Connecticut program makes therapy available, affordable, for anyone

Connecticut program makes therapy available, affordable, for anyone
(June 2009 Issue)

By Jennifer Chase Esposito

Eleven years ago, Richard Schulman, Ph.D., and a group of industry colleagues with experience from the Institute of Living, Yale University, and the University of Connecticut, feared that public clinics were subject to so many insurance guidelines that troubled people were going without badly needed therapy. Managed care dictated who was a viable candidate for psychotherapy and for how many sessions they were entitled once they were approved; clients' employers would also have full access to their psychological information.

"Access to therapy was being strictly rationed and managed care wanted to be privy to private discussions in order to pay for it," says Schulman, a licensed psychologist. "We thought we could set up a system that was much simpler. We wanted to make psychotherapy accessible in a way that it would put clients in the driver's seat for making their own decisions."

So Schulman and his colleagues founded Volunteers in Psychotherapy (VIP), a unique nonprofit organization in West Hartford, Conn., that provides free psychotherapy sessions to anyone who needs it. But as in life, nothing is truly free in psychotherapy, either, although VIP's system is pretty close. Working off of a barter concept, clients donate four hours of volunteer work at an organization of their choice in exchange for one free therapy session with a licensed practitioner, whose notes and diagnoses will never end up in the hands of a managed care worker.

"Most of our clients are in less than good financial shape," he says. But it's anonymity and not just financial distress that brings clients for more than 350 sessions per year to VIP. Says Schulman, the key reason why the psychologists and VIP's board have donated so much time and effort in developing VIP, is because of the hidden personal stories that people bring into each session.

"Often, the types of personal trouble people come in with is because people are afraid about people's reactions. All of us can kid ourselves about things we do in life. Here, the access to therapy is here if they want."

According to Schulman, VIP's signed agreement with clients requires them to pay a fee for any unkept or irresponsibly cancelled sessions - a requirement that insists on mutual responsibility but that is nearly unheard of at public clinics. Throughout VIP's existence, fewer than three percent of sessions were "no-shows." The average in public clinics is 30 to 50 percent.

VIP client volunteer jobs range in difficulty, but Schulman says that a common factor is that people donate time at a place that's important to them: some donate blood, some sweep the floors at their local church; some clients with numbers-driven skills have volunteered as grant writers, while others offer nursing skills or hours of restocking shelves at their favorite library. Clients get credit by providing their VIP practitioner with documentation from their volunteer site - maybe a log of hours worked or a thank you note for a job well done. Organizations never know why their volunteers are volunteering ... other than out of the kindness of their hearts.

"Volunteer work was symbolic, really," says Schulman of VIP's inception. "When people come to us, it's not a handout. Everyone is sacrificing."

Although VIP was founded to handle societal problems from a decade ago, the issues are still in play. According to Schulman, in the last year VIP has had an increase in referrals from clients who first sought therapy through larger public clinics and at hospitals like Hartford, but were denied treatment. Funding cuts and financial pressures have influenced numerous public clinics to focus more on short-term educational groups and medication provision, and worse, therapy that is less private. VIP, on the other hand, gives people a truly private setting to discuss hidden personal problems they can speak of nowhere else.

"We see the relief people gain from being able to gradually reveal secrets that they couldn't talk about, when they have a chance to put into words (and perhaps rethink) difficult personal situations which they've endured alone," says Schulman. "I'm talking about people in our region who grew up in families where parents beat them in alcoholic rages, where an uncle or neighbor secretly seduced them, where their compounded relationship misunderstandings have left their marriages teetering or their parenting is passing problems along to their kids.

"These problems can't even be honestly discussed without real privacy - with no reports sent to insurers or employers," he adds.

And that's the premise of VIP: Helping people address their demons amid the privacy that they deserve.