My Process with Caring

My Journey from Gatekeeping to Gateway Building in Mental Health
My Process with Caring

You know that moment when you realize your carefully crafted life plan has a tiny flaw? Well, mine had several, and they all pointed to an unexpected plot twist in my professional journey.

The Great Mental Health Access Paradox

Here's the thing about privilege: it's complex, layered, and different depending on where you're standing. In Brazil, I'm privileged. In New York, I was just another person wondering if I could afford both dinner and a City Bike subscription. Some people even started referring to me as a woman of color, even though I look very white by Brazilian standards. This spectrum of experience taught me something crucial about mental health care access.

The Uber Effect: When Old Rules Meet New Tech

Remember when getting a taxi on a rainy day was like winning the lottery? Then Uber came along and disrupted everything. While I don't love every aspect of how ride-sharing apps changed the industry (and some drivers might want to have a long conversation about that), it's a perfect example of how technology can democratize access.

Think about it: before ride-sharing apps, we needed strict regulations to ensure safety and quality. But once technology provided new safety mechanisms and quality controls, those same regulations became barriers to access rather than protections.

Sound familiar? Welcome to mental health care in 2025.

My "Wait, What?" Moment with Traditional Therapy

I started pursuing an MFT degree with stars in my eyes and dreams of providing remote therapy from Brazil while earning a U.S. salary (hello, geographic arbitrage!). But then reality hit.

After consulting with lawyers, I discovered:

  • Insurance and Malpractice Coverage: Taking insurance coverage as payment or obtaining malpractice insurance for safety? Forget about it.
  • Remote Therapy Limitations: Practicing therapy remotely from Brazil? Only be feasible if I operated a private practice, attracting my own clients and handling payments directly (essentially functioning as a coach).
  • Supervision Requirements: Regulations, which had been relaxed during the pandemic, are tightening. California is updating its policies to mandate in-person supervision for licensure candidates by the end of the year. And it takes an average person five years to get licensure. That was the hardest hit, not only because of its short-term implications. Even if I established a practice in Brazil, ethical guidelines would prevent me from accepting Brazilian patients, and I could be one regulatory change away from losing my livelihood.

The Plot Twist: From Gatekeeper to Gateway Builder

Here's where it gets interesting. Just as telehealth was proving its worth during the pandemic (turns out you can cry just as effectively on Zoom), the mental health industry is facing its own Uber moment. But unlike ride-sharing, our goal isn't just disruption—it's transformation.

Three Paths Forward That I See for Myself

  1. The Coaching Route: Less regulated, more flexible, but in Brazil, saying you're a coach sometimes gets the same reaction as saying you're a self-proclaimed spiritual guru and I don’t know if I am past caring for what people think about me…

  2. The Social Work Path: In the U.S., social workers can provide therapy, unlike in Brazil. The field is mission-driven and embraces tech for better care. A great example is the University of New England's (UNE) SOS practicum model, where MSW students use simulation tools to complete part of their practicum, boosting access and skills. The program includes 16 weeks of AI-driven simulation followed by 16 weeks in an agency. This tech-forward approach makes training flexible and future-ready. Contrast that with MFT licensure, where I would need in-person supervision for hundreds of hours just to qualify. No flexibility. No tech-driven solutions. Just rigid rules built for a pre-pandemic world. While social work innovates, MFT regulation clings to outdated models, making access harder, not easier.

  3. The Entrepreneurial Highway: This is where my heart is pointing, honestly, with all its promises to help address the current mental health crisis humanity is now facing.

The Plot Twist Part 2: When the Former Goldman Analyst Meets the Relationship Advocate

I've turned my analytical skills toward an underserved facet of mental health: relationship coaching.

The Relationship Crisis as a Market Opportunity

Consider these insights:

  • Delayed Intervention: Dr. John Gottman's research reveals that couples endure an average of six years of dissatisfaction before seeking help.
    Gottman Institute

  • Persistent Stigma: While individual therapy has become more accepted, couples therapy still faces societal stigma. Many view seeking help as admitting failure, deterring proactive counseling.

