Difference between revisions of "BetterHelp"

Revision as of 18:18, 27 January 2023

BetterHelp is a telehealth therapy platform aimed at providing accessible, convenient therapy and counseling^[1]. Telehealth, or telemedicine, allows for patients to seek medical treatment and care virtually, or without going to an in-personal location ^[2]. BetterHelp functions as a telehealth platform through which clients and therapists can facilitate their communication using four different modalities: a chat feature, phone calls, video calls, and text messaging^[3].

Background

BetterHelp was founded in 2013 by Alon Matas and Danny Bragonier, and in 2015 was acquired by telehealth company Teladoc Heath, Inc. ^[4]. The company is one of the largest telehealth online therapy providers, with over 20,000 licensed therapists and over 2.5 million users ^[5]. Recently, however, it has been involved in various ethical debates after a series of scandals involving the quality of therapists provided and information-sharing with Facebook.

How It Works

Signing Up

To sign up for BetterHelp, users must go through a series of basic questions to match them to their ideal therapist. Users are asked to provide their gender, age, and general health information. Each question typically has many response options, at least one of which acting as an opt-out (such as “Other” or “I don’t know”). Questions get more personalized depending on a user’s answers. Some questions come with additional information to indicate why they are being asked. For example, one question is “How Would You Rate Your Current Physical Health?” Underneath is an information box that indicates a correlation between physical health and mental health. At the end of the questionnaire, users are asked to make an account, by providing a first name, email, and agreeing to the Terms & Conditions and Privacy Policy. Afterward, users are given an open space to explain why they sought therapy with BetterHelp, and then a detailed explanation as to what happens next, including a FAQ section, financial options, insurance information, and a cost analysis. Lastly, to complete their account, users are asked to provide credit card information. There is also an option to click “I can’t afford therapy,” at which point users are directed to financial aid information^[6].

Finding a Therapist

The questionnaire required to complete in order to sign up for BetterHelp acts as a match-maker to a therapist. To begin, users choose from one of three options to indicate the type of therapy they’d like to receive: Individual, Couples, or Teen (the latter then gives the option to redirect to teencounseling.com). After answering more general questions, users are asked to answer questions about their mental health, to specify which areas of focus they’d like their therapist to specialize in. They’re also asked identity-related questions. For example, if a user indicates their sexual orientation is something other than straight, they receive a question asking if they would like to work with a therapist who specializes in LGBTQ+ issues ^[7].

Therapist Qualifications

BetterHelp requires that every therapist on their platform is fully licensed with proper documentation provided, according to industry standards, and experienced in their specific field. Their licensure is cross-checked and available for users to see and evaluate on their own. Therapists are also required to complete a case study exam to be graded by a licensed clinician, and partake in a video interview^[8].

Cost and Insurance

BetterHelp costs are ultimately based on location of the user and specifics such as therapist preference and availability. Users are billed every four weeks, with an average cost of $60-90 per week. Therapy on the platform is typically not covered by insurance, with no therapist provider accepting Medicare, Medicaid, and most insurances. However, this can vary between insurance companies, and some users can utilize partial coverage through their specific insurers^[9].

Advertising

BetterHelp utilizes many modern online platforms for advertising, such as social media platforms like YouTube, as well as many popular podcasts ^[10]. Podcasts in particular are a focal point of advertising. In the first half of 2021, BetterHelp was the top advertiser across all podcasts, having spent at that point $35.7 million on advertisements.

Controversies and Ethical Concerns

Therapist Quality

In late 2022, the hashtag #betterhelptherapyisascam began trending on TikTok after various viral videos questioning the platform’s quality and legitimacy. One user described a therapist who arrived late to their first meeting, another in which a therapist didn’t focus on the user and instead promoted their own book, another whose therapist had messaged the user after missing two sessions saying they were at another job, and another whose therapist was meeting in a public space and violating privacy expectations ^[11]. Some experiences were described as traumatic, with one user reporting that their therapist recommended conversion therapy in order to reunite with his family^[12].

Advertising

Much of BetterHelp’s advertising is through social media influencer partnerships. In 2018, attention was called to various brand deals with YouTube influencers such as Shane Dawson and Philip DeFranco, who made videos detailing their personal mental health struggles and providing affiliate links to their subscribers. Some users were upset at mental health stories being used to sell a product. Others were dissatisfied with their subsequent BetterHelp experiences, after using influencer affiliate links. Some YouTubers began to retract statements and distance themselves from the BetterHelp brand, following the controversy. The YouTubers themselves were also accused of making money off their subscribers’ mental health issues, through their personal videos and affiliate links provided^[13].

In 2021, after the crowd crush at Travis Scott’s Houston Astroworld concert, Scott partnered with BetterHelp to offer one month of free therapy to survivors. Critics online pointed out BetterHelp’s previous controversies over therapist quality and condemned the partnership, arguing that it exploited the tragedy and the mental health struggles of those who were there^[14].

