If you listen to any podcast or radio show or watch TV shows, you’ve most likely heard or seen an advertisement for BetterHelp (will refer to them as BH from now on) which is one of the ‘big box’ therapy platforms, offering both texting and chat therapy, as well as telehealth sessions. BH is a Venture Capital/Private Equity funded company acquired by Teladoc a few years ago with a current valuation of over a billion dollars.
Any time someone asks how to find a therapist, I try my best to provide useful information as to why supporting these platforms are problematic and why finding a local therapist who works in a solo or small group practice is a much better option.
Privacy Concerns
In 2023, the Federal Trade Commission (FTC) reached a $7.8 million dollar settlement with BH for sharing their users’ personal information and health information with third parties such as Facebook without knowledge or permission from these users.
At Mindful Psychology Associates (MPA), we use Zoom for Healthcare platform for telehealth sessions and an Electronic Health Record (EHR) and Google suite platforms which are all HIPAA (Health Insurance Portability and Accountability Act) compliant. We take confidentiality and HIPAA laws very seriously as confidentiality and privacy are essential for clients being able to safely reveal their most vulnerable thoughts and feelings. In addition, all of our staff completes HIPAA training as part of their onboarding. We do not offer texting therapy as a modality due to problems such as privacy/confidentiality, as well as unique difficulties to texting such as not being able to verify who is receiving treatment and absence of non-verbal expressions, i.e., tone and intonation.
Technology
We do not use artificial intelligence (AI) in any form at Mindful Psychology Associates. You will not get an AI-generated response, we do not use AI in marketing or any client communications. AI will not be listening in on your therapy sessions nor generating notes for our clinicians!
Therapists and Care Standards
BH therapists are all 1099 independent contractors so BH does not have much oversight, review, or investment into their clinical skills. Additionally, despite these platforms having much financial backing, they pay their therapists quite low so therapist turnover is high.
Therapists at Mindful Psychology Associates are W2 employees and we pay our therapists fairly (with benefits) designed for ethical employment, work-life balance, growth, and longevity; most of our staff has been at MPA for two or more years. Our full-time therapists’ caseloads are around 25 clinical hours per week, which allows for a reasonable workload with plenty of time for activities related to clinical care, such as reading, researching treatment modalities, and consulting with other professionals.
Because we are a small practice, we take hiring very seriously. It is not enough for a therapist applicant to simply have their clinical license and some relevant experience; we screen for clinical skills and decision making, crisis intervention skills, and commitment to high ethical standards and professionalism. Additionally, we identify therapist candidates with personal characteristics (warmth, openness, curiosity) that increase the likelihood of a therapist being happy, effective, and successful. We aim for our therapists to stay at MPA for a minimum of two years so client care is least likely to be impacted. The big box platforms tend to have higher turnover due to low pay and other related difficulties, with many BH therapists treating their jobs more like a side hustle.
Platforms such as BH are often referred to as the Uber/Lyft model to therapy. As such, therapists utilize the platform to see patients and get referrals but there is no clinical oversight of their clinicians—no supervision, consultation, or any involvement with their clinical work.
At MPA, we offer every clinician several different levels of support. Our provisionally licensed clinicians have weekly supervision and close oversight to monitor their clinical skills, assist with their development as a clinician, and provide mentorship for work-life balance. Everyone has 24/7 access to our Clinical Director for professional consultation and we expect our clinicians to discuss high risk clinical situations because we know that discussing a safety issue or other pressing matter can be stressful so is best done with the support and guidance from seasoned colleagues.
Personalized Care
If a client is seeing a therapist on a therapy platform, they may be able to contact customer support but are unlikely to be connected to a clinical supervisor that has direct knowledge of the clinician’s work and may be able to help understand what might not be working for them in their therapy. If a client has concerns about their therapy at MPA, they can speak to their therapist, their therapist’s supervisor (if applicable), the Clinical Director, or myself as the Founder. We believe that the fit between therapist and client is a crucial part of the healing process, so if something is not working well we want to help clients understand if this can be resolved. If it doesn’t seem workable, we will work hard to facilitate a referral to another MPA therapist or a different therapist in the community if necessary.
If you have questions about your insurance coverage, need to update your credit card on file, or have a question about your recent invoice you can call our office and speak to our office manager who is an actual human working from our Evanston office, not some random customer service employee who you can only reach via email.
Unlike the big box platforms, we take the process of matching a client with one of our therapists very seriously because we want to set the client up for success from the very beginning. Some clients request a therapist based on modality or areas of specialty, other times clients request a therapist based on demographics. They prefer a younger or older therapist or one who is a parent or a woman…and we do our absolute best to honor these requests.
Ownership
BH and similar therapy platforms are not owned by clinicians—they are VC/PE funded companies and therefore answer to their investors and executives, most of whom are not clinicians. BH’s founder is also not a clinician. BH is owned by TelaDoc Health, a publicly traded company. These companies have a hefty budget for marketing, advertising, and SEO so have caused significant disruption to local practices by their sheer financial resources to dominate ads and sponsor google ad placements. When therapy clients pay BH for therapy services, a very small part of that is going directly to the therapist, and much of that fee is helping their wealthy investors become more wealthy, and fueling a high powered company to become even more disruptive.
MPA was founded by myself, a Licensed Clinical Psychologist, and I am still the CEO and actively engaged in daily operations including hiring and overseeing staff. The majority of our clients use their health insurance to receive therapy services, and we are proud that we are in network with three popular health insurance plans, even though we have to reduce our fees to be in compliance with their in-network requirements.
When you support a small practice, you know where your money is going—most of it directly to your therapist, and the rest covers expenses to the practice. We do not have investors nor are backed by any venture capital or private equity money. Additionally, we have been in the Northwestern University and Evanston community for 20 years now. We have enjoyed a solid reputation and have a strong referral network of other clinicians and referral partners such as psychiatrists, dieticians, and local treatment centers. If a client needs a referral to another treatment provider, we can give names of professionals we know and trust. We have contributed much to the local community including providing low-fee therapy and pro-bono speaking events to local schools and organizations. We have appreciated being a part of Evanston’s small business community since 2004 and many of our clients are now enjoying coming in person to our downtown Evanston location—again, another option that a therapy platform cannot provide.
As our country and world becomes more impersonal, tech-focused, and disconnected, some things cannot be replicated nor replaced by tech or AI. In my opinion, your therapy experience is one of those things—I feel strongly that human empathy, personal connection, and compassion are crucial to a successful experience in therapy. I also hate to think that someday all businesses will be owned by larger corporate conglomerates…I appreciate that my accountant and insurance broker are both woman-owned small businesses.
For all of these reasons, please consider supporting a local solo therapist or small group practice if you’re seeking a therapist! Meet our Evanston therapists, too!
Dr. Jennifer Contarino Panning, Phy, D., Founder, President, and CEO of Mindful Psychology Associates PC, is a mental health leader and innovator and has been an Illinois Licensed Clinical Psychologist for twenty years.
