My Computer, The Therapist: Is Digital Counseling the Next Big Online Frontier?

Who needs to trek to weekly appointments when you can “see” a therapist online?

By Ginny Graves

It’s 2:56 a.m., and I’m sitting in my bedroom armchair, listening to my husband’s steady breathing and gazing at my side of our extralong queen bed. It looks so inviting in the moonlight, with its tousled duvet. But I can’t crawl back in. Raphael Rose, Ph.D., the psychologist who has been working with me on my chronic anxiety, would forbid it. Just yesterday he said, “If you can’t sleep, get out of bed—and don’t go back in till you feel tired.” I wish I could ask Rose to consider making an exception, but he and I aren’t in the habit of discussing my problems. We’ve never even met. He’s the shrink in SMART-OP, a cutting-edge computerized program I’ve signed on for.

I saw an in-the-flesh therapist last year. Alice. She had a spot-on sense for when to probe and when to pass the tissues. I adored her. But I am perennially juggling numerous assignments, and committing to a regular weekly appointment is nearly impossible. That’s the reason I quit seeing her, and Stefan a few years ago, and Diane some years before that. So when I read about the surge in digital therapy—every session just a security code away—I figured, why not?

In the U.K. the approach has been adopted by tens of thousands of people; now it’s gaining a foothold in the U.S. “Busy women who don’t have time to squeeze in a weekly appointment with a therapist are particularly interested,” says Kathleen Carroll, Ph.D., the Albert E. Kent professor of psychiatry at Yale University School of Medicine. “It’s an obvious choice for digital natives,” says Kate Ryder, 33, who launched Maven, which puts an Uber spin on mental health. The app charges $70 for a 40-minute video chat with a qualified psychologist or a psychiatric nurse practitioner authorized to prescribe medication.

Until recently, the office visit was sacrosanct. Technology entered the picture only if you had to make an emergency call to your shrink when she was vacationing on Cape Cod. Now even some old-school therapists see patients by video. Though the American Psychological Association has voiced privacy concerns, “I like Skype appointments because they allow me to see a more relaxed side of my patients,” says Dora Attermann, M.D., a psychiatrist in Larchmont, New York.

No one who is seriously mentally ill or suicidal should attempt to replace her therapist with an avatar or a spot of FaceTime, cautions Renée Binder, M.D., president of the American Psychiatric Association. But for high-functioning types afflicted with mild depression, insomnia, or—as in my case—anxiety, computer-based therapy can be constructive. After considering options including mood-tracking app Moodnotes, and Talkspace, an app that offers on-demand therapy in a video chat or text, I came across what looked like a promising fit on the UCLA Anxiety and Depression Research Center’s site. SMART-OP stands for Stress Management and Resilience Training for Optimal Performance. Currently, it is being put to the test by a mission-control crew at the NASA Johnson Space Center—the team responsible for shepherding astronauts safely through the outer realms. (If stress were an Olympic event, they’d be going for the gold.)

SMART-OP utilizes cognitive behavioral therapy, or CBT, an action-based approach that helps patients identify unproductive thinking and change behavior. The program’s to-the-point-ness appealed to me, as did the absence of live conversation, which can sometimes move in endless circles.

This excellent article was originally published here – http://www.vogue.com/13404798/digital-counseling-therapy-online-app/


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