Textual Healing

Eye Animation

Our screens are our constant companions, could they also become our therapists?

Online therapy website, Talkspace (currently experiencing a post-election boomlet) offers cheap, text-based access to qualified counsellors.

While we must all celebrate the intention – affordable mental health care, hurrah! – we need to consider whether vulnerable individuals should really be encouraged to seek help via text.

Recent reports have also revealed some extremely questionable working-practices within this young and hazily regulated industry.

Anonymity and Confidentiality

For most people seeking online mental health support, confidentiality will be a deal breaker. Talkspace's therapists, as trained professionals, must maintain standards of clinical confidentiality.

What users of the service often don't realise is that these rules do not apply to the business itself. Check the small print and you'll find that, just like with a call centre, company employees can monitor the communications you have with your therapist for 'quality control' purposes.

Even more worryingly, it has been reported that counsellors working for Talkspace are not always able to access contact information for clients who have chosen to remain anonymous, even in emergencies.

By law, traditional therapists are obliged to report situations where a client endangers themselves or others – these are called 'duty to warn' laws and they are eminently sensible. However, on Monday theverge.com reported a story in which a Talkspace therapist was aware that a baby was regularly being driven by a heavily intoxicated individual, but could take no action.

This is the flaw of anonymous text therapy: how can you protect someone in the real world if all you know of them is their username?

It also encapsulates the central irony of the way we live our online lives – you may be anonymous, but in no way is it private.

It's therapy, Jim. But not as we know it.

The issues raised here are extremely complex. We know counselling works, but we don't know whether face-to-face contact (emoji faces don't count, btw) – along with all the non-verbal cues and the sense of connection it creates – is necessary to make it work.

Text therapy may be a step towards a world where everyone suffering mental anguish can get the help they need; or it may be "just another brick in the digital wall we are building between each other."

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