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A Teletherapy Startup Removes Barriers To Mental Health Care

Posted by timothy on from the more-than-a-nickel-though dept.

waderoush writes "Is the digital age sending the old therapist's couch the way of the reference librarian, the CD, and the travel agent? Could be: several recent studies have found that therapy via the Internet is just as effective as face-to-face treatment. But it's taken online therapy startup Breakthrough about four years to convince venture investors and insurance companies that online therapy can remove many of the road blocks to mental health care, including the high cost, the social stigma, and the difficulty of access. So far, Breakthrough has partnered with 100 licensed psychiatrists and psychologists in Texas, California, Virginia, and Maryland; every provider on the site has a profile and a welcome video that allows potential clients to evaluate them before they even talk online. 'Now we have greater research supporting telemedicine, and people are more comfortable digitally,' says co-founder and CEO Mark Goldenson. 'I think the market is ready for it.'"

22 of 102 comments (clear)

  1. I'm surprised this didn't catch on sooner. by Forbo · · Score: 4, Insightful

    Seriously, why the hell hasn't this already been a thing? I regularly engage in therapy, 99% of it is just discussion. Very little, if any, would be unable to be reproduced digitally.

    1. Re:I'm surprised this didn't catch on sooner. by Russ1642 · · Score: 3, Insightful

      And a lot of the people that would get help don't because getting therapy involves talking to their doctor about it, then booking an appointment, then leaving their house and interacting with the outside world.

    2. Re:I'm surprised this didn't catch on sooner. by HornWumpus · · Score: 4, Funny

      Bartenders are the best therapists.

      --
      John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
    3. Re:I'm surprised this didn't catch on sooner. by ThisIsSaei2561 · · Score: 5, Insightful

      Forcing people with social anxiety into uncomfortable situations is a piss-poor strategy. Mental disorders are not a "lack of skills", and it's beyond offensive that you would simplify it like that -- it's part of the reason we need remote care in the first place.

    4. Re:I'm surprised this didn't catch on sooner. by Russ1642 · · Score: 2

      I read that as "the only job you can get with a psychology degree is bartending"

    5. Re:I'm surprised this didn't catch on sooner. by anybody_out_there · · Score: 2

      There's a huge difference between seeing the doctor (psychiatrist) and therapy (with a psychologist or LISW). The doctor does the drug prescribing thing, the therapist helps work through other issues by helping develop 'coping skills' and the like, perhaps suggesting exercises to reinforce the process. It used to be that the doctors also did talk therapy, but that hasn't really been true for some time. Some good doctors will take the time to talk, but they still won't try to address 'therapy issues'. For example, I've got issues and stress (who doesn't?). Doctor says, if you didn't have the stress, would you still have mood swings? If yes, that's where the the medication (tries to) come in. As for dealing with the issues and stressors, doctor doesn't care, talk to the therapist. Now, don't get me started on the meds...... I do agree that a large part of therapy is what you do OUTSIDE the office.

    6. Re:I'm surprised this didn't catch on sooner. by xystren · · Score: 2

      There can be a problems with this, especially with tele/web-based/distance therapy. The resources to intervene within a crisis environment do not exist. For example, if someone is suicidal or homicidal, how does one intervene appropriately? What if a patient/client in a tough situation (ie divorice) and their coping skills are less than adequate, and they just terminate the session after stating "they hate their spouse. There is no way to ensure that the patient is safe. Even a 911 call to the police for a wellness check, the 10-12 minute response time is not immediate enough for crisis intervention. This could potentially setup any therapist using this type of session to have there A$$ sued off, even more than they already are.

      Certain patients/clients would be appropriate for this type of delivery for therapy - Any of the various paranoid flavored diagnoses would likely not work well (after all, we all used to be called paranoid when we thought the NSA was tracking our internet usage eh?). Border-line personality disorder are extremely difficult to work with in the first place... they can go from I love you, to I hate you in seconds - try and deal with that over the web, when their first instinct will be to disconnect the session. Leaves the therapist in an extremely vulnerable situation.

      The other issue is, as a therapist, you don't have control over the environment. What about the phone ringing during a session, or the young child that constantly wants to see mommie or daddy or the or the interruptions from the over-caffeinated teenager? Often people in therapy are lacking in coping skills and/or boundaries. That is where the office visit will be superior, because those boundaries are more clearly defined.

      The security/confidentiality/privacy of sessions would be extremely difficult to keep under control. Most relevant code of ethics have specific rules (and not to mention federal and state regulations) regarding this. If you are cross-state, which laws apply? Those of the therapist, those of the patient, or a blending of the two? In this regard, the duty/responsibility generally falls onto the therapist - talk about a liability nightmare.

      I'm not saying this method of delivery is not completely without value... there are circumstance that make it necessary or even desirable. Long distance, and/or limited access to mental health services, those that are constantly traveling for work, etc. would be some examples. In my own practice, this method of delivery would only be used in limited and very specific circumstances.

  2. Tell me about... by msauve · · Score: 2

    Eliza, is that you?

    --
    "National Security is the chief cause of national insecurity." - Celine's First Law
    1. Re:Tell me about... by Forbo · · Score: 3, Funny

      More like Dr. Sbaitso.

      xD

  3. Anyone else... by barlevg · · Score: 5, Funny

    Did anyone else at first misread that first word as "Telepathy?" Because a Telepathy-based start-up for addressing mental health issues... now THAT would be cool.

