Supporting the ALICE Community | Alison Pidgeon of Move Forward Counseling

When I started my private practice, I didn't realize at the time this population of folks was called Alice. But what would happen was people would call in and say, you know, I'd like to come to therapy, and this is the reason why, and here's my insurance. And we'd check their benefits and we'd say, okay, well, you have a high deductible plan, so it's going to be, you know, 90, $100 every time you come for therapy. And they would say, well, I can't afford that. And so they wouldn't make an appointment. And that still is very common today. That's really the population that we're talking about here. Like, they're employed, they have insurance through their work. They. They don't make enough to meet the federal poverty guideline, and they're just really struggling to meet their basic needs. So there was a charity here in my hometown that started a program where they were helping people pay their co pays and pay their deductibles if they sort of fell into this, like, income bracket right. Of this Alice population. So we became providers for that program, and it was great because obviously then the folks who were calling saying, well, I can't afford it. We could say, there's this great charity. They made it super simple to apply, and they would get approved, and then they'd be able to come for therapy, and then we'd be getting our regular rate from the balance of what the charity was paying.

Welcome to the Mental Health Entrepreneur Podcast. We are here to inspire creative ideas and connections for entrepreneurs and advocates working to address our mental health crisis. As you listen, I hope you will experience new ideas and motivation to innovate in your business, your community, and in your life. Welcome. Welcome, everyone, to the Mental Health Entrepreneur Podcast. I am your host, Rachel Harrison, and with me today to talk about innovative ideas in mental health is Allison Pidgeon. Alison is a group practice owner of Move Forward Counseling, as well as an advocate. Welcome, Allison.

Thank you so much for having me.

Yeah. So let's start a little bit with your journey. How did you get to this place of creating a group practice and doing some of the advocacy work that you're doing?

That is a great question. So I became a therapist, and one of my first, I guess my first job was really working in community mental health. And I was there for about eight years, and I had worked my way up through, you know, getting promoted, and I became the director of an outpatient clinic. And I had two little kids at the time, and I just got super burned out. And I actually was going to my own therapist at the time, and she said to me, like, why don't you start your own practice? And I was like, oh, yeah, why don't I do that? So I started my practice just with myself, and I just loved the business side of things. I really liked managing my team that I had at the outpatient clinic. And so I started hiring people. That was back in 2015. Now we have 80 employees, including 60 clinicians.

Amazing. That's awesome. Yeah.

So we've grown quite large, and one of the advantages of growing quite large is that you then have the ability to affect positive change in a way that we weren't able to do when we were smaller. So we've gotten involved in legislation in Pennsylvania and various things to try to improve the mental health system.

That's amazing. So what is your. Why, like, what is the sort of. You seem to have a driving force to what you're creating, so I'd love to hear a little bit more about that.

Yeah, I mean, I think it's personal and professional. So for me to be able to run my own business how I think is best, have some freedom of my time. I have three kids at home, be able to, you know, spend time with them. And, like, yesterday, I had to go pick up my son in the middle of the day because he hurt himself. Like, yeah, Like, I couldn't necessarily do that as easily when I was working for somebody else. So on the personal side is important to me. And then on the professional side, obviously, I'm really passionate about mental health. I went to school to become a therapist. You know, it became pretty apparent pretty quickly to me how broken the mental health system is, and there's just so many opportunities to make it better. And, you know, it affects everybody. And I think that, you know, for me, like, reducing the stigma is really important as well. So I think I kind of have that entrepreneurial brain where I just look at something and I'm like, oh, but you could change this and that would make it better. Or, like, you. We could do that and that. You know what I mean? Like, if only this thing was different. And then I realized, like, oh, I have the ability to make those changes, so.

Oh, I love this. Let's dig into this a little bit, because I think this is really central to what is going on with a lot of our. Our field right now and opportunities to promote mental wellness. So I'd love to know what are some of the things you see. You say, obviously, our system. I would absolutely Agree. But what specifically are some of those things that you see as broken currently?

There are so many, I'll name a few here all day talking about what's broken.

Right.

I think there's definitely, or there has been for a long time. I think it's changing now. But there's definitely been this like picture for people of mental health of like that happens to other people, other people are mentally ill and we think about sort of the, the most acute or the most ill people in our society, but it's like we sort of left out. There's all, you know, it's like a bell curve, right. There's like all these people in the middle that are having their struggles that are still pretty functional.

Yeah, yeah.

And then, you know, obviously there's people maybe that have very few struggles, if any at all. But I think we've kind of left that part of the population out of the conversation for a long time. And so it's like, yes, I can be a, a functional member of society, I can be a parent, I can work full time, I can own a house and pay a mortgage and I can struggle with mental health issues. And I think that wasn't a conversation before. So that's where the, the stigma piece is really important to me more logistically too. Like I look at the way our, you know, in my practice we take insurance. So there's just so many limitations with billing insurance.

So many. Yes, yes.

