This is an exciting initiative, especially since bridging a link between the community and volunteer efforts has the potential to change the field of mental health. However, would you mind providing more information on how the volunteering process works? Also, who are your community partners? It’d be great to hear more about your model. Thanks for a great entry!
I appreciate your interest in VIP and your request for clarification. Now I can get into the details without worrying about word-count limits in the application! ;-)
When people first contact us, we brainstorm with them about options for volunteering (based on their particular interests in choosing a place to work, their specific location or availability, etc.) We mention to them local volunteering resources such as websites which post the requests of local nonprofits for volunteers, or Infoline, the statewide information and referral service of the United Way. We tell them about opportunities through town volunteer offices, hospitals, and specific agencies they might contact based on interests they mention to us. But they then contact the agency on their own, so that their connection with VIP doesn’t compromise their privacy regarding being in therapy.
We want our therapy clients to maintain their confidentiality in volunteering – so they just take the initiative on their own to contact whatever charitable or nonprofit organization or government agency suits them. That is, they volunteer without anyone at the agency knowing of their involvement with therapy through Volunteers In Psychotherapy. So, a person contacts a hospice or children’s hospital, an agency that assists the blind, a medical charity, state department of environmental protection, a soup kitchen, library, school, etc. and offer to help – as any other volunteer would.
The "ticket" for a person to get started with VIP is the documentation the agency gives them of the hours they’ve worked. So, if a person gets a thank you letter, a copy of their schedule, a time log or sign in sheet – even a printed e-mail exchange in which they get their agency to confirm to them the number of hours they’ve donated, and when they volunteered – when they get it to us, they've earned their first session, and they’re set to begin therapy. The agency doesn’t need to be in touch with us, nor do they write to us, nor do they even know that their volunteer is in therapy through VIP.
We also give "back credit" for volunteer work an applicant to VIP may have already done, in the two (2) months before they first call us. We give extra credit for some types of volunteering: donating blood (or platelets, plasma) through the Red Cross or donating hair that is made into wigs for children who’ve lost their hair through cancer treatments through Locks of Love.
As to our community partners: we’ve established contacts with the United Way, with volunteer offices of local colleges, area hospitals, volunteer offices in local town halls, the Connecticut Women’s Education and Legal Fund, Advocacy Unlimited (a recovery and assistance group for people who’ve had psychiatric difficulties), with local homeless shelters or shelters for battered-women, psychiatric clubhouses and self-help groups, chapters of Parents without Partners, state psychiatric hospitals, the local mental health association, and other relevant agencies. We’ve spoken repeatedly at health and mental health fairs run by senior centers and colleges, at YWCA sexual assault resource conferences, and at local town counseling agencies, or college and high school counseling departments. There is no formal partnership, but our ongoing relationships through all these agencies makes VIP known as a private resource for therapy at no cost.
We’ve partnered with many academic graduate and undergraduate departments of psychology, sociology and counseling at local universities (Yale, Wesleyan, Trinity, University of Connecticut, U. of Hartford, CCSU, St. Joseph’s College) in order to produce colloquia, guest lectures, evening lecture/film events that are open to the public – all of which describe VIP and its embodiment of core values which are often lacking in other mental health institutions. We hope that these discussions promote thought about the nature of this field of endeavor and programmatic attempts to help people.
Also, we’ve strengthened VIP’s charitable service by "partnering" with many agencies who have provided help to us ("in-kind" donations) for free: we were given free consultation by the University of Connecticut Law School (faculty and students who specifically researched information for us relevant to the "export" of VIP), the Legal Center for Connecticut Nonprofits, Community Accounting Aid and Services (a nonprofit that provides pro bono accounting assistance); the local United Way, CT Association of Nonprofits and the Hartford Foundation for Public Giving, all of whom have provided consultation, workshops or access to libraries or online databases which have helped us. We’ve gotten for-profit businesses to repeatedly donate quality stationery (Southworth Paper Company) that we’ve printed into brochures or newsletters, or to cut paper into usable sizes for such purposes (Southington Printing Company, Printing Express), or on several occasions to donate used computer equipment or discounted toner cartridges.
We believe we’ve been successful in eliciting this help because people at these businesses and nonprofits have wanted to partner with us on the basis of the relatively selfless nature of VIP’s work, and its unique approach to fulfilling an important community need -- including an organizational culture in which everyone sacrifices a bit for the common good.
I think this is a great idea. So many people don't have insurance that covers mental health coverage, and can't afford to pay for therapy, so this is an interesting way of giving people access to therapy and ensuring that it is something they really want to do.
