began with intensive efforts to understand in depth the uniqueness of each individual.
Therapies for you — not your insurance company
In many industries, marketing and advertising work – especially when backed by lots of spending – and psychotherapy is no exception. The big advertising spenders are promoting what they have to sell, which is not necessarily what’s best for you. Decades of research show that therapies of depth, insight and relationship are highly effective, evidence-based treatments. They are also more effective than other treatments when it comes to personality and relationship issues, and they are the only ones shown to offer enduring results that stick for the long-term, well after people leave their last therapy session.
Publications and Events
2024
April 2024: PsiAN Advocates for 90837 and Against Audits
PsiAN members have been reporting burdensome audits, particularly when they bill 90837. These audits negatively affect clinicians and patients alike, and seem to be lacking both in clinical rationale as well as the educational component that the audits purport to offer. As a result, clinicians report being overburdened by excessive administrative demands and not offered sufficient opportunities for education.
We have written the attached letter outlining our concerns about audits of 90837, and have sent it to the Senators of Illinois. We appreciate the support of the Illinois Psychological Association, and are very glad that they agreed to sign onto our letter. We will be sending a similar letter addressed to Secretary Becerra at CMS.
PsiAN Letter to Illinois Senators Duckworth and Durbin
April 2024: The Importance of Professional Advocacy for Mental Health Treatment Choice in the Times of Ubiquitous Technology
Technology and the Mind Podcast Interviews Linda Michaels, Co-Founder and Chair
Dr. Nicolle Zapien interviews Dr. Linda Michaels, Chair and Co-Founder of the Psychotherapy Action Network (PsiAn) on season 2 episode 6 of the Technology and the Mind Podcast. Linda discusses grassroots efforts to provide public information and advocacy for therapies of depth, insight and relationship. She discusses the role of marketing as a major source of information to the public about treatment options for mental health. Further she emphasizes that psychoanalysts and psychodynamically-oriented clinicians should advocate and educate the public, particularly while there are significant strategic interests in among tech apps, investors and insurance companies in shaping the marketplace for consumers.
Link to Podcast from Apple
Link to Podcast on Spotify
March 2024: Psychiatry & Psychotherapy Podcast Interviews Linda Michaels, Co-Founder & Chair
Linda Michaels, PsyD, MBA, PsiAN Co-Founder and Chair, featured on episode 208 of the Psychiatry and Psychotherapy Podcast called What People Want from Therapy with Linda Michaels” hosted by David Puder, MD. David interviews Linda about PsiAN's original market research on what the public wants and needs from therapy. They get into a wide-ranging discussion on the mental health landscape, the influences of for-profit entities like insurance companies and venture capitalists, what it takes to provide depth therapy in these times, and PsiAN's mission and vision.
Link to Podcast from Apple
Link to podcast from Google
Podcast Shownotes
March 2024: PsiAN Co-Founder and Chair, Linda Michaels Responds to Wall Street Journal
Linda responded to this article, “Stop Constantly Asking Kids How They Feel,” which was written by Abigail Schrier about her new book, Bad Therapy: Why Kids Aren't Growing Up. Schrier's article, which was previously discussed on the PsiAN listserv, is concerning, as it offers glaring misrepresentations of real therapy, especially therapies of depth, insight and relationship.
Linda counters, and below is her letter to the editor:
Ms. Shrier confuses a superficial overfocus on “happiness” with real therapy and developing a rich emotional vocabulary, which is a highly useful and important way of gaining more information about oneself, one’s relationships and the world. The goal of effective therapy isn’t to cultivate happiness—if it were, that would indeed be bad therapy. Effective therapy helps people understand themselves and the root of their issues and answer important questions such as why have they fallen into repeated failed relationships or why do they sabotage themselves at work. For many, the way out of these perplexing problems lies in understanding feelings and fears they had buried or been too ashamed to acknowledge.
We should be striving for greater emotional intelligence, not less, if we want people to live unburdened by depression and anxiety, form fulfilling friendships and relationships, and thrive in collaborative work environments.
In my experience, what helps people is when they understand that their emotions and reactions make sense, that they aren’t crazy for feeling disappointed, injured, embarrassed, jealous or happy. Understanding our feelings and being able to use that information is a strength, the key to growth and resilience, and an outcome of good therapy.
— Linda Michaels, Psy.D.
2023
November 2023: New Books Network features PsiAN’s book
PsiAN’s book, Advancing Psychotherapy for the Next Generation: Humanizing Mental Health Policy and Practice, was featured on the New Books Network podcast. PsiAN's chair and co-founder Linda Michaels is in discussion with host Judith Tanen discussing PsiAN's activities and goals as an organization, the value of therapies of depth, insight, and relationship, the various threats to these therapies, PsiAN's steadfast commitment to protecting and advancing them.