Privacy and Information Sharing

In 2020, a Jezebel investigation discovered that BetterHelp was sharing user information with Facebook, including messages between users and their therapists. Though BetterHelp argues it functions in accordance with HIPAA, and information users share with their therapists is encrypted, Jezebel found that shortly after beginning the sign-up process, BetterHelp began sharing their data to companies like Facebook and Google. Facebook specifically was alerted each time a user logged on to BetterHelp. The report also found that metadata from messages between users and therapists was shared to Facebook while a user was in-session, so the company could know when and where the appointments were taking place. Jezebel also found that MixPanel, a research and analytics firm, is sent information about users’ answers to the therapy intake questions during the sign-up process. Some of MixPanel’s clients include Uber and BMW. Later, in 2021, a Consumer Report investigation had similar findings, concluding that privacy statements made by telehealth companies like BetterHelp are often not clear or comprehensive enough to prevent data and information sharing^[15].

Much of this data sharing is intended to allow advertisers to specify and personalize the advertisements they show users, which has caused an ethical debate especially in relation to the kind of personal information shared in therapy sessions and on therapy apps. Many see personalized ads as convenient and helpful, allowing them to save time finding products they’re looking for. Others believe that ad personalization has gone too far, and to use mental health information to sell users products is exploitative.

References

1. ↑ Betterhelp is the world's largest therapy platform. BetterHelp. (n.d.). Retrieved January 27, 2023, from https://www.betterhelp.com/about/
2. ↑ What is telehealth? Telehealth.HHS.gov. (n.d.). Retrieved January 27, 2023, from https://telehealth.hhs.gov/patients/understanding-telehealth/
3. ↑ FAQ. BetterHelp (n.d.). Retrieved January 27, 2023 https://www.betterhelp.com/faq/
4. ↑ Betterhelp - Crunchbase Company Profile & Funding. Crunchbase. (n.d.). Retrieved January 27, 2023, from https://www.crunchbase.com/organization/betterhelp
5. ↑ Coward, K. (2022, February 24). Teladoc's mental health brand Betterhelp hits $700m in revenue, expects more growth in 2022. Behavioral Health Business. Retrieved January 27, 2023, from https://bhbusiness.com/2022/02/24/teladocs-mental-health-brand-betterhelp-hits-700m-in-revenue-expects-more-growth-in-2022/
6. ↑ Michelle Loyd, B. S. in P. (2020, May 28). Get started & sign-up Today. BetterHelp. Retrieved January 27, 2023, from https://www.betterhelp.com/get-started/
7. ↑ Michelle Loyd, B. S. in P. (2020, May 28). Get started & sign-up Today. BetterHelp. Retrieved January 27, 2023, from https://www.betterhelp.com/get-started/
8. ↑ FAQ. BetterHelp (n.d.). Retrieved January 27, 2023 https://www.betterhelp.com/faq/
9. ↑ FAQ. BetterHelp (n.d.). Retrieved January 27, 2023 https://www.betterhelp.com/faq/
10. ↑ How the BetterHelp scandal changed our perspective on influencer responsibility. blog - Maastricht University. (n.d.). Retrieved January 27, 2023, from https://www.maastrichtuniversity.nl/blog/2021/02/how-betterhelp-scandal-changed-our-perspective-influencer-responsibility
11. ↑ Bartov, S. L. (2022, November 29). Betterhelp patients furious at "sketchy" therapists. Newsweek. Retrieved January 27, 2023, from https://www.newsweek.com/betterhelp-patients-tell-sketchy-therapists-1762849
12. ↑ Varanasi, L. (n.d.). A therapist from online provider Betterhelp reportedly told a 22-year-old gay patient to turn straight so he could reunite with his family. Business Insider. Retrieved January 27, 2023, from https://www.businessinsider.com/gay-patient-said-betterhelp-therapist-told-him-turn-straight-wsj-2022-12
13. ↑ Lorenz, T. (2018, October 12). YouTube stars are being accused of profiting off fans' depression. The Atlantic. Retrieved January 27, 2023, from https://www.theatlantic.com/technology/archive/2018/10/youtube-stars-accused-of-profiting-off-depression-betterhelp-shane-dawson-phillip-defranco-elle-mills/572803/
14. ↑ Nolan, E. (2021, November 10). Travis Scott's BetterHelp offer after AstroWorld branded 'exploitative'. Newsweek. Retrieved January 27, 2023, from https://www.newsweek.com/travis-scott-betterhelp-astroworld-tragedy-exploitative-backlash-1647872
15. ↑ Germain, T. (2021, March 2). Mental health apps aren't all as private as you may think. Consumer Reports. Retrieved January 27, 2023, from https://www.consumerreports.org/health-privacy/mental-health-apps-and-user-privacy-a7415198244/