And now, auto suggestion ... therapy

The grey van glides to a stop. A fiftyish woman with a halo of strawberry-blonde hair steps out of the passenger's side. Dressed in a red knit suit and sheer black stockings, she flashes a smile: "Hello. I'm Ursula Strauss. Let's hop in the back."

I settle into one of two extremely plush swivel chairs while she instructs Dave, the chauffeur, to "watch the bumps, please". Ursula Strauss smiles again and arranges herself on a sofa opposite. The van rumbles into the Manhattan traffic.

This is my introduction to a phenomenon that only the Nineties could have spawned: therapy on wheels. Last April, Dr Strauss, a psychologist of 20 years' standing, began Mobile Psychological Services PC - "Chauffeured Psychotherapy for the Busy Executive". It's a success, a hit, a smash, and all because Dr Strauss identified a problem and found a six-cylinder solution.

"I noticed in my practice that whenever I was lucky enough to contact an executive type for a patient, that individual could not, would not, keep appointments," says Dr Strauss, smoothing back a stray hair. This is a group, she says, of organisationally challenged "dynamite kegs" - Type A personalities, who are most prone to heart attacks, high blood pressure, migraines and so on, who find that "their work schedules are getting in the way of their enjoyment of life". Dr Strauss fantasised about these patients, and in her fantasy rode in a stretch limousine to meet them at their workplace. Why a stretch limo? She shakes her head: "It's too close, too intimate." Anyway, she laughs at her dream now. As she says, it was hardly "discreet".

Vans are discreet. "I had noticed that vans had become an epidemic on the road. And it occurred to me that this would be a more feasible way to do it than with a stretch limo." So Dr Strauss suggested to Shelley Lennox, a fellow therapist with whom she has shared "stationary" clinic space in White Plains, New York, that they go into business together.

They bought a large state-of-the-art van, decorated the inside to resemble a therapist's office, hired a chauffeur, and placed an ad in the Wall Street Journal. Ten days later they had 20 clients.

After nine months, MPS has four vans, four additional staff therapists and 50 clients. "I really believe we're pioneers," says Dr Strauss. "There really is nobody else doing this."

It's the right idea at the right time. This is the age of instant gratification, in which convenience and efficiency are a standard demand for high flyers. Therapy by e-mail is already a fact for the chronically overworked.

Dr Strauss says she is a firm believer in patient-therapist continuity. When the New York Times mentioned the word McTherapy and suggested that her service may be feeding her patients' can't-stop-to-smell-the-roses neuroses, she bridled. "It's an irony that's not lost on us. But as one of the patients said, `It's this or nothing'."

Then there was Nathaniel Raskin, a psychotherapist in Evanston, Illinois, who told one reporter that he felt therapy should be "a process that calls for some relaxation, consideration, a slower pace". Dr Strauss shrugs. "He misconstrues what we do. We do it in depth, it's just that it can't be done in a quiet room. Those who really haven't paid attention, who want to stay in that conservative mode of the doctor lording it over the patient ... I think they find it threatening. It's not a gimmick - I wouldn't think of doing that."

Dr Strauss smiles again. "We didn't start out expecting any of this, never expecting the press to be interested, never, not ever. We're not in it for anything except to do a decent job ... and make a little money."

Fortunately, her patients are well-paid professionals - stockbrokers, TV network executives, dental surgeons, financial analysts, lawyers, investors, accountants - for whom "there's not even the blinking of an eyelash" at the fee - $175 (£111) an hour.

This buys the patient a ride to or from work (MPS's most popular bookings); to or from the airport: or an "on-site" visit outside the patient's workplace. "It's a very minimal price to pay for the convenience," Dr Strauss says, adding that there's no extra charge if heavy traffic adds extra time to the trip. "That's a perk."

One of her patients is Susan Anderson, a merchandising director in the apparel industry. She is coping (just) with a demanding job, two children and a recent divorce. "Therapy was important and beneficial, but I didn't have the time. So this became a way for me to continue. It's an unfortunate statement about the Nineties that this is necessary, but it's a reality."

Dr Strauss agrees. "The recession means that everyone is running scared - especially this sub-group of patients. It makes them run faster and harder."

Although Dr Strauss hopes that this mad dash will include a stop in one of her mobile offices, she insists that her objective is to get her patients out of the van ASAP. "I believe that an individual should begin to feel better within three months."

Her partner, Dr Lennox, puts it another way: "If we can be successful in giving therapy this way, then the hope is that we'll be put out of business." That is highly unlikely. Dr Strauss's plans for this year include doubling her clientele and establishing franchises in cities across the country. She's no stranger to the law of the fast lane: move it or lose it.