
Our company has a therapist - hitherejoe
https://medium.com/ribot-labs/our-company-has-a-therapist-7cd7e644f293
======
tunesmith
This sounds pretty dangerous - even if the executives of a company claim that
it is confidential, why should the employees believe it? Therapists talk about
their patients in a very general sense all the time, and even if they don't,
an employer is going to want to have some idea of how the therapist's job is
going. In a small company, it would be far too easy to put two and two
together, and then react in a way that is in the "company's best interest" yet
not in the employee's. I'd feel less comfortable confiding in a company-hired
therapist than I would confiding in HR - it seems the better alternative would
be to offer a heightened health insurance package that covers frequent
therapy, along with a liberal "time off for doctors appointments" policy.

~~~
DanBC
The company is in the UK so there are laws governing use of information.

Hopefully the company chose a BACP registered therapist and so that therapist
will be covered by their registration rules too.

~~~
chimeracoder
> The company is in the UK so there are laws governing use of information.

There are laws governing the use of that information in the US as well - some
of which exist federally, as well as some on the state level (which may be
stronger than the federal ones).

------
DanBC
I've spoken to a bunch of people at different companies. Their companies
provide confidential talking therapies through an occupational health service.

A lot of people I spoke to said they would be unlikely to use that service
because they wanted a clear seperation between health care and employment.
That unease didn't totally go even when the talking therapy was an external
service bought in by the employing company. People did say they'd be more at
ease talking to a fully independent therapist.

It's a shame because in England the therapists would not be allowed to share
anything with the employers, but there's no easy way to provide that
reassurance.

> I’ll be the first to admit that this is a fairly uncommon step for a company
> to take.

It's more common among big providers.

~~~
bayesianhorse
If someone is already willing to go to an external therapist, then that's
good. If not, a company therapist may be a good first start.

~~~
VLM
I like your analysis of the situation and propose its similarity to the
popular "health care fair" that large companies periodically have, where
benefits providers come in to various conference rooms for a lunch hour event.
They won't treat your blood pressure or cholesterol level or do an actual
wellness checkup but they'll do trivial screening tests and sign you up for
follow up appointments, or find you a primary care GP or whatever technical
medical benefit stuff you'd like to talk about. They exclude all billing
discussion probably to prevent outright riots (For non-USA people, medical
billing is totally screwed up in the USA). There seems no reason not to
include mental health providers as part of the existing health care fairs.
Some fairs probably do include mental health care providers.

------
penprogg
I would never go to a company therapist. Go out and pay for one yourself.
There is a clear conflict of interest for the therapist and while they may
seem to be nice it's not worth the risk.

~~~
Tenhundfeld
I disagree. It depends on many factors.

There've been numerous times in my life, and in the lives of close friends,
where having a few sessions with a therapist could have been beneficial. But
the situation didn't seem extreme enough to go through the hassle of finding a
decent therapist and making an appointment – probably for weeks in the future
with a good one. Sure, I could be proactive and find one before I need one,
but let's just add that to mountain of things I should be doing in my copious
free time while running a business, being a husband, father, etc.

My point is the availability and low-friction this setting provides could be
hugely advantageous.

To your point about conflict of interest, I think it depends if this person is
a licensed psychologist, psychiatrist, clinical social worker, etc. If so, the
Health Insurance Portability and Accountability Act (HIPAA) contains privacy
rules about psychotherapy and mental health. At your first visit, the
therapist should give you written information explaining privacy policies and
how your personal information will be handled.

If they don't do that and/or if they are some type of uncertified "life
coach", I would be more concerned about conflict of interest.

~~~
Tenhundfeld
BTW, I don't mean to disparage the general idea of a life coach. I know some
people who have used them with highly positive effects. They can be a more
affordable way to get impartial feedback and help accomplishing goals, like
the mental equivalent of getting a trainer to help with physical health.

It's just that I wouldn't be too concerned about the possible conflict of
interest with a healthcare professional where I am officially a patient and
have HIPAA protections. However, I would be concerned about possible motives
and conflict of interest with a company-provided life coach, who is not
necessarily bound by any privacy rules.

