Buyer Beware When Choosing an Online Therapy Service

People are often surprised to learn that researchers have been investigating telehealth and online therapy far before the pandemic started—for more than 30 years, to be exact. But despite the evidence on online therapy demonstrating that it can be as effective as a face-to-face treatment, people have been reluctant to try it out, with both therapists and the public worrying that it wasn’t as good.

The pandemic changed that.

As the world shut down and everything was forced to shift to virtual, including telehealth, everyone’s comfort with digital medicine shifted in a more positive direction overnight. An APA survey shows the increase in telehealth after the start of the pandemic, and this did not go unnoticed by the tech industry. A record 5.5 billion dollars was invested in 2021, according to CBInsights. Since then, more than 20,000 mental health apps have become available to download to your phone, with a slew of companies promising to help you with your mental health—through therapy or counseling—at a fraction of the cost of traditional mental health providers.

While this offer may sound tempting, it’s important to be aware of the risks before you sign up.

When you pay for a therapy session with a regulated health care professional, you are not only paying for the session but for their office space, liability insurance, professional fees, documentation time, telehealth platform, computer equipment, taxes, sick time, vacation time, and more. It’s not cheap, but it is in line with what most consultants need to charge to make a living.

Some companies will only charge you $25-$90 per week for something that costs $200+ with an individual therapist. A quick search on Indeed.com or Glassdoor will show that most therapists working for the bigger mental health platforms complain about being underpaid (often around $20-$30/hr) or are late receiving their payments or have surprise deductions.

More concerning are the accusations about mining the data collected from therapy sessions and selling it to third parties who will use it to target ads to you. But what about Health Insurance Portability and Accountability Act (HIPAA) and patient-therapist confidentiality? You need to do your research. If the data was collected by the company and not by your therapist, that might be the loophole they use to select some of your data for sharing with third parties. They may also anonymize or de-identify your data and say there were no breaches, although it is theoretically possible to link up the de-identified data with another data set and figure out who you are.

One of the biggest dangers of using these services is that you may not be getting quality care (even if the therapist they hired is trying really hard to provide that quality care). These companies are often more interested in making a profit than in providing effective treatment. Their goal is to keep you engaged and keep your subscription payments going.

Some therapists have reported that they were encouraged to upsell other features offered by the platform they worked for (something many of our regulatory bodies forbids us to do). Some platforms make money by also selling and shipping medications prescribed by their online psychiatrists. Mental health programs shouldn’t be making a profit from the sale of products or treatments they recommend. If you make extra money selling a drug, then there is the risk of overprescribing.

Before you enroll in any digital mental health service, do your research.

Make sure you understand how the company will use your data and what security measures they have in place. Look at reviews on job sites to see what therapists or employees have to say about working there. You can do a google search on “name of platform” and “ethical issues” or “complaints” or “privacy.” You don’t have to be an expert on telehealth or tech to see if there might be any problems with a service that you decide to use.

You will find stories of dubious therapists with unverified credentials, complaints of unresponsive therapists, hidden charges, loopholes in the use of your information (e.g., that the platform matches you with a therapist and doesn’t provide the therapy—so the initial data they collect on you isn’t protected by health care privacy laws). And the list goes on.

And most importantly, remember that you are the expert on your own mental health. If something doesn’t feel right, trust your instincts and seek help from a qualified professional. Working with a registered therapist protects you in many ways—they are required to follow strict ethical guidelines, they can’t upsell you on products or services, and if there are any concerns about confidentiality or safety, you have avenues to pursue.

When it comes to digital mental health services, buyer beware. Do your research and make sure you understand what you’re getting into before you sign up for anything. Digital mental health services can be a great resource, but it’s important to be an informed consumer. By doing your research and being aware of the risks, you can make sure you’re getting the best possible care for your needs.