Don’t get your Therapy from a Big Box Store

If you use social media and have searched for anything related to mental health, you’ve likely come across advertisements for  Mental Health Teletherapy companies. These companies promote psychotherapists who are in-network with insurance and are often described as  “available now!”  featuring flashy sayings and appealing logos. For instance, the Better Help website boasts 35,000+ licensed therapists who are “ready to help.” Similar sites like Alma, Headspace, Regain, TalkSpace, and Cerebral are rapidly gaining traction in the psychotherapy market, capitalizing on the growing awareness of mental health as an important issue.

 Access to quality mental health services is a huge need for many in this country. Online therapy offers a great deal of opportunity and convenience, leading corporations and investors to jump into the mental health market. 

During the Pandemic, temporary laws allowed clinicians to provide services to clients across state lines. Once the National Emergency ended, these exceptions were lifted, and mental health clinicians are now prevented from seeing clients outside of the state(s) in which they are licensed. This makes it difficult for both clients and clinicians to continue to see their current therapist if one moves out of state. Despite some nationwide “compacts”, all states are not included. Now, a clinician must be licensed in the state where the client is currently residing. Which is costly as each state requires different continuing education requirements and their own licensing fees. If you choose to accept insurance, it is a lengthy process to get credentialed and become an in-network provider. 

As a therapist, I receive weekly recruitment emails to join one of these venture capitalists-backed online platforms which boast sign-on bonuses, easy insurance credentialing, and flexibility! The only requirement for working with these websites is that you hold a valid license to practice in your State. Many of these companies have minimal requirements for their clinicians other than multiple forms to complete. Additionally, many of these companies do not interview their therapists or require any specific screening if one has an active license. 

There are significant concerns regarding the qualifications and suitability of therapists on some platforms. Once you are connected with a therapist, these companies have the ability to terminate clinicians without any prior notice. There have been stories of therapists being let go from these platforms without informing the clients ahead of time. Imagine signing in to your scheduled session only to find that the clinician is not there, and you are never able to connect with them again. Most clinicians’ code of ethics encourages what’s called a “termination” or ending session to provide closure and prevent emotional harm to the client. Last June, Headspace laid off 33 therapists with no warning and clients were not informed of what happened to their therapists. Aside from this being a huge ethical violation, it can cause irreparable damage to clients struggling with attachment or trust issues.

Large corporations also have bargaining power to negotiate higher reimbursement rates for their clinicians than those solo practitioners in the same market with the same experience. This is another ethical gray-area.  These companies are partnering with Amazon, Carefirst, Cigna, and others in order to cut costs to insurers by offering bulk billing. With their substantial advertising budgets, they can push their clinicians to the top of various therapist directories.  Venture capitalist companies are working hard to “disrupt” the mental health industry and make it as profitable as possible for their investors. 

“But I need to use my insurance to pay for therapy and these apps are so easy!” Yes, I completely understand. However, just as you wouldn’t get your college degree from Costco, it’s essential to research the source of your mental health services. There are PLENTY of good, local in-network psychotherapists out there (I was one of them). It may also be easier to get reimbursed from your insurance for services than you think. We have questions on our website that you can ask when you call insurance to find out more information. 

Despite the convenience of all these services, keep in mind that you are sharing your information with a large Corporation, and that can come at a price. Not just your data, but you are also turning over your sensitive mental health information to a corporation. In 2023, BetterHelp was required to pay $7.8 million in fines to consumers for selling personal information to social media platforms like Facebook and Snapchat for targeted advertising. Talkspace has faced class action lawsuits for sharing user data with TikTok and using deceptive practices when matching clients with therapists. Class action lawsuits have also been filed against Headway and Lyra for selling personal data. 

Remember, when you see a local psychotherapist, you are supporting a small business and your local economy. Additionally, seeing a therapist in your community or one who is not involved with a large corporation means that it is unlikely that your data will be sold. Private therapy practices set their own requirements regarding required paperwork and forms. When therapists are not contracted with insurance companies, they are only required to share minimal information—such as the date of service and type of service—with the insurance provider.  You have the option of not submitting at all to ensure total privacy. 

While I personally think it’s wonderful that so many more folks are accessing mental health services, many don’t know how to start looking for a therapist.  It’s important to “shop around” for a mental health provider that fits your needs. Oftentimes, if people have a negative experience with a psychotherapist, they may not return to therapy in the future. Therefore, take time to research when choosing a mental health therapist. If you were shopping for anything online, you would read the specs, reviews, and side-by-side comparisons. Ultimately, dedicate more effort to selecting a therapist than you would when buying a blender.