From dealing with difficult patients to getting ahead of rapid technological change, therapists have plenty of challenges to overcome. As a new decade begins, there’s no better time to reflect on present-day challenges, and what to expect in the future.
Psychotherapists and mental health professionals face different challenges than speech and occupational therapists, but these issues affect (or will affect) everyone who works in therapy.
Let’s start with what’s facing therapists, clinicians and other healthcare professionals. Here are some of the most pressing issues.
Resistance & Discontinuity
One challenge for all forms of therapy is patient resistance. The unwillingness to share personal info, perform therapeutic exercises, or the refusal to schedule a second visit. Many experts such as Clifton Mitchell, the author of a book on dealing with resistant clients, advises that therapists and counselors avoid blaming patients and instead find ways improve their techniques. Easier said than done!
Remember that resistance is a natural human behavior with many forms, for instance, the resistance to spend money frivolously. Resistance is a necessary part of therapy and must be treated as such. Consider these techniques.
Meet Clients in Their Realty – Robert Wubbolding, director of training for the William Glasser Institute, advises counselors to help clients by demonstrating the practical disadvantage of their resistance. He suggests therapists should ask clients about their environment and daily life, instead of directing them down a preferred conversation path.
Find Consensus on Goals – Oftentimes a resistance client is ignorant to the goal of the therapy, despite their initiative to sign up. Clifton Mitchell, Ph.D. explained with this quote, “Most people do not come to therapy to find solutions to their problems. Most people come to therapy, “…because they realized what the solution was and were terrified.“ Confirm the goal of overcoming this fear with the patient.
Slow Down and Accept “I don’t know” – Constant “I don’t know” answers can be frustrating but the refusal to accept this only makes things worse. Accept and embrace theses answers then move onto a new tactic.
Another issue facing therapists today is the idea of cultural competence. The patient base is becoming more diverse in terms of race, gender, age and socioeconomic backgrounds. It’s crucial to not only understand these different perspectives but provide quality and personalized care. Here’s more context on culture competence.
It’s an Organizational Issue, Not Individual – The Substance Abuse and Mental Health Services Administration (SAMHSA) created a guide for cultural sensitivity. Their first point is cultural competence is an organizational issue, meaning individuals need support from their employer. Implore your organization or community for assistance if needed.
Know Your Own Culture – Another point made by SAMHSA is that practitioners must understand their own culture before appreciating the diversity of human dynamics. This concept is central to most cultural appropriation cases.
Example: Storytelling – Studies from three different researchers looked at the use of storytelling with Puerto Rican children. By using Puerto Rican folktales, cuentos, instead of traditional approaches, they were able to record better emotional and behavioral outcomes from the children.
Upcoming Challenges (1 to 5 Years)
The therapy industry is segmented into different verticals, but growth is slow and steady. For example, the speech-language pathologist industry grew 3.4% per year on average between 2015-2020, and is expected to reach $4.2bn in 2020. With that mind, here’s a look at the challenges expected in the next 5 years.
Less Paperwork & More Automation
In the 2018 American Speech Language Hearing Association (ASHA) SLP Schools Survey, 79% percent of speech therapists said the large amount of paperwork was the greatest challenge of their work. This is a small increase from previous years of the survey. The paperwork problem has persisted despite the rise of software, EHR requirements and automation.
Technology influence and adoption will continue to grow. The challenge this presents is change. Experienced therapists will have to adapt to technology running more of their business.
How to Prepare: Consider embracing technology, even if you’re not tech-savvy. As technology improves, the learning curve becomes smaller and the benefits become larger. In fact, 59% of surveyed ClinicSource customers said they switched over from paperwork before using an EHR, while 70% say they now save time and avoid hassle on their documentation.
Niches and Diversification
Developing a niche is already a popular move for therapists, especially those in a private practice. It helps clinicians stand out and pick up new business easier. Expect this trend to continue as the field grows and the stigma of therapy dissipates.
Family or marriage counseling is considered a niche now but expect more specific niches in the future such as therapy for siblings or middle children. Therapy niches will be created based on current events such as therapy for refugees. Some therapists have even created “running therapy” as a niche.
How to Prepare: Explore other career paths or side income opportunities. ASHA shared a video with speech therapists discussing niche careers in audiology research, working with actors, teaching, and international outreach.
Future Challenges (5 Years and Beyond)
Malcolm X said, “The future belongs to those who prepare for it today.” There’s no sense in fretting about possible industry and technological changes but it doesn’t hurt to be forward thinking. Expect two major challenges to impact therapists.
The online revolution has extended to healthcare and will continue. Services like Talkspace and BetterHealth offer platforms for virtual counseling and therapy. The idea is to help patients save on cost and open services up to more people. But in the future, telehealth might extend beyond apps and into the mainstream. Cloud-based, high quality video conferencing is less than 20 years old and will continue to evolve and become more reliable. Further, technologies like augmented reality could bring the closeness of a one-on-one setting into a virtual or semi-virtual setting. There are many variables involved with this evolution of the practice. Clinicians and patients will resist if the quality of care starts to deteriorate.
How to Prepare: Think about how telehealth can increase access. For example, pediatric occupational therapists who work on sensory integration, fine, gross and visual motor skills can use telehealth to help children who can’t leave their home often or live in rural areas.
AI and Algorithms
Perhaps the most contentious issue pertaining to the industry is the growing talk of “evidence-based therapy.” This refers to using scientific evidence to support treatment decisions. However, the term has been co-opted by the movement to apply more artificial intelligence (AI) and algorithms in therapy. This is concerning for any healthcare professional who isn’t interested in handing over their livelihood to robots.
How to Prepare: Stay active in the medical community by writing, commenting and participating in the conversation. Review details of randomized controlled trials and other studies. Especially those funded or in the interest of Big Tech.
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