173: Owning Your Power in a Shifting Therapy Landscape with Matt Cohen

Owning Your Power in a Shifting Therapy Landscape with Matt Cohen Episode Cover Image

“When we think about a lot of therapist dynamics, yes, now we’re seeing clinics and franchises and these virtual companies and what have you, but the majority of therapists historically have either part-time worked in a clinic or worked on their own and things of that nature. And so there’s associations and such, but there’s not really that community of therapists where you’re able to use that broad voice to say, these are our demands in set terms, and actually ensure that you can help yourselves in that way.”

~Matt Cohen

Meet Matt Cohen

Matt Cohen, CEO of PlaySpace, has over 20 years of lived mental health experience and has dedicated his career to the digital health space. With a background working in mental health, medical device, and digital health companies, Matt is driven by his passion to make mental health care accessible to all. His vision is to create solutions that support health practitioners, enabling them to deliver care that is engaging, effective, and available to those who need it most.

In this Episode...

How do we protect the future of our profession in a rapidly evolving mental health landscape?

In today’s episode, I sit down with Matt Cohen, founder of PlaySpace Health, who brings a unique perspective from the world of business and innovation into the therapy room. Matt shares how his company is helping therapists reimagine engagement with young and neurodivergent clients, both virtually and in person, and what it means to build tools that truly serve therapists’ needs. But our conversation doesn’t stop there.

Together, Matt and I explore the rise of venture capital in the mental health space and why therapists often get caught in the middle of business models that weren’t built with us in mind. We talk about the undervaluing of therapists’ work, the structural challenges baked into the system, and how we can step into our power as professionals, both individually and collectively.

If you’ve ever felt the tension between your clinical values and the way therapy is being shaped by outside forces, this episode will leave you thinking about what’s possible when we choose to be term-setters instead of term-takers.

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Episode Transcript

[00:00:01] Matt: When we think about a lot of therapist dynamics, yes, now we’re seeing clinics and franchises and these virtual companies and what have you, but the majority of therapists historically have either part-time worked in a clinic or worked on their own and things of that nature. And so there’s associations and such, but there’s not really that community of therapists where you’re able to use that broad voice to say, these are our demands in set terms, and actually ensure that you can help yourselves in that way.

[00:00:29] Linzy: Welcome to the Money Skills for Therapist podcast, where we answer this question: how can therapists and health practitioners go from money shame and confusion to feeling calm and confident about their finances and get money really working for them in both their private practice and their lives? I’m your host, Linzy Bonham, therapist turned money coach, and creator of the course Money Skills for Therapists.

[00:00:52] Linzy: Hello and welcome back to the podcast. Today’s podcast guest is Matt Cohen. Matt is the founder of Playspace, which is a tool that helps therapists use play therapy online with their clients. Matt is coming to us today with a perspective we don’t usually get on this podcast, which is the perspective very much of somebody like in the business startup space, right?

[00:01:17] We are aware as therapists of, you know, startups coming into our world, some big tech money came into our scene, especially around COVID. And so now we have these large companies around that, employ therapists or are offering different services and tools to therapists in different ways.

[00:01:34] There’s a lot to that. There’s a lot there, and today Matt and I talk about his perspective on therapists, like what we don’t understand about our position, like the power that we hold as therapists,

[00:01:47] the fact that there’s so much demand for therapy and not enough supply, puts us into a position where we can be really setting the terms of how things are happening, but we’re not really doing that. So we talk about that today. We talk about what these large companies were looking for when they came into our space, what they’re still looking for, what is starting to not work about some of these business models.

[00:02:08] And we talk about different silos in the health sector. This is very much a businessy chat today about therapists. This is great insight into how folks coming into our space, who live in the world of startups and MBAs, and they live and breathe business… Matt gives some great insights into what those folks are seeing when they look at the therapist space and what they’re looking for and hoping for in the therapist space.

[00:02:32] And then what we as therapists can start to do to hold our power and hold our ground, and make our careers and the services that we offer really align with how we want the world to be. Here is my conversation with Matt Cohen.

[00:02:58] Linzy: So, Matt, welcome to the podcast.

[00:03:01] Matt: Thank you so much for having me.

[00:03:02] Linzy: Yeah. I am excited to have you here. In a way I almost feel like you’re like a visitor coming from somewhere else into our space in terms of the knowledge that you’re bringing today. ‘Cause it’s not often on the podcast that we talk to somebody who just has a completely different training and professional experience.

