Big Business vs. Your Child's Mental Health

A Personal Reflection on What We're Losing

The recent loss of my father has given me profound pause to reflect on the values that shaped both his medical practice and my own approach to therapy. For decades, my father dedicated his life to rural medicine in Iowa. After an entire career of personal care that included regular house calls, the delivery of over 200 babies, sometimes in cars or other unexpected situations, and serving the community in the demanding role of medical examiner, he eventually reached the end of his long career. He witnessed firsthand the transformation of healthcare from a relationship-centered practice to an increasingly corporate-driven industry. His determination to find a doctor to take over his practice dragged on for years to no avail. He eventually resorted to selling his practice to a corporation with the convincing promise that they would make a concerted effort to keep looking for that “needle in a haystack”. It wasn’t long before the corporation gave up and closed his clinic, thereby forcing his dear community of patients and friends to fit into a system like numbers on a spreadsheet. He lived the rest of his life with the guilt that accompanied this heartbreaking choice. His stories about the evolution of rural medicine over the past 50 years have become even more meaningful as I watch similar patterns emerge in mental health care today.

In the 1960s through the 80s, rural medicine was characterized by doctors who knew their patients' families, understood the unique challenges of small-town life, and made treatment decisions based on individual needs rather than corporate metrics. My father would tell me about making house calls, designing his clinic to meet the needs of his unique patients, and having the autonomy to practice medicine according to his clinical judgment rather than shareholders' expectations. I heard from others in the community the remarkable stories they recalled of him making split second decisions and having the freedom to use his expertise to respond with unique solutions. Over the decades, he watched as healthcare became increasingly consolidated, with small practices being absorbed by larger hospital systems and eventually corporate entities focused more on profit margins than patient outcomes.

This transformation didn't happen overnight in rural medicine, and it's not happening overnight in mental health care. But the parallels are striking, and as a therapist in private practice in Lafayette and Walnut Creek, California, I feel a responsibility to address what's at stake when we allow venture capital to reshape how mental health services are delivered to families like yours.

The Corporate Takeover of Mental Health: What Parents Need to Know

Private equity deals now make up more than 60% of behavioral health transactions, with private equity owning about 6% of all mental health facilities and 7% of substance use disorder facilities nationally as of 2023. These numbers represent more than just statistics—they represent a fundamental shift in how mental health care is conceptualized, delivered, and prioritized.

When venture capital firms acquire therapy practices, their primary obligation is to their investors, not to the families seeking help. This creates inherent conflicts between what's best for your child's emotional development and what generates the highest return on investment. The business model requires standardization, efficiency metrics, and scalable solutions—concepts that run counter to the deeply personal, nuanced work of understanding your unique family dynamics and your child's individual needs.

The implications for parents seeking therapy services for their children and teens are profound. In corporate-owned practices, treatment decisions may be influenced by factors that have nothing to do with clinical judgment: How many sessions can be delivered most efficiently? Which therapeutic approaches can be standardized across multiple providers? How can client throughput be maximized? These aren't the questions that should drive decisions about your teenager's anxiety or your family's communication patterns.

Why Your Choice of Therapist Is a Political Act

Every time you choose where to seek mental health services for your family, you're making a decision that extends far beyond your individual needs. You're participating in a larger economic and social ecosystem that shapes the future of mental health care in America. When you choose to work with an independent therapist in private practice, you're exercising a form of consumer activism that supports an alternative to the corporate consolidation transforming healthcare.

This choice becomes particularly powerful when we consider it as part of taking charge of your own mental health through assertiveness and intentional decision-making. One of the core principles I work with in my practice—drawing from person-centered therapy and family systems theory—is that healing occurs when individuals and families feel empowered to make choices aligned with their values. The decision to seek therapy is already an act of assertiveness; choosing where to seek that therapy can amplify that sense of personal agency.

When parents tell me they've specifically sought out independent therapy because they want their treatment decisions made by a clinician rather than a corporate algorithm, they're already demonstrating the kind of assertiveness and values-based decision-making that I hope to strengthen through our work together. This alignment between their choice of provider and their therapeutic goals creates a powerful foundation for growth and change.

