The Pitfalls of Large Online Counseling Telehealth Corporations: A Deep Dive into Client and Counselor Concerns
The digital age has ushered in a new era of convenience and accessibility, including within the realm of mental health care. Large online counseling telehealth companies, touted as platforms offering therapy at the click of a button, have gained immense popularity in recent years. While these giants offer a veneer of efficiency and instant support, a closer examination reveals a complex tapestry of concerns for both clients and the counselors they contract. In this article, we delve into the drawbacks of entrusting one’s mental health to these behemoths, shedding light on the limitations and pitfalls that can undermine the quality of care provided and the well-being of both parties involved.
1. Limited Personalization and Connection
The foundation of effective therapy lies in the rapport and personal connection between therapist and client. However, the sprawling nature of large online counseling telehealth corporations can inadvertently undermine this critical element. Clients seeking therapy through these platforms may find themselves shuffled between different counselors due to high demand and turnover rates. This results in a lack of continuity and a diminished opportunity for the therapeutic relationship to truly flourish.
Additionally, the cookie-cutter approach these companies often employ can lead to generic treatment plans that don’t adequately cater to individual needs. Effective therapy requires a deep understanding of each client’s unique history, circumstances, and goals – a level of personalization that can be challenging to achieve in the fast-paced environment of these platforms.
2. Counselor Burnout and Quality of Care
While the appeal of working as a counselor for a large online telehealth corporation may be the promise of a steady stream of clients, the reality for many contracted therapists is quite different. Counselors are often required to maintain a high caseload to meet the corporation’s demands, leading to burnout and a decline in the quality of care they can provide. When counselors are stretched thin, the depth of their engagement with clients may suffer, ultimately impacting the therapeutic experience.
What about specialties? Many online programs ask counselor applicants to indicate their specialty areas and skills. But beyond self report, many of them don’t actually verify this or require industry-approved credentials to support it. Yes, most check and verify licenses but for the most part, that’s where it ends. Consider this, physicians have a medical license, they also have areas of medicine they specialize in. If you have a heart condition, you want a cardiologist. If you have problems with you feet you go to a podiatrist, if you are dealing with cancer – ideally you’d see an oncologist. However, with online therapy programs you might go for grief counseling or an addiction and be paired with a children’s therapist who simply indicated those areas of interest. The bottom line – you really don’t know who you’re entrusting your personal issues and care with.
It’s also important to note that many of these platforms rely on contractors, rather than employing full-time therapists. This can result in a lack of benefits and job security for those providing crucial mental health services. This precarious employment situation can negatively impact the well-being of counselors, potentially compromising the quality of care they’re able to deliver. Paired with ruthlessly poor compensation (see more below) – it begs the question; what kind of professional would tolerate these situations – and why would they have to?
3. Therapeutic Limits of Remote Communication
While the advent of telehealth has expanded access to therapy, it also introduces limitations inherent in remote communication. Digital interfaces may hinder non-verbal communication cues that therapists rely on to understand their clients’ emotional states. Additionally, addressing complex mental health concerns often requires a holistic approach that takes into account a client’s environment, relationships, and physical well-being. Remote platforms can restrict a therapist’s ability to fully assess and address these multifaceted factors.
For some clients, in-person sessions may be more conducive to their therapeutic needs, and the convenience of telehealth may not fully align with their preferences or requirements.
4. Confidentiality and Data Security Concerns
Confidentiality is paramount in the field of mental health. However, the data security measures of large online counseling telehealth companies have come under scrutiny. With the potential for data breaches and privacy concerns in the digital realm, clients may be apprehensive about sharing sensitive information through these platforms.
In many cases, the data collected (including video and audio) by these companies can be used for purposes other than providing therapy, potentially eroding the trust that clients place in them. This concern is particularly relevant given the sensitive nature of the information shared during therapy sessions and the basic premise that sessions should be private and confidential.
5. Therapeutic Approach and Flexibility
Each therapist brings their unique therapeutic approach, and finding a counselor whose approach aligns with a client’s needs is crucial for successful outcomes. In the case of large telehealth corporations, clients may not have the freedom to choose their preferred therapist or therapeutic modality. This limitation can hinder the effectiveness of therapy, as clients may not resonate with the therapist’s style or approach.
Furthermore, these platforms often prioritize short-term therapy models due to the volume of clients they serve. This can be insufficient for clients with complex or long-standing mental health concerns that require a more extended treatment timeline.
