Therapy by text? Yes, and that’s good

By Tomasz G. Sienicki [CC-BY-SA-3.0 (], via Wikimedia CommonsEarlier this year, Talkspace raised eyebrows when it raised $2.5 million in venture-capital funding for its platform linking therapists with clients by video or simple text messaging. The site offers video therapy for $29 for 30 minutes, or unlimited text-messaging contact with a therapist (that is, therapy by text) for $25 a week.

This is good. Here’s why.

Lots of us are too busy to work in a weekly therapy appointment, especially if it means travel time to a therapist’s office. And while private practitioners like me might gripe about downward pressure on rates, the people who aren’t paying what I charge usually aren’t cheap, they’re broke. Services like Talkspace and its competitors (like Breakthrough Behavioral) aren’t stealing away my in-person clients. More likely, they’re connecting clients with therapy who wouldn’t have the time or money to access a therapist through traditional face-to-face means.

Sure, we could have a whole separate discussion about whether face-to-face therapy is better than texting. I think it is. It’s not lost on me that studies of online therapy so far have focused on simple behavioral changes rather than severe or complex problems. Researchers haven’t looked at the effectiveness of online couple or family therapy, and with current technology I think such therapies cannot be as effective via technology as they are in person.

But I do think that when it comes to therapy, something is better than nothing. And clients of these services aren’t typically choosing between therapy via technology or a therapist like me. They’re choosing between the technology and nothing.

On the therapist side, it’s also beneficial. We can see clients when we choose, from the comfort of our homes (assuming we find ways to protect confidentiality). We don’t need to pay the overhead costs of an office. And we have paying clients through these services that we wouldn’t otherwise have — again, most of these clients are probably choosing between therapy via technology and no therapy at all. The pay rates may not be great, but for a therapist struggling to build a practice, it may also be a choice between something and nothing.

Something is better.