The Pros and Cons of using TalkSpace and BetterHelp in lieu of traditional therapy
Life is stressful right now. Those of us who needed mental health support before really need it now, and many who haven’t used it in the past are looking for a way to access it. The wonderful news is that THERAPY IS STILL THERE! But…it has moved to video. Every therapist that was offering in-office therapy is now administering that same therapy over phone or video chat. I’m using it, and it’s going great.
Now that all therapy is online I know many folks, including myself, have asked the question:
“What about online therapy through companies like BetterHelp and TalkSpace? Is that just the same?”
What these web-based companies are offering is easier to set up than a potentially stressful call to your insurance company, their websites are user-friendly, and the services are reasonably affordable. But is the therapy good?
Over the last few months I have polled mental health professionals and past users to get a sense of what these companies are bringing to the table. I came in with my own biases as someone who has loved the benefits of traditional, in-person therapy my whole adult life. Many of my misgivings about these online services were confirmed, and other interactions opened my eyes to some benefits of this new frontier of mental health support.
*A little disclaimer before we get going: I don’t work for any of these companies. Nor, for that matter, do I work in a competing industry. I’m just a girl who loves therapy, loves helping people get into therapy, and wants to give a non-funded perspective.
Who Are The Therapists?
Working online rather than in-person takes away several elements that are very beneficial for a therapist’s process, such as an ability to clearly read subtle body language or the ability to control the therapeutic environment and ensure it remains peaceful and undisturbed. Online therapy is a perfectly workable solution, but it is by no means an ideal one. So which therapists are choosing to work for BetterHelp and TalkSpace in lieu of working with clients in-person?
Understanding the pay structure and costs associated with doing business can shed some light on this question.
The highest paid therapists are those who are working in private practice and who don’t work with insurance companies. Clients with insurance are usually still able to retroactively bill their insurance companies for “Out of Network” treatment, which is reimbursed at a lower rate than “In Network”, but it is up to the client to pay the therapist up front and deal with the reimbursement on their own. These therapists trust that their reputation is strong enough that they will not need insurance companies feeding them new clients to maintain a full practice, and they typically make anywhere from $100-$300/hr.
Therapists who work with insurance companies take a lower rate that is set by the insurance company, but they can also count on a more reliable stream of clients because their names will be listed on the insurance companies’ provider lists. They will be much more affordable to prospective clients, who will likely only be responsible for a $15-$30 copay. These therapists typically make between $50-$100/hr.
Both In-Network and Out of Network therapists will have to pay for an office space and handle their own billing, be it directly to their clients or through insurance panels (which can be very complicated).
In comparison, online therapy companies pay therapists the least of all. According to the BetterHelp website:
“Counselor jobs at BetterHelp can earn therapists as much as $15.00 — $25.00 per hour.”
This is significantly lower than what a counselor in private practice would make, and at BetterHelp’s current price of $80/week, the majority of the money you pay for that therapy is going to the middleman.
If someone needed to work from home, was simultaneously raising young children, or didn’t want to deal with the financial investment and hassle of renting a space and billing clients/insurance companies, perhaps taking that lower pay would be worth it to them for the convenience. On the other hand…it is ALSO possible that that person taking a pay cut is a therapist who currently has trouble maintaining clients and is not making a reliable income from their private practice. All therapists are NOT created equal; there are good ones and there are bad ones, just like in every profession.
A few people I spoke to had tried therapy at these online companies and said they had a decent experience. I frequently heard the phrase: “It all depends on the therapist you get” and no matter what medium you’re receiving counseling through, this is always true. The #1 thing I emphasize to people when they are exploring therapy for the first time is that not every therapist is YOUR therapist. Much like dating, it is a matter of your personalities meshing. If someone goes into their first therapy session thinking “Well, this is the person I’ve been assigned and they know best what is right for me so I have to stick it out”, they may have a bad experience in therapy and write it off forever. If you are trying these sites, don’t feel you are stuck with someone you don’t jive with because a site administrator chose them for you. Ask to try again.
How is the Therapy?
One of the positives of the web-based service is that it is here and now and immediate. If you are in crisis, they’re probably going to get you talking to someone faster than any more traditional therapist will be able to get you in. While most therapists in private practice respond to voicemails from prospective clients within 24 hours, BetterHelp and TalkSpace are set up to respond to you within minutes.
Text messaging therapy is unique to these services and not something you will find with private practice therapists. With TalkSpace’s text-only therapy plan clients are able to pay a lower fee to send and receive texts and video messages with their therapist in lieu of a weekly face-to-face session. According to their website:
“For some, text therapy enables them to plan out exactly when and how they want to get their point across to their therapist.”
If a certain phobia or anxiety disorder makes the idea of speaking to a therapist live, whether over video or in an office, feel overwhelming, this could be a solution to get someone started on their healing journey.
However, this texting format is inherently limiting. A therapist is trained to listen not only to what it being said by their clients, but to what is not being said, to periods of silence, and to a client’s energy and body language in order to understand how they are truly feeling. Anyone who has ever had a misunderstanding over text message knows that NONE of those things are possible on the phone.
Overall, it seems to me these websites are best able to provide a surface or triage-level of counseling; providing support or coping skills for someone dealing with an emotional crisis, helping someone navigate a life-transition, etc. If you are interested in building a deeper relationship with someone and working through attachment issues, trauma, addiction (the list goes on…) and addressing the root causes of your suffering, you will be much better served making the investment in a traditional therapist. This kind of healing is the greatest form of self-care. A massage can make you feel good for an hour. A vacation can make you feel good for a week. This work sets you up to feel good for the rest of your life.
Further reading can be found at: https://www.choosingtherapy.com/betterhelp-review/
