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Robert's Blog

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Now Accepting Insurance!

I’m happy to share that I have started accepting insurance! To do so, I have partnered with Grow Therapy, a company with a brilliant model that essentially takes the time consuming and confounding work of interacting with insurance companies out of the hands of therapists so that we can focus entirely on what we do best - therapy! Part of participating in this partnership means that as a client you will likely interact with Grow’s scheduling portal or billing platform but all of it is still tied to me. It might just look a little different than what you see here on my website. I’m genuinely excited about this development and would like to share my process for making the decision to accept insurance.


In my personal experience as a patient there have been a number of instances in which I have had to devote hours of effort to ensure that routine services get covered by my insurance. I am sure that many of you have had similar experiences. Precious free time has been spent on hold over the phone or filling out long and confusing forms that have often required the assistance of my mental health provider. As a provider myself, for as far back as I can remember, I have desired to start a private practice that is completely self-pay. No insurance. Even as a graduate student, before I saw my first client, I was aware of the pitfalls of working with insurance companies. I had heard stories of how they make clinicians jump through hoops to receive reimbursement and heard tell of more than one nightmare scenario where a therapist went months without receiving pay for the services that they provided. So it was decided - I would start my own practice and free myself from the whole system by only accepting cash. 


It can seem as though the whole insurance business is based around maximizing their profit at the expense of patients who need care. That can be frustrating and it has actually been the topic of more than one therapy session with some of my past clients. As recently as this past March I was steadfast in my decision to maintain a practice without accepting insurance. I came across a story published by ProPublica about Cigna and the internal system they have set up to reject patient claims without ever examining the details of those claims. The story suggests that Cigna is not alone in this practice. And to be fully transparent, as a provider it has been my experience that Cigna is routinely one of the lowest reimbursing insurance companies. So why would I want to work with them? 


The system as it exists today, with all of its flaws and the machine of capitalism driving aspects of it to injustice, is the only system we have. So I’ve found a way to work with it. Because in doing so there are clear benefits for both me and my clients. One of the nagging doubts that I have had about a practice that does not accept insurance is how that practice would limit access to care. And as we have heard over the past three years, the demand for care is high. Accepting insurance means lower costs for clients and it means more referral sources for my practice. These are positive things, to be sure. Ultimately this is what has led to decide to begin accepting insurance. I want as many people as possible to get the mental health care they need. There are some things that clients need to keep in mind, however.


Accepting insurance usually means that I must provide the insurance company with a formal mental health diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Providing a diagnosis is something that will be a part of your medical records. These records are protected by law (HIPAA) and should remain confidential but in some situations a diagnosis could be the subject of discrimination and make access to things such as employment, housing, and military service more difficult. How you choose to talk to others about your therapy is, of course, entirely up to you. But stigma could make disclosing a mental health diagnosis to others a complicating factor in relationships with others. It could even lead to challenges in regards to how we think about ourselves. These are all things to consider when using insurance to cover therapy costs and I am more than willing to help you think through them as you decide what is best for your situation. Contact me and let’s discuss. Should you decide that using insurance is not the best choice for you then paying out of pocket is still an option.


For many people using insurance is an easy choice and I am entering into this aspect of my practice with hopefulness and great anticipation!

May 4th, 2023


Kooth and virtual support for teens

In a recent article published in the wellness section of the Philadelphia Inquirer, journalist Kristen Graham reported on a new app called Kooth that is now available to all Philly high school students. The app is free and confidential. It gives teenagers access to informative articles about mental health, discussion boards where teens can engage in conversations with peers about a variety of mental health related topics, a mood journal to help teens track what helps and what doesn’t, and a messaging function for those looking for support from a real live professional. That last detail is key, as I’ll mention later. Naturally as a mental health clinician I found this to be exciting news! But it appears as though not everyone shares in my excitement, as the article mentions that some parents are concerned about privacy, the disclosure of personal data and at least one other person interviewed for the article expressed their opinion that their teen already spends too much time on their smartphone and this is actually the main problem. Perhaps these are reasonable concerns for today’s parents but I found myself wondering if these potential risks actually outweigh the benefits. 


I”ll admit that I was disappointed that this article did not include any research regarding the efficacy of virtual mental health resources. Because it’s out there. In fact, there is already been research conducted about Kooth specifically as it has been used in the UK for several years now. A study published in 2022 for example, has found that over a one month period Kooth was able to help participants reduce "psychological distress, suicidal ideation and loneliness". 


Additionally, while smartphones and access to the internet without boundaries or adult participation can lead to problems for adolescents, we need to acknowledge that phones, social media, and texting are how many of our youth are learning to make social connections. As licensed clinical psychologist Dr. Sharon Saline says, “Virtual reality is their reality.” Whether we like it or not, regardless of how different it may be from our own childhood and upbringing, the fact remains that smartphones have become a necessary part of our teenagers and emerging adults social lives. And, as we’re seeing with the surge of artificial intelligence technology, they may already be accessing virtual options for advice and companionship. The problem, of course, is that AI chatbots like Snapchat’s My AI are not actual people. There is no professional person sitting on the other side of our teenagers AI chat about things like dating and early sexual experiences and that’s how we end up with problematic and dangerous exchanges.  So why not give our teens an option to use their device for something healthy? Kooth is  a no- cost, low barrier option when other resources are not available or are not effective. This is a good thing. 

April 17, 2023

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