November 2023: The Art of Listening podcast launches — and inaugural guest is PsiAN
Psychologist and psychoanalyst Eileen Dunn has created a new podcast, The Art of Listening, where she interviews expert listeners and gets to the heart of relationships and depth therapy. Her conversations bring out the essence of what we do, what heals, and what people experience in therapy, sometimes for the very first time.
Her first guest is Linda Michaels. Eileen created this podcast “in the effort to support the mission of PsiAN.” We deeply thank Eileen for her creation and all of her hard work, and dedication to therapies of depth, insight and relationship.
October 2023: Comments to the Mental Health Parity and Addiction Equity Act (MHPAEA)
With the help of the Kennedy Forum, PsiAN prepared and submitted comments to the federal government in support of revising rules for the Mental Health Parity and Addiction Equity Act (MHPAEA). The 19-page letter was submitted on October 2, 2023 and consisted of comments provided by our membership. Your unique contribution provided concrete examples of problems related to holding insurance companies to true compliance.
Honoring and remembering Erika Schmidt
Linda Michaels pays tribute to Erika Schmidt and her impact and contributions to psychoanalysis, PsiAN, and the wellbeing of children. Erika was a part of PsiAN from our beginnings, and most recently served as our Vice Chair. She was also very active on the APsA Board, and was the immediate past president of the Chicago Psychoanalytic Institute – the first woman, the first social worker, and the first child analyst to become their president.
August 2023: PsiAN in the Wall Street Journal
PsiAN is focused on changing the narrative about psychotherapy in the media. For the very first time, we were featured in the Wall Street Journal when they ran a letter to the editor by our own Linda Michaels. Her letter was in response to an article that raised concerns about new screening guidelines for anxiety. The letter, is a timely reminder that any discussion of mental health symptoms is incomplete if it fails to mention the role of psychotherapy.
July 2023: PsiAN honored by ROOM and featured in podcast
In July, ROOM featured PsiAN co-founders Janice Muhr and Linda Michaels on their podcast, Voices from ROOM, for a fascinating conversation about how the experience of advocating for depth therapies has impacted them, from the consulting room to the outside world. You can listen to the podcast here.
PsiAN, Janice and Linda were honored at ROOM’s annual gala, for their activism on behalf of depth therapy, along with a psychoanalyst and visual artist. We are humbled and delighted by this recognition of PsiAN’s work, and look forward to more opportunities to collaborate with ROOM. To read more about the gala and honorees, please click here.
Jun 2023: When Talkspace Sued PsiAN and Me
Here’s the harrowing story of what happened when PsiAN dared to stand up to a major corporation. Linda Michaels offers her personal account of the experience of Talkspace suing PsiAN and its cofounders as individuals.
Our friends at ROOM published this article - thank you for supporting our work!
Apr 2023: PsiAN issues comments to FTC on BetterHelp
PsiAN issued comments to the FTC on its proposed consent order that would ban BetterHelp from sharing customer data internally and with Facebook and others for advertising purposes, especially after BetterHelp had promised to keep such data private. And it would require BetterHelp to reimburse customers $7.8 M. (full press release here.)
Here is the link to PsiAN's comments, as posted on the FTC website.
Apr 2023: APA Update to PTSD Guidelines
PsiAN issued a comment to the American Psychological Association regarding Guideline Update Panel's (GUP) proposed framework for updating the PTSD guidelines, first published in 2017.
When the Guidelines were first published, we wrote a petition, Protect PTSD Treatments that Work! It was signed by over 57,000 clinicians and invested members of the public, bringing significant attention to the narrowly defined criteria APA was using to write its guidelines.
We have focused on GUP's misapplication of Institute of Medicine (I0M) and APA's definition of evidence-based practice, exclusive use of meta-data, and the failure to include research studies from the last five years. We have also expressed deep concern about its failure to consider the high drop-out rates from exposure-based therapies; although exposure-based therapies have been frequently studied, they have not been successful in reducing suffering from PTSD. In addition, we've pointed out that the timing of the updates misses many studies in the pipeline, including psychodynamic RCT research, that are in process or not yet published but are yielding promising outcomes.
Apr 2023: Update on Talkspace
Follow-Up to Sep. 2022 Petition to FTC on CareDash/BetterHelp/Talkspace
Important story on Talkspace, featuring PsiAN, "Talkspace is a Business First, and a Mental Health Resource Second." The journalist outlines the many shortcuts and problems with Talkspace's business model, and how it leads to the "platformization" of mental healthcare, enriching only investors' pockets.
