Take Action: Fight


Benjamin E. Caldwell, PsyD

Therapists tend to be peacemakers. Many of us grew up as the kids who would step in to stop a fight, to hear and value both sides and negotiate a truce. Our ability to hear all sides, to accept clients as they are, and to stay calm in the face of intense emotion makes us good at our work.

The exact same abilities also make us bad at standing up for ourselves. For our shared professional future to be bright, we need to become better fighters.

Insurance. I hear lots of MFTs complaining to each other, and on Facebook, about the practices of insurance companies. Some companies consistently dawdle in making payments. Others attempt to refuse or even claw back payments for what are supposed to be covered services. Still others have such a complex process of resolving payment issues that some therapists simply give up.

No one should put up with such shenanigans. Insurance plans in California are governed by either the Department of Insurance or the Department of Managed Health Care. The departments themselves can give you guidance as to which plan is governed by which department, but you might find it useful to ask the insurer. It gives them a heads-up that you are moving towards filing a complaint, which might lead them to be more cooperative.

The complaint process with each of these departments is relatively easy and highly impactful. Use it. The state has issued millions of dollars in fines in the past few years against carriers for doing exactly the kinds of things we complain about. But the state can only act when complaints come in that establish a pattern of illegal behavior. In other words, your complaint doesn’t just help you and your clients. It helps all of us.

Employment. I also hear a great deal of complaining about the job market, usually on two fronts: Salaries and unpaid internships. Low salaries may be due in part to how heavily female the profession is – an institutionalized sexism that we all have a role in combating. Unpaid “internships” are sometimes illegal even in nonprofit settings, and yet many employers continue to refuse to pay prelicensed therapists for work that is, in the eyes of the law, a job that requires pay. If you have worked in an unpaid internship and think you might be owed back wages, check out this article. If you can’t find resolution with the employer, complain to the state Labor Board. If you’re in an unpaid position right now that you think might be illegal, start here. (Check out the other article too.) Either way, the worst thing you can do – for you and those who might follow you at the same workplace – is to stay silent.

These are just two examples. There are many issues in our field where we shouldn’t hear and value all sides, because one side is genuinely more right and just than the other. We should not accept insurance company practices, unpaid internships that legally should be jobs, or other problems in the field as they are. And some of these issues require an intense response, not a calm one, to force change.

Peacemaking is a great ability. But it takes a good fight to make our field better. What have you fought for this year?

We’re all in this together. Thanks for all you do.

– Benjamin E. Caldwell is a Licensed Marriage and Family Therapist (#42723) in Los Angeles. He is the author of Saving Psychotherapy and Basics of California Law for LMFTs, LPCCs, and LCSWs.