I have a couple of questions:
1. How do you ensure the quality of the people providing the therapeutic service? Do you check references, or board certifications, etc.? And are the therapists who participate in VIP required to volunteer a certain number of hours per month to help your clients? Do you have any type of feedback system that allows you to hear back from the clients as to how their therapy sessions went?
2. How do you let consumers know that your program exists? Many people don't ever come in contact with a psychiatrist or therapist, partly because they are specialists, partly because they may fear needing to use such services because of stigma, and partly because of the privacy reasons you mention in your entry. Is it simply word of mouth, or do you use any types of nontraditional messaging in nontraditional locations (outside of hospitals or health clinics)?
Thanks for your questions and for your kind comments. I’ll break out the questions and reply.
How do you ensure the quality of the people providing the therapeutic service? Do you check references, or board certifications, etc.? And are the therapists who participate in VIP required to volunteer a certain number of hours per month to help your clients? Do you have any type of feedback system that allows you to hear back from the clients as to how their therapy sessions went?
All of the therapists who apply have to be fully licensed by the state. Besides the documentation they all submit, and preliminary written and phone interactions, we ask them to reserve a 2 hour block for us to have an intensive discussion of a particular client they’re working with. That is, we ask therapists to do an anonymous case presentation (they discuss a person they’re working with, but without divulging any identifying information) in which they review how one particular session went in great detail. By focusing on one session in such fine detail (together with whatever relevant information would put that session in context) – we get a very specific sense of how the therapist works, what they think in response to each comment of their client, how they form judgments about others, etc. [I forgot to include: we've mostly worked with Clinical Psychologists, though VIP therapists have also been Social Workers, Licensed Professional Counselors and one Psychiatrist.]
VIP therapists have always been paid less than half the average local fee. For years VIP paid $45/session – only increasing to $55 a couple of years ago. That low reimbursement rate stopped several therapists from pursuing work with us – but we also had to consider our own ability to raise grants and donations to pay therapists (VIP’s major expense). In effect, to work for VIP, most therapists are donating a portion of their time, since the pay is so low. Some donate additional funds to VIP and some have donated most of what they earn from VIP back to the organization. As I mentioned in the application, for the first 10 years of the organization all administrative work was donated to VIP, as well as office space and local phone, in order to strengthen our program by limiting overhead. Now the Director is paid $9,000 yearly, and in the last several months, VIP has begun to pay the rent for the office.
As to feedback mechanisms – We feel strongly that VIP’s strength derives from returning therapy clients to the role of being the consumer who "pays" for their own services, rather than having them remain passive in the face of decisions made by their "third party payer" (managed care, insurance company, or government payer). In that sense, our clients’ willingness to keep doing substantial ongoing volunteer work (4 hours per therapy session) demonstrates their own valuation of the services they receive. That is why we emphasize that we believe in fair exchanges. Clients get something in exchange for giving something back to the community, which should demonstrate VIP’s ongoing worth to them. People’s continued volunteer work in order to receive therapy sessions provides evidence in their actions that speaks louder than what they might arbitrarily write in an evaluation regarding their satisfaction with VIP services they receive.
Also, VIP clients choose from among our available therapists. Our clients have the right to interview their prospective VIP therapist, to switch to another available therapist – even to meet with several therapists – although this rarely happens. We encourage clients to discuss any difficulties, misunderstandings or frictions that may arise directly with their therapist; since frank exploration of miscommunications, differing expectations, assumptions about what the other person is saying can be key to making sense of another person with whom you’re discussing sensitive personal matters.
Another interesting feedback loop is that a Doctoral Psychology dissertation study was done about VIP clients. It would take a while for me to describe the safeguards, protections of privacy and client prerogatives which went into how we let our clients know about the option of anonymously being interviewed by the researcher. But ultimately, a sample of VIP clients were interviewed by that researcher, leading to a dissertation by Dr. Robert Hubbell. That dissertation is available through library resources, and is cited in the Hartford Courant 2007 feature article about VIP.
Eve, you may be interested to know that many VIP clients in this study spoke of their appreciation of the fact that VIP’s structure puts them in the position of helping others in their volunteer work. So that, though they’re receiving help through VIP, it is just part of the system in which they’re helping someone else in the community.... addressing the issue you raised.
How do you let consumers know that your program exists?
If you google the term "Volunteers In Psychotherapy" you’ll see hundreds of articles, interviews, references and other online mentions of VIP. We’ve made all sorts of efforts to inexpensively spread the word about our work, so that people can know about VIP’s charitable service’s availability to them. We have our website, postings on Craigslist, links on other mental health websites and online articles about VIP. There have been online interviews that have been reproduced on dozens of mental health websites.
