On 2006-06-04 06:13:00, Pls help wrote:
"Hi Again
3. What exactly is the American definition of a therapist. Are you a psycologist or a psychiatrist or just a social worker?
On 2006-06-04 06:13:00, Pls help wrote:
"Hi Again
3. What exactly is the American definition of a therapist. Are you a psychologist or a psychiatrist or just a social worker?
In the USA there is a division between what the Federal Government has jurisdiction over and what belongs to the States. Generally, issues involving the Constitution are within the jurisdiction of the Federal Government. Much of USA Federal law is based on the concept that the Federal Government can regulate trade between the States and Internationally.
That said, you will find laws vary drastically between States. For example, in Ohio and Pennsylvania you cannot provide therapy unless you hold a PHD (doctorate degree - the highest post graduate degree offered) in psychology or you are a psychiatrist. In New Jersey, you can be a 'counselor' with an MSW (Master's degree in Social Work). In most States, only psychiatrists can prescribe medications. To be a psychiatrist, you first must be a licensed MD (Medical Doctor). Psychiatry is a medical specialization much like internal medicine, surgery, or anesthesiology. The highest accreditation for doctors is to be 'Board Certified' for the specific specialization.
In general, prestige runs from lessor to greater: MSW, PHD, MD (Psychiatrist). Compensation also follows this with PHDs in psychology charging slightly over 100 US dollars per hour and psychiatrists charging 150 to 200 US dollars per hour. Therapy is expensive. Often, medical insurance only covers a very small portion by limiting what constitutes an acceptable diagnosis, the number of visits, and restricting the patient to the use of MSW level providers. Insurance companies generally require both a diagnosis and a treatment plan before approving coverage. They then approve a limited number of visits or sessions, after which the therapy provider must give progress reports and justification for further treatment to the insurance provider. Very few insurance companies will pay for these schools.
This lack of insurance is actually considered a plus by investors in these schools. Because the customer (parent) pays directly to the school, they avoid all the regulations, checks and balances, that are required by insurance companies and the laws that surround acceptable practices. For example, the law requires hospitals, clinics, and individual practitioners to have malpractice insurance in place. Insurance companies insist on this coverage and also insist that the provider is licensed to practice (medicine or therapy) by the State where they are working. It also speeds collections. Insurance companies often make partial payments based on approving only some procedures and treatments. Insurance companies also have maximum limits for services, above which the patient/customer is responsible to pay.
These schools often use technicalities to avoid regulations by describing themselves differently to different groups or people. They call themselves 'boarding schools' to avoid the legal restrictions under which therapy providers must operate. They call themselves 'residential treatment centers' to avoid State requirements under which academic schools must operate. In some States, these facilities only need a 'business license' to operate and there are no regulations governing their conduct.
Because these facilities are private, they cannot be visited or investigated by government agencies (child protection agencies, police on all levels, medical licensing boards, state inspectors) unless a complaint is filed against them and that State's Attorney General feels the allegation has merit and gets a search warrant from a Judge. The warrant must state exactly what and who the authorities are looking for when they visit. These schools contribute large sums of money in the form of political donations to local police and the attorney general as well as State Legislatures. This ensures they are looked on kindly by these law makers and enforcers. In some cases (notably Florida) police or former police are counted among the owners and employees of these schools. It must be stated that law enforcement and judges often approve of what these schools are doing.
It is difficult to prove cases of abuse because often there are no witnesses and the word of the accuser is discredited by the very fact that they were sent to one of these facilities. Also, in the USA, minors cannot file lawsuits. They require an adult to file on their behalf and their parents won't do this because they; 1. are the people that sent the kid there, and/or 2. would be exposing themselves to charges of neglect since they are legally responsible for their child's safety. Thus the few lawsuits filed are generally based on business laws (misleading advertising, fraud, breach of conduct). These lawsuits can only result in fines and monetary restitution to the victim. They are civil, but not criminal charges. Most are settled 'out of court' avoiding the bad publicity associated with going to trial and allowing the facility to pay off the victim without admitting any guilt. That said, once your read
Help at Any Cost you will read of one successful lawsuit in New Jersey based on medical malpractice.
Finally, it must also be mentioned that these programs often send the teen out of their home State or even overseas. They are now under the jurisdiction of the laws of the State or country where the program resides that applies, not the teen's home State. When it comes to custody issues, like yours, this makes things very complex because in principle States say they will honor the custody, visitation, and child support rulings of the home State, in practice they often do not. Thus there are cases where the opposing parent is denied access to their own child which is technically illegal, but so difficult to resolve between the States that the child can end up completing the program before the Courts can enforce the parent's custody/visitation rights.
Thus you can see that this industry is a slippery animal tacitly approved by the State and as such is difficult to assail through legal means.
[ This Message was edited by: AtomicAnt on 2006-06-04 12:43 ]