And so many requirements that don't necessarily make sense. And so in my practice we allow the staff to choose their own schedule. And that's the one thing that we get the most feedback about, that they love working for us because they get to choose their own schedule. And so we don't have a lot of folks who opt to work in the evenings, which of course is the time everyone wants an appointment. Right. So like, wouldn't it be great if the insurance company would pay you like a differential rate if you had an appointment at 5pm or later, just like they do in the hospital system. You know, when you work second shift, you are getting paid a higher rate than the people who work first shifts to make second shift be a little bit more desirable? Because not a lot of people want to work second shift. So like, why can't we do the same thing in outpatient therapy? Why can't, why can't the insurance company, you know, we could add that after hours code which already exists, and get paid a little more to offer those sessions after 5pm

hey everyone, this is Rachel, host of this podcast and Owner of the Trauma Specialist Training Institute. I wanted to just reach out and tell you a little bit about something that we have coming up. It's called Borderline Personality Disorder through a trauma lens. Destigmatize bpd, gain skills and reduce your fear. We're having this training on December 12, 2024 and it's designed for all levels of learners and does not require EMDR basic training to register. I know I have talked to so many clinicians that feel like borderline Personality disorder is a scary thing to treat. It can be something that as clinicians sometimes makes us feel overwhelmed and unsure of what to do. But I would like you to learn more about this and conceptualizing BPD through a trauma lens. If you're interested in that, then this training is for you. This one day virtual training will help you feel more confident in your ability to treat BPD with concrete trauma informed skills and techniques. You'll also gain insight into how BPD manifests in the therapeutic relationship. And only for you, our podcast listeners, you can use this code mhetraining. That's mhe training to get $20 off your registration. So check us out, go to the website www.traumaspecialiststraining.com and join us on December 12th to take the first step in reducing fear and effectively helping your clients heal. Yeah, that's interesting. I know with one of the insurance companies we have, they do offer that, but it has to be after, after hours. So if you regularly work an evening, say as a therapist, you can't get that pay. It has to be if you are doing that because of a crisis situation or something like that. So maybe it's a small step closer. But as you know, regular therapy is what affects the most change for people. So it doesn't help in that situation. Right, Yeah. I love that idea though. That would be tremendous. Good thought. So let's talk a little bit about this advocacy piece that you've done. I. I want to dig in specifically to Alice today. So for our listeners that are listening, Alice is a term that is used to try to identify a group of people, families really in the United States, that it stands for Asset Limited Income Constrained employed. So this is identifying that there are a lot of people in the United States who have jobs, sometimes multiple jobs, who have insurance even and still struggle to make ends meet and have difficult choices like maybe do I pay my medical bills or do I pay my electric bill this month just because of the cost of living and the wages level that things are at. So I'd Love to hear a little bit about how you've gotten involved with some programs for this community in your state and kind of what you're doing there.

Yeah. So this is really exciting. When I started my private practice, I didn't realize at the time this population of folks was called Alice. But what would happen was people would call in and say, you know, I'd like to come to therapy. And this is the reason why. And here's my insurance. And we check their benefits and we'd say, okay, well, you have a high deductible plan, so it's going to be, you know, 90, $100 every time you come for therapy. And they would say, well, I can't afford that. And so they wouldn't make an appointment. And that still is very common today. Yeah, that's really the population that we're talking about here. Like, they're employed, they have insurance through their work, they don't make enough to meet the federal poverty guideline. And they're just really struggling to meet their basic needs. So there was a charity here in my hometown that started a program where they were helping people pay their co pays and pay their deductibles if they sort of fell into this, like, income bracket. Right. Of this Alice population. So we became providers for that program and it was great because obviously then the folks who were calling saying, well, I can't afford it. We could say, there's this great charity. They made it super simple to apply and they would get approved and then they'd be able to come for therapy, and then we'd be getting our regular rate from the balance of what the charity was paying. So in our discussions with different community institutions and things like that, we ended up talking to the United Way of Pennsylvania, and they said, we've done all this research on the Alice population and we're trying to figure out what programs and things that we can put together to help them. Because I believe. And they might agree with that. I think Alice is probably the most underserved population.

Yeah.

Whereas we often think of people living in poverty, but they're getting free healthcare, they're getting food stamps, all those things. And so we told Dina Inouye, Pennsylvania about what this charity in Lancaster county was doing. And they were only serving the residents of Lancaster county. And we said, like, it would be amazing if you could do something like that through the United Way and do it for the whole state of Pennsylvania. So they spoke to the charity and they are collaborating on starting that program. So they're all in. Everybody at the United Way is on board. They're just trying to figure out now how to. How to fund it.

Oh, yeah, yeah.

That has been an amazing experience. To, like, connect the dots for those various organizations and then to have that come into effect is going to be incredible.

Right. So that's going to be in the entire state. Anyone that fits in that bracket can apply for copay assistance kind of thing. Co insurance. Oh, wow. That's huge.

Yeah.

Nice work.

Thank you.

Yeah. I mean, I think it does make mental health services so much more accessible to a huge group of people.

Absolutely. Yeah. The research that the United Way has done estimates that 29% of the population in Pennsylvania falls in. In the Alice income bracket.

That's fantastic. So what other things have you been involved in in terms of advocacy? I'm curious to hear about some of your other initiatives.

