The medical model draws a significant amount of critique in clinical psychology these days, especially from existential and humanistic psychologists, and for good reason. The medical model is deeply flawed in its basic assumptions, including its construction of mental illness and conceptualization of what it means to be human. Although ongoing critique of the medical model is needed, it is increasingly evident that another disconcerting model is also in need of our attention and critique: the business model.
The business model is nothing new in mental health. We were first introduced to it when managed care invaded mental health. Despite our complaining about the negative impacts of managed care, it is important for clinicians to recognize that it came about largely because of the abuses of the system perpetrated by many practitioners. With managed care, clinicians encountered lower pay and greater challenges in reimbursement, leading to the need for many therapists to give more attention to the business side of practice in order to survive.
Although often not acknowledged, managed care brought some needed reform. Individuals and groups that were exploiting the system were more closely regulated and many mental health organizations began emphasizing financial responsibility. Yet, this is not the business model I am addressing this article. In recent times, we have seen the introduction of for-profit companies, agencies, and models (including in nonprofit companies) into various levels of psychological training and practice. These for-profit models have infiltrated mental health hospitals, community mental health centers, prisons, education and training programs, and even hospice programs. The for-profits often have a different motivation than the traditional mental health worker: profit. Although it is important to emphasize that not all for-profits are problematic, increasingly it seems there are few exceptions.