We recently hosted a webinar with Talkspace and Aetna titled, “Advancing Mental Health through Asynchronous Therapy.” We were joined by Dr. Derrick Hull, Research Director at Talkspace, Dr. Varun Choudhary, Chief Medical Officer at Talkspace, Pablo McCabe, SVP of Healthcare and Account Strategy at Talkspace, and Brooke Wilson, the Head of Resources for Living, a division of CVS Health/Aetna. In the session, we discussed the newly-released, impressive research on asynchronous, text-based therapy and how Aetna and Talkspace successfully executed their partnership.

Background about Text-Based Therapy

With a growing need for mental health support, it is important for people to think creatively about how mental health care should be delivered in the United States. There is a mental health provider shortage and 55% of US counties have no psychiatrist, psychologists, or social workers. As we consider new ways to offer mental health resources to those who aren’t able to easily access care, text based asynchronous therapy is one solution.

Text therapy can be convenient for those with busy schedules, it’s cost effective, accessible, and allows people to be in the privacy of their own home. As Dr. Hull explains, “even if you have the money to seek care, some people don't. Scheduling the sessions can be a challenge, the travel, the commute, all of that can be a challenge,” and text therapy can help with that. Additionally, it may be helpful for people to look back on the conversations with a therapist to reflect on helpful tips and talking points. Some people may even find that writing difficult things in text might be easier than saying them aloud. Text therapy has also been shown to be a great way for people to be introduced to therapy, and some studies show that people then decide to seek face-to-face therapy after a positive experience with asynchronous text therapy

‍How Talkspace Works

Talkspace is a HIPAA compliant app where members have access to therapists through texts, voice messages and/or video visits but most of the interaction with providers is done through asynchronous text messaging. As Dr. Hull explains that Talkspace makes sure to use “licensed professionals who can structure the treatment with the same kind of clinical frame that you would expect if you were going face to face.” In other words, their aim is to provide as similar a treatment as possible.

Additionally, some mental health providers have seen the benefits of using asynchronous text based therapy. As Dr. Hull explains, “because messaging is unfolding daily, you almost have more insight into what's going on with the client than you do [if you’re meeting] weekly.” In their early research studies, Talkspace has also seen “that people engage more frequently, and they also tend to stay longer [than traditional therapy], and our assumption here is due to convenience.” More of their studies have also seen that as patients' improvement slows down, therapists are reaching out more, to keep members engaged. 

In a Talkspace study, they found that over a 12 week period of treatment, patient GAD-7 scores, measuring anxiety, decreased 48% and patients PHQ-9 scores, measuring depression, decreased 53%. In studying their effect on workers, they found that Talkspace users missed 50% fewer hours over a 90 day period, compared to prior to treatment, 64.7% increase in employee activities outside of work, and 56% increased work productivity. 

How the CVS and Aetna Partnership Works

Brooke Wilson mentions that the Talkspace partnership started as a pilot in 2018 as a new way to engage members. As she explains “we thought it would allow people another choice and preference in how they might like to access care.” As the pandemic started, Brooke mentioned that they had an increase in demand for mental health support and that traditional providers didn’t have appointments. 

Brooke continues, “we also were able to offer these different modes of connection beyond async. So for our customers, we have that option of a telephonic session, a video session, a live chat session as well as that asynchronous.” She echoes that giving their members choice and lots of different watts to connect opened up options for care. She adds, “we did think that this could attract new members who maybe weren't engaged with traditional means because it reduced barriers and was less stigmatized.” Brooke concludes that after adding in Talkspace, some members have seen utilization of their EAP jump 20% in one month.

Things to Keep in Mind for Asynchronous Text Based Therapy

Asynchronous text based therapy is a wonderful option for many people, including those who cannot talk freely such as those experiencing domestic violence, those with complex schedules such as airline workers, healthcare workers, and young parents, and for those who are new to therapy because it offers a low barrier to entry. Typically, clients with more serious mental illness or more severe symptoms such as those dealing with psychosis or mania may need more treatment than text based therapy can provide. 

Pursuing text-based asynchronous therapy is an individual choice and can be an excellent way of accessing mental health care. 

You can watch the full webinar here and to hear more conversations about digital mental health, please join us for the Going Digital: Behavioral Health Tech conference on June 8-9, 2022. Registration for the conference is free, or consider making an optional donation to our 2022 non-profit partner, the American Foundation for Suicide Prevention. 

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