Personal Technology

Is Your Shrink on Vacation? Try Online Therapy


It’s a myth that depression and suicide rates peak during the holiday season. Springtime is a much darker time for the melancholy. But plenty of people deal with elevated stress as the calendar year changes, a time when vacationing therapists can mean an absence of professional help. These days, some are turning to online video therapy and telepsychiatry.

Online therapy has been around in various forms for years, having gained traction as websites begin accepting insurance. Breakthrough.com, which accepts several policies, has seen a roughly 15 percent increase month-over-month during the past year, although the company declined to comment on its customer numbers. “It took us two years to sign our first contract with Blue Cross Blue Shield, but it’s been worth it,” says Mark Goldenson, chief executive officer of the Redwood City (Calif.)-based website. Roughly 75 percent of customers use insurance, and Goldenson says 70 percent re-book after their first appointment.

Breakthrough’s customers aren’t exclusively suffering from holiday blues. “Some have agoraphobia, or fear of leaving their homes,” says Goldenson. “Some live in rural areas where there aren’t a lot of therapists nearby.” Most, he says, use the site to find and quickly vet new therapists without ever leaving home.

Breakthrough facilitates the process by making professional, two-minute videos of shrinks. A second company, Therapick, also produces brief therapist videos. “[People] know right off the bat from watching the therapists talk—their mannerisms, their intonation, those intangible things—whether this person appeals to them,” David Brundige, Therapick’s founder and CEO, told me last year. “People have compared it to online dating.”

Research shows that online therapy can work just as well—and sometimes better—than in-person therapy. One study, published in 2009, found that patients treated for substance abuse reacted just as well to online counseling as to on-site counseling and greatly appreciated the added convenience. Another found that depressive patients who received online therapy, in addition to the customary care, were nearly twice as likely to recover than those who received only ordinary care.

“It may be that people are able to find a therapist who fits them better online,” says Goldenson. There’s also a disinhibition effect: Just as people tend to be meaner online than in person, they may also be more open and honest in online therapy. “I think there is something that helps people feel more comfortable, which is really important when you’re trying to deal with an issue,” he says.

It seems unlikely that teletherapy will replace in-person counseling altogether, but you never know. China’s growing love of psychotherapy, for example, is being facilitated by American shrinks who conduct sessions over Skype (MSFT), according to Evan Osnos’ fascinating 2011 New Yorker article. “Skype has become so routine among Chinese patients,” he wrote, “that Shmuel Erlich, an Israeli analyst, says he met a woman in Beijing who ‘was astonished that there was some other kind of analysis.”

Cwinter
Winter is a reporter for Bloomberg Businessweek in New York.

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