Looking for a good online psychologist/therapist
October 10, 2020 12:24 PM   Subscribe

I live in a part of the world where my therapy options are pretty limited. Can you help me locate a good online therapist?

Problems I’m going through are related to garden variety of anxiety and depression, career woes, CPTSD-related fun, frequent exposure to narcissistic abuse, and ADHD.

Googling “online therapy” and the like returns pretty generic results with no indication whether they’re good or bad.

Bonus points if:
1. They can teach me stuff like CBT, DBT, Acceptance and Commitment Therapy, EMDR, or other proven therapeutic modalities.
2. You or someone you know have tried them and had a good experience with them.
posted by thenickeldropped to Health & Fitness (9 answers total) 1 user marked this as a favorite
This is going to be governed in part by where you are located, so a jurisdiction would help us provide more relevant responses. (For example, a therapist licensed in Texas may not be able to see anyone from anywhere else. A therapist licensed in the US will not likely be able to get authorization to work with someone in China, but could perhaps work with someone in Spain.)
posted by crunchy potato at 1:19 PM on October 10, 2020

No personal experience, but this is heavily advertised on various podcasts I listen to: betterhelp.com. They provide a lot of details about their team including qualifications here, and also include links to media coverage of their service.

As crunchy potato said, you don't say whether you're paying for this yourself or have some kind of insurance, if it's the latter we will need more information about your insurance's requirements to suggest something that's going to be covered (jurisdiction, registration requirements, etc.). On the other hand if you're paying yourself that gives some flexibility and might get more answers.
posted by tiamat at 1:46 PM on October 10, 2020

Open Path Collective is similar to BetterHelp or Talkspace, but they have a sliding-scale model specifically for people who are self-pay or who have crap insurance. My former therapist did work for them, but I did not personally use this service.
posted by blnkfrnk at 2:57 PM on October 10, 2020

I had a good experience with talkspace.com . they do an inital consultation to help match you with possible providers in your area who cover what you are looking for, and then give you a few people to choose from. You can also change therapists if needed.
posted by nalyd at 4:06 PM on October 10, 2020

Maybe people could post in what countries or regions the links provide counselling in?
Being not in the US and trying out these links:

* Open Path Collective is US only, and we can't assume the poster is in the US.

* betterhelp.com appears to have international options, but wants to charge US$260 before showing you who you can be matched with, and before clarifying whether and what time I can schedule a video appointment, because I'm not really interested in email or txt counselling.

* Talkspace also doesn't seem to show me who I can match up with, and it is US$316 per month for one monthly video appt + messaging (US$79/week), or
US$99/week / US$396 monthly for four sessions a month.
Does that mean a session each week, or skipping a session in a month with 5 weeks? The US thing of paying for weekly things monthly is bizarre. :P

Are there online options for just, like, normal therapy, rather than subscription services?
Where I can just... read the bio of a therapist, see what time they have available appointments, and pay for one appointment at a time??
posted by Elysum at 6:43 PM on October 10, 2020 [2 favorites]

I've been pretty impressed by the TEAM-CBT approach developed by David Burns. You might want to look and see their list of trained therapists and see if any of them would work for you. (Note TEAM is an acronym that has nothing to do with teams of people) You can look Burns' latest book for any idea about his approach (or even starting with some self-help in the meanwhile.

You might do some research and find out if practicing psychotherapy requires a license where you live. An American therapist can get in big trouble with their own licensing agency if they practice without a license somewhere else but if no license is required then they aren't breaking any law. If you know that ahead of time (and can document it for the therapist) you will have a better chance finding someone who might work with you.
posted by metahawk at 7:26 PM on October 10, 2020

Are there online options for just, like, normal therapy, rather than subscription services?
Where I can just... read the bio of a therapist, see what time they have available appointments, and pay for one appointment at a time??

The issue, as others have pointed out, is that in US at least, therapists are usually licensed by state and have to follow their state laws in how and where they practice. Because other states have similar laws about therapists needing to be licensed by that state in order to practice in that state, they don't generally allow people who are licensed by other states to practice with their residents.

