Over the past few weeks, I had noticed ads appearing on my Pinterest feed with the headline “Text your therapist, not an ex.” This line caught my attention, for a few reasons. Even though I am currently in a happy long-term relationship and am not struggling with mental health issues, I have close friends and family members that are. The aspect of “texting your therapist” was completely foreign to me so I decided to dig a little deeper and found that there are many online and sometimes automated services claiming to offer secure, private connections to talk to a therapist. This raises many concerns about the role that technology plays in the legitimacy, automation, and privacy of treating mental health in a digital age.
Two examples of these types of sites are Talkspace and 7 Cups of Tea, both of which offer online access to a variety of “trained online therapists” and listening communities. These sites offer different benefits than traditional in-person session. By talking online users can forgo limitations such as having to figure out transportation to an office location, fitting a session into a busy schedule, allowing for anonymity due to perceived stigma of mental health treatment, and in some cases affordability based on how much the service is used. These types of services could help reach individuals that may not have access to mental health services due to their income, location, or family situation. It could also serve to alleviate the issue of a lack of trained professionals for the growing number of people that need help, especially since some individuals would be more comfortable communicating about difficult topics through texting rather than a face-to-face conversation.
In a recent article published by the Journal of the American Medical Association, Stanford scholars have raised some concerns regarding the reliance on technology to solve very real and sensitive situations. For instance, if a user has a negative experience with a digital entity, they may be even less inclined to seek help for mental health issues in real life. These programs may be good for initially triaging the severity of a concern but there are nuances of in-person conversation that cannot be captured through a screen. Additionally, using a technologically-based therapist may lead to increased feelings of disconnection from the real world or an unhealthy reliance on texting their professional with unlimited accessibility. Finally, privacy can be a concern especially when it comes to HIPPA laws, which is why many hospitals and mental health facilities are wary about implementing these types of systems. Overall these sites seem to be operating for the purpose of improving mental health but certainly need to be held to a high standard in order to bring the right benefits to people who need it most.
https://www.talkspace.com/online-therapy/unlimited-messaging-therapy/
https://www.7cups.com/
Image Credit: http://money.cnn.com/2014/11/05/smallbusiness/text-therapy/index.html
For me, the largest drawback to this technology would be the fact that using technology-based therapists might actually exacerbate feelings of disconnectivity.
Social distance and isolation can be one of the largest causes of depression. The drawback to ‘text-your-terapist’ applications is that text messages can not relay true emotional connection. Humans develop connections–even in interactions with strangers–through body language, facial expression, vocal tone, feeling, etc. An application like this would be much more successful if it could incorporate more of these methods of human expression. Video conferencing might be a suitable replacement, since therapists can communicate their empathy if they can speak and communicate directly.
A more revolutionary form of this technology might actually find a way to incorporate touch. Floyd’s (2011, pg. 89) review of literature on affection found that those who receive affectionate contact with humans (commonly referred to as therapeutic touch) are less likely to feel depressed, abuse alcohol or drugs or engage in physical aggression. If researchers can develop a technological proxy for human touch, then I think that they are really on to something.
Floyd, Kory (2011). Communicating Affection: Interpersonal Behavior and Social Context. University of Cambridge Press: London. Print.
This is an interesting concept, and can be a great way for people to access help when they most desperately need it, and helps those without the resources to pay for a traditional therapist. However, while I do trust individuals to be able to make an impact on these sites, it sounds like a potential recipe for disaster. I don’t really trust the internet as a whole, and as mentioned, a bad experience can really turn someone off or even cause harm to someone in a suicidal situation, for example. In addition, one-off therapists may be able to help in short term crises, but aren’t able to help long term issues. Having a relationship with the person is a huge advantage for traditional therapy.
I like the idea, and I know a lot of people who have benefited from such services. However, digital therapy has a long way to go.
This was a really interesting concept to read about because while reading your post, different pros and cons popped into mind.
Another pro of texting your therapist would be the ability to immediately contact someone in a time of crisis. Say you are having your first panic attack, alone, with no concept of how to deal with it. Instead of going into it alone and having to make an appointment for the next day, maybe even the next week, you can quickly and easily contact a therapist to walk (or text) you through your situation. This idea is also (probably) on the more fiscally-friendly side of the spectrum as opposed to paying for a therapist.
A con, however, is the idea of not having that face to face interaction. Part of seeing a therapist is the fact that while they are listening to you, they are observing you. They are observing you and your reactions and body language. This is not possible if you are just texting your therapist. You also do not have that sense of reliability and trust with your therapist as you would if you were visiting in person.
This idea is very interesting, and as far as I can tell it was designed to help people, which is a success all in it’s own. However, there are concerns with it just as there are concerns with everything.