[00:03:18] Most of the folks that I speak to are, you know, therapists themselves or very therapy adjacent and you’ve moved into the therapist space, but you have all this knowledge that we do not have as therapists. So excited to bring you here. Can you tell folks who are listening more about yourself and what you do?

[00:03:33] Matt: Yeah, so, I am not a therapist, as you said, and I just want to say that from the outset, I have a business and finance background, but I say that because I have a lot of lived experience. I’m neurodivergent, I have a number of severe conditions like bipolar disorder, and so I always say that mental health for me is not cured. It’s managed. And so I’ve always been quite passionate about this space because when I was younger, I used to say it was a luxury to destigmatize it. As I got older and people became more aware, I realized the truth in that statement.

[00:04:05] While I say that in this context, I don’t promote that message, but I say that ’cause my therapist of 20 years came to me in Covid and said, you know, Matt, we do Zoom. Now you sit on your couch no problem. But when you came in 20 years ago, you crossed your arms and went and talked to me as a kid,

[00:04:20] and it was board games and art and things like that that allowed us to build rapport, and is there anything out there I can use because I can’t do it on Zoom? And I looked around, I spoke to companies that could, at the time, easily do it, and I was getting a lot of sort of cold reception. And kids don’t make their own care decisions.

[00:04:39] It’s a niche. Play: why is that needed? And what was interesting for me is for all that we’re doing in the space and building these care continuums and innovation, what the therapists actually need and rely on to be effective was not being considered ’cause no one’s in the session seeing that and so there was a bit of a gap there. And that’s why Play space was invented. 

[00:05:01] So Playspace Health is a company that builds software for therapists that work with children, adolescents, and neurodivergent adults to support them with engagement, to build content, and allow care to be more accessible  because it’s quite inequitable today.

[00:05:15] Linzy: Yes, and that’s such a great point about identifying what therapists actually need and are actually asking for ’cause I think so often innovations that come to us come from somebody outside who’s like, you need this, and you’re like, ah, it’s kind of what I need, but it’s not really what I need.

[00:05:29] So what I’m hearing is you solved a problem that was very directly brought to you by your own therapist, which is, how do I engage people in this online space without just us staring at each other? ‘Cause yeah, as you say, those in-person elements of therapy, especially obviously with kids who are dynamic, I think about my own son who goes to an occupational therapist, right?

[00:05:49] So occupational therapists are very physical. We’re taking him there with a suspicion that he probably has ADHD not diagnosed, but if he doesn’t, it would be bizarre in our family, frankly. When I watch him in that space with a therapist, he’s so physically engaged, right? He’s bouncing off the walls and he’s going from this activity to that activity, which actually he doesn’t do in a lot of other environments where that’s not possible.

[00:06:10] And so what I’m hearing you’ve come up with is a way for that to become more possible in the online space for kids who are sitting at the computer, not to just be staring at their therapist, but actually have like creative ways to be together with their therapist, which is essential for working with kids.

[00:06:25] Matt: Yeah, very much so. And I’ll say it’s both for virtual, but what was interesting early on in the company was we started hearing that, for example, our virtual sand tray was actually starting to be used in person because at the time germs were a big deal and sand trays are disgusting. And so there’s that.

[00:06:44] But then, too, kids are used to iPads, right? Kids are used to playing and using technology, and so we have to find ways to bring that in and in some cases make it better. And you know, I use the example of mouse trap, ’cause I don’t know if you remember how long that takes to set up, but now kids don’t have the patience for that.

[00:07:00] So it is both environments but to your point to just start, that was important in that we’re solving a problem that therapists actually have, not trying to capitalize on an opportunity that we believe exists. And I think that’s where the gap is ’cause in health it attracts so many people because it’s, there’s so much opportunity and it’s so big, but yet there’s sometimes the gap between where we want to go, and where we’re starting from, and how we need to get there and so that disconnect is really what we sort of wanted to avoid.

[00:07:36] And really starting with understanding where therapists are today. And the reason I bring that up in the in-person side is because after Covid, while most therapists stayed online, and today 55% of sessions are actually done online,

[00:07:51] for children 90% of sessions went back to in-person and it’s ’cause they didn’t have the tools. And so we’ve almost reinforced this perception that it can’t be possible or we believe that there’s virtual happening, and it’s all accessible and it’s changed when in reality they are in person today. So when it snows, or when someone’s sick, or when you have to go on vacation, that’s not the time to learn a new tool.

[00:08:18] So if we meet them where they are today in person, then it creates that continuity and familiarity that I think will allow us to be successful over time by meeting them on the evolution or adoption curve where they are today.

