From PsiAN (Psychotherapy Action Network): “Every therapist is familiar with therapy-interfering behavior (TIB). Historically the literature has focused on TIB in the client or patient, such as when a client misses a session, shows up late, sits silently, or even refuses the treatment altogether. Chapman and Rosenthal (2016) define TIB as follows: ‘any behavior that interferes with the client benefiting from therapy could be considered a TIB’ . . .
TIB in the therapist has also been explored, and examples include being late, ending early, changing policies, forgetting information (Vaughn, 2021). And of course, just like clients, the source of these can be conscious or unconscious . . .
What we may not typically frame in this way are behaviors from other entities that clearly interfere with the therapy, and may even be more damaging and pernicious than the TIBs already discussed. A prime example of such ‘corporate TIBs’ stem from the interference from insurance companies and administrative entities that represent attempts to control, constrain, or direct therapy, at times to the point where such individuals or groups are actually practicing without a license.
. . . in an agency setting, TIBs might include the agency establishing unreasonable ‘performance’ targets, onerous documentation requirements, or outcome measures not directly related to therapy. In addition, there may be policies that are contrary to ethical practice and wisdom in the field . . .
For insurance companies or other payors, TIBs can be found throughout their administrative processes and controls. For example, payors interfere with therapy when they set severe limits for coverage (rendering therapy nearly meaningless or neutering it), have a lack of transparency in data sharing arrangements, use overly complicated or convoluted explanations of benefits and reimbursement procedures, and delay processing claims. Beyond these, and perhaps even more problematic, are instances of insurance companies defining therapy itself through the ruse of ‘evidence-based treatments,’ and creating improper and unvalidated ‘equivalents’ for therapists, such as bots and other forms of artificial intelligence.
Given the profoundly negative impacts on the client and the therapy process, our profession must take a firm stand against interference with therapy wherever possible, and call it what it is: TIB, therapy-interfering behavior, which amounts to practicing without a license in many cases. ‘Corporate TIBs’ can often exist for reasons having to do with improper motivations to frame therapy for the benefit of others and not the client, thereby harming the latter.”
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