Online Therapy Platforms: They are Not All the Same

Several Options for Therapists to Choose From

Online therapy services: They’re not new. They’re not in their infancy. But they’re having a growth spurt, spurred by public health crisis. People are depending on them more than ever. A growing number of mental health professionals are offering services online, and there are companies actively seeking them to provide services through their platforms. Therapists may have any of multiple licenses including social work, professional counseling, marriage and family therapy, and psychology.

There are quite a few options. Those who are considering joining these networks should be aware that they don’t all work the same, though there are some commonalities among legitimate providers – things like checking credentials and offering a secure platform. Modalities vary. Some organizations are about counseling-on-demand for the lay person. Some organizations partner with businesses. Some have a tiered system of interventions. They may utilize coaches as well as mental health professionals. They may offer face-to-face services as well as online.

Businesses often seek independent contractors. They can still be very selective. Online therapy doesn’t mean ‘therapy light’.

While there is promise, there are potential pitfalls, as noted in Monitor on Psychology, a publication of the American Psychological Association (https://www.apa.org/monitor/2017/02/online-therapy). Therapists will want to consider issues like handling of emergency situations: Do they feel comfortable that the platform is doing enough? Do they feel they can adequately determine a client’s mental state through messaging? Are they confident they know where their client is?one

Ginger: A Corporate Presence

Ginger is well-known for bringing coaching and mental health into the business world. Companies can opt to include the service in their wellness plans; employees can receive services on their phones. Members who need clinical care — something beyond mere coaching — are connected to psychiatrists and coaches. Ginger has a HIPAA-compliant platform for their mental health professionals to use. During the pandemic, Ginger is offering free coaching on-demand to healthcare workers.

Spring 2020 finds Ginger with multiple postings. The organization is seeking therapists and also psychiatrists. In both cases, it can be a plus to have licensing in more than one state. The company notes, though, that there is an opportunity to become licensed in additional states as needs warrant. The company has stated a preference for professionals with at least three years of experience. They’re looking for professionals with competency in evidence-based practices, for example, CBT and mindfulness. Therapists will maintain their availability calendar and lock case notes on the appropriate schedule.

Ginger is aptly named made ginger tea. Ginger co-founder Karan Singh grew up using Ginger tea as a preventative. Somehow his mother had a cup ready before he got sick (https://www.ginger.io/about-us).

Lyra: Seeking Committed Therapists

Lyra, too, has a major presence in corporate well-being. Services range from self-care resources on up to medicine management. Lyra offers services to some well-known companies, including Uber and eBay. Starbucks recently announced employees would receive as many as 20 free annual therapy sessions through Lyra (https://stories.starbucks.com/press/2020/starbucks-transforms-mental-health-benefit-for-us-employees).

Lyra utilizes clinicians on-site as well as online. In spring 2020, Lyra sought blended care clinicians for part-time remote roles in the following states: California, Washington, Illinois, Massachusetts, New York, North Carolina, and Virginia. They wanted leading therapists who could contribute to protocols and provide feedback on technologies. This would not be a small side venture; they were in the market for professionals who could commit to at least 20 hours a week. For these positions, they could utilize therapists with backgrounds in clinical social work, marriage and family counseling, professional counseling, and psychology; titles could include LCSW, LMFT, LPC, or PsyD.

Lyra was also care navigators in a separate set of cities. Here they were looking specifically for social workers (LCSW or equivalent).

Lyra therapy positions are very competitive. The business uses predictive analytical models to determine who is likely to provide the type of care they seek; interviews are confirmation of suitability.

BetterHealth: A Proven Track Record

BetterHelp offers its adult, teen, and couples services entirely online. The business self-describes as the “world’s largest counseling service” (https://www.betterhelp.com). Effectiveness has been validated with some populations. Evaluation is provided in Effectiveness of a Multimodal Digital Psychotherapy Platform for Adult Depression: A Naturalistic Feasibility Study (https://mhealth.jmir.org/2019/1/e10948). There are multiple modalities: video, phone, messaging, and chat; all are handled through the BetterHealth system.

BetterHelp sought licensed therapists in 2020. Therapists, they note, are independent providers. In addition to credentials and references, therapists are evaluated through a case study and interview. The process takes a while. The organization has stated that they only take on about 15% of applicants (https://www.betterhelp.com/faq).

TalkSpace: Using Messaging Effectively

TalkSpace is no newcomer; it had its start in 2012. The organization offers messaging therapy for adults, teens, and couples; the service can include video and audio messages. Clients can buy plans with unlimited messaging service. Therapists are not, however, expected to be on and responding all the time. Plans may include one or more conferencing sessions a month. Client progress notes are completed through the platform dashboard. Clients are informed that the site is not to be used for life-threatening emergencies. The organization tells prospective therapists there are built-in emergency protocols.

TalkSpace can point to effectiveness research, including a study out of Columbia University, The Treatment Effectiveness of Asynchronous Text Therapy for Depression and Anxiety: A Longitudinal Cohort Study.

An Eye to the Future

While online therapists are not quite at the front line during the pandemic, they’re helping those who are — as well as others who are dealing with heightened stress. Some see long-term psychological impacts (https://www.cnbc.com/2020/04/06/coronavirus-is-taking-a-toll-on-workers-mental-health-across-america.html ). It’s not forever. Today’s therapy platforms will see changes. Some current clients will return to face-to-face. But there’s always a market for skilled mental health professionals and chances are this new model is here to stay. It attracts many who have never felt comfortable with counseling – and it attracts the busy and the over-scheduled as well as the homebound.