The Intimacy of Independent Practice: What You Gain

In my solo practice serving families in Lafayette, Walnut Creek, and throughout California via online sessions, I have the privilege of working with each family according to their unique constellation of needs, strengths, and goals. This isn't just a therapeutic philosophy—it's a practical reality that's only possible when treatment decisions aren't filtered through corporate priorities.

When parents come to me concerned about their child's emotions, behavior, or wellbeing, I can draw from my training in multiple modalities—family systems theory, somatic therapy, narrative therapy, drama therapy combined with internal family systems theory, person-centered therapy, and CBT combined with ERP for anxiety treatment—to create a truly personalized approach. This flexibility isn't just beneficial; it's essential when working with the complex interplay of factors that influence a child's emotional development and family dynamics.

For instance, when working with a teenager struggling with anxiety, I might incorporate somatic approaches to help them reconnect with their body's wisdom, while simultaneously using family systems theory to understand how family patterns might be contributing to their distress. I might integrate narrative therapy techniques to help them reauthor their relationship with anxiety or talk back to it, or use drama therapy combined with internal family systems to explore different aspects of their inner experience. This level of therapeutic creativity and responsiveness is rarely possible within standardized, corporate-driven treatment protocols.

The embodied approaches I specialize in—somatic therapy and other body-based interventions—require particular attention to individual differences in how people process emotions and stress. Some children are naturally more sensitive to environmental stimuli; others might hold tension in specific areas of their body; still others might benefit from movement-based interventions that help them regulate their nervous system. These nuances can't be captured in a one-size-fits-all treatment manual designed for corporate efficiency.

Rural Medicine Lessons: What My Father Taught Me About Authentic Care

The parallels between rural medicine's transformation and mental health's current trajectory run deeper than simple corporate consolidation. Both involve the loss of what healthcare professionals call "continuity of care"—the ability to develop long-term therapeutic relationships that evolve over time.

In rural Iowa, my father knew that “Mrs. Johnson's” diabetes was inextricably connected to her grief over her husband's death, her isolation during harsh winters, and her financial stress from farming uncertainties. He understood that treating her diabetes effectively meant addressing the whole person within the context of her community and life circumstances. This holistic understanding wasn't possible through brief, standardized encounters focused on metrics and throughput.

Similarly, effective therapy with children and families requires understanding the intricate web of relationships, developmental patterns, communication styles, and environmental factors that shape a child's emotional wellbeing. When I work with a family over time, I begin to understand not just the presenting concerns, but the underlying strengths, the family's unique language and humor, the cultural influences that shape their values, and the specific triggers that dysregulate their system.

Although clients ultimately make decisions about the length of treatment, this decision is best made in response to guidance based on a depth of understanding that takes time, attention, and clinical freedom—resources that become scarce when practices are structured around venture capital priorities. Private equity firms typically focus on acquiring established mental health practices with stable revenue, often acquiring majority ownership which provides significant control over business operations. This control frequently translates into pressure to see more clients in less time, use standardized interventions regardless of individual needs, and prioritize easily measurable outcomes over the subtler indicators of emotional growth and family healing. Therapists tend to feel squeezed and undervalued as their expertise becomes less valued and their percentage of what clients pay gets smaller and smaller.

The Ripple Effects: How Your Choice Impacts Community Mental Health

The decision to support independent mental health practitioners creates ripple effects that extend throughout the community. When families choose independent therapists, they're supporting a model of care that maintains space for innovation, clinical creativity, and responsiveness to local community needs.

Independent practices like mine can respond quickly to emerging needs within the community. If I notice several families struggling with similar issues related to local school policies or community changes, I can adapt my approach, develop specialized expertise, or create resources that address these specific concerns. Corporate-owned practices, bound by standardized protocols and distant decision-making processes, lack this responsiveness.

Furthermore, independent practices contribute to professional diversity within the mental health field. When therapists have the autonomy to develop specialized expertise and innovative approaches, the entire field benefits from this creative ferment. My background in community mental health at Concord Children’s Mental Health allowed me to develop expertise in a wide variety of challenging areas. I was regularly in the clinic, schools, clients’ homes, and even in the hospitals and the streets. Integration of my drama therapy background was combined with my growing knowledge about client needs and continuing education in exciting and promising theoretical developments like somatic experiencing, internal family systems theory. I developed nuanced approaches that combined these new developments with the tried and true approaches like client centered therapy and play therapy. I was able to develop a parenting program during the pandemic, that served families in a more comprehensive way during this time of increased stress and need. In this way, my clinical freedom allowed me to experiment with approaches that seemed promising for the specific families I was serving. This kind of clinical innovation is simply impossible within corporate structures focused on standardized, scalable interventions.

