VIP has just one program, which has been functioning for ten (10) years now, in which time we have worked with over 380 individuals or families. All clients are required to do 4 hours of documented volunteer work for the community charitable organization of their choice in exchange for each therapy session. [VIP clients provide us documentation from their volunteer site, such as a time log showing their work, or a thank you letter sent to them which documents their hours, without that agency knowing of the client’s VIP involvement. This maintains the client’s privacy.] The more than 3200 therapy sessions we’ve provided translates into about 12,800 hours of volunteering completed by VIP clients.
This exchange, of charitable volunteer work for psychotherapy through VIP, empowers people to be in charge of decisions about their own private life, and their therapy. The volunteer work encourages self sufficiency and asks for a substantial contribution and commitment by clients. Volunteers benefit from the sense of accomplishment in contributing to the well being of others, working in a cause that is meaningful to them, while gaining the social benefits of rubbing elbows with others. VIP functions independently of insurance, so that everyone can earn truly private psychotherapy. We feel that VIP’s system embodies Maimonides’ value of helping a person by finding them work so that they can help themselves. Of course, VIP also provides access to psychotherapy where people can discuss their most troubling and intimate personal and family difficulties, knowing that their private information will not be documented in reports required by managed care insurers that may become part of their permanent medical or employment records.
Dr. Richard Shulman began constructing VIP in April, 1997, with a pilot program, offering pro bono therapy to all new clients, in exchange for volunteer work they independently provided to the community charitable organization of their choice. He had decided to construct VIP when he left the Hartford Hospital - Institute of Living public clinic – a poor person’s clinic underwritten with public funds -- where he had worked for 10 years, as he saw the impact of managed care’s rationing on his clients. Managed care and financial pressures severely cut the provision of private psychotherapy, people were shifted into short-term groups, and pills were overemphasized. The success of the VIP pilot program encouraged him to pursue nonprofit status for VIP together with trusted colleagues Drs. Mark Burrell, Karen D’Avanzo and Rachel Sampson, who had worked at Connecticut hospitals, clinics and universities for years. All recognized the need for a new organization that would permit better conditions for the provision of psychotherapy to the public. These licensed Psychologists and others, along with directors with nonprofit expertise from the United Way, the Hartford Foundation for Public Giving and a regional substance abuse action council, as well as psychology professors at Wesleyan University and Manchester Community College, a former Director of the Connecticut Civil Liberties Union, a Psychiatric nurse, a former Superintendent of Schools, a nonprofit attorney and a recovered psychiatric survivor, comprise a Board of Directors and Advisory Board with diverse professional and personal backgrounds and experience.
We now have a considerable track record of successfully offering therapy to people in the community, and requiring them to earn it through substantial and documented volunteer work. While in 2001 VIP provided roughly 250 therapy sessions, we averaged about 350 psychotherapy sessions yearly in 2002 -2008 – a 42% increase in service. This year VIP’s network of Licensed Psychologists, Counselors and Psychiatrist are on track to provide 450 sessions. We expect demand for our services to grow as our visibility as a community resource continues to increase.
The key reason why we psychologists and our Board have donated so much time and effort in developing VIP, is because of the hidden personal stories which people bring to us.
VIP gives people a truly private setting to discuss hidden personal problems they can speak of nowhere else: childhood molestation, incest or rape; marital infidelities, child-rearing misunderstandings and entrenched family frictions, secret sources of stress which people feel ashamed about, misunderstandings which lead to pronounced and repeated friction in families, problems for which people drown themselves in alcohol and drugs.
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. These are people 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 sorts of problems make people feel ashamed, so that they often suffer in silence. These problems can’t even be honestly discussed without real privacy – with no reports sent to insurers or employers.
That’s the central idea behind VIP. To preserve a private place where people can speak openly about things they’ve avoided, but which trouble them – and to help people to resolve those problems and live better personally and in their families.
As the Supreme Court recently underlined (Jaffee v. Redmond), “Because of the sensitive nature of the problems for which individuals consult psychotherapists, disclosure of confidential communications made during counseling sessions may cause embarrassment…For this reason, the mere possibility of disclosure may impede development of the confidential relationship necessary for successful treatment….”
With cuts at public clinics and the growth of managed care insurance, psychotherapy has become much less available to people, particularly if they aren’t wealthy. (Please see our enumeration of those problems, above). We offer truly private therapy of reasonable duration to clients who want it, and who provide volunteer work for the community charity of their choice, in exchange for therapy services. This includes people whose insurance does not cover any more than minimal psychotherapy sessions, people who are uncomfortable with reports about their private lives being sent to insurers from therapists, or who are concerned about their employers seeing documentation about their therapy, and people who dislike insurance company pressures that they agree to take medication in order to continue to receive benefits. Many people have no insurance benefits to cover their therapy and find private practice rates (often averaging $100 per session or more) to be unmanageable.
Funding from JChoice.org would permit VIP to continue to broaden our offering of therapy to the community, with modest reimbursement to VIP therapists. For 10 years office space, local phone and all work involved in grant-writing, publicity, report writing and administering the program have been donated. The work of VIP’s Board and staff has been unpaid, except for modest reimbursement for the provision of psychotherapy until our Board’s recent decision to pay the Director a small administrative salary ($9K/year). Everyone involved with VIP is asked to contribute to the common good, including psychotherapists, who work for well below average fees. Compensation for therapy is set at less than half the local average private practice fees, based on a survey by the financially independent “Compensation Committee” of VIP’s board (average local fees = over $100, while VIP therapists are now reimbursed $55 per session… after 8 years of being paid $45).