  • Untapped Market Potential: Platforms like BetterHelp and Talkspace have navigated complex therapy regulations, yet the $50 billion relationship enhancement market remains largely uncharted. The focus has been on therapy, whereas many couples seek guidance in:

    • Communication skills

    • Conflict management

    • Parenting support

    • Work-life balance

    • Financial planning

    • Pre-marital preparation

These aren't clinical needs - they're skill-building opportunities. The revelation here is powerful: by connecting couples with coaching tools earlier, we can prevent many relationships from ever reaching crisis point. And since coaching is unregulated (unlike therapy), we can innovate faster and reach more people without regulatory barriers. This isn't just a business opportunity - it's a chance to transform how relationships thrive.

That's exactly why we're building "The Operating System for Relationship Enhancement"

Introducing: "The Operating System for Relationship Enhancement"

For Couples:

  • Personalized Matching: Connect with coaches and experts tailored to your needs.
  • Diverse Support Formats: Access one-on-one sessions, group workshops, courses, and AI-driven tools.
  • Affordable, Preventive Care: Invest in your relationship before challenges escalate.
  • Seamless Transition to Clinical Services: Clear pathways for situations requiring therapeutic intervention.

For Coaches and Experts:

  • Comprehensive Practice Management: Streamlined tools for efficient client management.
  • Content Marketplace: Platform to offer courses and resources.
  • Integration with Complementary Services: Collaborate with legal and financial advisors.
  • AI-Powered Progress Tracking: Monitor and enhance client development.
  • Ethical Guidelines and Support: Resources for appropriate client assessment and referrals.

The Future is Both Digital and Human

The best part? We don't need to wait for some distant future. We can build it right now, one line of code and one relationship at a time. I can see this starting as a prototype of an AI-powered relationship coach, trained in evidence-based approaches like Gottman's research on what makes relationships work. Imagine couples having 24/7 access to communication tools, conflict resolution frameworks, and guided exercises - all based on decades of relationship science.

The relationship enhancement industry is ripe for innovation—not to replace human coaches, but to scale their expertise, make it accessible, and help couples long before they hit crisis point. Think of it as having a relationship mentor in your pocket, helping you build stronger connections one conversation at a time.

And the best part about starting with coaching rather than therapy? We can launch, learn, and iterate quickly, helping real couples strengthen their relationships while we grow. No need to wait for regulatory approval or navigate complex healthcare systems. Just pure focus on helping couples thrive.

References:

  1. Global Mental Health Market: The industry is valued at $423 billion in 2024 and is projected to reach $625 billion by 2033. (GlobeNewswire)
  2. Access to Mental Health Care: Only 66.7% of adults with serious mental illness (SMI) in the U.S. received treatment in the past year, leaving one-third without support. (NIMH)
  3. Divorce Rates in the U.S.: Nearly 40% of marriages in the U.S. end in divorce.
  4. Size of the Continuing Education Industry for Licensed Professionals: It should be big, but I did not find the stat yet. The overall U.S. continuing education market was valued at $60.52 billion in 2022 and is projected to reach $93.25 billion by 2028, growing at a 7.47% annual rate, driven by increasing licensure requirements. (Arizton)
  5. UNE SOS Practicum Model: The University of New England (UNE) offers a Simulation and On-Site (SOS) practicum model in its MSW program, allowing students to complete part of their practicum virtually, enhancing accessibility and skill development. (UNE Online)
  6. Johnson, S. (2008). Hold Me Tight: Seven Conversations for a Lifetime of Love. Little, Brown Spark. Dr. Sue Johnson also explains that while individual therapy has become widely accepted, couples therapy still carries stigma, often perceived as an admission of failure, preventing many from seeking help. (Dr. Sue Johnson)
  7. Gottman, J. M., & Silver, N. (2015). The Seven Principles for Making Marriage Work: A Practical Guide from the Country’s Foremost Relationship Expert. Harmony Books. Dr. John Gottman also highlights that couples, on average, wait six years before seeking professional help for their relationship struggles, making intervention more difficult. (Gottman Institute)
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