We post VIP brochures in libraries, volunteer offices, hospitals, health clinics, town halls, pharmacies, groceries, banks and other stores, nonprofit agencies, and even on an easel on the sidewalk outside our central office. We’ve given public talks at state psychiatric hospitals, at psychiatric clubhouses, for self-help groups, shelters, and for any civic or community group that we can arrange (Kiwanis, Regents, Parents without Partners, Mended Hearts, etc.). We’ve spoken at sexual assault resource meetings of the YWCA, at regional mental health boards, at health and mental health fairs run by colleges and senior centers. We’ve put on lecture and film events in conjunction and co-sponsorship with university Psychology departments and Psychology clubs; events whose publicity we’ve magnified by arranging local print or media interviews. We’ve arranged interviews with local TV news stations, with public access television on numerous occasions and with whatever media outlets we can reach. We’ve given dozens of guest lectures at public libraries and universities, as well as colloquia.
As we mentioned in our application, we’ve ultimately affected the publication of feature articles in the New York Times, Psychology Today, Hartford Courant (several times), Hartford Advocate, and numerous professional publications such as the American Psychological Association’s Monitor on Psychology or a competing publication, the National Psychologist. We’ve given presentations about VIP at the conferences of the American Psychological Association, Connecticut Psychological Association, American Institute of Medical Education and a Grand Rounds at a midwestern medical school, as well as other conferences. The New England Psychologist has several times published features about us, as have some other professional publications (Mental Health Weekly, Family Therapy Networker, Psychotherapy Finances). An interview was aired on National Public Radio through the Marketplace show and we had been described in Worth magazine.
We’ve also given many presentations about VIP at psychiatric consumer conferences (several by Advocacy Unlimited in CT, in years past) such as the Alternatives conference hosted in 2007 by MindFreedom International. We’ve continued committee work that derived from that conference, toward the publication of listings of non-coercive psychiatric treatment programs.
[I should've also mentioned: we get lots of referrals from Infoline, a statewide information and referral service of the United Way. Also, some prominent public psychiatric clinics in greater Hartford, which really don't offer much access to private psychotherapy, now mention VIP to people who call them seeking such services.]
This is indeed an intriguing idea and I would like to know how the author answers the questions a previous commenter posed. At the same time, I applaud the concept of volunteering in exchange for therapeutic services. Receiving treatment is often an experience that puts the person receiving services in a 'one down' position, which is quite contrary to the goal of treatment: to help the person up. This model certainly deserves consideration.
You'll see that I integrated a response to the issue you raised in the long response to Katherine. I'm sorry that I can't seem to get the formatting to include the paragraph breaks I'd inserted - for ease of reading.
I really do think you are doing great work and I wish you the best on spreading your idea to others. It's nice to see such empowerment and positivity built into the need for psychotherapy, which is often considered (mistakenly, I believe) as a negative thing.
On November 20, 2009 the judges reviewed the entries for the Changemakers Rethinking Mental Health: Improving Community Wellbeing competition and would like to pass on the following feedback (listed below) for your entry. Thank you for applying and for your hard work in the field. We are excited to archive your entry to serve as a leading solution for the worldwide community of innovators. We wish you continued luck with your innovative, sustainable, and socially impactful initiatives.
All the best, The Changemakers Team
“Thanks for a great entry! This idea is very innovative, and we’re intrigued by your unique strategy toward creating care systems and integrating them with meaningful volunteer work. Your time-dollar model is interesting, but it does seem a little small scale. How would you plan to grow and replicate this initiative? Do you use references to refer the volunteers? In general, how do you screen the volunteers? We’re also interested in learning how therapists are meeting the needs of individuals with serious mental illnesses. Lastly, how do you address stigma? Thanks!”
- Changemakers Rethinking Mental Health: Improving Community Wellbeing Judges
Hello, and thanks for posting the Judges’ comments about Volunteers In Psychotherapy’s application.
It’s true that we’re small scale: We started VIP over ten years ago with no resources except the energy and enthusiasm of several founding Clinical Psychologists (who could envision a better alternative to the problematic, compromised and limited provision of therapy through managed care and public clinics), and some people with nonprofit expertise who enlisted to help. Over ten years of service, we’ve helped almost 400 individuals and families – a number which is accelerating as VIP’s charitable service is increasingly well known.
As I mentioned in our application, national publicity has yielded roughly 90 licensed psychotherapists who have contacted us, inquiring how they might collaborate, or develop a similar program in their locale. For years we’ve provided free initial consultation with each of them by phone. Now we’re at the point of offering ongoing consultation with such developing community groups. Besides helping them develop their adaptations of VIP without “reinventing the wheel” – another benefit will be to VIP. We’d ask some fees be paid for this more intensive, ongoing consultation. That earned income will strengthen our program [that’s where our Ashoka/RWJF application borrows the model of “Share Our Strength/Community Wealth Ventures”].