6. Undervaluing Mental Health Services
The economics of large online counseling telehealth corporations can inadvertently contribute to a perception that mental health services are disposable or replaceable. The emphasis on cost-effectiveness and scalability can inadvertently undermine the inherent value of therapeutic work. This attitude can perpetuate a culture where clients are viewed as commodities rather than individuals seeking compassionate care.
The focus on quantity over quality can lead to a devaluation of therapists’ expertise and the vital role they play in promoting mental well-being.
For example, one of these companies currently offers $30 an hour for counselors – regardless of license levels, years of experience or specialty certifications. That is less than the most copays from major insurance companies. Ask yourself this, why would a person with a graduate degree, licenses and years of experience accept that kind of rate? Think about it. Some of these companies even do all of the charting for the sessions! How? If no one is listening in, how can they chart the details of your session. Moreover, who is charting? Is it a licensed person? Is it a automated transcribing app? License boards don’t allow unlicensed persons to chart for sessions – unless an intern supervised by the person given the session and you as the client would have to know this and approve it. No need for paranoia, but think critically about what this all actually means.
7. Detachment from Local Community and Context
Mental health challenges are often intertwined with an individual’s community, culture, and environment. By focusing solely on remote therapy provided by large online platforms, clients may miss out on the opportunity to engage with therapists who understand their specific local context and cultural nuances.
A therapist familiar with the local context can better address the unique challenges clients face, helping them navigate their environment and build coping strategies that are tailored to their circumstances.
One Last Comment
While large online counseling telehealth corporations offer the allure of convenience and accessibility, it’s essential to recognize their limitations and potential drawbacks. The challenges discussed above highlight the need for a balanced approach to mental health care that values the human connection, individualized support, and the well-being of both clients and therapists. For many individuals, in-person therapy or smaller, community-based mental health services may provide a more comprehensive and effective approach to addressing their mental health needs. As the landscape of mental health care continues to evolve, it’s crucial to critically assess the pros and cons of different platforms and prioritize the well-being and quality of care for everyone involved.
A Reality Check for Therapists
Here’s a reality check for therapists who are looking at these large online therapy companies. These are 3 of the hooks they often use to get you to sign on and a bit of how that might be worth considering more closely before you decide.
- We do your marketing and get you clients
This is true, to some extent, but getting clients for a total reimbursement to you (before taxes) of less than most insurance copays is not a gift to you and quite frankly, marketing you these days is not rocket science. (more below). Additionally, the questions becomes are they marketing you? Is your name and website benefiting from this, or is it theirs? Are they actually maximizing your online presence or simply funneling the clients they have already collected on to you at a super discounted rate? Who is benefiting from this traffic?
- We take care of the charting for you
I don’t know how it is with your licensing board, but mine would have serious questions about having an unknown person do my charting. Are they even an intern? How do they know what to chart? Are they recording or listening in? Or just creating some unfounded or generic filler? And here’s the kicker – it’s YOUR license…so who do you think your license board is going to hold responsible?
- We build and manage your online presence
Twenty years ago this may have meant something, but these days there are practices using a LinkedIn account in lieu of a website and many people build their own with WordPress or WIX. And if you don’t have the chops for that – you can have someone build you one using UpWork or another type hire on service. All great options.
Let’s look at it from a dollars and cents perspective:
I have a Word Press website with a blog. It’s costs me $130 a year to have it hosted and about $20 to keep my domain.
It has a blog in which I write articles (in down time) and commentaries on new things in field or things my clients might be interested in. This helps keep my site ever changing, relevant and organically maintianing value online – $0
I send out a holiday card and a happy summer card (personally signed noted in) – that’s $200 a year and
I list my services on one marketing site at $25 a month ($300 a year).
My website is tied to my profile on X (formerly Twitter), LinkedIn and Instagram. Nothing big to set up and – $0.
I attend several local, monthly networking meetings a year – $0
I make a point of reaching out personally to meet key people in local businesses, education and more and follow up with them – $0 (this is highly valuable on many levels)
That’s a total annual cost of $650 and it could be less in some years. If I take only 3-4 sessions as a participant of one of the large online therapy companies – not cases, min you – just sessions – I have already lost the cost of doing my own, listed above, for an entire year. It’s criminal. But, do your own math and go ask people in successful, thriving practices in your area.
If you want to make mental health access more affordable consider holding a couple spots in your caseload for pro bono or sliding scale clients and let local resources know. You determine the discount or scholarshiping that your practice can weather without an amorphous corporation making a reputation and a hefty profit off your time, efforts and expertise.
