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19/11/2022 Therapy AppsYou'll have had to be living on Mars to avoid a widely advertised therapy app. Technology generally improves people’s lives, and it’s worth knowing what you’re getting. 'Licensed therapists’ don’t exist in the UK but the wording is a clue to the disruption model that apps like these use. Disruption models seek and exploit niches within established models, which often makes things much more convenient for the customer: Uber, streaming platforms, Just Eat, AirB&B have made, taxis, TV, takeaways and holidays more competitive. Then when these models become ordinary in our lives the terms and conditions change, and we may feel pressure to pay more for a convenience that a couple of years previously we didn't know we needed. Disrupters don’t initially need to know any professional nuances, they focus on how far they can push profit making and cost cutting before they make an expensive mistake. "Move Fast And Break Things". That's fine when you're working with code but has very different implications when what you're disrupting is how children in the care of the state are managed. Specialist knowledge of how an industry or profession actually functions beyond profit/loss is just as necessary. Just Eat has comprehensive health, safety and higeine policies covering food standards that Netflix need have no interest in. This specialist knowledge also serves to soothe consumers who may be wary of trying a new service: talking about 'licensed therapists' and even 'therapists' (which simply means a person qualified to provide a physical or psychological treatment) reassures a potential buyer about expertise. The disruption model involves accelerated evolution. Partial failure is anticipated and worked towards in order to test to destruction areas that don't work. The service becomes fully functional sooner which serves to attract and retain investors. This is fine when you don't get the TV show or takeaway you paid for. Products that involve any degree of human precarity ‘failure’ unavoidably has a different impact. Uber drivers had to go to court for basic rights (and got them); individuals suddenly had agents of massive media groups hunting them for thousands of pounds for an image they used in 1994 which has since been acquired by is a multinational. Strategic Lawsuits Against Public Participation. SLAPPs purposefully intimidate individuals or small unfunded groups to prevent legitimate concerns from reaching the light of day. One part of the business creates standards for good practice while another part of the same business is a pool full of barracudas going after anyone who raises questions. No therapy app group would dream of Therapy apps give you access to a human, trained therapist via video, phone or text with an average contact time of 30 minutes a week. In the UK many therapists have been given £800 to sign on and many make more money from recruiting other therapists, which is not difficult when you're paid £30 a session. The client pays £65 a session. The therapist need only interact with the client for 30 minutes, and if using text are paid by the word. Many therapists subsequently transfer these clients over to their private lists. What’s less clear is what happens when, the client being used to paying £65 for 30 minutes, is given the conventional 50 minutes in private practice. And there are obvious grey areas around building a relationship in order to exploit it. It’s all too easy to build over-dependence and no therapist would admit to it. Apps like large numbers of human interactions because they offer all kinds of highly valuable commercial data. The simplest information - age, location, the kind of product and access you pay for and how you use it - is priceless and the small print that no one reads is very clear that nothing you say or do on any app or programme is confidential. Therapy apps are here to stay, they're by no means the end of the world, but they’re at the Wild West stage right now. Online therapy was around way before covid but the pandemic normalised it. Many commercial landlords have made office hire prohibitively expensive - a cost that must be passed on to the client - while meeting online means that clients save the time they once spent coming to and from therapy and can give themselves some breathing space between the end of a session and getting back to work or family responsibilities. In a perfect world, I’d see clients face to face in a pleasant, airy, sound-proofed room, one to three times a week. All clients would be able to prepare for, attend, and leave therapy in a relaxed manner, have the time to reflect afterwards and the money to pay for long term work, but the world isn't perfect. As it is, I meet people online for 50 minutes. If they’re EAP clients I’m only allowed to meet them once a week and the one EAP I work with gives clients what I consider to be a reasonable and ethical number of sessions. (I made that decision after being handed a suicidal person to 'sort out' in 150 minutes.) While therapy, even in the NHS, is certainly a commercial offering, it is also a professional and boundaried health service: the purpose of therapy is deep, lasting change and that can only emerge via a meaningful therapeutic relationship. Anyone under the age of 30 is very comfortable with short interactions via apps, so therapy apps are here to stay. I don't know if they're good bad or indifferent. Ultimately, the market will determine a financial version of success. It’s never been easier to access therapy, the stigma has all but disappeared, and apps are making it much more accessible. By all means use an app, it may be an excellent introduction to therapy, it may be precisely what you need. But if you find you want something more think about giving yourself 50 minutes a week to speak with a therapist who doesn’t get paid peanuts to see you for a very limited period of time so that investors can profit. 19/11/2022 Why Psychotherapy?Many people are working harder than ever while feeling that they are achieving less, enjoying it less, and finding it increasingly difficult to maintain a sense of balance or meaning. The causes are complex. Economic uncertainty, technological change, workplace restructuring, increasing performance expectations and the sheer pace of modern life all play a part.
