Although it existed before the pandemic, text therapy is something else that’s relatively new to many and has helped several people who have been unable to visit a therapist in person and want to address their mental health issues. Dr. Roseann Capanna-Hodge, an integrative mental health expert who wrote the first book ever written on teletherapy activities called Teletherapy Toolkit™, says that there has been a rise in all forms of remote access psychotherapy due to the increased stress in Americans. She cites the American Psychological Association Stress in America Survey™, saying that “not surprisingly” stress has increased by almost 20% in 2020. “And due to the pandemic, people are seeking out therapy in different ways,” she adds. Teletherapy can come in various forms: phone, video, and text chats. Brittany A Johnson, LMHC, defines text therapy as “a newer form of therapy that consists of the therapist and client exchanging SMS text or email. This can be done either standalone or in addition to talk therapy.” Does the idea of receiving mental health guidance without leaving home appeal to you, whether there’s a pandemic going on or not? Read on to learn about text therapy’s benefits, downsides, and effectiveness.
How does text therapy work?
Dr. Capanna-Hodge lays out the steps of text therapy:
First, you’ll sign up with a particular therapist or platform. With a platform, you’ll answer questions that will match you to a therapist who has experience with your particular issue(s). Once matched to a therapist, you’ll be able to text chat with them. “Live chats need to be scheduled, but regular messaging doesn’t,” Capanna-Hodge adds. Then you’ll begin chatting with your therapist. Capanna-Hodge notes, “Just like in-person therapy, committing to the time needed to change behaviors, as well as actually taking steps toward those changes, is paramount to good treatment outcomes.”
How do I talk to a therapist over text?
Although some healthcare providers offer teletherapy options, many people nowadays are turning to online platforms. The most important thing is that you confirm that a text therapy platform is HIPAA compliant, private, and secure. These platforms vary according to their rates, their pricing structure (i.e., pay per session or pay monthly), if they take insurance, and if they require increased fees for audio and video chat in addition to text therapy. That’s why it’s important to do your homework before choosing a platform that works for you. Some of these text therapy platforms include:
BetterHelpTalkspaceTherachatReGainTeen Counseling
Does text therapy work?
Many people have had to turn to teletherapy out of necessity during the pandemic because their therapist isn’t seeing clients in person. Or perhaps anxiety around the pandemic has caused you to switch to teletherapy out of caution. Luckily, text therapy is considered to be effective—but there’s a catch. Dr. Capanna-Hodge says, “One of the biggest text therapy platforms, Talkspace, has some preliminary research which found that 90 percent of participants reported an improvement in overall wellness. A 2020 text messaging research study found that messaging improved treatment outcomes for those with anxiety and depression” and “their overall outcomes were comparable to in-person therapy.” These results are promising, but both experts agree that text therapy is really best as a supplement to standard, face-to-face therapy. “In my opinion, [text therapy] works best as an add-on to traditional talk therapy because therapists often use non-verbal cues during therapy, and with text, you lose that,” Johnson observes. For the majority of therapy clients, in-person sessions just aren’t possible at the moment. But remember that video appointments are available through many providers and platforms, which can count as “in-person” sessions. “I think text therapy is a good adjunctive to traditional in-person or video-based sessions,” Dr. Capanna-Hodge says. “Text therapy is a wonderful way to give patient education and support patients in between sessions. Face-to-face conversation is necessary to create that safe space to help patients move the dial on therapeutic goals.”
How much does text therapy cost?
Online platforms provide a wide range of packages, memberships, and offerings, and that can make pricing vary quite a bit as well. Some platforms charge by session while others charge by week, month, or year. One positive aspect is that most plans include unlimited, 24/7 messaging. To give you an idea, the cost of counseling through BetterHelp can range from $60 to $90 per week. Talkspace offers several subscription possibilities which range from $260 to $396 per month. According to GoodTherapy, most people can expect to pay between $100 to $200 per in-person session.
Does insurance cover text therapy?
On their website, Talkspace says that over 40 million Americans are covered through their insurance to use their services, while BetterHelp currently does not take insurance. This is yet another example of online teletherapy platforms differing from one another. If you’re looking for the short answer: it really comes down to your particular insurance carrier. Dr. Capanna-Hodge states, “Depending on your individual insurance provider, your therapy may or may not be covered. It is best to check in advance.”
What are the benefits of text therapy?
Text therapy is a good fit for many lifestyles and mental health needs. Johnson points out a top benefit of this therapy approach, saying, “The benefits of text therapy are convenience for busy schedules. Some symptoms of mental illness make it hard for someone to communicate, so being able to text a thought is helpful.” She adds that it’s useful to be able to look back at a message if your therapist sent a great tip or talking point you want to remember. Dr. Capanna-Hodge lists several additional benefits of text therapy:
It’s cost-effective. The accessibility can’t be beat.There’s a higher level of “touch points,” or points of interaction. Patients can think through their responses. It’s a good way to provide “patient psychoeducation,” or helpful information on mental conditions.
Are there any downsides to text therapy?
As you likely know from experience, while texting is convenient and efficient, it can’t quite hold a candle to in-person interactions. Johnson agrees with this, saying, “The biggest downfall is that [text therapy] takes away the ability of the therapist to see your non-verbal facial expressions and hear your tone.” She adds that this can be particularly concerning if a client is suicidal or experiencing symptoms that require a higher level of care. Dr. Capanna-Hodge details other negative aspects to consider:
Text therapy isn’t always immediate. Writing responses may feel frustrating. There can be delays between text responses. Text therapy can over-rely on verbal communication and cognitive processing. There can be a lack of a therapeutic relationship that can “really create change.”
As with all therapy, text therapy is an individualized choice based upon your preferences and the depth of your mental health condition. Although it’s an excellent stand-in due to the pandemic, many experts agree that text therapy should be secondary to in-person or video appointments. “Any time someone is highly distressed and really struggling with self-regulation, face-to-face therapy, either virtual or in-person, is more clinically appropriate,” Dr. Capanna-Hodge concludes. “As a therapist, there are definitely times you need to ‘have your eyes on’ a client.” Next up, learn more about how online therapy works. Sources
Dr. Roseann Capanna-Hodge, an integrative mental health expert with Dr. Roseann & Associates.Brittany A Johnson, LMHC, a licensed mental health counselor, author, and strategist. American Psychological Association: “Stress in America™ 2020” Talkspace: “A Preliminary Study of Talkspace’s Text-based Psychotherapy” BMC Psychiatry: “Two-way messaging therapy for depression and anxiety: longitudinal response trajectories”GoodTherapy: “How Much Does Therapy Cost?”
