Our company has a therapist | Hacker News Reader

Our company has a therapist

medium.com

44 pointshitherejoe47 comments

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.

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.

> 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).

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

Are there laws against invading privacy via subverting cell phones in the UK? Did it happen?

As if laws are never broken.

Downvoting me doesn't mean UK laws are always obeyed.

While employees should definitely get their own therapists, I'm not sure it's a bad idea for a company to offer one for free while encouraging them to find their own. Removing the barrier to entry and the stigma by making it a standard thing might be worth doing.

Then again, if there are insurance plans that have this sort of thing in mind, making that plan standard and encouraging people to use it sounds better.

You touch upon a couple of very important points here - removing barriers and the stigma.

What we're trying to do here is just provide a completely independent person to talk to. They're able to talk to them about anything and everything and none of that information will come back to the employers. Why do this then? By offering this, people are able to work out/unravel any problems/goals/challenges they've got. The hopeful result is that this private chat will then provide a focus, a decision and a more fulfilled human.

They can believe it because as I sat in bed thinking how much talking to someone in confidence has helped me, I thought that maybe others might be able to benefit from the same feeling. I have absolutely no interest in what is discussed in these sessions, just that they happen at all, if people are interested in doing so.

I disagree about the point that trusting in a company-hired therapist makes one feel less comfortable than confiding in HR. If I broke up with my girlfriend, I'd hope that the confidential conversations had with a trained therapist would prove more fruitful than a conversation with HR.

I came up with this idea because it helped me, and not primarily because it is best for the company. I care enough about the people I work with that I'm happy to support a free service that might help others too, if they want it.

Thanks for the comments. It's an interesting issue that remains an important subject not just for companies, but society in general.

Jerome

Having someone neutral to talk to is important - even just for the simple fact of verbalizing to process it.

I'd like to think for the same reasons you don't sweep your backpack for bugs that your employer has planted on you, or check under your desk for secret spy cameras. Unless your employer has some sort of reputation, I don't see why the default should be to believe that they are morally bankrupt enough to run some kind of therapist sting operation.

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.

>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.

Additionally, if you build a relationship with a therapist, you might want to be able to continue with that therapist beyond your current employment.

"because they wanted a clear seperation between health care and employment. "

And yet... there's very strikingly little political movement to reduce/remove/eliminate "benefits" which include health insurance provided by employers.

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.

Yes! I should have said that it's great that this company is thinkin about mental health and is actually doing stuff. It's really nice to see.

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.

> "they wanted a clear seperation between health care and employment"

Couldn't the company let the employee choose their own therapist and then the employee can claim the money back up to a certain amount?

It would provide the necessary separation that the employees wanted whilst still allowing for the employer to pay for the treatment.

And, it wouldn't be that difficult to implement seeing as a lot of companies already do something similar with benefits like travel/petrol.

Well, in England this kind of talking therapy is available free under the IAPT (improved access to psychological therapies) system. You search for various combinations of "talking therapy" or "cbt" and the name of your county.

Companies could allow employees to go private and send the bill to the employer. I guess buying in therapy as a service allows the costs to be more predictable.

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.

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.

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.

It depends on the problem. Of course, "I compulsively steal from my office" wouldn't be a good candidate.

But suppose it has to do with the serious illness of a parent, or the passing of a friend or family member. There are plenty of situations where the issue may not be volatile relative to workplace concerns, but still worth talking to a therapist.

One other thing to consider is that a workplace-specific therapist may be tuned in to the specific ways engineers deal with problems. I was at an info-session where my own workplace therapist was talking about the ways tech people cope, vs. the ways entertainment industry people cope. It's very different, according to him: compartmentalize and keep going vs. substance abuse.

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

>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.

That's a good point. Here's a list of protected titles: http://www.hcpc-uk.co.uk/aboutregistration/protectedtitles/

http://www.bps.org.uk/what-we-do/bps/regulation-psychology/r...

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...

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.

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.

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.

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.

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?

> 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

(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

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...

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... 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.

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.

What choice does it remove?

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.

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.

I think he meant that it implies that an employer can pick a single therapist for all of their employees, and that there may be perceived pressure to see that therapist over others. In reality it can take quite a bit of visiting different people to find a therapist one feels comfortable with.

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

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

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

Reply on news.ycombinator.com