The journalist also tells the story of the stands PsiAN has taken against Talkspace, and how these lead to Talkspace suing us for $40MM. Everyone should know this incredible story and cautionary tale - and how PsiAN emerged stronger than ever, while Talkspace pushed out its founders, continues to lose money, and is now being sued themselves for misrepresenting their financials.
Quoted extensively are our Chair and CoFounder Linda Michaels and our Advisors Todd Essig and Hannah Zeavin. They all offer such important perspectives on the problems with this platformization of this incredibly valuable entity -- our mental health -- which should be seriously attended to, if not cherished - and definitely not commodified.
Mar 2023: New Article on Telehealth, Parity, and Protecting Therapy
This wonderful article in the American Prospect, The Fight for Mental Health Parity, does a fantastic job outlining the impacts of telehealth and the concerns over what happens to access to care when the public health emergency ends.
Quoted throughout are our Chair and Co-Founder Linda Michaels, Steering Committee member Kate Gallagher, Board Member Brian Hufford, and Advisors Eric Plakun and Meiram Bendat. And, the journalist links to our recent webinar on parity and access, sponsored by the Austen Riggs Center.
A few nice quotes:
Linda Michaels, a psychologist and the chair and co-founder of the advocacy organization Psychotherapy Action Network, told the Prospect that though teletherapy is “certainly different than being face-to-face,” it has nonetheless helped patients immeasurably in recent years. “The most effective ingredient of therapy, which has been studied and reconfirmed over many decades,” Michaels pointed out, “is the relationship between patient and therapist.” Teletherapy allows for that relationship to flourish.
Alongside other advocates, Michaels and Gallagher are calling attention to the ways that insurance companies and employers have exploited loopholes to avoid offering equal mental health coverage. To these stakeholders, true parity between mental health services and physical treatments means that insurers must honor the terms of their plans and pay for whatever care has been deemed necessary by a treating clinician, not what has been decided by a company’s finance department.
As a psychologist, Gallagher reflected, “it’s easy to fall into a passive bystander position in relation to insurance plans.” She urges clinicians “not to take a back seat, and to take an active role in fighting insurer denials. Otherwise the companies just continue to profit.”
2022
Dec 2022: What People Need and Want from Therapy
Great new article by Linda Michaels, our Chair and Co-Founder, What People Need and Want from Therapy: Advancing Access to Quality Care. Linda brings PsiAN's market research to a general audience, highlighting key results that support therapies of depth, insight and relationship, such as 68% of people want to get to the root of their issues. She explains how apps and other approaches, like manualized therapy, lack a strong evidence base and result mainly in relapse - not sustained benefit. Linda also outlines what makes for effective therapy, and how the insurance industry, venture capital and a consumerist focus are all barriers to real access and quality care.
Oct 2022: Push Back on Mental Health Apps
We published our position paper on mental health apps and technology, and launched our Push Back on Apps campaign. We asked our members to contact businesses that accept advertising from "therapy" apps. Our hope is that these businesses reconsider their advertising policies, especially during this time of high demand for quality mental healthcare.
UPDATE MARCH 2023: The FTC is calling for a ban on BetterHelp from sharing customer data for advertising purposes, especially after BetterHelp had promised to keep such data private. And they'd require BetterHelp to reimburse customers $7.8 M.
"When a person struggling with mental health issues reaches out for help, they do so in a moment of vulnerability and with an expectation that professional counseling services will protect their privacy,” said Samuel Levine, Director of the FTC's Bureau of Consumer Protection. "Instead, BetterHelp betrayed consumers’ most personal health information for profit. Let this proposed order be a stout reminder that the FTC will prioritize defending Americans’ sensitive data from illegal exploitation." Read the full press release here.
Oct 2022: Comments to the US Preventive Services Task Force on anxiety/depression screening
In our efforts to support increased public awareness and access to effective therapy, PsiAN offered a series of comments to the USPSTF on its recommendation to screen all adults for anxiety and depression. We noted the absence of therapies of depth, insight and relationship in the evidence proposed to support screening. We also emphasized that screening instruments have both strengths and challenges in identifying levels of emotional distress associated with anxiety and depression, and that screenings can only be effective if there are adequate resources for further intervention and amelioration. Finally, we encouraged our members to submit their own comments to the government.
Follow this link to read PsiAN’s comments.
