Volunteers In Psychotherapy

Competition Finalist

This entry has been selected as a finalist in the
Patients | Choices | Empowerment competition.

Volunteers in Psychotherapy (VIP) makes strictly private therapy available to anyone, regardless of their ability to pay or possession of health insurance. People earn their therapy in exchange for documented volunteer work they donate elsewhere, independently and privately, for the nonprofit, charitable or government agency of their choice.

About You

Organization: Volunteers in Psychotherapy Visit websitemore ↓↑ hide↑ hide

Section 1: You

First Name

Richard

Last Name

Shulman

Organization

Volunteers in Psychotherapy

Country

United States

Section 2: Your Organization

Organization Name

Volunteers in Psychotherapy

Organization Website

Organization Phone

(860) 233-5115

Organization Address

7 South Main St., West Hartford, CT 06107

Is your organization a

Non‐profit/NGO/citizen sector organization

Organization Country

United States, CT, Hartford County

Your idea

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Name Your Project

Volunteers In Psychotherapy

Country and state your work focuses on

United States, CT, Hartford County

Describe Your Idea

Volunteers in Psychotherapy (VIP) makes strictly private therapy available to anyone, regardless of their ability to pay or possession of health insurance. People earn their therapy in exchange for documented volunteer work they donate elsewhere, independently and privately, for the nonprofit, charitable or government agency of their choice.

Innovation

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What makes your idea unique?

VIP is increasingly recognized as an ethical, innovative alternative to the problems of managed care and public clinics (managed care and public clinics save money by limiting access to therapy; insurers require therapist reports which undermine privacy, and documentation of psychiatric services may go to employers). Since everyone sacrifices and contributes to the common good through VIP, we are able to function as an independent nonprofit. We provide strictly private therapy outside of the problematic lack of privacy and external control of managed care (and its profit motive toward strict rationing of therapy) or the similar budget-induced curtailment of therapy in public institutions. Those institutions often provide treatment from a primarily medical model. Many psychotherapy clients are seeking a private and trustworthy haven for discussion of powerful secrets in their personal and family lives, which are the source of their distress, confusion and sometimes self-destructive patterns of living. Many local people come to VIP for assistance, since they know we won't pressure them to take medication as the primary form of help. Where institutional psychiatric treatment can at times be coercive, we sign contracts with VIP clients that put them in the driver’s seat. As consumers (volunteering to earn their sessions), they know that they maintain their autonomy, but can consult their therapist at whatever rate suits their circumstances, to make sense of difficulties in their lives. This also fosters a sense of trust and personal responsibility, with clear boundaries and maintenance of civil liberties (which can be problematic in the psychiatric field).

Do you have a patent for this idea?

Impact

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What impact have you had?

In one of the poorest cities in the country (Hartford region) 420 individuals and families have earned over 3700 VIP therapy sessions. Local charitable and government agencies (hospices, schools, hospitals, soup kitchens, volunteer ambulance or fire corps) received 14,000+ hours of volunteer work. This provision of a truly private haven for therapy, which our clients earn through community volunteering, is our primary mission. People with severely traumatic personal circumstances, who have been sexually abused as children, grew up in violent or substance abusing homes, people undergoing wrenching divorces, or who have fallen into destructive patterns with their children – now have a private place to rethink and resolve entrenched difficulties.

A Doctoral Dissertation study of volunteers from among VIP clients documented their high valuation of therapy services they’ve received, and the volunteering they did in exchange. Our clients’ willingness to keep doing substantial volunteer work (4 hours/therapy session) demonstrates evidence in their actions that speaks louder than what they might arbitrarily write in an evaluation.

We’d now like to catalyze a greater impact by exporting adaptations of VIP’s approach. Nationally, over 90 therapists, agencies or psychological associations have contacted us about borrowing from our model. We’ve done that number of consultations with each, pro bono, by phone. Last year we were contracted by the Lehigh Valley Psychological and Counseling Association [LVPCA], to give a "kick-off" 3 hour continuing medical education presentation about VIP, with a continuing option to help them develop their own VIP-like service through ongoing consultation during the coming year. We've developed a listserv to assist these adaptations of VIP in other regions.

Problem

Millions of people have no access to therapy, can’t pay for it, or have insurance which undermines privacy and client control. Psychotherapy has been curtailed and greatly rationed. Insurers profit by supplying much less therapy – often declaring it “not medically necessary.” In the decade leading to 1998, insurance-based mental health funding decreased 54% (Hay Group, 1998). Access to psychotherapy was particularly severely cut; which trend has only grown. People with pronounced personal problems are less likely to be referred, or to have access to therapy

Privacy is undermined: Therapists are often required to send reports detailing clients’ personal lives to insurers. Employers may receive documentation of employees’ therapy involvement. People are justifiably reluctant to enter therapy, or to honestly explore embarrassing problems with compromised privacy [Supreme Court: Jaffee v. Redmond].

