Insider’s Guide: Educational Consulting and Therapeutic Placement

It was warm, breezy day in the little cove where the treatment center was located where my client and her parents were standing. We were all on the back deck of the main building and the parents and I had just arrived. The client smiled after a few minutes of small talk and said, “Um, not to be rude or anything, but who are you?” Her parents looked mortified and embarrassed that she didn’t know who I was.

“My name is Rob Danzman and we’ve met several times before you came to treatment. I helped your parents find a healthy place for you.”

The client, after pausing for a second smiled again and said “I think I was so high I don’t even remember you. Thank you.” She started crying. Her parents started crying and they hugged.

There is a deep and broad gap between what families need and all of the treatment options available. There are a ton of variables to consider when your son or daughter need treatment, whether its outpatient therapy or residential treatment. Insurance, location, modality, diagnosis, and housing options are just a few things families need to consider when figuring out what’s best.

There is a dramatic range in expertise and costs and they are not often aligned. Some of the most expensive consultants with whom I’ve worked have minimal understanding of psychological conditions and the evidence-based approaches that best treat them. The goal of treatment is either assessment, intervention or maintenance of a behavioral health issue. If a consultant does not have a combination of academic and experiential background they may not serve clients well. In fact, my agency has worked with clients who were given terrible advice on what types of service to use. You would never have a mechanic give advice on spinal surgery because, while the mechanic may be really well-intentioned and personable, they may due considerable harm. The same is true when dealing with behavioral issues, many of which either in the short or long term may have life and death implications.

Evidence-based interventions need to be well understood and require clinical expertise. Therapeutic placements do a great job of presenting themselves as comfortable, safe and a good value yet many do not provide evidence-based treatments. Evidence based treatments are not for broad spectrum of psychological issues.

Another confusing aspect is the terminology. Decades ago, educational consultants did a few things and did them well – they focused on private school and college prep admissions. They provided deep advice on testing strategy, applications, and how to write a great essay. They coached clients through interviewing and often the whole education process. But over the years, ECs expanded their service offerings, often outside of their area of expertise. ECs without credentials or appropriate degrees started advising parents on treatment recommendations, presumably assuming that applying to a treatment center is similar if not the same as applying to college. Since those wild-west days of ECs pushing kids into cookie-cutter programs and charging a fortune, more clinicians with actual therapeutic experience have entered the EC world. Granted, there is still the old guard of older, white women who had their own children placed in a treatment center and saw an opportunity to help other families while making good money in an unregulated field. There are essentially only one entity that oversee ECs – the Independent Educational Consultants Association. The division continues to widen between those serving families

EC should not receive gifts from treatment centers though it’s not unusual for them to have travel expenses covered when they are touring programs.

There is a symbiotic relationship between treatment centers and ECs. Treatment centers count on ECs for referrals. ECs count on treatment programs to cover travel expenses and, sometimes, provide referrals back to the ECs when a client needs a different placement or the family needs advice on treatment options.  

Where to Find These Magical Beings

First thing to do is just google the terms “educational consultant” and “treatment.” You should get plenty of options that pop up. You could also just contact my agency but I’m a bit biased since I believe we do great work for a fair price.

Next way to find a placement consultant is to go to the Independent Educational Consultants Association (IECA) website (below in the Resources section) and look for the ‘Search’ option under the Parents tab. All of the people listed in this resource are paying members of IECA and met the IECA’s criteria. If you are going this route, I encourage you to, at a minimum, look for a consultant who has a graduate degree in a behavioral health discipline like counseling, psychology or marriage and family. Pastoral counselors or ‘Qualified Mental Health Practioners’ are not nearly qualified enough. It’s even better if they are a licensed professional (eg. Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Clinical Social Worker).

Do Your Homework

A great EC can support your family through the most difficult times while a bad EC can cost your valuable time and money and have nothing to show for it or set things back even further with a terrible placement.

Consult: If you can’t meet them face to face, then schedule a call with them. Before you go into any details, dig into the business end of their service first. Do they offer therapeutic placement consulting or do they focus on prep school and college? What are ALL the costs associated with what they do. What is their degree in and what active licenses do they hold. Ask if they are a member of any associations and if they have any disciplinary actions against them. Ask when and how they got into educational consulting. Ask what the scope of their work is – Do they meet clients at treatment centers for admissions? Do they continue to work with families while the client is in treatment? Do they assist with discharge planning?