Sep 2022: PsiAN Changing the Narrative about Therapy
In this Grand Rounds presentation, our chair and cofounder Linda Michaels presents our research results and recommendations at the Austen Riggs Center. Therapies of depth, insight, and relationship have been missing from, if not pushed out of, the public conversation on mental health treatment. After decades of attack from multiple fronts, these therapies are misunderstood, undervalued, and overlooked by the general public. To assess what people know about therapy and mental health, and what they really want from treatment, the Psychotherapy Action Network (PsiAN) conducted extensive original research with the general public. From this innovative and unprecedented effort to “listen” to the public, we learned about the attitudes and expectations people have towards therapy, which benefits matter most, what their misperceptions and biases are, and what they know and don’t know about mental health and therapy. This presentation shares the findings from PsiAN’s qualitative and quantitative research. It also offers a blueprint for engaging and communicating with the public, so that the public gains greater awareness, understanding, and appreciation for therapies of depth, insight, and relationship.
Watch the presentation and earn CEs!
Aug 2022: Petition Against CareDash.com Practices
PsiAN penned a letter and petition with nearly 2,500 signatures to the Federal Trade Committee and the Attorneys General of New York, Illinois and California to object to the misleading business practices of CareDash.com, an online directory of medical and mental health practitioners. In our view, CareDash is neither transparent nor trustworthy. Far from its nicely worded mission, CareDash functions to drive potential referrals only to CareDash and BetterHelp.com affiliated clinicians. CareDash receives commissions from BetterHelp, uses the names and information about therapists without their knowledge or consent for the purposes of CareDash’s and BetterHelp’s profits. None of this is clearly stated up front on its website.
As mental health practitioners and stakeholders, we are concerned not only about the damage to our trade, but also to the impact of this duplicitous practice on prospective patients. Therapists take very seriously the need to have accurate, reliable information available about their services as part of the ethical conduct of their therapeutic practice. For people in need, obtaining accurate, trustworthy, and reliable information about therapists and engaging with a trusted therapist is the first and very important step to getting help.
UPDATE: Days after our petition was launched, BetterHelp and Talkspace quietly exited their marketing agreements with CareDash! We celebrate this, and continue to push for clarity and accounting with CareDash. We won’t stop until CareDash allows therapists control over their own profiles, and stops their practice of using therapists’ names and likenesses without their knowledge or consent.
UPDATE FEB. 2023: CareDash is closed down and will dissolve its business.
Aug 2022: PsiAN Stands with Kaiser Permanente
This week, thousands of mental healthcare workers at Kaiser Permanente, the large HMO in California, went on strike. They are protesting ongoing and persistent problems in providing mental healthcare, staffing shortages and excessive workloads, and harmful restrictions on patient care. For example, there are wait times of six months or more for appointments, limitations on the number of sessions, and unacceptable barriers to access and quality care. The union representing the workers and Kaiser have been negotiating for a year to no avail -- and thus the workers chose to strike.
PsiAN wrote this letter of support, outlining the importance of the clinicians' demands. We also supported a similar strike by the same union back in 2018. Unfortunately, these systemic problems persist.
Here's a recent article on the strike: https://www.theguardian.com/us-news/2022/aug/15/mental-health-workers-strike-kaiser-permanente-california
UPDATE: On October 21, 2022, Kaiser and the National Union of Healthcare Workers (NUHW) representing Kaiser clinicians announced an agreement. This new contract includes provisions to improve mental healthcare services for Kaiser patients, as well as significant economic gains for the more than 2,000 Kaiser therapists.
July 2022: Last Week Tonight with John Oliver
The hit HBO show, Last Week Tonight with John Oliver, took on the thorny and complex issues of mental healthcare. From apps posing as therapy, to insurance companies' ghost networks, to lack of real parity, to a systemic focus on crisis management as opposed to healing and recovery, Oliver makes smart, insightful, cogent points - and many a good joke.
To create the show, Oliver’s producers interviewed our Chair and Co-Founder, Linda Michaels, two of our Advisors, Meiram Bendat and Hannah Zeavin, and our friend at the Kennedy Forum, David Lloyd.
Last Week Tonight - Mental Health - 7.31.22 show.
Thank you to the PsiAN folks who helped inform the show, and thanks to John Oliver and his staff!
MAR 2022: PsiAN Acts to Preserve Wit v UBH
PsiAN joins the Kennedy Forum and other major mental health organizations in protesting the reversal of the Wit v UBH ruling. The victory in this landmark class action lawsuit held insurance companies to account and helped ensure that they cover the basics – treatment that met generally accepted standards of care. This ruling also formed the basis for new laws in California, Oregon, Illinois and Georgia.
JAN 2022: PsiAN pushes back on No Surprises Act, stands up for therapy and therapists
The No Surprises Act is meant to protect individuals from surprise bills from expensive medical treatments, such as surgery or air ambulance transport. Unfortunately, the big surprise was applying this to individual mental health clinicians. In therapy, our Codes of Ethics outline how we share information on billing and terms of service up front, so there are no surprises. Forcing us to comply with this Act would be unethical, and also likely result in barriers to seeking treatment.
