BetterHelp — For better or for worse?

BetterHelp specifically is a low-cost option that many universities and organizations partner with to provide counseling to large communities. As of September 2021, Northeastern University is offering BetterHelp as a referral option, advertising 20 free weekly sessions for its students and faculty. 

Online teletherapy platforms are merely a fragment of the telehealth realm, and should not be confused with teletherapy as a whole, which is broadly defined as counseling over the phone and online. Teletherapy is widely used, becoming a post-pandemic standard for counseling. According to a 2021 TIME poll, 58% of Americans using mental health services have met with a therapist over video or audio call in the past year. 

Drawbacks to teletherapy are widely understood — in the virtual realm, interfaces are difficult to navigate and personal contact is difficult to replicate. Yet in a world where workplaces have migrated online, a remote option for therapy is not too far outside our collective comfort zone.

The need for mental health professionals is high, which Andrew Ferrante, a licensed counselor in Boston, attributes to the “stressors of the COVID-19 pandemic.” In a 2020 survey conducted by the American Psychological Association, or APA, a third of U.S. therapists reported that they are seeing more patients overall. 

On virtual platforms like BetterHelp and Talkspace, enrollment is also spiking. BetterHelp reported a 60% increase in its user base in the past year, reporting over 2 million users as of October 2021. But Ferrante notes that some reliable mental health solutions do not always translate to large-scale online platforms like BetterHelp. 

“There is a difference between a private practice approach where you schedule with one therapist pretty consistently, versus using a service where you have various and sundry experiences,” Ferrante said.

On BetterHelp, users create an account and fill out a questionnaire concerning preferences that they may look for in a therapist, such as gender identity, age or counseling specialities. That user is then matched with someone who fits one or more of those qualities. MacKenzie Stuart, a care manager at Find@Northeastern, said that this option is a time-efficient alternative to searching for a private practice therapist.

“We are finding that private practice therapists in Boston have been overbooked because of COVID. It’s not as timely for students who may be looking for care,” Stuart said.

This year, according to a nationwide APA survey of psychologists, 81% of respondents indicated that they continue to see between 75% to 100% of their patients via telehealth. 

Diana Appell, a marriage and family private practice counselor in Boston, completely abandoned her in-person private practice in the wake of the pandemic. Appell’s services are now offered completely via video conferencing, and she does not use the therapy-by-text feature found on many teletherapy platforms. 

“I’m not going back to an office, I’m all-virtual. I’ve figured out how to work virtually in a way that is as efficient as my in-person sessions used to be. I can manage it, but I recognize the limitations,” Appell said. 

Appell explained that her patients prefer to stay virtual since many of them have already adjusted to working from home. While the virtual format provides flexibility for both private practitioners and patients, Appell said that private practice therapists are becoming harder to find due to an increased need for mental healthcare.

“I have so many referrals that I just can’t take any more,” Appell said.

The need for therapy has grown exponentially. According to a 2020 study by the APA, nearly 70% of U.S. psychologists with a waitlist reported that it had grown longer since the start of the pandemic, and 40% reported being unable to meet the need for treatment. This is where virtual telehealth services come in — their virtual interfaces make it easier to get in contact with a therapist at all.

“At one point, there were only two counselors in the Boston area that had availability. Since most private practice counselors in the area are doing virtual counseling anyway, BetterHelp is a solid option for our students,” Stuart said. “From the time you make the account and get matched with a therapist, it’s 24 to 48 hours before you can start [scheduling sessions],” Stuart said.

However, Prifti said that BetterHelp’s quiz-like interface that matches users with therapists was not as effective as the app promotes. 

“I really wanted a woman or gender-nonconforming therapist, and I just kept getting matched with men,” she said. Prifti ended up filling out the questionnaire multiple times before finding a therapist she felt comfortable talking to.

While problems with telehealth platforms are easy to identify, Ferrante admitted that there is a hesitancy for many in pointing out the benefits of telehealth therapy as a whole. The advent of telemedicine for mental health has brought about an easy method of care for those who may be unable to attend in-person sessions.

“Folks who experience a great deal of social anxiety or even some folks on the autism spectrum have benefited a bit from the new context — being able to pull up their therapist on their computer, and not have to get on the subway and manage all the social stimuli that come with that,” said Ferrante, who has a focus in addressing the needs of those on the autism spectrum.

Ashley Brown, a second-year biochemistry major, has used BetterHelp since January 2021. Brown said having BetterHelp as a resource put mental health solutions at her fingertips.

“I think the convenience balanced out my experience. It’s Zoom fatigue, instead of the fatigue of having to travel to a place and have that take an extra 30 minutes of my day,” Brown said.

Prifti explained that the accessibility that platforms like BetterHelp bring, especially for students who may be struggling financially, is beneficial in the long run. 

“I wouldn’t say I had the worst experience with BetterHelp. When I have friends that are like, ‘I can’t find a therapist right now,’ I do recommend it, especially if they’re students. I say, if it’s free you have nothing to lose,” Prifti said.

Additionally, Stuart said that the school actually offers unlimited free counseling through BetterHelp, which is a sweeping move for accessible mental health resources, but does not want to make that information widely known.

“It is unlimited, but we don’t advertise it as such. We give the students 20 sessions to start due to the chances students could call for multiple referrals. If students need more than 20 sessions, they can let us know privately,” she said. 

But no online therapy service is perfect, and BetterHelp provides a different experience than one could find, virtually or in person, through an independent therapist. Prifti has now switched to a private practice therapist that she continues to see virtually — every Monday.