Public clinics often view people's emotional problems as quasi-medical disorders; utilizing medication, with little private exploration of secret dilemmas.

Actions

Through the American Psychological Association, National Psychologist and in multiple places on the internet, VIP has published offers to assist other communities develop adaptations of our program. We've been featured in articles, interviews and other publicity in the New York Times, Psychology Today, NPR and in multiple professional media. We've sought regional and national funding to underwrite the export/adaptation of VIP's charitable service. We've already done initial, one-time consultations with over 90 therapists in different regions on a pro-bono basis. We maintain a listserv to assist them in developing their own programs, adapting VIP's approach to their own area, needs and resources. We've been awarded 78 grants [from 30 foundations]to provide VIP's core program locally, but have no regional or national funding to help export VIP to groups of interested therapists elsewhere. These therapists might use our model, including stakeholders (such as ex-patients, families who have benefited from psychotherapy, college Psychology professors, and privacy and civil liberties experts) to form their Boards in developing their independent local programs.

Results

The initiative to export VIP is primarily aimed at helping others provide a similarly powerfully confidential and helpful therapy program in their own regions. We also see this effort as a way to develop a revenue stream to strengthen our local charitable service, much like the Community Wealth Ventures initiatives encouraged by Share Our Strength. Incipient community groups would also be required to contribute some matching funds toward the consultation they would receive from VIP. We would bill at a rate of $50/hr for our ongoing consultation as other community groups construct their organizations, and could help with "kick-off" events which describe the viability of the VIP model to local stakeholders -- as we've previously done with one community group (pro bono) already. (We've also given invited presentations to groups of therapists in Washington State, Boston, DC, NYC, the Lehigh Valley Psychological Association and a Midwestern medical school.)

What will it take for your project to be successful over the next three years? Please address each year separately, if possible.

A $10,000 grant would enable us to offer a competition to select at least 6-10 other incipient organizations who would receive a year's worth of consultation toward the implementation of their own charitable psychotherapy service. We envision each of them contributing $800-1000 toward the consultation (which they would be reimbursed through their own charitable fundraising as they attain nonprofit status), which sum would also evidence their own commitment toward construction of their particular organization, and would propel them toward their own fundraising. We are already in ongoing contact with the Lehigh Valley Psychological and Counseling Association, which has moderate resources which other communities might not have. We envision helping groups of therapists in each applying community to ally themselves with local stakeholders (ex-psychiatric patients, therapists, academics, civil libertarian groups, privacy advocates, families who've reaped the success of constructive therapy in the past, faith-based groups and org's with an interest in such a hard-working, community-building program, etc.) as well as local resources (nonprofit technical assistance programs, community foundations, United Ways, academic assistance through Business and Social Work departments, legal and accounting pro-bono programs) in order to construct their own Boards of Directors and organizations. We would guide them through this process, and would offer to help them publicize their local initiatives to garner resources. We would also help in construction of local "kick-off" events, documenting the viability of such a program through a presentation about VIP's model and their potential adaptation of it.

The first year would entail publicizing this competition and encouraging applications, followed immediately by selection of the best applications from regional programs. They would receive matching funds (and contribute their own), to begin consultation and catalyzing their inertia forward, based on their own resources and particular chosen adaptation of this service. These milestones should be easily accomplished in 1-2 years, with incipient programs functioning by the 3rd year. We developed VIP in less than 2 years; and have been a fully functioning IRS-approved nonprofit charity for over 11 years.

What would prevent your project from being a success?

Of the 90+ therapists we’ve consulted with pro-bono, the major reason for not progressing is their own lack of local allies, resources and money to develop their own programs. Ashoka/Amgen competition funding and publicity would help us to catalyze such regional initiatives -- giving them incentive to make alliances in order to receive matching funds to progress. Their own (required) contribution of seed money will further commit them to bringing their programs to fruition, with our consultative help.

We’ve overcome many obstacles in the 11 years of VIP’s functioning. We started with no particular access to funding; aided only by the enthusiasm of our Board (primarily psychologists, assisted by nonprofit specialists), their energy and persistence. The recession is difficult, but we’ve overcome such problems previously.

VIP is frugal. Our clients” volunteer contributions to local charities are matched by the sacrifices of our board and therapists. The latter receive less than half of average local fees (VIP pays $55 per session, up from $45 after 8 years). Our Board and director donated all administrative work, office space and local phone for 10 years, though now we’ve initiated a Director’s administrative salary ($9,000).