------
sergers
Many large corporations I have worked for offer similar services for years

My current job offers me yearly therapist/psychiatrist dollars that can be
utilized as part of benefits packages as well as online phone chat with
therapist and counselors. they have been offering this for at least 8 years
(maybe even earlier, but they just didnt advertise it)

It is done through 3rd party services through our company health insurance and
benefits package.

actually going to see a psychiatrist is completely confidential, as i goto any
psychiatrist i find and i simply get re-reimbursed the dollars. my company is
not involved at all and doesnt know about it (unless there is a re-imbursement
issue which i have to engage HR to figure out, but they still do not know the
details of who i went to see and why, i just give them a receipt to chase down
with the insurance company)

and the online/chat/phone counselling is completely anonymous besides
mentioning the company codes during signup (not distinct to me, same code used
by 20,000+ employees and i can signup using any alias that my company does not
know).

these services are also extended to my immediate family aswell.

edit: i would not trust a company employed psychiatrist ever as some have
outlined their experiences, that person is on the company dollar and you are
not in a real confidentiality scenario. essentially they are just
advisors/counsellors in HR on the company dollar with company interests in
stake, not your personal health, typically without any confidentiality
agreement.

utilize services through your health insurance and never directly with your
employer.

edit2: just wanted to add that just in general, if health insurance/benefits
packages are important to you and weighs in on taking the job, ensure that the
health insurance is through a 3rd party company not in which your employer
would directly re-reimburse you at their discretion. there should be a
distinct line between.

Edit3: Confidentiality issues aside, I especially would not want to discuss
potential therapeutic/psychiatric/mental state issues with someone you might
interact with at work outside of your session ( bump into them while getting
coffee in the cafeteria at the office, see them interacting with other
employees casually cause they are colleagues and not a patient).

Need a separation personally

------
phren0logy
>Life-coach. Counsellor. Therapist. Call it what you will.

This is not merely a matter of terminology. I don't know how it is in the UK,
but here in the US "life coach" requires no sort of training or licensure. In
most places in the US, to call yourself a "therapist" requires those kinds of
credentials.

So, as usual, words are important.

~~~
DanBC
That's a good point. Here's a list of protected titles: [http://www.hcpc-
uk.co.uk/aboutregistration/protectedtitles/](http://www.hcpc-
uk.co.uk/aboutregistration/protectedtitles/)

[http://www.bps.org.uk/what-we-do/bps/regulation-
psychology/r...](http://www.bps.org.uk/what-we-do/bps/regulation-
psychology/regulation-psychology)

------
aeflash
I think this is a great idea. While I think the execution could be improved
(maybe a person wants to see an different therapist, or one outside the
office), but attempting to remove the stigma surrounding mental health, and
giving low friction access is huge. There is also the acknowledgement of the
fact that most people aren't perfect, and nearly everyone could benefit from
some sort of counseling. If everyone at your company is in perfect mental
health you're either incredibly lucky, or kidding yourself.

I think Shanley Kane put it best[1]: "People are broken, and people work at
companies."

[1] [https://modelviewculture.com/news/the-eternal-and-toxic-
opti...](https://modelviewculture.com/news/the-eternal-and-toxic-optimism-of-
startup-advice)

------
bayesianhorse
I was sceptical when I read the headline. For one thing, employees may not
believe the confidentiality. For another, if only a few people attend, and
then office is in the building, these visits aren't all that confidential.

But it looks as if that's not a problem because so many employees are actually
using this service. So the benefits seem to outweigh: More employees are
seeing "any" therapist at all, they are taking their own mental health more
seriously and early interventions are more likely.

They also seem to see the therapists as helping them get "better" rather than
just fixing some flaw.

------
lrvick
I am not the type of person that would ever go out of my way to book a
therapist. I won't even go to a doctor unless it is life-threatening. Such
things require a lot of planning and fuss and I have better things to do. (Yes
yes I know that is unreasonable/unhealthy thinking, but I am who I am).

That said, if I was having a stressful week, and a neutral party was just down
the hall I knew was paid to be there for me to vent at and get advice from
with no strings attached... That is something I could see myself taking a
break to walk over and take advantage of.

I mean, companies provide all kinds of junk food snacks for employees to take
advantage of a few feet away, why not healthy things too? There is a
significantly better chance of me visiting a company provided health
professional of any kind, than bothering to take time off work/life seek one
out myself. I am sure I am not alone in this thinking.

I hope more companies follow the example of Ribot on this and the stigma
starts to go away. Good going guys.

------
rdl
The normal version of this is "employee assistance program", but that's mainly
designed for people with drug/alcohol/etc. problems. Often provided by the
health insurance companies, or other benefits. It probably is paid for with
<$1/employee/month by the employer.

------
nraynaud
I had some troubles with an employee of mine in the past and think he would
have benefitted from a shrink (I suspect he was heavily depressed), but as the
boss, I found it complicated to do that for various reasons: 1) conflict of
interest 2) free will of the patient to go there 3) we're bordering on medical
territory and it's a minefield for a company.

There is no happy ending, I left the company without having acted on it and
the employee left recently, but as far as I know he's living erratically and
unemployed now.

