Remote therapy employer that doesn't suck
June 10, 2024 6:19 PM   Subscribe

Mrs. Thief had an accident and is working remote under doctors orders. Long term, she is looking to work remote full time. She's a LCSW and licensed in a couple states. For those who do this kind of work, which sites would you avoid/recommend? She'd like to be equitable to her clients, so those that do a good job helping their clients is a bonus.
posted by BobtheThief to Work & Money (7 answers total) 8 users marked this as a favorite
Is she considering going into private practice or does she only want to work for an employer?

I have a friend who used to work in community mental health for 30 years who quit about 18 months ago, launched his own private practice doing fully remote therapy working from his home office. He is also an LCSW licensed in just our state. He put his profile up on psychology today and got himself a basic website on Foursquare. He also reached out to other practitioners and past contacts in the field for referrals. He had a slowish start because he was too hesitant to ask for referrals directly in the early months, feeling like he hadn't proven himself as a generalist therapist (in CMH he had a very particular niche). But he did get over himself after 2-3 months and started to reach out to his former colleagues/etc more rigorously. His practice was full with a waiting list in about 8 months after he first began.
posted by MiraK at 6:39 PM on June 10 [5 favorites]

Does she want to take insurance? If so, the simplest thing is probably to join Alma. It's essentially like working for a giant group practice. Some upsides are:

-you don't have to deal directly with insurance companies and this simplifies things a great deal
-it kind of easily automates a lot of your practice like scheduling and sending out intake stuff
-you reportedly get higher rates than individuals contracting with insurance panels
-they take care of some other bullshit for you like initial credentialing and renewing your CAQH (which is minor) and stuff like that
-you get some referrals from them though people get very different mileage from this and it's good to also have a Psychology Today ad or something.

The downsides are

-interface between company and therapist is not always great, but it's functional
-there is a monthly or yearly fee
-if you talk to people who run small group practices about it, they will give you side-eye for, I don't exactly know, being complicit in the problematic role of insurance in therapy. Obviously I find this one a little ¯\_(ツ)_/¯

I don't love everything about it but I found it very useful in building my practice.

If she wants to be private pay it's a whole other ballgame and more competitive and I don't have any useful advice.

If she wants to be part of a smaller group practice rather than private, she should ask around on a local fb therapist group.

Things I'd say to avoid: #1 is BetterHelp, which is shady, but also stuff like Two Chairs, they take a big cut, require quite a lot of client contact hours, and are just...iffy. In order to pay the admin staff of the company, they end up paying like $45/hr which is appalling.
posted by less-of-course at 7:24 PM on June 10 [3 favorites]

One of the billing platforms with no minimum case load is probably the easiest way with the least startup cost and stress. I have tried a few of the online therapy platforms and the easiest to use has been Headway. They will let you do private pay (but they charge you the Stripe processing fee) and will panel you with insurance and deal with all that for you. You’re on your own to find clients, which I found I preferred; some of the other companies allowed people to add themselves to my schedule without a consultation. Reimbursement rates are similar to Alma but there’s no fee, and you aren’t required to document within their system, just to certify that you documented somewhere. I basically never interact with their staff at all, just use the cwlendwr and get paid. The whole thing is not very different from Alma. I hear Grow is similar. I do think you can only use one state license at a time on Headway for the time being. AVOID Rula (formerly Path).
posted by assenav at 8:01 PM on June 10

I don’t think they’re in your state (of course it depends where she is credentialed, and they're expanding into more markets) but i used to work for Sondermind. They’re… fine, ethically a lot better than eg Betterhelp. They handle insurance. I have no idea how their rates stack up for providers.
posted by supercres at 9:54 PM on June 10

Just seconding Headway as a client. Relatively frictionless and doesn’t bombard me with marketing emails, surveys, etc.
posted by moonmoth at 1:25 PM on June 11

If Lifestance Health is in any of those states, I know lots of people like them where I’m at. A lot of private practices ended up joining with them.
posted by brook horse at 1:49 PM on June 11

It would depend on her goals - but one option is, she could work for a health insurance plan with a medicare/medicaid line of business as a behavioral health care manager or as a social work care manager. These jobs are often remote in more liberal states, and they pay pretty well. These are often also for non-profits, in case she’s interested in PSLF. And while a lot of insurance companies are the bad guy, the ones that work for the state and have state plans have pretty strict guidelines that require them to put members first.
posted by invincible summer at 8:31 PM on June 11

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