Here is PsiAN's letter to CMS, written in collaboration with the Clinical Social Work Association: PsiAN-CSWA letter to CMS
PsiAN was interviewed about this important issue, and our Co-Chair Linda Michaels was quoted about her concerns that the Act would make people less likely to seek treatment. Here's the article that ran in NPR and Kaiser Health News: Therapists say a new law requiring upfront cost estimates could discourage patients
2021
AUG 2021: PsiAN featured in The New York Times, in article on public workers being left out of MH coverage
PsiAN co-chair Linda Michaels was featured, photo and all, in an important article on mental health parity, Teachers, Police, and Other Public Workers Left Out of Mental Health Coverage. She is quoted throughout the article on the ways in which insurance coverage falls far short of covering mental health, especially for the employees of the City of Chicago -- our first responders in this pandemic.
Here’s the article: “Teachers, Police, Other Public Workers Left Out of Mental Health Coverage”
JUL 2021: Opinion piece on TalkSpace
PsiAN co-chair Linda Michaels wrote a Medium piece in response to Kara Swisher’s interview with Oren Frank, CEO of Talkspace, a text therapy service. “In all, stranger things have surely happened, but finding myself in any agreement with Oren Frank is certainly unexpected,” she writes. “Still, he is an expert marketer, Talkspace is a well-funded brand, and I question what lies beneath the polished veneer. I’m not so sure our agreement is anything more than skin deep.”
Here’s the article: “Stranger Things — After being sued by Talkspace, I never thought I’d be agreeing with them. Or am I?”
JUN 2021: PsiAN hosted a presentation on our original research
Santiago Delboy, LCSW, MBA, and PsiAN co-chair Linda Michaels, PsyD, MBA, hosted a special presentation for PsiAN members, entitled “PsiAN's Original Research: Repositioning Therapies of Depth, Insight and Relationship.” The presentation covered the large-scale original research study PsiAN conducted examining the general public’s attitudes, beliefs, and biases about therapy. The good news: We learned that people want what we’re offering—not just symptom relief, but therapy that gets to the root of the problem—but they don’t know how or where to find it. Based on our data, we’re now in a position to help them find what they’re seeking.
JUN 2021: PsiAN featured in The New York Times, in article on therapy bots
PsiAN co-chair Linda Michaels was quoted in a NYT article on Woebot, a therapy app that uses AI to deliver CBT-style interventions. “These apps really shortchange the essential ingredient that — mounds of evidence show — is what helps in therapy, which is the therapeutic relationship,” she said.
Here’s the article: “Something Bothering You? Tell It to Woebot.”
MAY 2021: Wrote letter, published in The New York Times, on “retail therapy”
In response to a New York Times article on bringing “retail therapy” to the masses, PsiAN’s co-chairs wrote a letter arguing that drugstore therapy is the wrong approach. “While we face a growing mental health pandemic following the Covid-19 pandemic, the retail offerings from CVS, Walmart and Walgreens are unlikely to help in significant ways,” we wrote. “We know what helps people who are suffering — a trusted relationship with a well-trained professional who will help get to the root of issues.”
Here’s the letter: “Drugstore Therapy: The Wrong Approach”
MAY 2021: Letter to the NICE Chronic Pain Guidelines Committee
In a letter to Nick Kosky, Chair of the Chronic Pain Guideline Committee, PsiAN offered feedback and revisions to the organization’s Guidance Recommendations for pain management, based on a wealth of evidence about diagnosis and treatment of Chronic Primary Pain. The letter points to a growing body of evidence and clinical experience that diagnosis and treatment of underlying psychosocial stress can alleviate chronic pain when there is no organic or structural cause, and that alleviation of Psychophysiologic Disorders (PPD) is best done with psychotherapy of depth, insight and relationship.
Here’s the letter.
MAR 2021: Health is Health Illinois
PsiAN joined the Kennedy Forum Illinois, Inseparable, and other organizations to support the Health is Health Illinois campaign, which is focused on ensuring mental health parity and writing the standards of care, as specified in the Wit v UBH decision, into law. The campaign aims to update Illinois law with clear and commonsense definitions and standards of mental health care in order to decrease costs, reduce homelessness, and save lives.
Here’s the campaign: Health is Health Illinois
2020
DEC 2020: PsiAN featured in The Atlantic, in article about “therapy” apps
From The Atlantic, here's the latest "cautionary tale about what can happen when tech companies control peoples’ psychological treatment." And yes, our own Janice Muhr, Co Chair of PsiAN, is quoted here! The reporter also references how PsiAN was sued by Talkspace - and how we prevailed in court!
