Psychotherapy’s Image Problem Pushes Some Therapist to Become ‘Brands’
by Lori Gottlieb
In the summer of 2011, after I completed six years of graduate school and internship training and was about to start my psychotherapy practice, I sat down with my clinical supervisor in the Los Angeles office we’d be sharing. It had been a rigorous six years, transitioning from my role as a full-time journalist always on tight deadlines to that of a therapist whose world was broken into slow, thoughtful hours listening and trying to help people come to a deeper understanding of their lives. My supervisor went over the filing systems, billing procedures and ethical quandaries like whether to take referrals from current clients, but we never discussed how I would get these clients. I fully assumed, in what now seems like an astounding fit of naïveté, that I’d send out an e-mail announcement and network with doctors, and to paraphrase “Field of Dreams,” if I built it, they would come.
Except that they didn’t. What nobody taught me in grad school was that psychotherapy, a practice that had sustained itself for more than a century, is losing its customers. If this came as a shock to me, the American Psychological Association tried to send out warnings in a 2010 paper titled, “Where Has all the Psychotherapy Gone?” According to the author, 30 percent fewer patients received psychological interventions in 2008 than they did 11 years earlier; since the 1990s, managed care has increasingly limited visits and reimbursements for talk therapy but not for drug treatment; and in 2005 alone, pharmaceutical companies spent $4.2 billion on direct-to-consumer advertising and $7.2 billion on promotion to physicians, nearly twice what they spent on research and development.
According to the A.P.A., therapists had to start paying attention to what the marketplace demanded or we risked our livelihoods. It wasn’t long before I learned that an entirely new specialized industry had cropped up: branding consultants for therapists.
I couldn’t imagine hiring a branding consultant to lure people to the couch. Psychotherapy is perhaps one of the few commercial businesses that doesn’t see itself as one, that views financial gain as unseemly when connected to the delicate work of emotional insight. Moreover, the field is predicated on strict concepts of authenticity, privacy and therapist-patient boundaries. Branding was the antithesis of what we did.
But a couple of months after setting up my office and waiting for people to call, I found myself wondering — first idly, then deliberately, and always guiltily — about those branding consultants and how exactly they helped therapists like me. Sitting at my desk one morning when my appointment book looked particularly dismal, a combination of curiosity and desperation got the best of me. On Google, I came across a branding consultant named Casey Truffo. Her Web site’s home page spoke directly to my situation: “You are called to be a therapist. Are you also called to poverty?” I immediately dialed her number.
“Nobody wants to buy therapy anymore,” Truffo told me. “They want to buy a solution to a problem.” This is something Truffo discovered in her own former private practice of 18 years, during which she saw a shift from people who were unhappy and wanted to understand themselves better to people who would come in “because they wanted someone else or something else to change,” she said. “I’d see fewer and fewer people coming in and saying, ‘I want to change.’ ”
(I highly recommend you read the rest of this article - click here to do so - and I’m also interested in hearing feedback from others, on either side of the couch, as to what they think about the direction psychotherapy seems to be heading in, and whether this is a good thing or not.)