[00:08:30] Linzy: Yeah, and just to you know, bring that into thinking in therapist speak, if we’re talking about the evolution and adoption curve, we’re talking about, you know, it takes a while for us to get used to something, and you and I chatted about this when we chatted once before, is therapists,

[00:08:44] we’re not super fast to adopt. We’re probably not the first people to buy a new type of technology. Like I will say for myself personally, when there’s a new technology that comes out, if it’s some sort of AI, or a new phone or whatever, I just wait and watch other people use it, right?

[00:08:59] Like I’m not an early adopter kind of human. I’m like, I’m going to let other people work that out. I’m going to see how it goes for them. Then I might think about trying it myself. And so I find with many therapists, we don’t tend to be fast movers. We’re not the first to jump on something, but once we decide to do something, we’re usually quite committed to it and we stick with it, right?

[00:09:19] Matt: Yeah, and I’d say that’s true for all really in the health space, but what’s interesting about it and why I think that exists is because, and this is sort of again, where there’s sometimes a disconnect. You know, therapists go to school, they get real training and they know what they’re doing.In any role, let’s say you are in business development or

[00:09:37] sales in a company, you’re willing to try different things all the time because you’re maybe in a new role, maybe selling a new product, maybe trying to do something more innovative. Whereas in health, you’re following what the research says and that doesn’t change by the day,

[00:09:52] and your training is much more robust. And so you feel comfortable following your training and if you’re going to do something, it’s because you have a real strong belief that is worth potentially employing long term in your practice rather than every day when I see something new, I’m going to try new things and, you know, run fast and break things as they sometimes startups.

[00:10:15] Linzy: Running fast and breaking things in the mental health space is not good. It’s actually our ethical obligation to not break things. So yeah, that’s an excellent point. I think about the training that we have that makes us more rigorous and thoughtful about what we’re doing and why.

[00:10:28] And so I think that’s an excellent distinction between maybe the orientation of people in health, you know, the actual providers, therapists and practitioners and doctors too. There’s a different orientation there, as you say, compared to like a sales person or marketing or I’ve got this great idea, let’s go.

[00:10:44] but these worlds are kind of colliding now, you know, as we see more startups and more venture capital coming into the therapist space. So I would love to hear your perspective as somebody who’s very much from the business space, but has a deep personal appreciation of therapy. What do you see happening in the landscape right now? How would you describe what’s happening with all of this big money coming into the therapy space?

[00:11:09] Matt: Yeah, so just to give some context even to what exists now in that vein, I think it’s important to just give a little bit of context on how we’ve gotten here over the past few years and I say that because. Prior to, let’s call it twenty fifteen, twenty sixteen, mental health was not in vogue. It wasn’t being talked about in the same way that it was today.

[00:11:30] And we’ve seen an incredible change where now we are talking about it, people are more aware and that’s created business opportunities. And so I was actually part of the founding team of the first digitally native mental health product in Canada, which used a therapist to connect with an individual with asynchronous messaging or you know, not live messaging.

[00:11:50] And then had content and it was CBT, based care, they called it T-I-C-B-T Therapist Assisted internet delivered Cognitive Behavioral Therapy. And so I say that ’cause that was the first, and so what’s happened is between 2016 and 2015, and now, you know, we’re talking 10 years. That’s not a long time in health, which collectively moves slowly.

[00:12:13] And it has to, for safety. And so what’s happened is that between, let’s call it 2015 and then into Covid, everything was just about the opportunity of itAnd in Covid, now all of a sudden it wasn’t just, oh, technology can help this. Now technology is the only way that you can do this. You know, potentially it depends on, you know, what was happening. And so that was sort of the peak and then covid was, I’m using air quotes here. is was

[00:12:43] over, so to speak, or the peak of it passed, and then reality set in. And yes, a lot of therapists continued with Zoom, but for example, pediatric therapists largely went back in person, you know, even if they were using Zoom as part of their practice, they weren’t using all the other piece of technology that you would have to use to really move the needle and make it worthwhile for a lot of companies. And so from aventure capital, which is, you know, where you’re investing in these early stage companies, you are betting on that velocity. And so all these people just looked at the upside and then sort of the bubble burst and valuations came down. And so you have all these venture capitalists and that are now nervous to invest and have a lot of money in companies that they don’t know how to get that money out of because they invested their money,

[00:13:34] let’s say at a valuation of the company, let’s just call it a billion dollars, and then immediately after Covid, they don’t know how they’re going to make it worth a hundred million dollars or whatever it might be.

