While the nature of mental health issues has not changed, the way people are getting help is. United States startups are disrupting the talk therapy tradition with apps that give you unlimited access to therapists. Angela Waters explores the virtual deconstruction of the therapist’s couch.
Traditional therapy happens on a couch, once a week, for 60 minutes, at roughly $100 per session — while it works for some, a lot of people fall through the cracks of the mental health system. To fill these gaps, tech companies have sprouted up offering a different take.
“I realized that the mental health system in the United States is completely broken,” Roni Frank, co-founder of online therapy app Talkspace told Highsnobiety. “Recent studies show that one in five Americans — 50 million people — suffers from mental health issues each year. However, 70 percent of those have no access to mental health services.”
Cost is one of the main barriers to therapy as many insurance policies only cover physical health. Even among those who can afford a therapist, there is often an old-fashioned conviction that you should just be able to pick yourself up by your bootstraps instead of asking for help. But even if money and stigma are not a problem, there is the complicated process of picking the right therapist and finding a time to put sessions into your schedule.
The main difference between traditional therapy and mental health apps is that they make the process casual with less commitment. An algorithm helps you find a therapist and switching to find the right fit is a quick chat to customer service.
You are accessing therapists the way you would speak to your friends, via text, video messaging/calling and voice notes. This also means you have way more access to your therapist.
Talkspace offers an unlimited text, video and audio messaging plan starting at $32/week, where therapists respond one or two times a day five days a week.
“You are talking to a therapist the way you would friends and colleagues so it makes the whole process feel more normal, compared to going to a private practice which feels like a doctor’s room. It is very intimidating to go to the waiting room and sit on the couch,” Frank said.
Maybe this is what has attracted 500,000 people to the platform, sixty percent of which have never tried traditional therapy
The idea for Talkspace actually came to Frank when she and her husband were going through couple’s therapy. Although she credits the sessions with saving her marriage, she believes that putting feuding partners in a room with a therapist may not be the best way to deal with relationship problems.
“In traditional couple’s therapy the couple has to be together on the couch for 90 minutes, which is more expensive than regular therapy because it is longer than a single-person session,” Frank said. “It can actually be more stressful for the couple to sit in the same room together. There is too much tension and too much anxiety.”
She argues that in a messaging-based model some of the heat is being removed from the fights and it gives the two people more distance to really listen to each other and understand what the other person is saying. Another upside to the alternative model is a more immediate response to active issues.
“Let’s say they have a huge fight, right there and then they can reach out to a therapist and get help. Relationships are not easy; there is a lot of drama,” Frank said. “Couples deal with heavy things like anxiety and cheating. Sometimes it is unbearable to wait to talk to a therapist so we are providing immediate help.”
But Not Everyone Is a Fan
While many are warming to the casual vibe of therapy app platforms, some insist there are reasons traditional therapists do things a certain way and that cutting corners to reduce the costs can be dangerous when dealing with mental health.
Marlene Maheu, executive director of the Telebehavioral Health Institute, has been working with virtual therapy for more than twenty years and sees major red flags with popular mental health apps.
“Many groups use licensed professionals, but in many cases those professionals have absolutely no training and for the most part are unsophisticated about what their obligations are,” Maheu told Highsnobiety. “There are licensed people doing illegal and unethical things at a cut rate. This means that the consumer is not getting the services that they expect when they approach these professionals.”
One of her main concerns about online platforms is anonymity. While many apps let you volunteer what information you give to a therapist, including your name and locations, this prohibits therapists from contacting the proper authorities if a patient plans to harm themselves or others.
“The problem is everybody looks alike when they are showing up the first time,” Maheu said. “Most of these websites will say if you are suicidal or homicidal, don’t come here because we can’t help you, but the truth is that every clinician worth their salt knows that people overcompensate in the first few sessions, then they may fall apart and become violent.”
Another concern with anonymity is that a therapist may not have all the information necessary to help someone.
“You have to find out what the situation is – you have to do an intake. With some of these companies you just type in a question and you are supposed to be getting a legitimate answer; that is not psychotherapy. If the person is going to talk to you about a problem and not ask about if you are taking medication, if you have physical disorders then it is kind of strange. How can they council if they haven’t ruled out a physical problem,” Maheu said.
She added that a virtual therapist has to actually do more work than an in-person therapist to deliver the same quality of care, because they cannot use sensory cues to pick up on things that a person may not be telling them.
“There is definitely a benefit to virtual therapy, but the rubber meets the road with the training of the therapist,” Maheu said. “Look at the therapists and their bios, if they aren’t certified in online therapy, you need to ask yourself if you want to be their experiment.”