CASH, CHECK OR VOLUNTEER WORK: A new way to pay for therapy

PSYCHOTHERAPY

PSYCHOTHERAPY PATIENTS IN Hartford, Connecticut, are participating in a national trial, but no new drugs or behavioral tactics are involved. At Volunteers in Psychotherapy (VIP), patients volunteer four hours at a local charity to earn one free hour of psychotherapy. VIP participants have volunteered at a homeless shelter, a food bank or the Red Cross. "It's a way to tell clients, 'You have something of value to offer the community," says Richard Shulman, Ph.D., the psychologist who founded the nonprofit organization in 1998 after growing increasingly frustrated with managed-care medicine.

The community work provides its own therapeutic benefits. Many VIP clients have previously shuttled in and out of mental hospitals and suffered the loss of self-esteem that such hospitalization entails. "It gets them into situations where they are helping others and are being thanked and rewarded with the approval of coworkers," Shulman explains. "I had one client who said that just getting out of the house and volunteering was the most important thing for him."

Shulman has raised $25,000 from private donors and philanthropic organizations to fund VIP. He and four additional psychologists are paid $45 per hour by VIP for their services, which is slightly less than half the going rate in Hartford. To date, they have seen about 60 patients.

Last year, VIP was honored by the Connecticut Psychological Association, but the real gratification for Shulman is the chance to practice in an environment free from managed-care restrictions. Shulman cites clients' concerns about confidentiality with HMOs as an incentive to participate in the program. Clients also realize that they can receive therapy for as long as they tike.

"It feels like the right way to do therapy," says Shulman. "Clients know that they have earned the right for the session to be absolutely private."

Tags: care medicine, food bank, gratification, hartford connecticut, helping others, hmos, homeless shelter, hospitalization, mental hospitals, new drugs, nonprofit organization, therapeutic benefits