    1. Re:Anyone else... by Russ1642 · · Score: 2

      That would be cool. I could sit with Deanna Troy all day.

    2. Re:Anyone else... by funwithBSD · · Score: 2

      That's Commander Cameltoe to you!

      --
      Never answer an anonymous letter. - Yogi Berra
  4. Incoming Snark! by girlintraining · · Score: 4, Funny

    Yay! Now I won't have to leave the basement to get my prescription for my social anxiety! Thank you internet!

    --
    #fuckbeta #iamslashdot #dicemustdie
    1. Re:Incoming Snark! by Russ1642 · · Score: 2

      Historically, the flying machine has just been a stupid pipe dream. We shouldn't even try building one.

    2. Re:Incoming Snark! by Sarten-X · · Score: 2

      For electroshock, a stunt plane. It's built for one specific rare job, which it does pretty decently, but it's absolutely the wrong tool for every other job. In fact, treating it as the solution to everything will have disastrous, if not lethal, results.

      For phrenology, the Spruce Goose. It made it big, but was utterly unsuccessful, and existed solely on the hope that it would work.

      --
      You do not have a moral or legal right to do absolutely anything you want.
    3. Re:Incoming Snark! by kamapuaa · · Score: 2

      Therapists can't prescribe drugs, you have to go to a psychiatrist for that. Psychiatrists center around diagnosing mental problems and prescribing appropriate care, therapists are about talking problems out.

      --
      Slashdot: providing anti-social weirdos a soapbox, since 1997.
  5. Confidentiality by Blue+Stone · · Score: 5, Insightful

    Unfortunately no therapy transacted over the internet or the telephone system can, these days, be said to abide by the confidentiality agreement the therapist is supposed to abide by.

    --
    Corporation, n. An ingenious device for obtaining individual profit without individual responsibility. - Ambrose Bierce
    1. Re:Confidentiality by fa2k · · Score: 2

      I love the comment, great to bring it up, but it's slightly hyperbolic. NSA haven't broken encryption (that we know of).

      - They have access to all communicated data, but only the ciphertext if it's encrypted. This means that they can know when you "went to" the psychiatrist on line. The authorities could already learn this from security cameras and cops. It would be easier, though, to search for people with mental problems and to answer whether a given suspect has had therapy.

      - SSL security may be circumvented by the NSA having private keys for some big certification authorities. Blind use of SSL could be subject to man in the middle attacks, but the startup could write their own certificate validation code which only accepted their own certificate (if it's not a web app). Or not use SSL, but it's easy to get things wrong if re-implementing a SSL system

      - The NSA could do traffic analysis to learn more about the content of the communication. For example, if people are moving or talking on video chat, the bandwidth goes up. Same with text chat, but due to the low overall bandwidth, the application could just transmit padding at a fixed rate for text chat (and maybe audio too)

      - The NSA could replace the installer with a back-door'ed one. The startup could implement some DRM-like consistency checks to increase the time it would take to make a back door. Also post the checksum on some (can't remember what it's called) independent channel from where the download files are

        So it's still possible to have confidential communication over the internet

    2. Re:Confidentiality by nbauman · · Score: 2

      Unfortunately no therapy transacted over the internet or the telephone system can, these days, be said to abide by the confidentiality agreement the therapist is supposed to abide by.

      What confidentiality agreement?

      When Monica Lewinsky's therapist handed over her therapy notes to Kenneth Starr, that was the end of client-therapist confidentiality in the U.S.

      HIPAA explicitly allows therapists to disclose information for law enforcement purposes.

      Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; or to identify or locate a suspect, fugitive, material witness, or missing person. https://en.wikipedia.org/wiki/Hipaa

  6. Internet is just as effective as face to face by nitehawk214 · · Score: 2

    therapy via the Internet is just as effective as face-to-face treatment

    Meaning, it still isn't very effective... but at least it is cheaper. Why not give it a try?

    --
    I'm a good cook. I'm a fantastic eater. - Steven Brust
  7. Re:in other words by CanHasDIY · · Score: 2

    I don't know about therapy in general, but I did find some interesting material about pseudoscience in mental health.

    Anecdotally, my parents sent me to a child psychologist when I was about 8, presumably because I wasn't handling their divorce the way they expected (I wasn't bothered by it because I knew everyone would be happier that way, which is apparently considered quite an odd attitude for a kid that age)... While I question the validity of sending a rather well-adjusted kid to such a professional, it was nice to have someone outside the family I could talk to about stuff.

    I will say, though, the increasing prevalence in diagnosing children with previously unheard of conditions does seem to be an excuse to avoid taking responsibility by doping the poor little buggers out of their brains. Considering that most of the mass killings in recent history has been performed by people who have prescriptions for mood-altering drugs like Zoloft, it's fair to question the validity of today's mental health diagnosis, as well as the system in general.

    --
    An enigma, wrapped in a riddle, shrouded in bacon and cheese
  8. NSA screws up this idea... by superdave80 · · Score: 2

    Everybody who would like their private therapy sessions recorded and stored by the NSA raise their hands.