[00:13:46] And so that’s where we’ve gotten to today, which is there’s still a lot of bets being placed, but what’s happened is that people that are making some of these big bets from the investment side are using their singular context or their limited context to and think, oh, well maybe it was just this thing or that thing not really understanding that there were some real fundamental problems with these business models that are largely being continued

[00:14:16] in these new companies that they didn’t necessarily diagnose as the root of those problems. And so we’re seeing it happen again, and this is where the whiplash comes in for therapists that are parts of these organizations, and I’ll just pause there, but I think that’s, you know, that change, that cycle, like therapists are essentially becoming sort of Guinea pigs in these models,

[00:14:36] and that’s part of the problem and what’s happening is that there hasn’t been a historically scalable and sustainable way that not only engages therapists appropriately and you know, serves the patients truly in a way that delivers outcomes, but also then is able to deliver investor returns in an appropriate, truly ethical and impactful way.

[00:15:00] Linzy: Yeah, ’cause what I’m hearing is a lot of these companies and just to kind of describe the kind of companies we’re talking about. These would be like online platforms, where therapists can, you know, be matched with clients, easily because these platforms have large advertising budgets and you know, you might hear them mentioned on every podcast you listen to.

[00:15:19] That’s the kind of company we’re talking about. So people came in with millions of dollars, they expected those to turn into billions of dollars. ’cause they expected this trajectory of this is the new way. ‘Cause with Covid it was, as you say, the only way, it was the only way that we could get that support in Covid,but things are changing back to normal. So to speak nowit’s been an experiment is what I’m hearing. Partially like it was an experiment that seemed like a super good idea. Some people saw their fortunes, you know, being made from this experiment ’cause obviously, this was the new way that therapy was going to be done.

[00:15:51] But more and more we’re seeing that it’s not actually the only way that people want to receive therapy. Like there is a demand and an interest for in-person coming back. I’m seeing that, like you mentioned, 55% of sessions are happening online, still, but that also means 45% are not happening online and I’m hearing and starting to see this in, for instance, with the group practice owners that I work with where like people who are online are getting harder to fill now because clients want to see people in person again now that they can. So like again, it’s a slow shift back, you know, like the peak of Covid was a couple years ago now,

[00:16:25] but now more and more when people want to see a therapist, they would like to sit in the same room as them and they would like to go to their office. So yeah, there’s this bubble burst that’s happening. But what I think I’m hearing from you is that these companies still haven’t necessarily caught up with that reality. Like they’re still based on some of these assumptions that this is workable.

[00:16:45] Matt: I think it’s not only about the in-person and not, I think… It’s about the fact that… That’s one of the examples, but let’s take another one. There’s been some incredible companies, some of which are still very large and doing great work and are doing well today, but there was this massive idea of, okay, well most therapists in this, if we go back to, you know, years ago, but I’ll use just children today because it’s actually a perfect example about in-network providers, Most therapists in 2016 were not in network full stop. And so what’s happened is that let’s take children for example. Only one in 10 therapists that work with children are in network. So if you are a venture capitalist and or you’re an entrepreneur or business person and you’re like, oh, what’s a big opportunity that can be quote unquote solved.

[00:17:32] It’s you want something that’s intense wise that’s, you know, about a big opportunity. You have the perfect solution that’s going to be the panacea of the future and what ends up happening is great. Yeah, 90% of therapists are not in network, so there’s a massive opportunity to build a company, to bring them in network, but the real question is it because. Truly it was just the administrative burden of being in the network, or is it also the payouts?

[00:17:59] Are there many other things that need to be considered? And so what happens is, and we’re seeing this now with a lot of the pay cuts and some of the challenges people are having, it’s, you can bring them all in network, but if you don’t have a model financially to support them and to scale them and really empower them in this model, then

[00:18:15] they’re not going to stay and they’re not going to tell their friends and colleagues and others to participate. And that is not scalable or sustainable. And so you might get some that are willing to do it in a certain extent, but you don’t go to school this time and put all this work to make pennies and give it all to someone else.

[00:18:34] Linzy: No.

[00:18:34] Matt: Or work in a model that is just not conducive in general. And I think these companies fall in love with their solutions or the opportunity more than necessarily the root problems that exist in it because they know they can’t change those ones. And it’s just a misguided sort of approach to it. And I’m not saying there again, there haven’t been some that have done it well.

[00:18:55] But again, there’s going to be that challenge on an ongoing basis ’cause now they’re dependent on, let’s call it insurance companies or payers or regulators that are out of their control. And any minute can undermine their business model. And what are they doing to ensure they’re going to protect therapists and provide an alternative if should that happen.

