Brain Resilience
Holistic Recovery Process for TBI
Understanding and Using "Pay for Results" for Therapists
From Chapter 3 of the Subcellular Psychobiology Diagnosis Handbook (2014)
© 2014 by Dr. Grant McFetridge
"When we talk about our work with clients or professionals, their first reaction is often “where’s the proof?”, or from academics, “where are the evidence-based studies?”.
When we reply that we have a ‘pay for results’ policy so there is no need for it, there is a momentary pause, eyes glaze for a second, then they usually repeat themselves as if we hadn’t spoken. Apparently the leap to results-oriented treatment billing is simply too foreign a concept to comprehend at first."

"Why is this? Well, clients sometimes confuse this concept with some kind of scam, where people ‘guarantee’ a product, don’t deliver and then keep the money. Or they simply don’t believe that you are serious, because this is so far outside their previous experience. Academics tend to have a different issue, one that strikes at the heart of the practice of psychology and medicine. Currently, a great deal of statistical tools are used (often incorrectly) in research because investigators are not designing for a binary solution set of ‘it worked, or it didn’t work’. Instead, test outcomes are usually so vague or contradictory the best they can hope for is often only slightly above the threshold of the placebo effect. This mindset can also lead to completely bizarre situations like I saw in my own doctoral training, where we were taught measurement scales that ignored the specific client problem we were treating, and instead rated ‘overall improvement’ – sadly, because there really were no effective treatments for specific problems."

"When Frank Downey and I designed the structure of the Institute in the 1990s, we fully expected that our first generation techniques simply would not always work (or work partially) for some clients. We were developing something entirely new, there was a lot we didn’t yet understand, and people’s problems are often very complex. However, we were only interested in full elimination of symptoms (note that we use this phrase because is socially and often legally unacceptable to talk about ‘cures’). Partial successes were valuable from a research viewpoint, but with ‘pay for results’ the only meaningful outcome is “what we agreed upon is done”. This means that therapists have to actually deliver; and if they can’t, that they are not financially penalizing clients because of their (or the Institute’s) own limitations. This also has the tremendous advantage that we don’t have to do extremely costly third-party studies – after all, the client is the one who really knows if the problem is gone and stays gone."
~ Dr. Grant McFetridge
Hornby Island, BC
What is ‘Pay for Results’?
The Institute for the Study of Peak States is pioneering a way of charging clients that is different from the one used by most all conventional therapists (although it is already used in many other professions). When talking to clients, we call it ‘pay for results’, and when talking to therapists, we call it ‘charge for results’. All therapists who license our processes and use our trademark agree to abide by this condition in all the work they do, whether it is using our techniques or anyone else’s.

How does it work? In the initial session, the therapist and client come to a written agreement of what is to be worked on and what criteria would constitute success. The fee is negotiated at this time (although most therapists use a predetermined flat fee that makes this step much simpler). Open-ended fees such as by the hour are not acceptable – the client has to know exactly what he is agreeing to and what he is going to pay as part of the contract. Obviously, some people won’t choose to become clients, but there is no fee for this initial consultation since there were no results. After treatment, if the predetermined criteria for success are not met, the certified therapist does not get paid, and does not charge for the time spent. Clearly, some clients won’t generate income and, in cases with dishonest clients, the client will get the service but the therapist will not be paid. However, this fee structure is not unusual – it is standard for most businesses, and the fees are adjusted to take these problems into account.

In some cases, the Institute sets a non-negotiable criteria for success for some licensed, specific processes used by our certified therapists – for example, someone who hears voices no longer does; the addict no longer has cravings; peak states processes have to actually give the client the sensations of the state; and so on [This is the case for our TBI process]. Another example of this pay for results principle is in research. Although we on occasion do contract with a client for a specific outcome that we have to do research to solve, the Institute never writes a contract with clients charging them for the hours spent on investigating treatments for new diseases.


The Rationale Behind ‘Pay (Charge) for Results’
The ‘charge for results’ principle solves a number of serious problems in the medical and psychological healing profession.

In this chapter we’ll discuss a number of practical reasons why charging for results is a good idea for therapists. However, from our perspective the primary problem with current billing by the hour is an ethical one. It is simply morally repugnant to require money from clients you don’t help. The principle of the ‘golden rule’ describes this clearly – ‘do to others what you would have them do to you’. Many clients come to therapists in desperate need of help, and often they are the people who have the least ability to pay due to the nature of their problems. These people need their resources to get real help, not support a sense of entitlement in the therapist. This is very much like taking your car in for repair, and having the mechanic tell you he can’t fix it, but that you now owe him thousands of dollars for the time he wasted.

