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Affordable, Quality Psychotherapy in America: Open Path Psychotherapy Collective

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It's been about a year and a half since I first introduced my idea for making mental health care more affordable for more people. I blogged about it right here on HuffPost, explaining I wanted to build a Web-based community of thoroughly-screened mental health professionals willing to take on a handful of new clients at between $30 and $50 a session. I called it Open Path Psychotherapy Collective, and I asked for help. I got it.

We now have more than 900 participating therapists in 42 states, and every month we enroll and connect between 60 and 80 new clients. My original concept has changed a touch, and we're constantly evolving. For example, instead of taking a fee per session, we've chosen to collect a one-time, lifetime membership fee. That $49 allows a client access to our database of therapists anytime he wants to find help. I know people often start and stop therapy depending on need and circumstance. Our model accommodates that reality.

While Open Path Psychotherapy Collective's primary goal is connecting clients with therapists, I'm proud to share that we're fast becoming an invaluable resource for mental health professionals themselves. Too often psychotherapists work in a vacuum. Because the nature of what we do is so private and personal, little infrastructure exists to support a broad professional community. If I can't see a patient for any reason, it's not always easy to provide a referral, let alone one that may fit a patient's financial limitations. Now we have somewhere to turn.

Open Path also is creating a true community of dedicated professionals who care about the state of our nation's mental health care system. Behind the scenes, we've organized a private Facebook group that we use to exchange ideas, trade articles, post training news, and share thoughts on how to keep our profession moving in the right direction. Having a community of like-minded therapists committed to best practices and collectively prioritizing what's best for their clients is both helpful and inspirational.

I can't talk about the growth of Open Path without addressing one huge change that's taken place in the health care world over the past couple of years, and that's the full implementation of the Affordable Care Act. The new health care reform law has been a true help in that it makes mental health care one of the 10 essential benefits insurance companies are required to provide, and they must cover mental health and substance use disorders the same way they cover other medical and surgical services and procedures. However, as we all learn in due time, having health insurance doesn't guarantee we always can afford the health care we need.

As a private practitioner, I do accept some health insurance plans, but many of the large insurers contract out their mental health services to smaller companies with whom I don't have an agreement. It's heartbreaking to have to turn someone away from the care he truly needs because neither of us can afford to continue. Open Path offers an alternative, allowing that patient to find another fully screened, well-qualified therapist who has room for another lower-fee client.

The same goes for clients who can't find someone who takes their insurance in the first place. Unfortunately, the health insurance companies control their own provider networks, either by limiting whom they include or by offering prohibitively low reimbursement rates so providers have no choice but to opt out. A friend in New Orleans, for instance, has a decent health insurance plan by most standards but spent months trying to find a therapist who accepts her insurance for a specific type of counseling. She hit a dead end, heard about Open Path, and joined. Now she has a therapist, and she's a therapist she likes and can afford.

Speaking of affordability, let's say you have health insurance and can find a therapist in-network. Can you afford the co-pay? Even if it's $50/week, the lower end of an Open Path fee is $30, which is a $20 savings weekly. Add that up over the cost of a year, and we're talking about more than $1,000. No small change for most.

While needing therapy is becoming more widely accepted and understood, some people still feel shy about asking for or admitting they've sought help. Therapists who work through a patient's health insurance have to diagnosis a mental health disorder that then becomes part of the client's permanent health record. Open Path doesn't require therapists submit a diagnosis, and that can be a relief for everyone involved.

The question now is where do we go from here. Open Path Psychotherapy Collective is a non-profit (operating under the auspices of the Foundation for Excellence in Mental Health Care) so we are always looking for financial support to keep the virtual doors open. As I mentioned when I first proposed Open Path, quality control is my top priority, and our therapist applicants go through a thorough vetting system: each application is reviewed by two licensed mental health counselors who consider three requirements: 1. Experience, 2. Qualifications/specialities, 3. Ability to describe their process of working as a mental health professional without introducing red flags or areas of concern; each therapist must show us proof of their state license and liability insurance, and list a professional reference who we consult if one or both reviewers is uncertain about a given applicant. We do not welcome student interns into the Collective. It is integral to our success that we only introduce qualified, experienced therapists into our network, and that we maintain the resources to continue this course. We also need to get the word out about what we offer so that people searching for mental health treatment know that an affordable solution exists. And we must continue to recruit clinicians who are committed to improving our nation's mental health system because the strength to make substantial change lies in numbers.

I created Open Path Psychotherapy Collective because I saw a dire need for more connectivity in my field and a gaping hole where access to affordable psychotherapy should have been. Now that we've built the foundation for both, I'm excited to see just how far this new open path can go.