The ultimate reward is VIP’s spirit of fair exchange. Everyone contributes to the common good in an efficient and hardworking charitable endeavor. Most importantly, VIP preserves a haven where powerful and intensely personal concerns can be discussed and resolved – because of VIP’s privacy, and the sense of mutual commitment deriving from the work and sacrifice of all involved.

How many people will your project serve annually?

101‐1000

What is the average monthly household income in your target community, in US Dollars?

Less than $50

Does your project seek to have an impact on public policy?

Yes

Sustainability

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What stage is your project in?

Operating for more than 5 years

In what country?

United States

Is your initiative connected to an established organization?

Yes

If yes, provide organization name.

Volunteers In Psychotherapy

How long has this organization been operating?

More than 5 years

Does your organization have a Board of Directors or an Advisory Board?

Yes

Does your organization have any non-monetary partnerships with NGOs?

No

Does your organization have any non-monetary partnerships with businesses?

No

Does your organization have any non-monetary partnerships with government?

No

Please tell us more about how these partnerships are critical to the success of your innovation.

We don't have formal "partnerships" with nonprofits, but we’ve consulted with nonprofit legal and accounting assistance programs, have received training through several area foundations and technical assistance programs (fundraising, grant-writing, communications, publicity, etc.). We’ve cultivated connections with volunteer programs (hospitals, universities) to make VIP visible. We’ve developed ad-hoc alliances and initiatives with relevant academic departments locally, producing lecture or film events to make VIP visible at minimal cost, and to build the legitimacy of our unique approach. We’ve also gained Board members from these academic alliances. We've built connections with groups of ex-patients which have raised VIP's visibility as an ethical, non-coercive program.

Similarly, we’ve developed relationships that have brought us “in-kind” donations of fine stationery (from Southworth paper company on 4 occasions) to construct our own newsletters and brochures; donations of refurbished computers from corporations and the United Way, as well as paper-cutting and printing services – all in the effort to minimize overhead.

What are the three most important actions needed to grow your initiative or organization?

We’ve been successful in securing 78 grants from 30 (mostly local charitable) foundations, in order to offer our local charitable service for eleven (11) years now. But we’ve not yet been able to develop regional or national funding in order to export VIP to the 90+ therapists who’ve contacted us in other locales. We already have a wonderfully functioning program locally. We have an ethic of frugality, minimal overhead and shared work from both VIP as an organization and from our clients. We have the respect of professional psychotherapists, of ex-psychiatric patients who are justifiably critical of the sometimes coercive and inhumane institutional treatment they experienced, and of our many other VIP clients (as documented in a confidential survey of volunteers from among VIP clients, done as part of Clinical Psychologist, Dr. Robert Hubbell’s Doctoral Dissertation). We’ve been honored as recipients of the 2003 award of the American Institute of Medical Education and the 2000 Award for Distinguished Psychological Contribution in the Public Interest of the Connecticut Psychological Association. We primarily need:

1) modest funding, such as this Ashoka/Amgen grant, which would help catalyze groups in other regions to take advantage of the competition for matching funds that we would immediately run, in order to gain access to our ongoing consultation. 2) Secondly, the visibility that our receipt of this Ashoka/Amgen award would elicit interest from other therapists and communities who hadn’t previously heard of VIP’s approach. Some would be interested in bringing a VIP-like organization to their own communities -- and others would want to help us to do our work. 3) Third, receipt of such a heightened honor will undoubtedly bring other resources regionally and nationally, such as more publicity, offers of assistance, constructive suggestions and other resources, etc.

The Story

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What was the defining moment that led you to this innovation?

I'd been working for 10 years as a licensed clinical psychologist in a downtown Hartford psychiatric clinic (Hartford Hospital - Institute of Living) that primarily saw poor, uninsured people, many of whom came to us first through the emergency room, or from the state psychiatric hospital.

Increasingly, people who sought psychotherapy were instead diverted into medication groups, or short term "educational groups" on a given topic. This was a cost-saving measure, and also reflected the growing biological perspective on "psychiatric disorders" of the heads of the psychiatric services. Almost every patient was prescribed medication, no matter what their stated preference.

By coincidence, two young women came to my clinic for separate "intake" interviews with me -- in the same summer. Each confided to me that they'd been sexually abused as a child, that they were still greatly troubled and led their lives in self-destructive ways because of their pasts.

However, under new "managed care" procedures, each was blocked from the private therapy that they were seeking. Both times the insurer stated that they wouldn't pay for such "open ended" explorations -- instead, they'd be happy to pay for these women to enter medication groups, or to join a time-limited psycho-educational group.