Here’s the article, by Olga Khazan: The Problem with 'Uber for Therapy'
AUG 2020: PsiAN featured in NYT article about Talkspace
Over the last few years, PsiAN has noted a number of concerns about texting apps, ranging from lack of a substantive evidence base showing efficacy, to ethical problems, to the very concerning potential of diverting people from getting quality therapy. We’ve written to the American Psychological Association, even to Michael Phelps himself. Here's an in-depth look at Talkspace and the many problems we’ve been concerned about.
Great reporting by the NYT, and many thanks to Kashmir Hill for giving PsiAN the last word!
Here’s the article, written by technology reporter Kashmir Hill: At Talkspace, start-up culture collides with mental health concerns
JUL 2020: Position Statement on Telehealth Coverage
Because of the COVID-19 pandemic, we learned very quickly how to put sound telehealth procedures into place. Some of these changes need to stay in place, and be adopted as usual practice going forward, to ensure access to and continuity of care. Here is PsiAN’s statement on telehealth coverage and the policy, insurance and licensing changes that need to occur so that people can continue to access care, even after some of the emergency orders expire.
PsiAN Telehealth Position Statement: PsiAN Telementalhealth Statement
MAR 2020: Therapy that sticks
Our Co Chair, Linda Michaels, wrote an article on therapies that endure. She outlines the evidence base for therapies of depth, insight and relationship, and highlights the false narrative around quick fixes. Referencing her own experience in therapy, along with vignettes from her practice, she gives a moving testimonial and balanced support for therapies that stick. Take it from David Brooks, who highlighted the article, saying “this is a glimpse of a more human way to confront psychological problems.”
Published by Aeon, here’s the article: Therapy that sticks: Why depth therapy is more enduring than a quick fix
MAR 2020: Guidelines for Tele-Therapy Sessions
During this public health crisis of COVID-19, many of us need to transition our practices and conduct therapies of depth, insight and relationship via phone or screen. While there are unavoidable losses in doing so, there are some important ways we can stay aware of the differences of in-person therapy, and adapt to tele-therapy.
Here are TeleTherapy Session Guidelines, written by one of PsiAN’s Advisors, Todd Essig, and Gillian Isaacs Russell: Remote Session Guidelines
FEB 2020: ICE and ORR policies violate key premises of psychotherapy
In April of 2018, the Office of Refugee Resettlement (ORR) signed a formal memorandum of agreement with Immigration and Customs Enforcement (ICE) to share its therapy notes for therapy sessions with immigrant children. This policy not only formalized these children’s betrayal, but went some way towards destroying the integrity of psychological therapy as a whole.
PsiAN drafted a petition protesting this “weaponization” of therapy notes to incarcerate and deport vulnerable, isolated and traumatized youth. Other professional organizations have similarly protested. We all call upon ORR to revoke its Memorandum of Agreement with ICE immediately, and for an end to the use of therapy notes to betray immigrant children and the field of psychotherapy as a whole.
Sign the petition here: https://www.thepetitionsite.com/379/862/396/tell-orr-and-ice-stop-using-psychotherapy-notes-to-betray-and-endanger-children/
2019
DEC 2019: WebMD fails to mention therapies of depth, insight and relationship
In its mental health blog on How to Choose the Right Type of Therapy, WebMD outlines 4 types of therapy that are variations on a (short-term, structured, manualized) theme, and fails to mention that therapies of depth, insight and relationship even exist.
Steven Reidbord, MD, PsiAN member and presenter at our recent conference in San Francisco, wrote a compelling letter showing the disservice WebMD is doing to people who assume it should be a trusted resource.
Here is Dr. Reidbord’s letter: WebMD misses the boat_12.19
NOV 2019: APA fails to mention therapies of depth, insight and relationship — even though these therapies can cure (yes, cure) chronic pain
In its member magazine, the American Psychological Association published an article about best practices for treating chronic pain. The recommended treatments were all cognitive-behavioral and focused on symptom relief and management. PsiAN put together a team of medical and psychology experts who have decades of experience researching and treating chronic pain. They state that therapies of depth, insight and relationship can actually eliminate chronic pain. Yes, there is a cure. Why should people settle for symptom management, when they can have a cure?
Here is the letter from the experts: Response to APA article on chronic pain
OCT 2019: Chicago Teachers Union striking for more mental health professionals in its schools
CTU is requesting increases in school social workers and psychologists, as current clinician-to-student ratios are well below what is recommended by national professional organizations. PsiAN stands in solidarity with the CTU, as these minimal mental health resources must be made available to our children — our most vulnerable population, and our future.