Clients are required to provide four (4) hours of independently documented volunteer work to the community charity, nonprofit or government agency of their choice, in order to receive each psychotherapy session for “no fee.” They can also work fewer hours, and pay a partial fee, though more than 95% of sessions are earned through volunteer work only, with no fees being paid. For every therapy session VIP provides, 4 hours of volunteer work is provided to the community. Because of VIP’s high work requirement, clients ration their own receipt of services, rather than having a managed care company profit by its external rationing of therapy.
As we often point out, 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; not giving “something for nothing”. Clients get something in exchange for giving something back to the community, which should demonstrate VIP’s ongoing worth to them. People’s continued involvement with VIP provides evidence in their actions that speaks louder than what they might arbitrarily write in an evaluation. [Additionally, the Hubbell doctoral dissertation study documented clients’ valuation of the VIP services they received, as summarized in the recent Hartford Courant article about VIP.]
Three measurable objectives relevant to our performance in the community:
1) Number of psychotherapy sessions provided – indicates the need for VIP services in the community.
2) Number of hours of volunteer work provided by VIP clients -- demonstrates contribution by VIP clients to the community, and their valuation of VIP services and willingness to work for them.
3) Increase in number of hours of volunteer work and therapy provided over period of grant – indicates growing public awareness of VIP as an alternative resource and inclination to seek VIP services.
There already is significantly increased demand for VIP services. We provided roughly 250 sessions in 2001 and averaged 350 sessions from 2002 - 2008 (an average increase of 42%). This year we are on track to provide 450 sessions.
Name of Organization:Volunteers in Psychotherapy
Number of Paid Staff:1 f/t, 5 p/t
Number of Volunteers:24
Total Organizational Expenses:$33,210
% of Organizational Overhead Expenses:19%
VIP IS unique in provision of mental health services, as only professionals working in the field, or ex-patients who have experienced the problems of institutional psychiatry may fully appreciate.
VIP insists on providing therapy to everyone, regardless of their ability to pay, or possession of health insurance. Everyone works as a volunteer elsewhere, for the charity, nonprofit or government agency of their choice – so that VIP clients become consumers, who are earning or “paying for” their therapy themselves, and rationing their access to therapy, instead of that rationing being done by an insurer who profits by denying access to care.
VIP is strictly private. Where most psychiatric agencies give lip service to privacy concerns, but then often start intake sessions by asking clients to sign “releases of information” to speak to all other agencies in a clients life; VIP signs contracts with all clients indicating that all VIP therapy relationships will be as private as Connecticut state law allows. That is, we sign a “reverse release of information” – informing clients that we will only work with them if it is agreed that we will speak with no one about them – in order to insure that clients are in control of their own personal information. If a client wants to discuss their therapy conversations with someone else, that is their prerogative; but they know that we will not be discussing their private revelations with anyone. Of course, we also encourage people to consider the benefits of family therapy, which we also provide, particularly where children are involved – as a way of increasing communication between family members and clearing up misunderstandings which so frequently underlie family tensions.
Volunteers In Psychotherapy is also unique in putting more emphasis on the autonomy and primacy of the psychotherapy client. Though we will brainstorm with potential clients about volunteer opportunities they may develop, or refer them for consultation to volunteer centers with whom we’ve developed connections; we also think it’s important to not do too much for clients, nor to take over management of their lives in a way which stunts their own independence. This balance is recognized in professional psychotherapy circles as being key to successful therapy relationships. Unfortunately many public clinics encourage staff to manage clients’ lives more paternalistically. Our “Client - Therapist Agreement and Privacy Policy” assures clients that we will not involve ourselves in their private lives, outside of therapy discussions aimed at exploring and clarifying characteristic patterns of success and difficulty in their lives, so that they may live their lives more effectively. Our partnership is with our clients, in a way which may be diluted if we worked with other agencies, seemingly in the client's behalf, but potentially leaving the client out. VIP puts people in a position of autonomy, responsibility, independence and self-respect (as “co-producers” of services in the words of Edgar Cahn of Time Dollar Institute, a national organization with whom we’ve consulted).
We are regularly apprised by our clients of the uniqueness of VIP’s program, as quoted in a recent VIP newsletter: Two recent callers to VIP sought our services because they couldn’t find private psychotherapy at some of Hartford’s best-known public psychiatric clinics, who instead referred them to VIP:
“They gave me this [VIP’s] number because I’m interested in private psychotherapy. I was not very pleased that they just give people medication [at the other clinic].”
“I think your program is wonderful. [Public clinics] have little idea of what ‘private’ means. A lot of people don’t even know that they’re entitled to this sort of dignity.”
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; not giving “something for nothing”. Clients get something in exchange for giving something back to the community, which should demonstrate VIP’s ongoing worth to them. People’s continued involvement with VIP provides evidence in their actions that speaks louder than what they might arbitrarily write in an evaluation.
Family Harmony
Health
Poverty
Here are a few ways to get involved:
a. Organize an event to raise funding for this organization: A larger number of volunteers have helped with 2 days of charitable gift wrapping we’ve done in chain bookstores, again raising VIP’s visibility while earning roughly $1,000 in small donations. We’ve had teenagers assist with these events in particular.
b. Volunteer: Help VIP find speaking venues to give presentations about VIP (for local community groups, adult education, college classes, senior centers, health fairs, sexual assault resource meetings, public libraries, shelters, psychiatric social clubs and state hospitals, interviews on radio and television).
c. Connect via JChoice.org
Name:Richard Shulman, PhD.
Title:Director
Address:7 South Main Street, West Hartford, Connecticut 06107
Telephone:(860) 233-5115
Email:CTVIP@hotmail.com
Website:www.CTVIP.org