As pressures have increased, psychological support has become available in many different forms. Employee Assistance Programmes (EAPs), workplace counselling services, NHS services, therapy apps and short-term interventions can be valuable. However, they are designed to address immediate concerns, provide support during periods of crisis, or to help people regain stability and continue functioning in daily life. These are important goals. Private psychotherapy aims to achieve something different. Rather than focusing solely on symptom reduction, psychotherapy aims to understand the causes and patterns that sit beneath distress. This often requires more time than a brief intervention can realistically provide. There are several reasons for this. The quality of the relationship matters Research consistently suggests that one of the strongest predictors of successful therapy is the therapeutic alliance: the extent to which a client feels understood, trusts their therapist and agrees on the nature of the difficulties being explored. Inevitably, this takes time. Most people do not arrive in therapy knowing exactly what is wrong. They may know they feel anxious, exhausted, overwhelmed, irritable, stuck or dissatisfied and often these experiences are only the beginning of the conversation. What initially appears to be workplace stress may turn out to involve grief, loss, perfectionism, relationship difficulties, identity, values or long-standing patterns of coping. After six sessions, many people are only beginning to understand what they have actually come to therapy for. Significant problems rarely develop overnight Most difficulties that bring people to therapy have developed over months or years. Burnout, anxiety, relationship problems, low self-esteem, dissatisfaction with work, feelings of emptiness or a loss of direction are rarely isolated events. They tend to emerge gradually through a complex interaction of personal history, relationships, habits, beliefs and circumstances. Understanding those patterns, and finding more effective ways of responding to them, usually takes longer than a handful of sessions. Sustainable change requires more than symptom management Short-term work can be helpful for stabilising a difficult situation. Longer term psychotherapy allows something different, not least because the internet is heaving with the techniques and solutions that short term work focuses on. Longer term work creates the opportunity to explore not only what is happening, but why it continues to happen and what might need to change. After more than twenty years working in both fields, I'm relaxed that the most effective way of working towards solid and sustainable change is to move beyond emergencies and crises and take the time to be curious about what is happening, consider the underlying causes, decide upon an appropriate course of action and review progress over time. Medication absolutely has an important place for many people. A reliable starting place for a majority of clients is to discuss their mental health and get a thorough MOT from their GP. If your ferritin or B12 levels are too low, talking about your childhood is a dubious distraction. And medication is not a cure for bereavement, burnout, bullying, loneliness, meaninglessness, relationship difficulties or the many other experiences that contribute to emotional distress. How long does therapy take? There is no universal answer. Many people find that six sessions provide useful foundations. In my experience, most clients benefit from at least 12 sessions, and many choose to work for several months or longer. The goal is the opposite of dependence. The purpose of therapy is to help you develop greater understanding, greater freedom of choice and a stronger sense of control over your own life. If you are considering therapy, let's discuss what feels appropriate for your circumstances and what you hope to achieve from the work. |
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