Here is our letter: PsiAN letter in support of CTU_10.25.19
AUG 2019: The Othering of Psychoanalysis: Symposium given at the American Psychological Association Annual Conference (8.8.2019)
APA decided to make othering the theme of its annual conference this year, and PsiAN decided to take a look at the treatment of psychoanalytic thought and therapies through that lens. We’ve posted here the papers presented by Oksana Yakushko, Linda Michaels, and Janice Muhr, with discussion by Nancy Burke. These presentations look in at the history of Freud bashing in the United States through the lens of psychology’s historic ties to eugenics; the evidence base for psychoanalytic therapies; and PsiAN’s efforts to transcend the effects of marginalization.
Freud Bashing in Psychology_Yakushko
Psychoanalysis in CBT-Centric Era_What does the evidence say_Michaels
Transcending Otherness_Muhr
Discussion of papers_Burke
JUN 2019: Comment on the American Psychiatric’s Draft Guideline for Schizophrenia.
The American Psychiatric Association has issued a call for comments on its draft practice guideline for the treatment of patients with schizophrenia. PsiAN has written a strong response, with concerns about the specific treatment recommendations, types of evidence that were considered or not, and the overall guidelines process.
Here is the document we submitted to the APA: PsiAN_Comment on proposed APA Schizophrenia Guideline
MAY 2019: THINK CBT IS THE GOLD STANDARD? THINK AGAIN.
NBC posted a story claiming that CBT is the “gold standard” of psychotherapy treatment. NBC didn’t do its research.
Research studies and the experience of clinicians the world over know better: CBT is NOT more effective! Talk therapies of depth, insight and relationship have been shown repeatedly to be equally effective. No less than JAMA, the Journal of the American Medical Association, along with numerous psychology researchers, backed by comprehensive meta-analyses of research studies covering thousands of patients, agree.
We aren’t sure why the American Psychological Association is disseminating the NBC article. The APA should definitely know better: it has sponsored much of the research that shows the therapy relationship is at the heart of treatments, and that CBT performs no better than other psychological therapies.
Here’s our letter to NBC: PsiAN response to NBC news article on CBT_4.30.19
MAR 2019: CLOSURE OF ARGOSY SCHOOLS
Like many, PsiAN is concerned about the abrupt closure of the Argosy schools and its psychology and counseling graduate programs. We grieve for the 8,800 affected students and the many faculty members who no longer have a place to study and work. We wrote to Betsy DeVos at the Education Department and to Arthur Evans at the APA, outlining our concerns that neither institution sounded alarm bells sooner — despite the many warning signs along the way.
Here’s our letter: PsiAN_letter to APA,ED regarding Argosy
MAR 2019: INTERVIEW WITH JONATHAN SHEDLER, PHD
Jonathan Shedler was interviewed recently in conjunction with the British Psychoanalytic Council (BPC) conference “Psychoanalytic Therapy Now 2018.” It’s a wide-ranging interview about the state of our profession today. It’s been published in the British Psychoanalytic Council magazine, New Associations, and also in the International Psychoanalytical Association newsletter, IPA News.
In addition to his many roles and responsibilities, Jonathan is an Advisor to PsiAN.
Click here to read his interview: interview with Jonathan Shedler
MAR 2019: LANDMARK RULING IN CLASS ACTION LAWSUIT AGAINST UNITED BEHAVIORAL HEALTHCARE
In a nationwide class action suit, the United States District Court for the Northern District of California has found that United Behavioral Health (“UBH/Optum”), the country’s largest managed behavioral healthcare organization, illegally denied mental health and substance use coverage based on flawed medical necessity criteria.
UBH developed their own internal flawed criteria, which were found to be inconsistent with generally accepted standards of behavioral health care, as a means to limit payments for medical care, thus decreasing their costs, and increasing profits. Indeed, the judge, Chief Magistrate Judge Joseph Spero, noted that UBH’s restrictive guidelines were intended to mitigate against the financial impact of parity.
This ruling is a monumental victory for patients and providers, and will certainly impact our mental health landscape for decades to come.
Congratulations to the attorneys, Meiram Bendat at PsychAppeal, Inc, and Zuckerman Spaeder, LLC, and all of the plaintiffs who came forward on behalf of thousands of individuals nationwide.
