Will Digital Technology Disrupt The Psychotherapy Market?

@giorodriguez  Probably.  And a field called positive psychology may be helping to shape the disruption

Not long ago, I wrote a brief article about the curious rise of a new technology category, which for lack of a better term can be called happy-tech.  I asked the question, in my headline:  “Can Social Technology Help Make You Happy?”  The short answer:   “yes, but it depends on what you mean by happy.” The inspiration for the article was an application called Happify, which, according to its founders, took its own inspiration from the positive psychology movement.  The movement — an increasingly influential field of practice that is challenging the psychotherapy status quo – asks society to focus not just on what makes people miserable but also on what makes them flourish.

The core insight from that article was that apps like Happify were scratching an itch that technology was ready to scratch.  But my view, at the time, was that technology was only scratching the surface.  Recently, however, I began to appreciate that the provenance of some of these apps – the positive psychology movement – may be driving a larger tech disruption.  But, as we shall see, not all disruption is destructive.  The influence of positive psychology on tech-based disruption has thus far enjoyed a mostly positive storyline.

Expansion of services

First, by shifting the focus from mental illness to mental wellness, the positive psych movement is not just introducing a paradigm shift but provoking an expansion of services.  In addition to talking therapy (on the wane) and psychopharmacology (holding strong), practitioners of positive psych bring a mix of new interventions to the counseling experience.  And the practitioners include professionals trained in the oldest of psychotherapy traditions:  MDs.

On a recent business trip to New York, I met up with Samantha Boardman, who several years ago supplemented her medical education with a credential in positive psychology awarded by the University of Pennsylvania.  The program, the first of its kind, is led by the founder of positive psychology, Martin Seligman.  Today Boardman is helping the school develop the program, while incorporating its teachings into her psychiatric work. “Positive psychology has changed my practice on many levels,” she wrote in a recent email exchange. “It has changed the way I approach patients. Rather than focusing exclusively on what is wrong with them I also look for what is ‘right’ with them and explore their strengths.”

Boardman had already in fact shared this data point with me, and it was easy to see how the little tweaks in behavior advocated by the movement – i.e., expressing gratitude, savoring positive experiences, recording your blessings on a daily basis – deserve at least a few minutes in the hour one gets in traditional therapy.  But it was not what Boardman is doing in the offline world that got me thinking.  It’s what she is doing in the online world.  Like many other graduates of the Penn program, Boardman is using the Web not just to publish her observations but to prescribe the little behavior tweaks in small digital doses.  And Boardman does this particularly well.  She dispenses these tiny bits of virtual psychopharma in a beautifully designed blog called Positive Prescription, which features branded beats and columns like “Mind Tonic,” “Positive Rx,” and “Visual Prozac.”  It’s not silly stuff – she backs up her prescriptions with hard science, and, like all great doctors, with care and empathy. What’s remarkable, of course, is that Boardman is using digital artifacts as the units of therapeutic currency itself.  And when you consider the artistry of the artifacts – the quality of the design and the quality of the text – you will see that it’s in a different category from the advice column, a mainstay even today in mainstream media.  In other words, the addition of positive psychology to the psychotherapeutic toolkit – which favors bite-sized experiential exercises – easily lends itself to digital experiments.

Expansion of practitioners

And you don’t have to be an MD like Boardman or any kind of licensed psychotherapist or counselor to engage in these experiments.  You may be a physical therapist (Larry Bentz). You may be a coach (Emilia Lahti). You may be a may, in fact, be a tech entrepreneur — like the people who started Happify and other happy-tech apps – and take an even more serious interest in the potential of tech for potentially disruptive experiments.  The expansion of market entrants, especially from tech, is accelerating disruption in the psychotherapy.  Which is not to say that traditional psychotherapy is doomed; the need persists, and there’s no substitute for live experience.  But the disruption that digital has wrought in other markets – say media, education, and old-time retail – might force psychotherapists to rethink what business they are really in, or at least reimagine their business models.

One thing that’s sure to get attention:  the business model for distribution.  This year at SxSW Interactive – an annual convocation for innovation in tech – a new startup called ThriveOn won a prize in the health-care category with a platform that promises to deliver “personalized online programs coached by experienced professionals to strengthen your mental health.”  The platform is not yet available, though you can take a very impressive assessment (which I assume leverages some of the core IP).  But the point really worth making here is that the most disruptive idea in ThriveOn is the redistribution of content and talent, the same forces that are reshaping other markets.

Toward a more purposeful disruption

Though not technically a positive psychology app – similar philosophical bent, but from a more diverse background of founders – ThriveOn may win big because it is scratching a bigger itch.  But I’m betting there are even greater disruptions to come.  One reason is that the psychotherapy market is simply too big to ignore. Though antidepressants peaked in 2008 at $12 billion, they are still, according to a recent study, “the most consumed class of therapeutics in the US.”  Where there’s a market to disrupt, there will be disruption.  Another reason is the seemingly unstoppable demand for self-improvement and self-monitoring apps and devices; the future of that trend points to innovation in artificial intelligence, the perceived threat to so many professions. But I’m betting on yet another driver of innovation, and it goes in the opposite direction of artificial intelligence:  the need for a positive storyline for a profession that’s frankly in need of a boost in morale.  In an insightful cover story for the New York Times Magazine in 2010, Daphne Merkin chronicled her struggles in becoming clinical psychologist at a time when talking therapy was beginning its decline.  What she learned:  she wasn’t very good at branding herself.

As a business guy who once considered — and still considers — the life of a counselor, I found her conclusion depressing.  But if positive psychology can help professionals plot a more successful path into the marketplace, and if technology innovation can help facilitate those transitions – say through even more clever ways to match counselees with counselors, both online and offline, where some of the more serious stuff still needs to happen – that would be a blessing worth recording.

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