Research has documented the alarming frequency of child sexual abuse. Psychotherapists frequently learn secrets, in the course of their work; that sexual or physical abuse, growing up in a home where a parent was frequently drunk or violent, or other upsetting, confusing of shame-producing secrets from someone's past can often be the root of unsolved problems in someone's life.

Trustworthy and strictly private discussions about such sensitive topics, with an experienced, well-trained third party (psychotherapy), can be a powerful method of exploring and helping to resolve such problems.

The fact that third party insurance reimbursed psychotherapy has become increasingly inaccessible, and much less private, doesn't have to block people of modest means from access to therapy.

I constructed VIP together with two psychologists whom I’d known for years. We had often shared major criticisms of the different hospital and clinic programs we’d worked in, which often made the requirements of therapy (particularly privacy, voluntary participation and exchange or payment for services received) secondary to their own institutional needs.

We specifically designed VIP's "payment system" of volunteer work in exchange for therapy for a number of reasons: it makes clear that the therapy is voluntary, and is a fair-trade system where someone gets help for giving help. It implicitly says to all VIP clients that they have something of value to offer others. This isn't a “hand out,” but instead is part of an exchange system in which everyone sacrifices a bit and contributes to the common good (clients, therapists and VIP administrators). VIP clients know they've earned their therapy services through their own work. The volunteer work brings a sense of accomplishment, contribution to a good cause, and social interaction and community teamwork to VIP clients.

Tell us about the social innovator behind this idea.

I’m Rich Shulman, a licensed clinical psychologist. I left my position at a local downtown hospital psychiatric clinic to found VIP after years of work there and in other adult and children’s psychiatric clinics. [I'm still a member of Hartford Hospital - Institute of Living's Institutional Review Board, overseeing ethical and "informed consent" issues in psychiatric and medical research.]

After college, when I was deciding what graduate work to do, I left the US for the first time, working as a volunteer in a school for troubled kids in England, through “Community Service Volunteers.” For the two summers on either side of that experience I worked with troubled kids in the states in a summer camp program run by a social worker. I had planned to study Sociology in Graduate School at the University of Michigan, where I had been given a Rackham First Year Fellowship, but I transferred elsewhere after one year to study Clinical Psychology, largely because of my volunteer work experience after college.

My family background was not academic or white collar. My father worked with small farmers shipping potatoes and other produce, in a small business now run by my sister. His father had worked in produce markets and my other grandfather was a tailor. They and my grandmothers, who worked with them in those small family businesses, had all come to America to avoid the persecution that lost them their families who’d stayed behind in Europe. There’s an old joke: What’s the difference between a psychoanalyst and a tailor? Two generations.

I like my work because you end up gradually having meaningful conversations with people about secret concerns they have difficulty articulating and understanding -- private matters they wouldn’t discuss anywhere else. If trust, patience and good communication develops, you often end up discussing very real traumas and secrets they wouldn’t divulge in any other setting – secrets that drive people to drink and self-destruction, or to problems with their families or jobs.

VIP has allowed me and other therapists to do this good, meaningful work. We’d like your support so that we can help other psychotherapists and interested "stakeholders" who are already motivated to do similar work in their own communities.

How did you first hear about Changemakers?

Email from Changemakers

If through another, please provide the name of the organization or company

e-mail from Tyler Ahn on 9/28/10

177 weeks ago Richard Shulman said: Thanks, Meghan. It’s nice to know that we have friends (and referrers) at the Mental Health Association. It is a serious problem ... about this Competition Entry. - read more >
177 weeks ago said: As an information and referral resource for people looking for help with mental health issues, Volunteers in Psychotherapy is a Godsend. ... about this Competition Entry. - read more >
177 weeks ago Richard Shulman said: Thanks for your comments about Volunteers In Psychotherapy. First, to Deborah Brown’s comments about the importance of participating ... about this Competition Entry. - read more >
177 weeks ago said: VIP is pursuing a unique concept especially in times like these when people need psychotherapy but don't have money to pay for it but ... about this Competition Entry. - read more >
178 weeks ago said: love this organization, fills a real need, and shares volunteering as part of its payemnt plan. about this Competition Entry. - read more >
178 weeks ago said: This is an idea whose time has come. Nothing is more encouraging or empowering to an individual seeking help with mental or emotional ... about this Competition Entry. - read more >
178 weeks ago Jacquelyn Caglia said: Congratulations on being selected as a finalist! about this Competition Entry. - read more >
178 weeks ago Volunteers In Psychotherapy has been chosen as a finalist in Patients | Choices | Empowerment.
185 weeks ago Richard Shulman updated this Competition Entry.
185 weeks ago Richard Shulman updated this Competition Entry.