Most of these free initial consultations stop when these therapists in other states realize that they’ll have to put considerable effort [in collaboration with other stakeholders in their community] into developing their own nonprofit organization. People tend to be overwhelmed with the prospect of donating so much time and effort into getting started.
Our plan to grow this initiative is just what we proposed in our Ashoka/RWJF application: if we attracted seed money from a national or regional funder, we might use this to attract some of these many other beginning community groups to commit their time, energy and a small amount of matching funds to developing their own organizations. We proposed having a competition of our own; for these groups to apply to receive funds to underwrite ongoing consultation with us, to help each community group develop their nonprofit program. Based on their applications, we’d select 3-5 nascent community groups who would be awarded matching grants to fund ongoing consultation with VIP to develop their own community adaptations of our program.
We’d love for others to help us grow from being “small scale” by suggesting resources by which we might help others to adapt this model. Our experience has been that nascent community groups have to overcome the initial inertia to rally a small cadre of stakeholders to get moving on their project.
We’d also benefit from suggestions which might strengthen VIP’s core program locally. Though we’ve been awarded 77 modest grants from 30 foundations, most of our supporters are local.
When you ask about references to refer the volunteers… I assume you mean to their volunteer work? Our clients choose any IRS-approved charity or nonprofit which serves the community, or government agency (public school, Town Senior Citizen center, volunteer fire dept., etc.) where they want to volunteer.
When each new person calls us, we help them make decisions about where to volunteer, point them to information about volunteering which is available locally, [United Way websites or the United Way “Infoline” information and referral service, hospital, town and university volunteer centers,etc.] But our new clients make the inquiry about volunteering at their chosen agency individually. We don’t get involved, to maintain their privacy regarding their use of VIP services. Then they just get us documentation of hours they’ve donated (a copy of their schedule, sign-in sheet, thank you letter, acknowledgment that they donated blood, a printed e-mail confirming the hours they’ve worked, etc.) The agency doesn’t need to know that the person is in therapy through VIP.
We don’t screen volunteers -- the volunteer agencies routinely do that. If anyone offers to help at a soup kitchen, hospital, school, nursing home, etc. – they’re screened or go through orientation/training, etc. VIP clients have to find a place that will find them useful and trustworthy. [Professional volunteer administrators regularly discuss this issue: that it isn’t helpful to an organization to have volunteers who detract from their work, rather than contribute to it.] We’ve had people supply medical or legal or grant-writing services… and others who have re-shelved books at a library, shoveled community gardens, cleared brush from hiking trails or pushed a broom for a town public works department.
We work with a reasonable number of people who would be considered to have “serious mental illnesses.” Many of them are happy for VIP’s system which treats them with respect, is strictly voluntary, strictly private, non-coercive and non-paternalistic. Some people come to us as an alternative to more coercive public systems.
Some of the VIP psychotherapists have worked in clinics and hospitals which specialize in such clientele – people who have been in and out of state hospitals. I’ve learned through my association with ISPS-US [The International Society for the Psychological Treatments of the Schizophrenias and Other Psychoses] for 15-20 years. For roughly that long I’ve been in touch with Dr. Bertram Karon, Professor of Psychology at Michigan State University, former President of the American Psychological Association’s Division of Psychoanalysis, and author of Psychotherapy of Schizophrenia: The Treatment of Choice. Bert was one of VIP’s references for this application, and has been on VIP’s Advisory Board for years. Together we have prepared joint presentations about working with severely troubled people at two American Psychological Association conferences and an ISPS international conference.
So, we’re committed to providing VIP as a humane, respectful haven for addressing these sorts of severe difficulties.
We think we address stigma through the substantial privacy and personal control we provide to clients through VIP.
For example: for roughly 20 years I’ve served on the Institutional Review Board of Hartford Hospital – Institute of Living. We oversee ethical and “Informed Consent” issues in medical and psychiatric research.
Through VIP, we give informed consent to clients by trying to accurately reflect back to them the dilemmas and conflicts they communicate to us as we help make sense of them. Because of the privacy we provide and the autonomy our clients maintain – and since we think of VIP as treating people as human beings with a life story which often is at the center of their difficulties and confusions -- stigma is inherently addressed in our manner of working.
Here’s a message we got from one person: “I think your program is wonderful. [Public clinics] have little idea what ‘private’ means. A lot of people don’t even know that they’re entitled to this sort of dignity.”
I hope this addresses the questions you raised. I’d be happy to correspond further.