Payment: Another thing to consider is how the ED gets paid. It’s important to understand whether the EC sends you an invoice and bills as they go along or do they receive a retainer upfront. Though not a deal breaker, I don’t like asking for retainers from clients for the same reason I don’t like attorneys collecting a retainer from me. They have my money and pull from it as they do work. I’d prefer to pay for things as we go along through a project. We only accept credit cards so that a) there is protection for the client and b) we don’t need to run after clients to pay an invoice. We also itemize every time we charge a client’s card so that everything is 100% transparent. Ask about how folks get paid before you agree to work with them. If they can’t agree to provide itemized billing or seem too focused on money upfront, you may want to consider working with someone else.

Guarantee: It’s unlikely anyone is going to offer you a guarantee for their services but it doesn’t mean you can’t ask about their responsibility if a treatment option doesn’t work or a treatment option can’t be found in a reasonable amount of time.

Cost

Take a deep breath for this section. Expect to pay between $10,000 – $300. Yes, I know that’s a ridiculously large range but there are no regulations on what an EC can charge. The spectrum of fees is truly that big. Some charge as much as $10,000 for a placement. They may put in 5-10 hrs but their rate doesn’t change. Other ECs charge a lower rate but most have a basic flat fee which covers support and advice through the admissions process. In my humble opinion, a lower flat fee or hourly rate is more fare. For instance, my agency has a free consultation to determine if someone really needs an EC. If we determine the client really can’t find an appropriate treatment option on their own, we charge $179 per hour and use as few hours as possible. We’ve had client come to us after spending $25,000 on placement services only to realize the ECs they were using had no clue about severe clinical issues like substance abuse and schizophrenia. Fortunately, we quickly found them services and billed them less than $500.

FAQ

Q: I know how to do internet researching. Why can’t I just find a treatment program on my own?

A: You could totally do this own your own. There are three easy steps. First – get a graduate degree in some counseling or psychological discipline to learn the clinical aspects of behavioral health and intervention. Next – work in the behavioral health industry for about five years so you can see what makes a program great and what makes a program terrible. Finally – go and visit 50 treatment programs. Granted, that will take a few years, and by the time you’re finished visiting, staff at each program will likely have changed (so start over). Ultimately, this experience  will be very helpful in determining which programs are good and which ones you would not trust to take care of your house plants. After all these steps, you should totally do some internet searching to decide which program is most effective at serving your loved one.

Resources

Independent Educational Consultants Association – https://www.iecaonline.com/

Elements Behavioral Health Expanding

Elements Behavioral Health has been actively expanding as evidenced by the purchase of  Park Bench Group Counseling in New Jersey and the opening of Brightwater Landing in Pennsylvania right outside Harrisburg and Hershey.

Elements portfolio are also ramping up programs to meet increased market demands. Centers in Texas and Tennessee are adding new services, and a detox program in Florida launching in the first quarter of the year.

On The Market?

Within all this activity, observers are reporting that Elements is for sale. Reuters reported in December 2014 that private equity and venture capital firm Frazier Healthcare is potentially looking to sell Elements, and that  investment bank Jefferies Group LLC has been retained to facilitate the next steps. Across the entire industry, valuations are up, and the market is ripe for activity.

Elements has been estimated to be worth $30 million in EBITDA (earnings before interest, taxes, depreciation, and amortization) and get 10x more in actual negotiations.

Acquisitions!

Founded by two clinicians in 2006 the newly acquired Park Bench in New Jersey provides day treatment and intensive outpatient services, including an individualized aftercare program (…often a big missing piece in substance abuse treatment).

Elements was targeting the Northeast for some time, particularly in the New York/New Jersey Tristate area because of population density and the need for young adult treatment. The services they’re providing, which are addiction and co-occurring disorders, fit with the Elements family of programs.

Elements has an existing property in York, Pa., and this month, it added a new location, Brightwater Landing in Lancaster County – west of Philadelphia. The center is on a 150-acre campus that lends itself to treatment interventions that require more outdoor space as well as landscape features appropriate to experiential and adventure-based therapies.

Treatment at Brightwater will include equine therapy and a ropes course to enable clients to process the emotional and behavioral parts of their addiction. The experiences will address not just the substance-use disorders but also the underlying trauma that contributes to using. The center will offer primary psychiatric and active mental health models of care – early on-ramp for those seeking treatment for the first time. 

Elements Behavioral Health is part of a trend within the industry where small mom and pop outpatient and treatment centers built over the last few decades are being gobbled up by some big players. We expect more merger and acquisition activity in 2015.