Understanding the Stakes: What Corporate Mental Health Really Means

The venture capital approach to mental health care isn't inherently malicious, but it does operate according to fundamentally different values than those that guide effective therapeutic relationships. Investors seek predictable returns, scalable business models, and efficient operations—goals that can conflict with the unpredictable, highly individualized, and relationally intensive work of therapy.

As one therapist noted about leaving venture capital-backed mental health platforms, these companies present themselves with "punchy, single-word names suggesting a fresh and breezy alternative to the dusty, musty therapy of the old days." The marketing appeal is understandable—who wouldn't want therapy to be more accessible, more efficient, more modern? But beneath the appealing branding lies a fundamental tension between therapeutic values and business imperatives.

When therapy becomes a product to be scaled and optimized, several concerning changes typically occur:

Standardization of Treatment: Complex therapeutic modalities get reduced to standardized protocols that can be easily replicated across multiple providers and locations. The nuanced integration of approaches that I use—taking time to attune to somatic symptoms that arise while talking with a client about beliefs and choices—becomes a stressor, maybe even an impediment, within corporate requirements for consistent service delivery. This is not what clients want or need from their provider.

Pressure for Quick Results: Investors expect measurable outcomes within predictable timeframes. But authentic therapeutic change, particularly for complex family dynamics or childhood emotional challenges, often follows a non-linear trajectory that doesn't conform to corporate timelines.

Provider Turnover: Corporate employment structures often lead to higher therapist turnover, disrupting the continuity of care that's essential for effective treatment. Families may find themselves repeatedly explaining their history and rebuilding therapeutic relationships as providers come and go. They report losing choice about a provider who is a cultural match or “gets them”.

Limited Clinical Autonomy: Therapists working within corporate structures may have limited freedom to make treatment decisions based on their clinical judgment, instead being required to follow standardized protocols that may not fit the specific needs of individual families.

The Personal Is Political: Mental Health as Social Justice

Choosing independent mental health care becomes a form of quiet resistance to the broader trend of corporate consolidation that affects not just healthcare, but education, media, agriculture, and virtually every sector of American life. When small businesses are absorbed by larger corporations, communities lose more than just local ownership—they lose the responsiveness, creativity, and personal accountability that characterize locally-owned enterprises.

In mental health care, this loss is particularly significant because therapy depends on qualities that resist commodification: trust, attunement, creativity, and the kind of deep listening that can't be rushed or standardized. These qualities flourish within relationships where the therapist has the autonomy to respond authentically to each family's unique needs and circumstances.

Your decision to seek therapy is already an act of courage and self-care. When you choose where to seek that therapy, you have the opportunity to align your healthcare decisions with your broader values about community, authenticity, and resistance to corporate homogenization.

Assertiveness in Action: Using Therapy Choices to Practice Personal Agency

One of the most powerful aspects of choosing to work with an independent therapist is how this decision can model and reinforce the very skills that many families come to therapy to develop. Parents concerned about their children's emotional wellbeing often struggle with their own sense of agency and effectiveness. The decision to research options, ask questions about therapeutic approaches, and choose a provider based on values rather than convenience demonstrates the kind of thoughtful assertiveness that supports both individual and family growth. And it might be as simple as scrolling past the “sponsored” section at the beginning of your Google results.

In my work with families, I often explore how parents can model healthy boundary-setting, values-based decision-making, and assertiveness with their children. The choice to work with an independent therapist rather than defaulting to the most heavily marketed or convenient option demonstrates these very qualities in action.

Children and teenagers are remarkably astute observers of their parents' choices and values. When they see their parents making thoughtful decisions about mental health care—decisions that prioritize authenticity and individualized attention over convenience and cost—they internalize important messages about their own worth and the importance of seeking help that truly fits their needs. Just as I learned from my father’s values by observing his lifetime of serving the community in his medical practice.