Comments
This is an exciting initiative, especially since bridging a link between the community and volunteer efforts has the potential to change the field of mental health. However, would you mind providing more information on how the volunteering process works? Also, who are your community partners? It’d be great to hear more about your model. Thanks for a great entry!
- Naveen Shakir, Ashoka’s Changemakers
Hi Naveen,
I appreciate your interest in VIP and your request for clarification. Now I can get into the details without worrying about word-count limits in the application! ;-)
When people first contact us, we brainstorm with them about options for volunteering (based on their particular interests in choosing a place to work, their specific location or availability, etc.) We mention to them local volunteering resources such as websites which post the requests of local nonprofits for volunteers, or Infoline, the statewide information and referral service of the United Way. We tell them about opportunities through town volunteer offices, hospitals, and specific agencies they might contact based on interests they mention to us. But they then contact the agency on their own, so that their connection with VIP doesn’t compromise their privacy regarding being in therapy.
We want our therapy clients to maintain their confidentiality in volunteering – so they just take the initiative on their own to contact whatever charitable or nonprofit organization or government agency suits them. That is, they volunteer without anyone at the agency knowing of their involvement with therapy through Volunteers In Psychotherapy. So, a person contacts a hospice or children’s hospital, an agency that assists the blind, a medical charity, state department of environmental protection, a soup kitchen, library, school, etc. and offer to help – as any other volunteer would.
The "ticket" for a person to get started with VIP is the documentation the agency gives them of the hours they’ve worked. So, if a person gets a thank you letter, a copy of their schedule, a time log or sign in sheet – even a printed e-mail exchange in which they get their agency to confirm to them the number of hours they’ve donated, and when they volunteered – when they get it to us, they've earned their first session, and they’re set to begin therapy. The agency doesn’t need to be in touch with us, nor do they write to us, nor do they even know that their volunteer is in therapy through VIP.
We also give "back credit" for volunteer work an applicant to VIP may have already done, in the two (2) months before they first call us. We give extra credit for some types of volunteering: donating blood (or platelets, plasma) through the Red Cross or donating hair that is made into wigs for children who’ve lost their hair through cancer treatments through Locks of Love.
As to our community partners: we’ve established contacts with the United Way, with volunteer offices of local colleges, area hospitals, volunteer offices in local town halls, the Connecticut Women’s Education and Legal Fund, Advocacy Unlimited (a recovery and assistance group for people who’ve had psychiatric difficulties), with local homeless shelters or shelters for battered-women, psychiatric clubhouses and self-help groups, chapters of Parents without Partners, state psychiatric hospitals, the local mental health association, and other relevant agencies. We’ve spoken repeatedly at health and mental health fairs run by senior centers and colleges, at YWCA sexual assault resource conferences, and at local town counseling agencies, or college and high school counseling departments. There is no formal partnership, but our ongoing relationships through all these agencies makes VIP known as a private resource for therapy at no cost.
We’ve partnered with many academic graduate and undergraduate departments of psychology, sociology and counseling at local universities (Yale, Wesleyan, Trinity, University of Connecticut, U. of Hartford, CCSU, St. Joseph’s College) in order to produce colloquia, guest lectures, evening lecture/film events that are open to the public – all of which describe VIP and its embodiment of core values which are often lacking in other mental health institutions. We hope that these discussions promote thought about the nature of this field of endeavor and programmatic attempts to help people.
Also, we’ve strengthened VIP’s charitable service by "partnering" with many agencies who have provided help to us ("in-kind" donations) for free: we were given free consultation by the University of Connecticut Law School (faculty and students who specifically researched information for us relevant to the "export" of VIP), the Legal Center for Connecticut Nonprofits, Community Accounting Aid and Services (a nonprofit that provides pro bono accounting assistance); the local United Way, CT Association of Nonprofits and the Hartford Foundation for Public Giving, all of whom have provided consultation, workshops or access to libraries or online databases which have helped us. We’ve gotten for-profit businesses to repeatedly donate quality stationery (Southworth Paper Company) that we’ve printed into brochures or newsletters, or to cut paper into usable sizes for such purposes (Southington Printing Company, Printing Express), or on several occasions to donate used computer equipment or discounted toner cartridges.
We believe we’ve been successful in eliciting this help because people at these businesses and nonprofits have wanted to partner with us on the basis of the relatively selfless nature of VIP’s work, and its unique approach to fulfilling an important community need -- including an organizational culture in which everyone sacrifices a bit for the common good.
I think this is a great idea. So many people don't have insurance that covers mental health coverage, and can't afford to pay for therapy, so this is an interesting way of giving people access to therapy and ensuring that it is something they really want to do.