[00:19:14] There’s no answer to that. And so again, it’s this idea that it’s big opportunities that they look at, but then we’re not solving the root problems that actually make those big opportunities sustainable over time.

[00:19:27] And then once you’ve reached that sort of that high, and you reached a sort of critical mass or threshold that you know is growing, it becomes diminishing returns and you struggle because there’s way more demand for therapy than there are supply of therapists and there’s not enough therapists full stop and so when your business is predicated on, let’s call it owning or managing therapist capacity, and that’s the scarcity, that’s a very challenging model regardless of the rest of the context.

[00:20:02] Linzy: Yeah, And I so appreciate you bringing that up. Because I was talking about kind of the, maybe the demand side of the equation, right? Which is people aren’t looking for online therapy so much anymore. They want to go in person, but you’re talking here about the supply sides or like the work conditions basically of therapists.

[00:20:15] There’s a reason that therapists were choosing not to be in the network, for American therapists who have that big choice to always make: do I go on insurance, do I not go on insurance? You know, in network, not in network. There are reasons that people were not in network that was not just as you say, because the paperwork, as you mentioned, like therapists pay so much for our education, right.

[00:20:34] And I’ll say that that’s not the case in a lot of Canadian contexts. So, you know, myself being Canadian, I didn’t actually pay a lot for my education, but I work with American therapists who have $200,000 of debt in order to get where they are. Therapists don’t take on all that debt and then feel satisfied making $40 an hour.

[00:20:52] That’s just like bad math. The math doesn’t work for them. But, yeah, if companies don’t recognize or understand that, there’s a problem there, but I also loved what you mentioned there, and you’ve mentioned this to me before in, in our conversations, is. There is so much demand for therapy and so little supply, like there are not enough therapists for all the folks out there who would love to get good therapy. And like, I think in many kinds of industries, if that was the case, I think there would be maybe like there’s more empowerment, excitement, recognition of that. We don’t feel like that as therapists.

[00:21:30] Matt: I mean, Economics 101. when there’s more demand for a good, then there is supply of that good. Then supply is the term setter, and so if we’re looking at economics, if there’s way more demand, there is supply, then you increase the price because now that balances it out hypothetically.

[00:21:49] You know, if there’s an abundance of something, then you can make it more affordable, but when there’s not, it’s then a scarcity, and therefore there’s a premium to it. But the problem is that. You have to then be a term setter in that.

[00:22:01] And I think what’s happened in therapy, and this is why I brought up the context earlier, is that It has not been a mature industry. It’s still in its early innings, and it doesn’t mean the practice and profession is immature. It means the business side, the industry of it, like the corporate side of it that is not there. And so when When we think about a lot of therapist dynamics,

[00:22:25] yes, now we’re seeing clinics and franchises and these virtual companies and what have you. But the majority of therapists historically have either worked part-time in a clinic or worked on their own and things of that nature. And so there’s associations and such, but there’s not really that community of therapists where you’re able to use that broad voice to say, these are our demands in set terms, and actually ensure that, you know, you can help yourselves in that way. And I think that’s what’s made it vulnerable because now it’s made it that now all these companies can come in,

[00:22:59] they can get people to be part of their group, set whatever terms that they want, and then hope that’s going to get them where they want to go. And when it doesn’t, I mean now you need to start changing how you pay therapists or cutting the therapists you have, or making it not conducive to therapists.

[00:23:14] And while, as you said, if you’re trying to be in the network, I can acquire the patients, I could do your finances, I can do your admin, we can do your count. We could do everything for you, but if the last sentence of this is you make $35 an hour, well then that undermines everything else that I just fell in love with that you said, and I think that has never been solved for. And so, that’s, where we have to change the 

[00:23:37] dynamic here because any of these companies that are not thinking about the therapists, putting them first and really building for them, they’re inherently not scalable. When you take advantage, you are not creating an advantage. You’re creating a temporary opportunity that if you can get out in great, maybe you can make a return for your investors, but you’re not going to have any sustainability if you’re taking advantage there.

[00:24:02] Linzy: Yes, yeah, and I mean, there’s a few things that come to mind for me here as we think about what we’re hearing, what you’re saying is that therapists, we are in the position where we could be, as you say, the term setters. We have this incredible service to offer that folks want and need.

[00:24:17] There’s more folks needing the service than the services available. There’s just not enough therapists to meet it. So being the term setter, you know, if I think about private practice could be like, you can set the fee that you actually need to earn, right? There is enough demand out there that if you set the fee, as long as you, you know, market effectively and people understand what you do and who you’re there to serve, you know, there is enough demand that can be met

[00:24:39] but there’s so much that gets in the way for therapists. As I’m thinking about it, I’m like, so why don’t we just do that? So many reasons. First of all, I don’t think we really recognize that we are professionals, in the way that a doctor would recognize that they’re a professional. I think there’s something about the fact that, and we’re talking about mental health therapy here too, but I think it also does apply to some of the other kinds of manual practitioners, too.

