Is online therapy worth your time?

A growing offering of services promise relief through cognitive behavioural therapy from the comfort of your own couch. Do they have anything to offer?

As a professional journalist, I’ve long taken it as my sacred duty to find something good in the world and dump on it. It’s standard practice in the industry and probably a big part of why nobody pays for news anymore and rolls their eyes when the mainstream press decides to take up an issue.

That sense of professional snootiness has probably kept me from enjoying hundreds of enjoyable things. It’s weird to think back to concerts I’ve covered or books I’ve reviewed, the whole time looking for one thing that wasn’t quite perfect so I could offer a “balanced” view of something that tens of thousands of people enjoyed without question.

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When I came back from overseas, I promised myself that I’d approach every opportunity to improve my mental health with an open mind instead of giving in to the journalistic impulse to ruin things. That philosophy has seen me try all sorts of things - some have done me some good, some have been as terrible as they sound, and I’m still figuring out if others are helpful.

That’s what led me to MindBeacon - an online cognitive behavioral therapy platform offered at no cost to residents of Ontario. The service usually costs money, but the province has given the publicly traded company millions of dollars to help residents deal with their mental health issues amidst backlogs and roadblocks in the mental health system.

How do you access MindBeacon?

If I were to take the traditional journalism approach, I’d have already mentioned my biggest problem with the platform. MindBeacon isn’t meant to be a crisis intervention service and isn’t really right for anyone with complex needs, which means it needs to screen potential users and decide whether they should be granted access.

Here’s how it works: You fill out a questionnaire asking about things related to your mental health. Are you anxious? Do you find enjoyment in the things you once found enjoyable? Pretty standard stuff.

You’re encouraged to answer honestly. So when it asked me if I had any suicidal ideations in the recent past, I said yes, because just a month prior, I had been admitted to the hospital and was still trying to piece myself back together after months of “bad thoughts.”

I wasn’t suicidal anymore and was under a doctor’s care. I was back home with family and friends and putting my brain back together piece by piece. But, I answered honestly, and three weeks later, I received an email telling me my case was too complex to benefit from what the program had to offer.

It’s a bit disheartening to hear that you are too crazy for a programme that helps crazy people. So as any good crazy person would do, I went back and applied again using a different email. I answered all of the questions the same. Still, when it came to suicidal intentions, I declared myself firmly on the side of the Life Enthusiasts.

That got me in. My new online therapist went through the answers I provided and decided the modules on post-traumatic stress would help the most, so that’s what we pursued. 

I still don’t know which particular trauma we’ve been addressing, because like everyone else, I’ve had my share of disasters (unlike everyone else, a couple of mine have been ridiculously public). But I’ve done the weekly modules with specific things in mind to help focus the reading.

Who is this therapist, anyway?

Once you’re in the program, your assigned therapist sends you messages from within the app encouraging you along. This is not high-level work - mine primarily uses the messaging system to remind me to start my weekly reading and to calmly repeat the things I’ve written into the forms while doing the coursework.

It took me a few weeks to decide my therapist was an actual human being and not a bot (even though she said she had a masters degree in social work from an American university). It makes sense that a therapist would use some cut-and-paste replies to cover off common questions, but the first couple of weeks lacked any sort of rapport that you’d expect to develop in a real-world situation.

I’m in the last few weeks of what I think is a 12-week programme. Her answers have become more insightful, and the feedback she’s providing has been good enough to cause me to sit down and think about what she’s said.

This took a bit of effort - my natural inclination every time I opened the app was to get annoyed at the therapist’s light touch. She’s probably only written 2,000 words at me since Christmas, but I do think she’s read through my entries and taken the time to think about what she writes.  

That’s definitely more than nothing.

How do you know if it’s working?

MindBeacon isn’t my first time trying an online therapy service. The National Health Service in the UK has a module called “Beating The Blues,” which it offers for free to anyone presenting with mental health issues. Still, I never took it incredibly seriously because I hated the name so much. Petty, but true (the “blues” don’t make you suicidal).

One thing Beating The Blues had going for it was your weekly check-ins were available for reference at any time. Each week you’d fill in your little questionnaire about how you were feeling on a scale of death-to-ecstasy. You’d be able to see if you were doing better or worse than you were the week (or weeks) before. 

It’s an excellent feedback mechanism that looks to add a layer of quantitative data to what is necessarily an amorphous process. Anyone who’s gone through any sort of mental health challenge knows that it’s sometimes impossible to tell if you are improving or declining - the right words just don’t exist to articulate recovery.

That doesn’t exist in Beating The Blues. I asked my therapist if I could access a summary of my weekly check-ins, and she said she’d have to check with her supervisor. She offered some interesting numbers - if you compare my answers this week to my answers in the first week my “symptoms of trauma” have reduced by 44 per cent and my “low mood” has improved by 44 per cent.

Those numbers don’t actually mean anything, but any sign of positive traction is always welcome. Obviously, MindBeacon is only one component of a broader recovery strategy that relies more on pharmaceuticals than talk therapy and online surveys.

Should you use an online service such as MindBeacon?

Investors certainly think these services are the future of mental healthcare, and it’s hard to argue. More than a billion dollars has been directed toward companies such as MindBeacon in the last quarter alone, with investors betting that accessing services from home will remain attractive to those with mental health issues even when it’s possible to return to a therapist’s office.

Some of the people who have traditionally provided the services disagree, arguing that nothing can replace in-person care and programmes such as MindBeacon represent the “McDonaldization” of their industry. The programmes don’t last long enough and are difficult to follow, they argue, and research suggests the outcomes aren’t great.

“Internet-based interventions have poor outcomes,” two academics wrote in the Toronto Star. “CT is also the only psychotherapy offered by the roadmap, despite it helping only a modest portion of patients. Ontario’s diverse population needs access to a diversity of evidence-based psychotherapies.”

Fine. 

But until there’s such a diversity of offerings on the table, something is better than nothing. And MindBeacon certainly offers something. Complaining that many people don’t finish their therapy seems especially peevish, considering how hard it is to get those with mental health problems to even continue with essential drug therapies.

And that really sums up what any online service has to offer - something.

For anyone looking for anything at all to hold onto, that’s enough.

I give MindBeacon a solid 8/10.