I have a couple of questions:
1. How do you ensure the quality of the people providing the therapeutic service? Do you check references, or board certifications, etc.? And are the therapists who participate in VIP required to volunteer a certain number of hours per month to help your clients? Do you have any type of feedback system that allows you to hear back from the clients as to how their therapy sessions went?
2. How do you let consumers know that your program exists? Many people don't ever come in contact with a psychiatrist or therapist, partly because they are specialists, partly because they may fear needing to use such services because of stigma, and partly because of the privacy reasons you mention in your entry. Is it simply word of mouth, or do you use any types of nontraditional messaging in nontraditional locations (outside of hospitals or health clinics)?
-- Katherine Stone, Postpartum Progress, http://postpartumprogress.typepad.com
Hi Katherine (and Eve),
Thanks for your questions and for your kind comments. I’ll break out the questions and reply.
All of the therapists who apply have to be fully licensed by the state. Besides the documentation they all submit, and preliminary written and phone interactions, we ask them to reserve a 2 hour block for us to have an intensive discussion of a particular client they’re working with. That is, we ask therapists to do an anonymous case presentation (they discuss a person they’re working with, but without divulging any identifying information) in which they review how one particular session went in great detail. By focusing on one session in such fine detail (together with whatever relevant information would put that session in context) – we get a very specific sense of how the therapist works, what they think in response to each comment of their client, how they form judgments about others, etc. [I forgot to include: we've mostly worked with Clinical Psychologists, though VIP therapists have also been Social Workers, Licensed Professional Counselors and one Psychiatrist.]
VIP therapists have always been paid less than half the average local fee. For years VIP paid $45/session – only increasing to $55 a couple of years ago. That low reimbursement rate stopped several therapists from pursuing work with us – but we also had to consider our own ability to raise grants and donations to pay therapists (VIP’s major expense). In effect, to work for VIP, most therapists are donating a portion of their time, since the pay is so low. Some donate additional funds to VIP and some have donated most of what they earn from VIP back to the organization. As I mentioned in the application, for the first 10 years of the organization all administrative work was donated to VIP, as well as office space and local phone, in order to strengthen our program by limiting overhead. Now the Director is paid $9,000 yearly, and in the last several months, VIP has begun to pay the rent for the office.
As to feedback mechanisms – We feel strongly that VIP’s strength derives from returning therapy clients to the role of being the consumer who "pays" for their own services, rather than having them remain passive in the face of decisions made by their "third party payer" (managed care, insurance company, or government payer). In that sense, our clients’ willingness to keep doing substantial ongoing volunteer work (4 hours per therapy session) demonstrates their own valuation of the services they receive. That is why we emphasize that we believe in fair exchanges. Clients get something in exchange for giving something back to the community, which should demonstrate VIP’s ongoing worth to them. People’s continued volunteer work in order to receive therapy sessions provides evidence in their actions that speaks louder than what they might arbitrarily write in an evaluation regarding their satisfaction with VIP services they receive.
Also, VIP clients choose from among our available therapists. Our clients have the right to interview their prospective VIP therapist, to switch to another available therapist – even to meet with several therapists – although this rarely happens. We encourage clients to discuss any difficulties, misunderstandings or frictions that may arise directly with their therapist; since frank exploration of miscommunications, differing expectations, assumptions about what the other person is saying can be key to making sense of another person with whom you’re discussing sensitive personal matters.
Another interesting feedback loop is that a Doctoral Psychology dissertation study was done about VIP clients. It would take a while for me to describe the safeguards, protections of privacy and client prerogatives which went into how we let our clients know about the option of anonymously being interviewed by the researcher. But ultimately, a sample of VIP clients were interviewed by that researcher, leading to a dissertation by Dr. Robert Hubbell. That dissertation is available through library resources, and is cited in the Hartford Courant 2007 feature article about VIP.
Eve, you may be interested to know that many VIP clients in this study spoke of their appreciation of the fact that VIP’s structure puts them in the position of helping others in their volunteer work. So that, though they’re receiving help through VIP, it is just part of the system in which they’re helping someone else in the community.... addressing the issue you raised.
If you google the term "Volunteers In Psychotherapy" you’ll see hundreds of articles, interviews, references and other online mentions of VIP. We’ve made all sorts of efforts to inexpensively spread the word about our work, so that people can know about VIP’s charitable service’s availability to them. We have our website, postings on Craigslist, links on other mental health websites and online articles about VIP. There have been online interviews that have been reproduced on dozens of mental health websites.