[00:24:59] There is a lack of reverence that we have for what we do ’cause often we’re so naturally good at it that we don’t realize that no, it’s really special. Like many people can’t and would never be able to do that. They could study for a hundred years and they won’t be able to do what you do

[00:25:12] because it’s a combination of natural gifts plus education that allows you to do it. But I also, I just came back from a conference in Orlando, Florida, the American Counseling Association Conference, and we had so many grad school students come into our booth. You know, they’re going to be therapists in a few years.

[00:25:28] They have to go through the licensure process, which is a whole other story of you know, they just need to work for free for a thousand hours before they’re allowed to, you know, make money. But they were saying to us, they’re not allowed to talk about money in grad school. If they bring it up, their professors say, that’s not why you’re here.

[00:25:43] There’s kind of this dismissive hand wave. I had another person come to the booth like, share this phrase, which is about the outcome, not the income. It makes my blood boil because here we are. We’ve sunk so much money into education in so many cases. So talented people have this thing that’s in super high demand and yet we are actively being shamed into not even thinking that we deserve to make, like sometimes, Matt, I’m serious, like a middle class income. Folks have to wrap their mind around the fact that maybe they deserve to make a middle class income

[00:26:13] and that I think is systemic and structural. In our industry, like our industry is cutting us off at the knees by telling us we’re not supposed to earn money. And then you have all these other folks and they look at our industry and they see nothing but dollar signs. ’cause they’re like, look at all the demand.

[00:26:28] Matt: I think that’s exactly right, is that there’s we talk about schooling and even you mentioned, what you pay for school, but it’s not only the paying for school, it’s the time and the extra time you’re putting into school and the opportunity cost, which is what you could otherwise be doing during that time. And so say, let’s take myself, I have an undergraduate degree. I don’t have a master’s.

[00:26:47] I don’t have a PhD. I don’t have anything like that, but what I’m going to tell now, people with PhDs who have been in school for so long, how should they practice? Never. That doesn’t even make sense. But if I have a good idea, I can talk about ebitda. A RR, and I can keep throwing out terms that are just, you know, random letters like that gives almost me some credibility

[00:27:11] with people who then have the money to invest and that’s a big problem. And I’d say the other thing is, again, going back to the context of this, prior to 16, mental health was not spoken of in the same way, and even now when we talk about mental health, we talk about mental health and physical health.

[00:27:25] We don’t talk about leg health, we don’t talk about heart health. We talk about mental health and physical health and as if those are separate things. And don’t get me wrong, they are, but everything in health is a separate thing. Health is a collection of markets and services and cases and causes. So I think just even just the broader sort of sentiment around it being a separate sort of health function or, you know, I think that feeds into all of this.

[00:27:55] Linzy: Yeah, for sure, and actually, you know that sparks another thought that I was having earlier, too. We are so siloed even within the silo, right? So let’s say mental health is a silo ’cause really we know that, you know, health is a combination of all these systems that result in like ultimate, like you’re doing well or you’re not

[00:28:12] because of all of these different things together. Within mental health, we have all these silos and we’re told that there’s something distinctly different between whether you’re a marriage and family therapist or a counselor or a psychotherapist or a social worker or a psychologist. Like we are actually taught that those things have real distinction and difference.

[00:28:34] And if I am a counselor. I’m taught to think certain ways about social workers and social workers are taught to think certain ways about psychotherapists. And it’s such bullshit and we do it to ourselves. I don’t know if it’s even being done to us. I think it’s very much like a kind of you know, I think about this a lot.

[00:28:50] Canadian politics. The left is very good at fighting with ourselves. We break up into eight or 10 small groups, the right, much more strategic. They’re like, nah, I don’t agree with everything, but let’s stick together. There’s so much power in sticking together and being a cohesive group and we are so splintered. That kind of bargaining power that we would have, that ability to set the terms as a larger profession right now feels really far away.

[00:29:13] And I am happy you said that because I remember even, again, going back to, let’s call it, you know, 2015, in different geographies, whether Canada, the UK, Australia, United States, they had,they’ve all done this at different times, but psychotherapist as a term. if you were a psychotherapist and not a social worker, let’s say, or a PhD, like insurance wouldn’t even accept that.

