Lauren Kay has never met her therapist in person. The 24-year-old entrepreneur found it difficult to take time off work for appointments.
So she started seeing a psychotherapist online.
"It's definitely been different," she says. Kay, who lives in New York, found her counselor through an online therapy service called Pretty Padded Room. When it's time for an appointment, all she has to do is log in to the website, click a link and start video chatting.
The format works well for her. "It felt like Skyping with a friend," she says. "And when I was at my parents' house the other day, I got to show my therapist my cat."
Now, she says, she prefers these video sessions to traditional therapy. And she's not alone in that thinking. More and more people — especially millennials — are trying Web therapy.
There's a real demand for this sort of therapy, says Bea Arthur, a licensed mental health counselor and the founder of Pretty Padded Room, which is based in New York. "Our target market is women in their 20s and 30s," she says.
People from all over the world can sign up. "We have clients in Belgium, Saudi Arabia, Korea," Arthur says. "It's been amazing."
Those seeking help can choose from nine licensed family therapists and clinical social workers. It costs $45 for a 30-minute session, or less if you sign up for a monthly plan. The company doesn't accept insurance, but Arthur says some clients have gotten their insurance providers to reimburse them for sessions.
Some studies suggest that therapy online can be as effective as it is face to face. "We have a lot of promising data suggesting that technology can be a very good means of providing treatment," says Lynn Bufka, a clinical psychologist who helps develop health care policy for the American Psychological Association.
"I don't think we have all the answers yet," Bufka says. There are cases where therapy online may not work, she notes. Therapists usually don't treat people with severe issues online, especially if they are contemplating suicide. That's because in case of a crisis, it's much harder for online therapists to track down their patients and get them help.
Privacy is another concern. Instead of Skype, many online therapy companies choose to use teleconferencing software with extra security. Arthur at Pretty Padded Room says her company takes measures to protect her clients' records.
But it can be hard for people to know exactly how secure the website they're using really is, Bufka says.
And then there's the issue of licensing. Family therapists, mental health counselors and clinical social workers are licensed to practice by individual state boards. But it's unclear whether a practitioner who lives in one state can or should treat someone who lives elsewhere.
"We'd like to see a little more mobility and flexibility with that, because certainly for licensed psychologists the standards are pretty similar across state lines," Bufka says. Perhaps, she adds, therapists could get a special certification that would allow them to practice in multiple states or countries.
The APA released a guideline for online therapy last year. It encourages online practitioners to take care protecting clients' data, and to familiarize themselves with state and international laws. But it doesn't resolve these issues.
Right now, some therapists try to dodge the licensing issue by calling themselves life coaches, which doesn't require state licensing. The problem with that, Bufka says, is anyone can call himself or herself a coach. Those seeking therapy online should ask potential therapists about their training, she says.
Policymakers are going to have to sort out these legal ambiguities sooner rather than later, says Arthur of Pretty Padded Room. "Ultimately it's about reaching people," she says. "We have to meet clients where they are. And if they're at home and they're not feeling so hot, why would you deny them [treatment]?"
Therapists have to keep up with the times, says John Kim, founder of The Angry Therapist. "It's kind of like bookstores and Blockbuster. Everything is shifting online. The same thing will happen with mental health."
In addition to therapy from a group of licensed therapists and life coaches that Kim trains, those who sign up on his website get daily motivational emails and access to group sessions via Google Hangouts. The service grew out of Kim's personal blog.
He's a licensed marriage and family therapist in California, and he sees clients both online and in person. But, he says, some of his clients actually feel more comfortable chatting on Skype than they do talking in person.
It helps that communication technology is getting better and better, Kim says. "When the Internet was on dial-up and stuff, it was really hard to do something like this. But now you can literally see a teardrop."
RENEE MONTAGNE, HOST:
All right, so let's talk about solving psychological problems in this next story. Traditionally, of course, talking to a therapist has required going to an office and talking face-to-face. But as NPR's Maanvi Singh reports that the Internet is changing that. More people - especially younger people - are going online for their mental health services.
MAANVI SINGH, BYLINE: Lauren Kay has never met her therapist in person. She is a 24-year-old entrepreneur who lives in New York.
LAUREN KAY: It can be really hard to have to take off from work and commute, especially, like, in New York - two hours round-trip to see a therapist.
SINGH: She finds that it's much more convenient to see her therapist online.
KAY: It's been the best relationship that I've had with a therapist.
SINGH: She found the counselor on a website called prettypaddedroom.com. She chose her out of a list of licensed therapists and social workers. When it's time for her appointment, she logs in, clicks on a link and begins her video session.
KAY: You know, it felt like Skyping with a friend. And when I was at my parents' house the other day, you know, I got to show my therapist my cat. So it, you know, it just makes it more personal where you can sort of bring your therapist into your home and really talk about what's going on.
SINGH: She's not alone in that thinking. More and more people - especially millennials - people born in the 1980s and 1990s - are trying this out.
KAY: What's happened is that we've gotten really used to using on-demand services to make our lives easier, you know, everything from booking a taxi to food to booking a date.
SINGH: The founder of the online therapy service Pretty Padded Room is Bea Arthur. She says there's a real demand for web therapy right now.
STEVE ARTHUR: For the most part, our target market is women in their 20s and 30s.
SINGH: She says it works really well for young people on-the-go.
ARTHUR: You know, job issues, breakups, adult friendships breaking up - just there's so many transitions that occur during this time, and we've really gone out of our way to kind of curate an experience that speaks to them.
SINGH: A 30-minute session is $45 or less if you sign up for a monthly plan. There are nine therapists to choose from based from all over the country. And patients from all over the world can use this service.
ARTHUR: We have clients in Belgium, Saudi Arabia and Korea. I mean, it's been amazing.
SINGH: Pretty Padded Room isn't unique. A bunch of other companies have the same idea. There's a website called Breakthrough, another called Virtual Therapy Connect. The list goes on and on. Studies suggest that therapy online can be just as effective as in person. Lynn Bufka is with the American Psychological Association.
LYNN BUFKA: I think we have a lot of promising data suggesting that technology can be a very good means of providing treatment. I don't think we have all the answers yet.
SINGH: There are cases where therapy online may not work. Online therapists usually don't treat people with severe issues, especially those who may be contemplating suicide. Privacy is another concern. To protect confidentiality, some of these companies use special teleconferencing software with extra security. And then there's the issue of licensing. Therapists are licensed to practice by individual state boards. Bufka wants to see a special certification for therapists who live in one state and want to treat people who live elsewhere.
BUFKA: We'd like to see a little more mobility and flexibility with that because the - certainly for licensed psychologists, the standards are pretty similar across state lines.
SINGH: Sorting these issues out is crucial because as the world continues to move online, people are increasingly looking for mental health care on the Internet.
JOHN KIM: This is going to be the new way.
SINGH: That's John Kim. He's the founder of The Angry Therapist, another online service. As communication technology gets better, Kim thinks online therapy will continue to grow.
KIM: Before, you know, when the Internet was on dial-up and stuff, it was really hard to do something like this. But now, I mean, you could literally see a teardrop. You could - you know, Skyping with someone is just as effective sometimes, if not more, than in person. When you open up your laptop or on your desktop, you just see your therapist and you - it's a lot more casual. It takes away the stigma of therapy.
SINGH: Kim sees clients both online and in person, and he says some of his clients actually feel more comfortable chatting on Skype than they do talking face-to-face. Maanvi Singh, NPR News.
MONTAGNE: You're listening to MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.