We post VIP brochures in libraries, volunteer offices, hospitals, health clinics, town halls, pharmacies, groceries, banks and other stores, nonprofit agencies, and even on an easel on the sidewalk outside our central office. We’ve given public talks at state psychiatric hospitals, at psychiatric clubhouses, for self-help groups, shelters, and for any civic or community group that we can arrange (Kiwanis, Regents, Parents without Partners, Mended Hearts, etc.). We’ve spoken at sexual assault resource meetings of the YWCA, at regional mental health boards, at health and mental health fairs run by colleges and senior centers. We’ve put on lecture and film events in conjunction and co-sponsorship with university Psychology departments and Psychology clubs; events whose publicity we’ve magnified by arranging local print or media interviews. We’ve arranged interviews with local TV news stations, with public access television on numerous occasions and with whatever media outlets we can reach. We’ve given dozens of guest lectures at public libraries and universities, as well as colloquia.
As we mentioned in our application, we’ve ultimately affected the publication of feature articles in the New York Times, Psychology Today, Hartford Courant (several times), Hartford Advocate, and numerous professional publications such as the American Psychological Association’s Monitor on Psychology or a competing publication, the National Psychologist. We’ve given presentations about VIP at the conferences of the American Psychological Association, Connecticut Psychological Association, American Institute of Medical Education and a Grand Rounds at a midwestern medical school, as well as other conferences. The New England Psychologist has several times published features about us, as have some other professional publications (Mental Health Weekly, Family Therapy Networker, Psychotherapy Finances). An interview was aired on National Public Radio through the Marketplace show and we had been described in Worth magazine.
We’ve also given many presentations about VIP at psychiatric consumer conferences (several by Advocacy Unlimited in CT, in years past) such as the Alternatives conference hosted in 2007 by MindFreedom International. We’ve continued committee work that derived from that conference, toward the publication of listings of non-coercive psychiatric treatment programs.
[I should've also mentioned: we get lots of referrals from Infoline, a statewide information and referral service of the United Way. Also, some prominent public psychiatric clinics in greater Hartford, which really don't offer much access to private psychotherapy, now mention VIP to people who call them seeking such services.]
This is indeed an intriguing idea and I would like to know how the author answers the questions a previous commenter posed. At the same time, I applaud the concept of volunteering in exchange for therapeutic services. Receiving treatment is often an experience that puts the person receiving services in a 'one down' position, which is quite contrary to the goal of treatment: to help the person up. This model certainly deserves consideration.
Hello Eve,
You'll see that I integrated a response to the issue you raised in the long response to Katherine. I'm sorry that I can't seem to get the formatting to include the paragraph breaks I'd inserted - for ease of reading.
Thanks - Rich
Thanks for your detailed response.
I really do think you are doing great work and I wish you the best on spreading your idea to others. It's nice to see such empowerment and positivity built into the need for psychotherapy, which is often considered (mistakenly, I believe) as a negative thing.
Best wishes!
On November 20, 2009 the judges reviewed the entries for the Changemakers Rethinking Mental Health: Improving Community Wellbeing competition and would like to pass on the following feedback (listed below) for your entry. Thank you for applying and for your hard work in the field. We are excited to archive your entry to serve as a leading solution for the worldwide community of innovators. We wish you continued luck with your innovative, sustainable, and socially impactful initiatives.
All the best, The Changemakers Team
“Thanks for a great entry! This idea is very innovative, and we’re intrigued by your unique strategy toward creating care systems and integrating them with meaningful volunteer work. Your time-dollar model is interesting, but it does seem a little small scale. How would you plan to grow and replicate this initiative? Do you use references to refer the volunteers? In general, how do you screen the volunteers? We’re also interested in learning how therapists are meeting the needs of individuals with serious mental illnesses. Lastly, how do you address stigma? Thanks!”
- Changemakers Rethinking Mental Health: Improving Community Wellbeing Judges
Hello, and thanks for posting the Judges’ comments about Volunteers In Psychotherapy’s application.
It’s true that we’re small scale: We started VIP over ten years ago with no resources except the energy and enthusiasm of several founding Clinical Psychologists (who could envision a better alternative to the problematic, compromised and limited provision of therapy through managed care and public clinics), and some people with nonprofit expertise who enlisted to help. Over ten years of service, we’ve helped almost 400 individuals and families – a number which is accelerating as VIP’s charitable service is increasingly well known.
As I mentioned in our application, national publicity has yielded roughly 90 licensed psychotherapists who have contacted us, inquiring how they might collaborate, or develop a similar program in their locale. For years we’ve provided free initial consultation with each of them by phone. Now we’re at the point of offering ongoing consultation with such developing community groups. Besides helping them develop their adaptations of VIP without “reinventing the wheel” – another benefit will be to VIP. We’d ask some fees be paid for this more intensive, ongoing consultation. That earned income will strengthen our program [that’s where our Ashoka/RWJF application borrows the model of “Share Our Strength/Community Wealth Ventures”].