[00:29:36] Matt: And there were many psychologist associations that were preventing psychotherapist associations and or regulatory bodies from becoming that to almost to defend their territory when the reality of that is they’re holding back the industry.

[00:29:52] And this is where even when we think about companies and why I approach it slightly differently than a lot of these companies, a lot of these companies, it’s about, you know, we need to win.

[00:30:03] When I look at this market as something so early that we need to get to where it needs to go. And so at some point, a rising tide floats all boats. And so rather than having that infighting where you’re actually not going to get anywhere, ’cause we can’t graduate enough PhDs to treat everyone.

[00:30:21] And so if it was only PhDs right now that we’re delivering mental health, then anyone that would be afraid of a chatbot taking over would have a very valid, you know, concern because that would have to be the case.

[00:30:32] Linzy: Totally.

[00:30:33] Matt: But the point is, if we don’t make it such that we create situations that are not tenable and not sustainable, and that are creating the opportunity and creating leverage. And it’s all about leverage. You know, there’s power in numbers, there’s power in that and there’s power in the opportunity. And who best to realize that opportunity and so anyways, that’s what needs to start happening. But that’s an interesting thing just within the psychotherapist term because there’s a lot of silos and I’d say that’s healthcare.

[00:31:03] Linzy: Yes.

[00:31:04] Matt: Before Covid, you could not even practice over state lines, right? You had to be in the state, you had to be in the province, you had to be in the geography, and it’s creating limitations almost to protect yourself, but then at the end of the day, that is limiting any type of growth. That is limiting your flexibility or therapist’s flexibility in taking advantage of the opportunities they want to, because they put up these sort of artificial barriers to protect themselves, but it sort of insulates them in their silos.

[00:31:30] Linzy: It’s protectionism, right? And we’re seeing this a lot now in the world in general. When there’s protectionism, you block out growth and, innovation to use a certain term, but I think about, for example, in the Canadian context, medical doctors migrating to Canada from Columbia or Afghanistan or Sierra Leone and having to

[00:31:50] jump through hoops, right, to be recognized in Canada. And you have like incredibly talented folks, you know, driving cabs who should be practicing family medicine, which we desperately need in this country, but again, these barriers put in the way and there has to be some balance, of course between the importance of regulation.

[00:32:08] and again, as we talked about earlier, like these professions, you know, we have a lot of education. We’re doing things in ways that are evidence-based. We’re not just kind of picking up the new ideas. So there has to be some balance there between regulation and just sure whatever, come on in, but I think right now we are too strong on the protectionism side in the health field.

[00:32:25] Matt: And I think why that’s happening, just as we said, just quickly on that is, because if you speak to, let’s just say a physician that’s gone to school in Canada, that’s compromised a lot to do so, and then they look at some of these other schools, and it’s not that these people are not talented or these schools are not reputable in any way, but it’s just some of them are much shorter in nature, much, you know, less sacrifice.

[00:32:47] And what happens is that let’s say a physician would recognize the capacity issues that we need more folks. It’s like, that’s not fair. And what happens is that then you get the bodies that take advantage of that

[00:32:58] and exploit that and I think if they said, like if we do this, like that doesn’t impact you at all, maybe there’s going to be something that can actually benefit you because we can do something more and be more effective and have some of these folks and there’s a different way, then it might make them more open. But I think the way it’s positioned is that it is potentially a threat or an inequity, you know, or a cheating of what they feel is fair.

[00:33:20] And it’s not natural to them ’cause they want to help people and it’s just that, you know, they are so passionate about what they do and they have put a lot of sacrifice in. There’s not an alternative being presented that of course, you’re then naturally going to agree with that.

[00:33:35] I remember when I was having the conversation with my old company on this CBT team, and we were sitting in a room with psychologists and it was 12 psychologists and we were pitching them like on, what we were doing and psychologists who, you know, I need to be with someone to do a course with CBT 12 to 16 sessions in person, and you’re telling me that an online thing where they’re reading some articles and then someone’s texting them like not in real time is going to be as effective as that is they were not happy with at least. And I understand what they’re saying. We’re not… it wasn’t trying to diminish it, but it’s saying, it’s not that it’s mutually exclusive, it’s that yes, it would be great for everyone to get 12 to 16 sessions, but when everyone has, let’s say $500 towards mental health and their insurance and your $250 an hour, what do you do after that second session? Nothing.

