Tech is Changing & Therapy is Too

Welcome to my website, and to my blog!

I've tried many times to maintain a presence in the blogosphere, but I've always struggled to be consistent in getting my thoughts on paper. But while I can't promise consistency, I can promise honesty. Thanks for joining me on this wild ride.

Back in my day...

When I started practicing therapy after finishing grad school in 2014, life looked very different than it does today. To paint a picture of what's changed, it may help to share a snapshot of the technological world over a deacde ago. Here are a few factoids about the landscape I faced as I entered the therapeutic world:

• Apple had just launched the iPhone 6

• The "influencer economy" wasn't yet influencing people

• ChatGPT was a figment of the tech world's imagination

• Candy Crush and Clash of Clans were all the rage

• Facebook hadn't yet gone the way of dinosaurs

The field of mental health in 2014 also looked dramatically different than it does today. Back then, many folks were still using paper charting systems, some therapists had basic websites but word of mouth and networking were the primary source of referrals, and it didn't occur to any of us to be fearful of AI taking our jobs down the road.

Therapy in 2014 was generally in person, (mostly) affordable, and fueled by therapists themselves. It wasn't perfect by any stretch of the imagination, but it was a career I truly loved.

The dawn of the BetterHelp era...

And then, along came venture capitalism.

Somewhere along the way, someone realized that there is money to be made (or, more accurately, extorted) from people who need help with their mental health. So in they came with their deep pockets and general lack of clinical knowledge or ethics to create large-scale "discount" therapy.

Leave it to capitalism to drag a good thing through the mud, am I right?

Before I move on, I want to be clear that I am in no way saying that therapy shouldn't be affordable or accessible. What I am saying is that we could have had (and have had) both of those things without venture capitalist-backed companies monopolizing the mental health space. Also, for legal purposes, these are all my personal opinions so please take them as such so I don't get sued. Thanks!

Anyway... BetterHelp and its peers have altered the ecosystem for therapists in some really big ways. To understand why they've had such an impact, it's helpful to understand how these companies generally work.

Step 1. Venture capitalists give money to create platforms.

Step 2. Platforms negotiate special rates with insurance companies.

Step 3. Platforms recruit therapists with promises of high pay and consistent work.

Step 4. Platforms spend millions of dollars to monopolize advertising spaces and get clients.

Step 5. Platforms deliver low-quality care from overworked professionals, often with an astronomical amount of disorganization, confusion, and unexpected financial burden that lands squarely on therapists and clients.

There are many examples of these types of companies being sued or getting bad press. Just a few of the many kerfuffles thus far include things like platforms initially offering therapists high pay but then cutting rates later on; platforms making errors with benefits checks leaving clients with hundreds in unexpected bills; individual therapists being unable to access advertising due to financially-resourced platforms thoroughly dominating the algorithms and SEO; and major privacy concerns related to where personal information about therapists and clients is being stored/sent.

I recognize that some people have had great experiences with these platforms, and I think that's fantastic. But, personally, the cost-benefits analysis (for therapists and clients, anyway) is really only pointing to one conclusion: these companies care too much about profit to put people's mental health first in the ways they should.

The impact of AI...

And, if that's not already enough chaos to get used to, let's introduce AI into the mix!

I promised you honesty, and I intend to deliver. Iniitally I was really excited about AI. It promised to ease my workload by taking burdensome tasks off my plate-- who wouldn't be excited by that? It didn't last long (one post to be exact), but I even tried using AI to help create content for this blog. I know, I know... but before you judge me, please understand that I immediately got the ick and took down my blog to re-think strategy.

Despite general advice in the field being to utilize these tools, I personally find them to be clunky, inauthentic, and a danger to both privacy and our overall ethical responsibility as helping professionals.

In this political climate, with information being weaponized against people in increasingly concerning and violent ways, I'm not sure how therapists are finding any sense of comfort in the idea of allowing AI to record sessions to generate notes. Or how any AI-using therapist can maintain strong ethics while knowing that this technology is contributing to everything from environmental destruction and colonialism to psychosis.

What the future holds...

Am I afraid that venture capitalists and/or AI will take my job? Kind of.

While I don't believe that AI will ever truly be able to replace the human element of therapy, I do worry that we will be forced into systems that leave us with limited options. If it's all about profit and we allow ourselves to abandon ethics, depersonalized mass-scale therapy and ineffective/dangerousAI therapy may be the only options left to us.

And that leaves me asking myself where we will choose to go from here.

I can't speak for anyone but myself, but despite everything, I do still have hope for the future. I have hope in humanity and hope in my community. I keep that hope close to my heart and protect it as the precious thing it is.

One of the beautiful things about this job is that I get to see good people doing good things every single day. I see therapists leaning into the chaos and finding ethical ways to go with the flow. I see them prioritizing the wellbeing of clients and the crucial, human parts of this work. I see clients showing up with a willingness to invest time, energy, and finances into therapy that acutally feels authentic and connected. I hear about them engaging with their friends and families outside of sessions, helping to prop one another up through a storm that often feels apocalyptic.

It is true and unavoidable that technology will continue to change, so we'll have to be flexible to avoid collapse. We will have to be discerning enough to find the good in technology, and disciplined enough to release the bad (no matter how tempting). But where I lack faith in capitalism, I have abundance of faith in the people sitting right in front of me.

At the end of the day, I trust that we will get through this together. One technology at a time.