As metahawk said, if you as a client live in a place where therapists can practice without a license, then a licensed therapist from another state could probably legally work with you, but they might be really wary of getting into legal or credentialing problems. What if you sued them? They'd need to know the laws and regulations of your locale. Even if you didn't sue, what if a family member sued, or subpoenaed your records? What are the laws about that? What if you had a crisis? They'd need to know the crisis services/resources available in your locale. What are your locale's laws for things like mandated reporting of child/elder abuse? Do you have Tarasoff Warning laws that would require the therapist to notify people if you were making a credible threat against them? Does your locale have totally different laws that the therapist would have to follow but may not even know to ask about or research?

Therapists would obviously want to weigh all this against the harm that may come from your not receiving help, but it's also a situation where as the potential harm gets higher, the potential risks also get higher (e.g., more likely to involve crisis work).
posted by lapis at 9:00 AM on October 11, 2020

Just chiming in to say, please avoid BetterHelp and TalkSpace if at all possible. Mental health help can be ridiculously hard to access, especially in your complicated circumstances, so I fully understand that BetterHelp and TalkSpace are filling a real need for many people. However, there are serious problems with these services.

If I could highlight exactly one red flag: THE PLATFORMS RECORD AND STORES THE ENTIRETY OF EVERY SINGLE THERAPY SESSION. This is not therapy... it is a disaster of unmitigated proportions, and it's breathtakingly unsafe for everyone who is on these platforms, provider and patient alike. Please see this recent fpp for further discussion.

In addition, this is not real therapy. The fine print says so. It may not seem important to you, because the providers on these platforms are indeed fully qualified therapists. But because this technically isn't real therapy, you are not protected by the usual laws and professional ethics codes which would apply to real therapy. For instance, if your "therapist" on such a service ghosts you after working with you for several months... or if they use your session time to sell you aromatherapy oils which they are hawking as a side gig... or if they make romantic overtures towards you after building up trust... you would not have any legal recourse and nor would there be professional consequences for the abusive "therapist". There is a long and sordid history of psychotherapists harming their patients in devastating ways before these protections existed. This is important.

And also, these platforms exploit therapists to an unconscionable degree. The pay is absolutely dismal and providers are not protected by these platforms any more than customers are (can't call them patients, not on the platforms).

I hope you can find an online provider to work with you in the "regular" way. Psychology Today is probably your best resource for finding someone legit to work with you, but if you tell us where you are located, folks can probably give you more useful and specific recommendations.
posted by MiraK at 2:12 PM on October 11, 2020

Not sure how limited therapy is in your country, I am guessing there should be some demand and supply unless there's a strong cultural taboo against seeking help for mental health issues. At the moment lots of therapists have switched to only offering their help via Skype/ Zoom/ phone calls, and for me this has actually expanded my options. There are two main sites where I live, one a sort of national register of certified counsellors, the other the local ones from the Psychology Today site. Since there's no local in-person counselling for the foreseeable future, I ended up choosing a counsellor about 50 miles away who had studied the exact form of counselling I wanted (person-centered, which worked for me, I see you are looking for different modalities) and also was up-front about offering a concession rate to those hit financially by Covid or otherwise low-income.

I found it has been pretty straightforward and actually am fine talking over Zoom, since I live alone with no one to eavesdrop on me, it saves me money not needing taxis to a counselling venue so it's good value for money. I know lots of other people who do have family or are at work who schedule appointments over the phone from their car during lunchbreak and things like that to get a little privacy. This is a challenging year for everyone, needless to say especially so for those with isolation or anxiety, so it's well worth taking time to seek out professional help to get you through things.

In theory it can helpful to try a few initial consults to find the right match but in my case the Psychology Today profile ticked every single specific box I had (things like specialising in long-term health diagnoses and also specialising in loneliness, plus as I said I needed a sliding scale to make it sustainable) that I went with my initial choice after a free 30 minute consult confirming the way they worked. I didn't click the links about Talkspace etc above but strongly prefer working with a traditional counsellor where they abide by a code of ethics, use a supervisor, have an ethics contract we both agree to etc.).
posted by AuroraSky at 7:51 PM on October 12, 2020

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