Here is the Judge’s complete ruling: Wit v. UBH
And here is PsiAN’s article published on Medium outlining our concerns: PsiAN’s take on the ruling against UBH — Why it’s bigger than it looks
FEB 2019: COMMENTARY ON GOVERNOR PRITZKER’S BUDGET
Governor Pritzker presented his first budget address since taking office. We appreciate his focus on increased mental health spending, even as the state of Illinois struggles to restore its fiscal health to solid footing, and are hopeful that this budget is a harbinger of a positive trend. However, Illinois needs not just increased mental health and substance abuse funding, but increased access to individualized mental health care of depth, dedication, duration and relationship. We can no longer afford to overlook the fact that the behaviorally-focused interventions offered to those without means are insufficient to help most people most of the time.
Our full statement is here: PsiAN Statement on IL budget_2.23.19
JAN 2019: CALL TO ACTION: SAVE TALK THERAPY
Published by TherapyRoute, one of our Strategic Partners, this article provides an overview of the founding of PsiAN and outlines the top issues we’ve taken on to date.
Call to Action: Save Talk Therapy
JAN 2019: CHICAGO POLICE DEPARTMENT CONSENT DECREE
Calls for reform of the Chicago Police Department (CPD) have been made repeatedly, following a number of incidents of police violence and excessive force, culminating in Officer Jason Van Dyke’s shooting of Laquan McDonald in 2014. The federal Justice Department investigated the CPD, and called for a consent decree in Jan 2017, citing the police force as poorly trained and prone to excessive violence, especially against minorities. Finally, the City of Chicago was sued in August 2017 to force the adoption of a consent decree.
On Jan 12, 2019, the Chicago Tribune published the Letter to the Editor written by Nancy Burke, PsiAN Co-Chair. Her letter reiterates that increasing the number of mental health counselors at CPD to 10 pales in comparison to the need, and eloquently outlines the dangers of failing to take seriously the traumas that first responders and their mental health treatment providers might experience. Her letter is here: letter to Tribune editor_1.8.19
In August 2018, PsiAN wrote in support of the letter crafted by the ACLU and other profit organizations. We specifically highlighted the needs to support police officers and others, such as 911 operators, who may be impacted by trauma, and to increase resources dedicated to mental health treatment, including supervision for those counseling first responders. Our letter is here: PsiAN Comments on CPD Consent Decree_8.17.18
2018
DEC 2018: MENTAL HEALTH WORKERS AT KAISER ON STRIKE
Mental health workers at Kaiser Permanente have gone on strike, because they, as trained and licensed mental health professionals, “want more authority to apply their professional judgment to how often they see their patients and whether individual or group therapy is indicated.” (NUHW press release Nov. 29, 2018). They are also protesting Kaiser’s financial restrictions that effectively ration care, with some patients receiving psychotherapy only once every 3-4 weeks.
See PsiAN’s letter in support of high quality mental health care where the clinician is empowered to determine the course of treatment and the treatment relationship between clinician and patient is respected as central. Please download and share.
OCT 2018: CHILD AND FAMILY DETENTION and SEPARATION
In the face of ongoing and increasingly lengthy detentions of families — parents and children alike — coming into the US, PsiAN has signed onto a letter sent to the President outlining the psychological and emotional effects of such potentially damaging treatment.
To help disseminate, please download both letters below. The “Intro for Reps” letter introduces the Detention Letter. Please customize the “Intro for Reps” letter, and send to your congresspeople, attaching the “Child and Family Detention Letter.”
Child and Family Detention Letter_10.8.2018
Intro for Reps for Child and Family Detention Letter
June 2018: ILLINOIS: Social-Emotional Screening of School-Aged Children
Psychotherapy Action Network’s Children’s Committee has tasked itself with responding to a new Illinois state law requiring social emotional screening of school-age children. Although the law was passed, its implementation was not specified, and a governmental Rules Committee is working on that. PsiAN members Erika Schmidt and Karen Foley wrote the following letter to the mental health representative on the Rules committee expressing our concerns–among them the lack of resources for treatment statewide, lack of an effective referral process to the resources that do exist, possible stigmatization, and possible over-medication. PsiAN will continue to work toward establishing alliances and recommendations to address these problems.
PsiAN child screening letter 6.24.18
PROTECT PTSD TREATMENTS
Drafted petition to Protect PTSD Treatments that Work, with other concerned psychologists. The American Psychological Association claims it is helping psychologists and patients by creating an official position regarding which treatments work for PTSD. The problem is that this guideline did not take into account the evidence for intensive "talk therapy" and for other treatments that have helped countless thousands of traumatized people get back on their feet and change their lives. In fact, it's likely that this guideline will restrict those forms of therapy by giving insurers, clinics and policy makers a justification for denying coverage for all but the mostly short-term, structured and symptom-focused treatments they advocate. Help us preserve patients' right to choose from among the many forms of effective treatment for PTSD!