Tech Trends

The Decline of In-Person Counseling: Impact on Employee Assistance

By Marina London, LCSW, CEAP


I entered the employee assistance field in 1991, hired as a “senior consultant–operations” for Personal Performance Consultants (PPC), perhaps the largest EAP in the USA at the time. Essentially, I was the clinical director of one of dozens of EAP offices scattered across the country, delivering a generous, up to 8-session model, to Fortune 50 employees and their dependents.

That office model is essentially extinct in 2017. Today, over 25 years after my first job in employee assistance, we are witnessing the perfect storm that may lead to the virtual extinction of in-person counseling. Of course, in 2017 the word “virtual” has a very different meaning than it had in 1991. In the 21st century, virtual means, “not physically existing but made by software to appear so.”

In fact, 2017 is turning into the year when apps and platforms geared toward a virtual or digital counseling/coaching experience gained ascendancy. Here are a few:

* Lantern. Instead of therapy, Lantern offers “coaching.” Users share problems via text messages and receive highly structured strategies for feeling better in that moment, such as guided meditation or breathing exercises. In 2016, Lantern raised $17 million for its mobile-based mental health coaching program. (Lantern starts at $49 a month.)

* T2 Mood Tracker. This free app enables users to track their own mental health, helping them to identify patterns and triggers by which they might gain greater insight and control over changes in mood. Who is behind this app? Like many innovations in tele-behavioral health, it’s the U.S. Department of Defense. The reasoning is simple: There are too many war veterans in need of help, and not enough VA counselors.

* Ginger.io. This app combines the concept of smartphone-based fitness tracking with live human feedback and care from a coach or therapist and/or a psychiatrist to help with medication support. It works with text message exchanges as well as videoconferencing. (Cost starts at $129 a month.)

* 7cups.com. “Free, anonymous and confidential online text chat with trained listeners, online therapists & counselors.”

* betterhelp.com. “Convenient, affordable, private online counseling. Anytime, anywhere.”

* Sam. Using artificial intelligence, Sam provides users with instant access anytime to help them lose weight. Sam is powered by IBM’s Watson, an advanced computer that understands questions asked in natural language. That’s right – Sam isn’t even a human being. The website states: “Talk to Sam, Your Digital Therapist.”

And I could have listed dozens more.

PsyberGuide
How do you know which apps are legit and effective? Fortunately, there is PsyberGuide (https:psyberguide.org,) initially created as a nonprofit website dedicated to consumers seeking to make informed decisions about computer and device-assisted therapies for mental illnesses. PsyberGuide is also intended for professionals and researchers seeking to enhance their knowledge in this area, ensuring that this information is available to all, free of preference, bias, or endorsement

If you go to their “Product Listing,” you will note that each app is listed along with a PsyberGuide rating that corresponds to the amount of research and support backing the product. In addition, there is an App Quality Score on a scale of 1 to 5. Finally, there is a link to an expert review – if one exists. How is that for “thorough” evidence-based vetting?

The founder of PsyberGuide, Stephen Schueller, PhD, is a member of the Internet World Health Research Center, a remarkable institution whose mission is to harness the power of technology to reach those most in need with effective interventions that can be administered via the Internet or a mobile device.

True Evidence-based Apps: Growing Need for EAPs
Employee Assistance Programs would do well to develop some of these capabilities or even consider a partnership with one or more of these app/platform companies. This need is especially prevalent when one considers that people born in 1993 are the last of the Millennial generation. Their cohorts will dominate the workforce for the next 50 years. In a couple of years, Gen Z will begin to enter the workplace. They have never known a world without Facetime or Skype.

Combine money, the U.S. military, IBM, millions of dollars in venture capital funding and a growing number of users who are perfectly comfortable with digital media; and then couple that with a demand for immediate responsiveness. It isn’t difficult to foresee a precipitous decline in the demand for in-person counseling – especially in more rural areas where seeing a counselor may require a long drive, and options for treatment are limited by geography.

Even more disruptive, some of these companies, like Talkspace and Joyable, bypass EAPs and market themselves directly to corporations. 

Joyable.com even trumpets on its site, “Digital therapy just got better by reaching more employees and reducing healthcare costs. Bite-size activities. Big-size outcomes.

“How do you make digital therapy enjoyable and effective for your employees? Simple. With 5-minute activities that are easy to do — and backed up with clinical proof.”

Summary
Those of us in employee assistance understand why an app can’t hold a candle to a full service EAP. But many client companies will not, and they will instead jump on the evidence-based app bandwagon. It behooves us to get there first.

Marina London is Manager of Web Services for EAPA and author of iWebU, (http://www.iwebu.info,) a weekly blog for mental health and EA professionals who are challenged by social media and Internet technologies. She previously served as an executive for several national EAP and managed mental health care firms. She can be reached at m.london@eapassn.org.

References


7cups.com (n.d.) Retrieved from https://7cups.com
betterhelp.com (n.d.) Retrieved from https://www.betterhelp.com
Ginger.io (n.d.) Retrieved from https://ginger.io
IBM Watson (n.d.) Retrieved from https://ibm.com/watson
Joyable.com (n.d.) Retrieved from https://joyable.com
Lantern (n.d.) Retrieved from https://golantern.com
Pai, A. (2016, February 10). “Lantern raises $17M for its mobile-based mental health coaching program.” mobihealthnews. Retrieved from http://mobihealthnews.com/content/lantern-raises-17m-its-mobile-based-mental-health-coaching-program. 
PsyberGuide (n.d.) Retrieved from https://psyberguide.org
Sam (n.d.) Retrieved from http://talk2sam.com
T2 Mood Tracker (n.d.) Retrieved from http://t2health.dcoe.mil/apps/t2-mood-tracker
Talkspace for Business (n.d.) Retrieved from https://talkspace.com/online-therapy/therapy-for-business