Over the last six months, we’ve seen a variety of new text messaging therapy sites that promise to bring the convenience of no-nonsense, 24/7 “therapy” to the consumer. Type your problem, get an answer — and move on. What could be better?
In October, the New York Times did an expose of All-You-Can-Text Therapy Services, wherein a service called BetterHelp connects licensed mental health professionals to consumers after completion of a simple questionnaire and a $40 credit-card charge. With a tag line of “You Deserve to Be Happy,” the service touts its advantages by stating, “Online Counseling is effective, affordable, and discreet.” In his description of the site’s service, the NYT journalist states,
My BetterHelp therapist asked the same kinds of thought-provoking questions as the traditional therapists I worked with in the past. (What is it about your future that you’re unsure of? Can you tell me about your old life and what is different now?) Because of the continuing, open-ended nature of the text chat, however, she helped me identify anxiety triggers and coping mechanisms much faster than it would have taken had we met only once a week. What’s more, I came to find that launching the BetterHelp site on my smartphone or laptop and writing out my thoughts became therapeutic in itself.
The same NYT article described Talkspace, which offers unlimited text-chat with a licensed therapist, “but it costs just $25 a week and gets you up and running faster.” What was the author’s experience? Here’s a glimpse:
My Talkspace therapist wrote long, thoughtful responses to my meandering journal entries, pulling apart the elements and dissecting them as only a true professional therapist can do. He asked me to expound on and reflect on my entries, always checking if I felt that we were making progress, and assuring me that what we were doing had a positive end in sight. The process was identical to what I had experienced in traditional therapy, except I had access to it any time I pulled out my iPhone.
The article went on to describe yet more services available at Talkspace, “The site allows you to change therapists (currently 90 are registered with the site) at any point. Should you want to go with a more traditional talk-therapy route, you can sign up for a 30-minute live-video session, which costs $29.” In November, CNN Money also commented on Talkspace in an article called, Does text therapy actually work? The NCC journalist seemed to be impressed with the efficacy of text-treatment, evidenced by this statement:
I was surprised by how much she was able to read between the lines, as she encouraged me to expand on certain issues or return to something I’d mentioned before. Despite not having much background on me, simple questions in response to my dating distresses (“[Why aren’t you] allowing yourself any more options?”) caused me to reflect on my own relationship history, and why I was viewing my current situations through a black-and-white lens.
The CNN article drew on the expertise of Dr. George Nitzburg, a psychological researcher from Columbia University, to conclude that online therapy solutions like TalkSpace (which raised $2.5 million in funding in May) are only effective for a subset of patients. According to Dr. Nizburg, those with serious addictions or risk-taking tendencies (like self-mutilation or reckless driving) need more treatment than digital therapy can provide. Tools to be used to differentiate both groups were not mentioned in the NYT article, however. Dr. Nitzburg is quoted at the end of the article as saying, Most online or texting therapy forms don’t offer crisis counseling or emergency services.
R U There?
This week’s R U There? – The New Yorker‘s expose outlines the newest company to fill the text-messaging opportunity — only to defy Dr. Nizburg’s warning about text messaging therapy and crisis services. A non-profit called DoSomething.org has apparently given birth to a new company called, Crisis Text Line, described by the New Yorker article as:
…the first and only national, 24/7 crisis-intervention hotline to conduct its conversations (the majority of which are with teen-agers) exclusively by text message.
What about You?
Perhaps it would be useful to consider this discussion in light of a more personal angle. Those of us who send and receive text messages know how convenient and yes, helpful they can be. As depicted in the image above, many people sleep with their mobile phones and check them first thing in the morning, sometimes before making any other human contact. Let’s think about text messaging for therapy, though.Would there be any use for this kind of service in your life? If your 19 year-old daughter, niece or mother wanted to receive such a service from a licensed therapist, would you support it? Why?
For a recent TMHI webinar recording addressing the legal and ethical side of these issues, see Text Messaging: 12 Risk Management Considerations To Keep You Out Of Hot Water.