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Online Therapy With Talkspace

A lot of psychiatrists and therapists ask me about good telemedicine options for them. As of 2019 there are quite few such options available. I wanted to highlight Talkspace which is a messaging based online therapy.

The idea behind Talkspace is to have the therapist and patient interact asynchronously. What made voicemails, email, and text messaging so popular is that they aren’t intrusive.

I couldn’t find out if psychiatrists can offer therapy (or meds) on their platform as well. Let me know in the comments if you find out.

Efficacy of Online Therapy

One of the first complaints clinicians have with telemedicine is that they believe that a healthy patient-clinician interaction is done face-to-face. Telehealth screams to them, “The British are coming, the British are coming!”. Healthcare has been commodified. It’s a consumer driven business and we are the suppliers.

Talkspace cites a few studies where internet-based therapy has been successfully utilized for women with eating disorders through online discussion groups.

Talkspace has published their own whitepaper using a group of 63 participants and measured their overall improvement after their text-based therapeutic intervention using a GHQ-12 questionnaire.

They also link to a Lancet article from the UK where patients were given CBT either in-person or through an online text-based interaction. All these studies show that online therapy is effective.

Talkspace Online Therapy Model

So yeah, you basically chat with a therapist online. They offer payment packages on a weekly basis, somewhere in the $50-80/week range (billed monthly). It’s mainly text based but you can also send audio or video recordings to your therapist.

You can even do a live video chat but that doesn’t seem to be the core of their model (30 minutes for $80). Perhaps this is a nice upsell for a client.

It’s very clever because once you stop your weekly payment, you’d probably have to start all over again with a new therapist.

I’m not sure if they allow for psychiatrists to prescribe medications. In fact, I have a lot of questions about their service which I couldn’t resolve with their website alone. I reached out to their media team but it’s rare to get anything useful back from media contact.

They advertise the following services for their clients. I’m not sure why sex therapy isn’t included because that’s very sought after online. Same with biofeedback. Maybe they are trying to come across a little more conservative, which is understandable.

  • teen therapy
  • couples therapy
  • social media dependency therapy
  • eating disorders
  • LGBT
  • PTSD
  • Addictions
  • Depression/Anxiety

Talkspace Therapists

Their website lists the following qualifications for therapists. It doesn’t include physicians, so maybe it’s no bueno for your docs. But I suspect that they will need to expand into that realm eventually.

  • LPC
  • MS
  • LMHC
  • LMFT
  • LICSW
  • PsyD
  • PhD

Future of Mental Health

The future of mental health will likely include some sort of technology to deliver therapy. With this supposed opioid epidemic, a lot of addiction medicine is going online. Trade one drug for another and make money; until the government blames physicians for another epidemic. (To all you therapists, you’re welcome.)

Artificial intelligence is also huge in the mental health space – at least in terms of research. AI chat is still a few years away from being a meaningful service to patients but it’s where everyone is banking their dollars.

It seems logical that some customers will want to see their therapist in person while others will prefer to chat with their therapist online. It’s great for the patient to talk from the safety of their home and it’s perfect for the therapist who wants to be location independent.

Physician Opportunities

If you’re interested in this space, you could consider carving out a healthcare consulting niche for yourself. I would start by working on as many platforms as possible. This is a great way to pad your resume and gain expertise.

Next, you can collect all the relevant research studies and summarize them beautifully on a website. Any commentary you might have could help demonstrate your voice to your potential consulting clients.

Personal technology, specifically for biofeedback, will likely play a big part for patients in the future. Sensors are becoming more advanced and will soon be marketed directly to consumers.

Finally, you don’t need to be a therapist for someone else. Using a platform like VSee, you can build out your own therapy platform and focus on a particular niche.

2 Comments

  1. I saw a recent add for a job for family docs on a platform called FasPsych to basically do confirmatory evals of previously existing Psych disorders. You don’t do the prescribing. You basically sign off on whether or not you think the patient meets criteria for their stated diagnosis. Because of the niche nature of Telemedicine right now (I agree it can only grow), there always seem to be some sort of abnormal workflow which seems gimmicky and makes me nervous. I haven’t branched out into it, but it is certainly tempting.

  2. I’m weary of these sign-off types. I have a consulting client whom I’m firing for this exact reason – they are switching to have FP’s sign off on anti-depressants based on their AI algorithm. I really don’t think it’s unethical but it just doesn’t sit well with the current atmosphere of telemedicine and I think it’ll expose the FP docs to too much risk.
    But there are so many great opportunities right now to make good money doing really good work for telemedicine patients. I just published my new course “Faster Telemedicine Visits” and I talk about decreasing risk, increasing speed, focusing on triaging rather than diagnosing, and decreasing prescribing rates. I hope that it helps a lot of docs out especially on medication mill platforms like Teladoc.

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