Yeah, so a few years ago, we attended Mental Health America, if you're familiar with that. There's a pretty big chapter here again in my hometown of Lancaster, and they had a legislative breakfast. So they have legislators come and talk about different mental health issues and their speakers and all that kind of stuff. And then I realized that. I don't know why I didn't put this together until then, but I was like, oh, we could just schedule meetings with these legislators and start talking to them about mental health. Because it was clear from that meeting that, like, this is on their radar across both sides of the aisle. These are things that Democrats and Republicans care about. So we started scheduling meetings with legislators and talking to them about, hey, here's what's broken, here's what could be improved. What if we did this and what if we did that? And obviously some of them, you know, weren't that interested. That wasn't their thing that they focused on. But there were quite a few who were and who are huge advocates of mental health. And we finally were able to get a meeting with somebody who actually sat on the licensure committee for Pennsylvania. And I said to them, you know, there's so many other states where there's provisional licensure for LPCs. So in Pennsylvania, we had provisional licensure for social workers, but not for professional counselors.

Right.

And I said, this makes no sense. It's like they're doing the same thing. They've gotten the same schooling, like, why don't we have this provisional licensure for the LPCs? And so I think it was, you know, my voice, among many others and some other things that were happening at the time with insurance companies and that's a whole nother story. But we did get that legislation passed in March of this year, and I was really pleasantly surprised. The state actually got the application process up and running really quickly, and so people can now apply to become an lapc. And so that's brought a whole flood of people into the employment pool that we can now hire.

Right.

Because we couldn't hire completely unlicensed therapists before. Just didn't make any sense. And so now we've increased the number of therapists in the. In the state. So that was an amazing win.

Amazing win. I agree with that. It moved fairly quickly. When did you start having these conversations?

Maybe like a year or so before it passed.

That's pretty impressive, too, because sometimes those things get really slowed down and take a lot of processes and votes and all of those things.

We're still waiting on the counseling Compact legislation to be passed.

Yes, many, many people are waiting that in many, many states. I know, I know. So what do you see as sort of the next thing to work on as field together, maybe in your state specifically. But I'm seeing you identify these things and work on them, and you've had some great success. What is sort of the next thing you see on the horizon for our industry?

I think, honestly that we may move into doing more of the therapy work while people are under the influence of psilocybin. I know that's a pretty radical idea, but I think it could be. So I'll explain what that is. So basically, in an office, you know, monitored by probably a nurse and a therapist, you are taking psilocybin, which is mushrooms, and then you're. They're conducting a therapy session while you're under the influence. And people say it's amazing. And then it has helped people who have, like, treatment resistant depression and all of that kind of stuff. I think the reason why it may catch on is because for an insurance company, they want some assurance of, like, okay, you know, you broke your leg, you're gonna, like, go for this many visits, you're gonna get a cast, then you're gonna go to the visit to get the cast taken off. Then you're gonna go to pt. Probably in eight visits, you're gonna be done with pt. Like, it's very, like, prescriptive.

Right, right.

And therapy is nothing like that.

No, it's not.

No, it's not at all. It's like, as much of an art as it is a science. And so I think that if there's more research done on it and it can get to the point where it's like, you have this diagnosis in 10 sessions, you're going to be all better. Like, what insurance company isn't going to love that?

True. That's interesting. Yes, we have talked about that a little bit on the podcast. I do think there are some interesting perspectives out there with that. But at this point, it is not insurance approved. So no one, anyone that wants to do that treatment, they just have to pay for it out of pocket. Right.

Something else that I think would be really interesting is if therapy and coaching, kind of like the best parts of coaching and the best parts of therapy, like, kind of got melded together. Like, for example, I was searching online recently because my son is 12, he's about to turn 13, and I was like, I really gotta have the birds and bees talk with him. Right? Like, he's in seventh grade, he's interested in girls. Like, we need to talk about this. So of course I go to Google and type that in. Well, there's a therapist who's like, created this whole, like, she's written books and there's like a whole E course about it, and there's a community. And I'm like, this is great. Right? Like, I had this specific problem. She's helping me with this specific problem. And I'm like, on there ordering the book. And so I was thinking about, wouldn't it be cool if therapy was like that? Like, you could say, hey, this is my issue. Here's a workbook, here's a group, here's individual therapy, here's an E course you can watch. And there's all that, like, psychoeducational stuff that can go along with having traditional individual and group therapy.

I like that.

I think that would save a lot of time in therapy.

Very good. If there was one thing that you could leave with our audience, whether it be like, entrepreneurial advice or in the mental health industry advice, what's one piece of inspiration you want to leave people with?

Yeah, I think us as clinicians who are working in the field, like, we know better than anybody what is not working and what could be working better. And so I would really encourage folks to think outside the box of, like, how could things be different and how can we design something that's more effective for people? Because I think the time that we're in now is really ripe for change in the mental health field. And I think we could all be a part of coming up with some really good ideas.

I love that. That's exactly what this podcast is all about. You're speaking my language. All right. Well, Alison, thanks so much for being with us. If anybody would like to find out more about Alison and her practice and her advocacy, all of the links and things will be in the show notes. So, Alison, thanks so much for being here.

Thank you so much for having me.

You bet.