Jeff Guenther on Jun 30, 2019
Have you ever thought about becoming an online therapist? If you have, you’ve basically got two options. You can join a telehealth service like Better Help or TalkSpace. Which means you become a contractor for them and they pay you an hourly rate while sending you clients and taking care of the technology part. Or you can provide online counseling yourself without a third party service and take care of all the marketing and technology on your end. Both paths have their pros and cons and I’d like to discuss them in this article. If you are thinking of joining Better Help or TalkSpace, or if you’re just curious about the ins and outs of exactly how they operate, then you should listen to this interview where I talk to a therapist that is signed up for both services. Honestly, it’s a fascinating conversation. The future of therapy is moving online and these two companies are trying to lead the charge. They have some growing to do and they have been evolving away from some problematic behaviors, but they know what they’re doing and they might be revolutionizing the mental health industry whether we like it or not.
Technology companies like Better Help and TalkSpace have millions of dollars invested in their success by big time investment companies. These investment firms typically put profit first. They want to get as much money back on their investment as possible. The drive to make money usually permeates every decision they make. These companies have an obligation to make their shareholders happy. That’s not to say they can’t do good important work and develop technologies that benefit the mental health field. But it’s something to keep in mind when trying to understand the decision making that could go on at companies like these. So if you decide to work for Better Help or TalkSpace remember that many of their decisions are made from a place of making the experience better in order to make more money, not necessarily making the care that they provide better for the client or therapist.
Providing online counseling yourself, without signing up for platforms like Better Help and TalkSpace, could not be easier these days. All the tools you need to create an online practice are either cheap or free.
The key to an online counseling practice is to make sure you’re using quality technology that is HIPAA compliant. A simple Google search will reveal many options that counselors can use to ensure quality video chats that are secure and safe. If you are a therapist that uses an EHR, such as Simple Practice or TheraNest, video conferencing and telehealth services are already baked into their platforms. Using their tools to communicate with your online clients is the easiest way to go.
However, you could cobble together your own secure tools if you don’t want to subscribe to an EHR. Many therapists use free or cheap services like Vsee or Zoom to video chat with their clients. To send and receive secure and encrypted messages from clients a couple popular email services are provided by Hushmail and Virtu.
One of the best ways to market your services is to sign up for an online therapist directory that attracts potential clients who are looking for online counseling services. TherapyDen caters to clients who are looking for a therapist in person or online. Prospective clients can toggle between search results that display counselors in their neighborhood or counselors across their state that provide online counseling. Click play on the video below to see how it works.
Another therapist directory that directly targets people looking for online therapy is onlinecounselling.com. They only list practitioners that provide online services. They also integrate therapists from Better Help into their search results so that people can choose between a therapist that runs their own online practice or a therapist that provides services through Better Help.
And it’s always a good idea to create specific pages on your website that include information on the online services you provide to clients in your state. Explaining the benefits of online counseling and how exactly it works will help your website visitors feel more comfortable using the services. Creating content on your website about online counseling will also have the added benefit of ranking higher in Google searches when clients perform a search for online therapy.
Better Help and TalkSpace are not the same company. I discuss the difference with a therapist that is signed up for both of them on this episode of “Say More About That”. However, they are providing very similar services. Better Help and TalkSpace are like the Uber and Lyft of online therapy. For the sake of convenience, I’ll be grouping them together and referring to them as “online therapy platforms”.
Joining an online therapy platform like Better Help or TalkSpace seems like a no brainer if you want to quickly set up an online practice and start seeing clients right away.
My guest on the podcast episode, Alyssa, reached out to Better Help and TalkSpace before she talked to me to find out what was off limits to say. The only thing both companies said is that she is not allowed to discuss how much money she makes. So we don’t go into the details of compensation on the show. However, we do talk about the “retention incentives” that she can earn if she keeps a client on her caseload for a certain amount of time. Which essentially means the longer you talk to a client, the more bonuses you’ll receive from the company.
Even though I don’t ask Alyssa about her hourly wage, I have talked to many therapists who work for these online therapy platforms and they all report similar pay. I also visited glassdoor.com to confirm the data I have collected from therapists and it matches up perfectly.
It is reported that Better Help pays around $30 per hour and TalkSpace pays around $20 per hour. Compare that to the average hourly fee of a therapist running their own practice, around $100, and it averages out to a 75% pay reduction. Should therapists be paid a lot more on these services? In my personal opinion, YES of course they should. However, I have no idea how much these online platforms are making in profit so I don’t know if they can pay more. And why would they want to pay more if they have plenty of therapists signing up to work for them? There may not be much incentive to pay therapists more money. I really can’t say.
I will note, however, that Alyssa does not complain about how much she is paid by Better Help and TalkSpace. She is appreciative of the clients and the pay she receives from them.
When you work for an online therapy platform every single client is handed to you. They are screened, and in some cases an intake coordinator places them in your caseload, so that you don’t have to worry about where clients are going to come from. Which can be one of the major stressors of running your own online (or in person) practice. Better Help and TalkSpace are well on their way to becoming brands that consumers and clients trust. Because of this, they perform well in online search. Which can make it hard for individual therapists to rank high in their state and attract new clients.
Online therapy platforms are constantly upgrading their technology and adding new features. This makes it easier for therapists and clients to connect and talk to each other. Which can also create more healing and growth opportunities for your client. In the podcast, Alyssa talks about how awesome it is to have client worksheets and journals integrated right into the app. This makes it so that clients can try out things they have learned in therapy and report on how it went in real time back to the therapist. And then, as the therapist, you can give feedback right away to the client instead of having to wait an entire week to talk to them again. This more constant connection and better integration of tools makes the counseling process more embedded into client’s every day lives.
As a therapist, you can request case consultations from expert practitioners that work at Better Help and TalkSpace. If you request their help, they take the time to look through your entire case with a specific client. And since much of your communication is documented, they can provide high quality and specific feedback.
Alyssa reports that she has become an overall better therapist because of her work with Better Help and TalkSpace. One of the main differences with online therapy platforms is that a lot of the therapy is chat based, which means you’re typing back and forth with your client. This allows you to pause in between your responses. The pause allows the therapist to gather their thoughts and reply carefully. Which is a lot different than responding immediately in person or on a video chat. This more deliberate approach has improved Alyssa’s skills overall.
Therapy, just like any other industry, wants to meet the needs of their customers. And more and more people want to access mental health services from the comfort of their phones. Whether we, as therapists, are comfortable with it or not, our services are moving online and people are expecting us to adapt. Seeing clients in person still seems like the best way to provide therapy in my opinion. But that might be because I am not of the generation that feels 100% comfortable receiving counseling services online. Which is kinda crazy because technically I’m a millennial. But the kids and young adults of generation Z are leading the charge and moving our industry into the digital realms. So we will we need to adapt. That doesn’t mean that we should all sign up for Better Help or TalkSpace. But if you are looking for clients (especially younger clients) it might be a good idea to sign up for a video conferencing service and at least signify that you can provide online counseling on your TherapyDen profile.
Jeff Guenther, LPC, is a therapist in Portland, OR. He has been in private practice since 2005. Jeff is the creator and owner of Portland Therapy Center, a highly ranked therapist directory. Jeff, and his team, have launched a new progressive therapist directory, TherapyDen.