Clinician's Digest


Clinician's Digest

Ethics and the Rise of Text Therapy

September/October 2017


What if you could treat a client while waiting in line for your morning coffee, walking the dog, or pausing between episodes of your favorite show? Throughout sessions, your client would remain anonymous. You’d never know his or her name, and you’d never meet in person. Sound a little too convenient? Or maybe like a license suspension waiting to happen?

More than a thousand therapists are now practicing in just this way through the mobile online therapy platform Talkspace. For as little as $32 per week, Talkspace will match users, based on their presenting problems, with licensed therapists. With this basic plan, the two agree to daily check-ins at mutually agreed-upon times, and communicate purely via text.

The company pitches its platform to therapists as a way of generating new income, having scheduling flexibility, and being available to clients who may otherwise not have access to services. According to company estimates, more than half a million people have used Talkspace since its founding, less than five years ago. According to The Verge—a technology news site operated by Vox Media—therapists are paid about half of what users pay; individual plans go as high as $99 a week for two daily check-ins. Clients and therapists negotiate the duration of messaging sessions. However, high-tier plans include a handful of live video sessions, which are limited to about 30 minutes. Talkspace also offers couples therapy, and users can even gift

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