Probably the most serious practical problem ‘charge for results’ addresses is the (hopefully) unconscious incentive for failure in the current system. When we charge by the hour we get rewarded for our failures. The payment reinforces the failures and as you know, what we reinforce we get more of. This principle is well described by Kylea Taylor in her book Ethics of Caring, where she displays a chart of the traps therapists can easily fall into with clients. Thus, standard billing practices where you are billing by the hour, not based on performance, has several potential problems:

    - The typical therapist unconsciously wants to keep his client coming in to therapy so that the therapist continues to be paid.
    - The typical therapist is again unconsciously resistant to learning new, faster techniques because this would interfere with his income stream.
    - The therapist has to suppress their own instincts and buy into a system that denies the ethical issue against charging people when nothing is accomplished.

From our perspective as a teaching and certifying organization, ‘charge for results’ also solves the major problem of how to verify a therapist’s competence. Normally, therapists and other health professionals take exams to show competence. Unfortunately, this measure does not actually work well, as anyone who has taken high school or college exams can well testify! By using pay for results billing, we find that therapists either are or quickly become competent or they simply don’t earn a living. Thus, this system itself is automatically self-correcting - our therapists are financially motivated to become better healers and seek out better treatment techniques. (Of course, we do check their knowledge and skills before licensing to help them through the transition as a new therapist. And we support them in becoming better therapists for the first year; but the problem of competency quickly solves itself without financially penalizing clients.)

‘Charge for results’ also solves another common problem – rejecting newer therapies simply because the therapist is comfortable with what he already knows. As the Nobel physicist Max Planck, the founder of quantum theory once famously said, “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” Fortunately, with the ‘pay for results’ principle therapists are forced to actively seek out newer, more successful techniques, rather than simply avoid change or rely on organizations that have a vested interest in promoting obsolete or ineffective techniques.

In summary, the Institute’s ‘charge for results (success)’ fee structure means that the therapist charges for performance, not for time. It has many advantages:

    It encourages therapists to be as capable as possible.
    It encourages the therapist to make clear and realistic criteria with their clients.
    It minimizes the problem of unrealistic client expectations.
    It discourages the problem of prolonging a client’s unnecessary suffering by becoming a ‘paid friend’.
    It encourages therapists to refer clients to therapists who can heal the client.
    It minimizes the problem of the client forgetting that they ever had the problem after it is gone (the apex effect). and
    Is ethically satisfying.

With the ‘charge for results’ format, the therapist is automatically supported to reinforce results, more focused on the client’s issues, and faster when working with clients. It is ethically satisfying, and is also an almost unique feature in the therapist or medical marketplace.
Pay for Results contract for TBI Resilience
As you can see from the text above, the pay-for-results policy is at the core of our ethical code.

This means concretely that, when we decide to work with you on eliminating your TBI symptoms, we guarantee our work will be efficient for you. Otherwise, you do not have to pay. This protect you from wasting your money on innefficient treatments, and we hope it will make you gain confidence in our work.

Our contracts generally cover the 3 main symptoms you suffer from, provided they originate from a mechanical injury to the brain. In general, most of the other symptoms will also be alleviated or disappear because our work is not symptom-specific. Instead, we target the whole brain and aim to acquire total brain resilience, which works on all/any symptoms from Traumatic Brain Injury.

In case your TBI symptoms overlap with symptoms from other causes, such as ADD, depression, generalized anxiety disorder, etc... we will assess and explain to you what is realistically achievable by our TBI Resilience process, or if appropriate, will suggest that we also run another of our process such as the Shattered Crystals for ADD, the Silent Mind for intrusive thoughts, etc...

What if we achieve partial results ?

If you get less than 50% improvement on your TBI symptoms, you simply do not have to pay us anything.
In case you get more than 50% but not quite a total recovery, we negotiate a partial fee (for instance, 70% of the fee if you get 70% of targeted results).

If you want to assess the possibility of eliminating your symptoms from TBI and fasten your recovery on a pay-for-results basis, please fill the survey to book a call with one of our specialists.
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