Building Therapeutic Relationships That Last

The continuity possible in independent practice creates space for therapeutic relationships to deepen and evolve over time. Families I work with often return periodically as children move through different developmental stages or as family circumstances change. This ongoing relationship allows for a kind of therapeutic accompaniment that's particularly valuable for families navigating the complex journey of raising emotionally healthy children.

When I work with a family dealing with their teenager's anxiety, for example, I'm not just addressing the immediate symptoms—I'm helping them develop tools and understanding that will serve them through future challenges. I might see them intensively for several months, then occasionally for tune-ups, then perhaps again when their child enters college or faces new stressors. This long-term perspective allows for much more comprehensive support than episodic treatment focused on symptom reduction.

The personalized nature of this ongoing relationship means that I can adapt my approach as the family grows and changes. A child who initially benefited from play-based interventions might later respond well to narrative therapy techniques, and eventually might engage with somatic approaches to manage stress. Parents who initially needed support with behavioral strategies might later explore family-of-origin patterns that influence their parenting responses.

Sometimes families initially present with a request for child therapy, then realize that focusing instead on parenting can create more lasting change and result in the improvement of their child’s self-esteem more effectively. Or sometimes a parenting focus reveals an underlying need within the couple. This evolution is only possible when the therapeutic relationship isn't constrained by corporate protocols or insurance limitations that prioritize brief, problem-focused interventions or strict adherence to the requested unit of treatment.

Making the Choice: Practical Steps for Families

If the vision of independent, personalized mental health care resonates with your family's values, there are concrete steps you can take to support this model while meeting your own therapeutic needs:

Research Your Options: Take time to understand the ownership structure of potential therapy providers. Or simply Google “independent therapists”, as they typically make this information readily available. Corporate-owned practices might be less transparent about their business structure.

Ask Direct Questions: When consulting with potential therapists, ask about their clinical autonomy, their ability to adapt treatment approaches based on your family's needs, and their philosophy about individualized care.

Value Expertise Over Convenience: While online platforms and corporate providers often emphasize convenience and quick access, consider whether these benefits align with your family's needs for thoughtful, personalized care.

Consider the Long-Term Relationship: Think about whether you want a therapeutic relationship that can evolve over time as your family's needs change, or whether you prefer episodic treatment focused on specific problems.

Align Your Values: Consider how your choice of mental health provider reflects and reinforces your broader values about community, authenticity, and resistance to corporate homogenization.

The Future We're Building Together

Every time a family chooses independent mental health care, they're contributing to the preservation of a model that prioritizes individual needs over corporate profits. This choice helps maintain space in the mental health landscape for creativity, innovation, and the kind of deep therapeutic relationships that create lasting change.

The transformation of rural medicine that my father experienced didn't happen overnight, and the changes occurring in mental health care are similarly gradual but profound. By the time the effects become undeniable, the infrastructure for alternative approaches may be much more limited. As we speak, independent providers are being squeezed out of practice and forced to either change careers or become a cog in the corporate wheel.

Your choice of mental health provider might seem like a small, personal decision, but it participates in a larger conversation about what kind of healthcare system we want to build and maintain. When you choose providers who can offer truly personalized care, you're supporting a vision of mental health services that honors the complexity of human emotional experience and the irreplaceable value of authentic therapeutic relationships.

Taking the Next Step

If this perspective resonates with your family's needs and values, I invite you to reach out to learn more about my approach to working with families in Lafayette, Walnut Creek, and throughout California. Every conversation begins with understanding your unique situation, concerns, and goals, and exploring whether my therapeutic approach might be a good fit for your family's needs.

The decision to seek therapy represents hope and courage. The decision about where to seek that therapy represents an opportunity to align your healthcare choices with your deepest values about authenticity, community, and the kind of world you want to help create for your children.

In choosing independent mental health care, you're not just investing in your family's emotional wellbeing—you're participating in the preservation of a model of care that honors the full complexity of human experience and the transformative power of genuine therapeutic relationships. In a world increasingly shaped by corporate priorities, this choice becomes both a personal healing decision and a quiet act of resistance that benefits not just your own family, but the broader community of families seeking authentic, personalized mental health support.

For information about scheduling and my approach to working with families, I encourage you to reach out directly. Together, we can explore how personalized, independent mental health care might support your family's unique journey toward greater emotional wellbeing and stronger relationships.