Ivan J. Miller, Ph.D.
Licensed Clinical Psychologist
Flatirons Medical Arts Building
350 Broadway, Suite 210
Boulder, Colorado 80305
(303) 499-3888


Ivan J. Miller, Ph.D.
Founder and President of Boulder Psychotherapists' Guild, Inc.

To learn more about the Guild, click here

In 1994, a group of Boulder psychotherapists began discussing how they might preserve quality mental health care in the era of managed care. At the time, managed care had begun to control most of the mental health services that were reimbursed by insurance. Managed care dramatically cut the costs of treatment by creating restricted panels of providers and using a variety of techniques to abbreviate or discourage therapy. Their restrictions decreased the effectiveness of therapy and undermined the privacy essential to therapy. Moreover, managed care misled purchasers and consumers by advertising that their abbreviated therapy was actually as effective or more effective than allowing providers and patients to privately determine the type, intensity and length of therapy.

Realizing that managed care was intent primarily on cutting costs regardless of the impact on quality, the founding members of the Guild thought that the best available alternative would be self-pay therapy conducted outside of the intrusions of managed care. They believed that by joining together, they would have the resources needed to provide consumers with accurate information about psychotherapy and its benefits and about the negative impact of managed care on psychotherapy. Because many consumers have traditionally paid a large portion or all of their therapy expenses out-of-pocket, the founders believed that many consumers would prefer to pay for their own therapy if they knew about the managed care interference with effective therapy.

Dr. Miller realized that he could establish an organization that would accomplish the goal of promoting psychotherapy and educating consumers about the advantages of treatment outside of managed care. He founded the Boulder Psychotherapists’ Guild, Inc. and invested his funds to establish the organization. Fifty-five other therapists joined and provided dues, ideas, and encouragement. A group of four therapists acted as an advisory committee.

The Guild was formed around a mission—“Our 56 therapists have joined together to respond to the growing impersonalization and decline in the quality of mental health care. We are dedicated to preserving the integrity of client-focused, confidential psychotherapy and counseling.”

The Guild is based on the principles of ethical marketing—providing consumers with accurate information about the potential benefits of psychotherapy so that they are able to make an informed decision about entering therapy. The Guild serves consumers by supplying information about psychotherapy and how to locate a therapist; serves referral sources by providing information about how to locate services or therapists; and serves providers by educating consumers and referral sources about their practices, services, interests and specialties.

The Guild is a marketing company that promotes psychotherapists, the value of psychotherapy and develops the self-pay market. It has been a success and has served as a model for similar organizations around the country. It now has 78 members, and is recognized in the Boulder Community as the leading referral source for licensed psychotherapists. It has been described in a professional journal and a Wall Street Journal article . The Guild has created a model program for giving consumers information about therapy and therapists.

Today consumers and providers are more aware of how managed care has interfered with quality, privacy, availability, and choice in therapy. Consumers are increasingly paying out-of-pocket for their therapy. The Guild therapists make therapy more affordable by offering a discount for self-pay clients. Some Guild therapists offer a sliding scale for people who cannot afford the full cost of treatment. Because many people need to use their insurance to help pay for therapy, most of the Guild therapists work with insurance and managed care companies even as they remain committed to the mission of the Guild.

An Alternative to Managed Care: A "Guild" model for the Independent Practice of Psychotherapy, Journal of Marital and Family Therapy, Vol. 25, No. 1, pp. 99-111, and With a ‘Guild’ Therapists Flee Managed Care, Wall Street Journal, Monday, November 22, 1999, p. B1