I live in the San Francisco Bay Area, so we are inundated with tech more than your average person. Most people I know are either working in tech of some kind or have a partner working in tech. I hear about research and development of therapy in terms of artificial intelligence and therapy by text quite often. It’s unfortunate that therapy is being pulled into the direction of automation and quick-fixes when I believe that therapy represents quite the opposite of those trends.
Therapy can be an oasis from the fast-paced, impersonal world of technology. I’m not against technology–I’m a millennial after all–I’m just concerned about how therapy and tech are coming together. I’ve been seeing ads on the streets for text message therapy recently. I imagine that this sprouted from the idea that therapy can be scary and time-consuming. However, this modality is leaving out what research says in the most important part of a successful therapy, which is a relationship. There is tons of research on the effectiveness of different types of therapy (Psychodynamic, Cognitive, CBT, Narrative, Attachment, etc) and the overwhelming evidence points to the relationship over the modality. To put it simply, if there is no relationship, there is no therapy.
Granted, there is a therapist on the other side of the text “therapy.” But how does one actually create a meaningful relationship built on trust, acceptance, and understanding if one never actually sees each other? We can’t actually hear tone through text. How many times do people who know each other very well, like a parent with a child, coworkers, or romantic partners, have miscommunications through texting or email? The written word is limited and I believe that therapy through texting is too limited to be effective.
Maybe some people feel more comfortable expressing their innermost secrets and feelings in an anonymous setting like text? That seems fair but I would challenge that. Therapy is absolutely a difficult endeavor. It pushes our limits when it comes to vulnerability. But in order to have deep and meaningful relationships in our everyday lives, we must be able to share our true selves. It doesn’t always feel good to share vulnerably, but often the payoff is worth the risk. We build meaningful relationships when we know we can trust the other person. If this is a difficulty for you, a therapist is exactly the person to work on this with. We can take things slow and deliberately in order to build trust. We can slow down when it gets overwhelming. We can talk about your fears and assumptions about what your feelings mean about you. We can talk about how you imagine I’m perceiving you. Therapists are trained to talk about these difficult topics and work through it. I’m skeptical this can be done over text. Seeing someone in person, or over video conferencing, is much preferred.
This begs the question: what can the tech industry do to support therapy in the modern age? I have many ideas about this. First I think that larger companies can invest in therapy for their employees. There are large companies like Facebook that are making it easier for their employees to access therapists on campus. However, I am concerned because the companies that they have outsourced to do the therapy only practice CBT and cognitive therapy which eliminates the possibility of access to other types of therapies. These companies are being funded by insurance companies, therefore they are keeping their bottom lines in mind, rather than actually providing diverse options that could better work for more people. Large, influential companies can push back and demand more diversity in the modalities being provided to their employees.
I believe that there should be in-house therapists that are hired directly by the companies to provide therapy to employees on a long-term basis, drop-in schedule, and also provide conflict resolution. Its good for the mental health of their employees and also promotes the retention of their workers, in particular women and people of color. HR is too limited to provides these services. Tech companies are paving the way for the future of work in America, and I believe that an investment like this would create change and opportunity for people wanting therapy all over the country.
When it comes to companies trying to change the fundamentals of therapy, I am extremely hesitant. I would rather see technology being used to promote therapy, making it easier for people to find a good fit therapist, and to help make it more affordable without the oversight of insurance companies.
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