[00:34:32] Or if all these people need to go to you and there’s not capacity for that, what do we do? And so it’s not about is this the best and should replace this. It’s, let’s be open to the conversation of where this fits and I say that too because this is where, as much as I say that it’s about potentially being exploited, I also think this is where on the therapist side, there needs to be not only the understanding of business, but maybe the openness to what we were talking about before of evolution, right? And what your role is in evolution, and if you prevent change, then you’ll get left out of change, or you’ll be the term taker of

[00:35:11] the change. But if you lean into change in a pragmatic way, which I’m not saying there’s one way to do it, but that’s what we have to explore, then you can be part of the term setters of that change and do that. And I think even for us, what we’re doing now with play space. There are providers that go, well, no, I should be in person;

[00:35:31] that’s best practice. And I go, absolutely. But are you going to want to drive back to the clinic after dinner, after you pick your child up from school to do that one session? Or can you do that from home when it snows and you get cancellations? Or if someone doesn’t live in your geography, whatever it might be, is there no case for this?

[00:35:48] And then if there is a case for this, then let’s work together to think about how you say jump. We’ll say how high, because you are the conduit to that change and we need to support you, but if you don’t want me to tell you what that is, then you need to tell me what that is. because I’m willing to listen and support.

[00:36:06] Linzy: Yeah, and I’m hearing here, part of it is as a profession, getting out of some of the rigidity that we can have around, you know, black and white thinking of it’s this or nothing, because we know nothing is not good. Folks getting no mental health care, because they can’t drive in person or whatever.

[00:36:22] They don’t have enough to pay outta pocket. That’s not a solution. So, yeah, what are some of these creative ways that we can meet the needs that are out there and make sure that we as therapists are being compensated well and appropriately, and working on our terms? Yeah, I think there’s a lot here that you’ve brought to the table, Matt, in terms of bringing in some of these, what’s in the oxygen for you?

[00:36:44] I think in the space that you occupy, in the business innovation space that we have just very little of in our space, and I love the idea of us starting to bring more of this flexibility and creativity and owning our collective power as a profession, into the way that we think about therapy.

[00:36:59] So thank you so much for joining me on the podcast today, Matt, and for folks who want to learn more about Play Space, where can they do that?

[00:37:08] Matt: Yeah, go to Playspace Health and look around, see if there’s any interesting tools that resonate with you or that you use. We’d be happy to see how we can meet you where you are today and not change or prescribe what you’re doing at all because you know better.

[00:37:24] Linzy: Yes, yes, but great tools. We all need lots of tools in our toolbox. So thank you so much, Matt, for joining me today.

[00:37:30] Matt: Thank you so much for having me.

[00:37:40] Linzy: I so appreciate Matt coming onto the podcast today to bring us a lot of language and theories that are certainly not how I think and speak, about business, but really, really, really helpful to understand just all these ways of thinking and understanding business that we have not been taught as therapists.

[00:38:00] I mean, we’re not taught business at all as therapists, but we’re certainly not taught to think about economics and markets and understand how we fit into this, this broader world in terms of the service that we’re providing. So lots of food for thought there. I especially, I’m feeling fired up about the need for therapists; we need to

[00:38:21] really communicate with each other across silos, right? Get out of the [silos of] I’m a social worker, you’re an MFT, you are a psychiatrist, or you’re a psychologist, and we do things differently, and we shouldn’t talk to each other. We need to be speaking to each other to understand what is happening in our different spaces.

[00:38:38] You know, what are different insurance companies offering different professions? The more that we speak to each other and the more that we own the fact that we have power. We are offering a service that’s really valuable and it’s really needed. The more we can actually start to take care of ourselves as people and offer services in a way that is effective.

[00:38:58] You know, we have a lot of education. We have a lot of knowledge and insight. We understand what this field needs to look like, and I’m feeling really fired up right now about the need for us to step up and claim that power and claim those roles and, start really recognizing that we are offering something really valuable in the world and that’s valuable in multiple senses, emotionally and societally and financially what we do is really valuable.

[00:39:19] So thank you so much to Matt for coming on the podcast today. You can check out Play Space. We’ll put some links in the show notes for you to check out these great tools that Matt and his team have developed to make play therapy and online work with kids and teens and neurodiverse adults more effective.

[00:39:36] Thanks to Matt for joining us today. You can follow me on Instagram at Money Nuts and Bolts. And if you’re enjoying the podcast, it’s really helpful when you tell your friends and colleagues about it. That is the way to get more therapists and health practitioners in on these conversations. Thanks for joining me today.

Picture of Hi, I'm Linzy

Hi, I'm Linzy

I’m a therapist in private practice turned money coach, and the creator of Money Skills for Therapists. I help therapists and health practitioners in private practice feel calm and in control of their finances.

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