~~~
VLM
Sounds like a stereotypical startup opportunity, a problem exists, hard to
solve, outsource the minefield to a TaaS (therapy as a service) provider to
rake in some corporate contract money.

I don't think its totally out of class as a startup idea, fundamentally you've
got a matchmaking service (more or less) and a scheduling system and a billing
system and maybe do it online in video conference or something. How to
monetize is not entirely clear. I guess you could bill the company one full
"screening" therapy hour per year living off the skim of not every employee
using the entire hour and most people having a mandatory ten minute talk along
the lines of "all is well" annually or whatever while some people end up
taking the whole hour (or more?). This is probably not the only possible
business model and probably not the only monetization model but it is the
first one I thought of. I used dental services as a model for my theoretical
therapy model, hang out on a regular basis with the dentist for a short
appointment and most of the time he has very little to do for most of the
people, but he can schedule a follow up for real work or a referral if the
checkup finds a problem.

I suppose there would be interesting conflict of interest issues where the
insurance company paying the therapy bills would probably prefer more
unhealthy untreated people for financial reasons so they'd actively discourage
hiring a company-wide screening service like this. Or, if it can be proven
numerically that early diagnosis saves treatment dollars, I think we have an
obvious endgame strategy of being bought out by a (mental) health insurance
company.

Like most startups the idea is free and not worth much, it'll all be in the
execution. It would be interesting to research the competition, the successes,
and the failures. It seems like an obvious idea, the past must be full of
failures in this field?

~~~
DanBC
> Sounds like a stereotypical startup opportunity, a problem exists, hard to
> solve, outsource the minefield to a TaaS (therapy as a service) provider to
> rake in some corporate contract money.

> It seems like an obvious idea, the past must be full of failures in this
> field?

There are very many providers of this kind of therapy. Relevant search terms
are combinations of "occupational health" and "talking therapy" (but
"occupational therapy" is something different).

Here's one of the first hits in Google:
[http://www.prohms.com/mental_health_wellbeing](http://www.prohms.com/mental_health_wellbeing)

(Their site feels a bit American to me; the US road sign, the rod of
Asclepius; but they're in the UK).

Here's another one providing services to different large orgs:
[http://www.atriumclinic.co.uk/about-us/what-we-
do](http://www.atriumclinic.co.uk/about-us/what-we-do)

This easy to understand document a out talking therapies in England has a
single mention of therapy provided at work but does have lots more information
about how to chose a therapist and how to access them etc.
[http://www.mentalhealth.org.uk/content/assets/PDF/publicatio...](http://www.mentalhealth.org.uk/content/assets/PDF/publications/talking_therapies_explained.pdf?view=Standard)

Here's a personal story of _terrible_ waits and delays one person had in late
2013. This treatment is clearly unacceptable.
[http://www.mind.org.uk/information-support/your-
stories/figh...](http://www.mind.org.uk/information-support/your-
stories/fighting-to-access-talking-therapy/#.VUb_DGKCPTp) I wish I could say
things are better. For most people things are better. IAPT did improve things;
GPs have more awareness; there's more capacity. So for short form first line
talking therapies like CBT things are better (but there are still some very
bad services around). Things are different for longer form heavy duty talking
therapies. These traditionally have very long wait times - years in some
cases. People should have to wait a maximum of 18 weeks for this long form
therapy.

------
swagmeister
My first instinct is to hate on this idea because it removes choice. But
sometimes, even when given a choice, people don't help themselves. The ethical
integrity of the therapist would have to be very strong though.

~~~
detaro
What choice does it remove?

~~~
swagmeister
I guess you're right, it adds choice, but softly discourages you from seeing
an outside therapist. Why not just see the company therapist? There is also
some moral hazard involved.

~~~
andreyf
I think it's potentially more than just soft, as it could also lead to an in-
group of people who are seeing the company therapist.

------
jkot
Hm, perhaps conflict of interest? I think HR and management will make more use
of therapist, then programmer who works for startup.

------
jacquesm
Keep your therapy if you need it and your corporate dealings separate if you
value your job _and_ your sanity.

------
1Psy2anXrpRZ7YW
"Shrinks for startups?"
([https://twitter.com/mikellsolution/status/571590631304388608](https://twitter.com/mikellsolution/status/571590631304388608))
really needed to be coined.

