Textual healing

A new trend in therapy is modern, convenient and affordable. Bonus: you get to sit on your own couch.

A new take on therapy

When Luyanda Vonai, 21, moved from Joburg, SA, and started university in California, US, she was overwhelmed with stress and anxiety. There was the culture shock, which led to increased social anxiety and panic attacks, then loneliness and self-doubt. After six months in her new city, she felt stuck and out of place. “It seemed as if everyone else at university was happy and fitting in, and I wanted that for myself, too,” she says. She’d seen a therapist as a teen but didn’t find it helpful, and the idea of trying again felt daunting. Yet she was intrigued by Betterhelp (free on IOS and Android), an app that offered a different kind of counselling – via online messaging. After being matched with a therapist, Luyanda started tapping out her worries on her laptop and phone, then waiting for a response (which usually came within 24 hours). “It felt like writing an email to a close friend, yet there was also that sense of professionalism,” she says.

Companies like Betterhelp and Talkspace (free on IOS and Android) are Uberfying psychotherapy. They connect subscribers with licensed mental-health professionals who have at least a master’s degree as well as clinical experience. Each therapist has favourite methods, so users may be asked to talk about their dreams, childhood, behaviour patterns, moods or goals. But unlike a traditional session, conversations don’t always take place in real time.

The delayed response can be a bonus. “In face-to-face therapy, some people talk just to fill the time,” says Nicole Amesbury, a licensed mental health counsellor on Talkspace. Online clients respond at their leisure, and Nicole says she has more time to formulate her response. She still tries to accommodate clients who need a back-and-forth. In the evening, when one client is tempted to call a manipulative boyfriend, Nicole encourages the client to message her instead (typical sessions on Talkspace can range from R160-R600). Nicole admits that connecting online is different – she can’t express empathy by just nodding her head or looking into a patient’s eyes. But she says that through writing, a deep and personal connection can be formed between her and her client.

And messaging may actually help patients open up. One recent study, from The New School for Social Research, found that people give more frank answers to sensitive questions via instant message than phone interviews – likely because they don’t have to answer as immediately.

Online clients might start feeling better as soon as they hit send. Research has shown that people who engage in deep and meaningful writing report increased well-being and reduced anxiety. While the writing in these studies was done on paper, one might conclude that the effects of online therapy would be similar.

Mental-health experts say that mobile therapy is promising, but so far unproven. While there’s been evidence supporting video-based therapy, the message-based kind hasn’t been studied as thoroughly. What’s more, therapists are trained to use their senses to assess clients. Instant messaging or email doesn’t give them a complete picture of your mental health.

Online therapy may not be a good fit for those who crave therapy’s human contact (though it can be used as a supplement). And neither Talkspace nor Betterhelp is intended for people with a mental illness like bipolar disorder, or who are in crisis or want to try antidepressants (counsellors are trained to recognise when a client needs a referral to a specialist or the ER). As in real life, it’s important to find a good match; if you’re not happy with your online therapist, you can switch.

Nearly two years since Luyanda ‘met’ her therapist, she’s adjusted to her new life. At first, she was messaging every day, then twice a week. Now it’s down to once. Still, she says, “I like knowing I can message her anytime something comes up.”