Most of these free initial consultations stop when these therapists in other states realize that they’ll have to put considerable effort [in collaboration with other stakeholders in their community] into developing their own nonprofit organization. People tend to be overwhelmed with the prospect of donating so much time and effort into getting started.
Our plan to grow this initiative is just what we proposed in our Ashoka/RWJF application: if we attracted seed money from a national or regional funder, we might use this to attract some of these many other beginning community groups to commit their time, energy and a small amount of matching funds to developing their own organizations. We proposed having a competition of our own; for these groups to apply to receive funds to underwrite ongoing consultation with us, to help each community group develop their nonprofit program. Based on their applications, we’d select 3-5 nascent community groups who would be awarded matching grants to fund ongoing consultation with VIP to develop their own community adaptations of our program.
We’d love for others to help us grow from being “small scale” by suggesting resources by which we might help others to adapt this model. Our experience has been that nascent community groups have to overcome the initial inertia to rally a small cadre of stakeholders to get moving on their project.
We’d also benefit from suggestions which might strengthen VIP’s core program locally. Though we’ve been awarded 77 modest grants from 30 foundations, most of our supporters are local.
When you ask about references to refer the volunteers… I assume you mean to their volunteer work? Our clients choose any IRS-approved charity or nonprofit which serves the community, or government agency (public school, Town Senior Citizen center, volunteer fire dept., etc.) where they want to volunteer.
When each new person calls us, we help them make decisions about where to volunteer, point them to information about volunteering which is available locally, [United Way websites or the United Way “Infoline” information and referral service, hospital, town and university volunteer centers,etc.] But our new clients make the inquiry about volunteering at their chosen agency individually. We don’t get involved, to maintain their privacy regarding their use of VIP services. Then they just get us documentation of hours they’ve donated (a copy of their schedule, sign-in sheet, thank you letter, acknowledgment that they donated blood, a printed e-mail confirming the hours they’ve worked, etc.) The agency doesn’t need to know that the person is in therapy through VIP.
We don’t screen volunteers -- the volunteer agencies routinely do that. If anyone offers to help at a soup kitchen, hospital, school, nursing home, etc. – they’re screened or go through orientation/training, etc. VIP clients have to find a place that will find them useful and trustworthy. [Professional volunteer administrators regularly discuss this issue: that it isn’t helpful to an organization to have volunteers who detract from their work, rather than contribute to it.] We’ve had people supply medical or legal or grant-writing services… and others who have re-shelved books at a library, shoveled community gardens, cleared brush from hiking trails or pushed a broom for a town public works department.
We work with a reasonable number of people who would be considered to have “serious mental illnesses.” Many of them are happy for VIP’s system which treats them with respect, is strictly voluntary, strictly private, non-coercive and non-paternalistic. Some people come to us as an alternative to more coercive public systems.
Some of the VIP psychotherapists have worked in clinics and hospitals which specialize in such clientele – people who have been in and out of state hospitals. I’ve learned through my association with ISPS-US [The International Society for the Psychological Treatments of the Schizophrenias and Other Psychoses] for 15-20 years. For roughly that long I’ve been in touch with Dr. Bertram Karon, Professor of Psychology at Michigan State University, former President of the American Psychological Association’s Division of Psychoanalysis, and author of Psychotherapy of Schizophrenia: The Treatment of Choice. Bert was one of VIP’s references for this application, and has been on VIP’s Advisory Board for years. Together we have prepared joint presentations about working with severely troubled people at two American Psychological Association conferences and an ISPS international conference.
So, we’re committed to providing VIP as a humane, respectful haven for addressing these sorts of severe difficulties.
We think we address stigma through the substantial privacy and personal control we provide to clients through VIP.
For example: for roughly 20 years I’ve served on the Institutional Review Board of Hartford Hospital – Institute of Living. We oversee ethical and “Informed Consent” issues in medical and psychiatric research.
Through VIP, we give informed consent to clients by trying to accurately reflect back to them the dilemmas and conflicts they communicate to us as we help make sense of them. Because of the privacy we provide and the autonomy our clients maintain – and since we think of VIP as treating people as human beings with a life story which often is at the center of their difficulties and confusions -- stigma is inherently addressed in our manner of working.
Here’s a message we got from one person: “I think your program is wonderful. [Public clinics] have little idea what ‘private’ means. A lot of people don’t even know that they’re entitled to this sort of dignity.”
I hope this addresses the questions you raised. I’d be happy to correspond further.
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