A combination of unlicensed therapists and the rise of therapy culture has led to the wild west of Betterhelp, writes Lucy Kenningham
Is there something interfering with your happiness? Maybe that’s preventing you from achieving your goals? Do you feel dissatisfied? Low in energy? Unmotivated?
Yes, that’s the insipid sound of a Betterhelp ad. Everyone who listens to podcasts or surfs Youtube has been bombarded by trailers for the online therapy service. Sometimes they are general, like the above. Other times they are alarmingly specific, but the advice is always the same. Gone through a breakup? You need therapy. Graduated university? Time for therapy. Affected by the war in Gaza? Therapy. Struggling with your “social battery”? You know the drill.
Given that one in four of us now has a mental health condition and NHS waiting lists are nearing the 2m mark, demand for help has boomed. And Betterhelp is here to exploit that. The premise is this: cheap, easily accessible therapy for any problem (bar suicide). It’s ostensibly a helpful mission: too many people are waiting for therapy, and traditional therapists tend to charge at least £100 per 50 minutes, whereas Betterhelp’s prices are closer to £60. Its services are online but with a variety of options: video call, phone call or a 24/7 messaging service.
It is not well known, but you do not need a qualification to be a therapist, psychotherapist or a counsellor in the UK
The company, which was founded in the US in 2013 and bought by $2bn firm Teladoc in 2015, has already been the subject of a legal challenge. Last year the Federal Trade Commission found the firm had shared 7m customers’ health data with social media companies like Facebook. It was forced to pay $7.8m in a settlement. This reveals both a disarming lack of concern for customer rights as well as unforgivable ineptitude. But that’s not the worst of it.
The scourge of unlicensed therapists
Many people have described their experiences with totally unsuitable therapists: therapists who have drunk alcohol during a session on alcoholism, body shamed clients or mocked them. One user told me: “As someone who has been diagnosed with several conditions, I forked out for Betterhelp on the fourth month of sitting on the NHS waiting list.
“The therapist I was ‘matched’ with broke several of the therapy rules – turning up late to our first session, walking around whilst I was speaking about deeply personal and traumatic experiences, and telling me that I was ‘very attractive’.”
It is not well known, but you do not need a qualification to be a therapist, psychotherapist or a counsellor in the UK. That is unusual. In Europe, training and supervision over a period of years are legal requirements for psychotherapists. In the US, you must have a licence – hence Betterhelp’s eternal refrain of promising its customer a “licensed therapist”; but alas, that means nothing here in Blighty. Unsurprisingly, the number of therapists in Britain has swelled from 100,000 to 200,000 in the last 10 years. “Worryingly, most people don’t realise there’s no regulation of therapy or counselling in the UK,” says Sue Dale, of the British Association for Counselling and Psychotherapy (BACP).
Who’d want to be a Betterhelp therapist?
Betterhelp’s pricing also begs the question: who would want to be a Betterhelp therapist when those with solid qualifications can charge as much as £200 an hour in private practice. And indeed, traditional therapists – those accredited by the BACP for example – have begun sounding the alarm. “Their pay structure is very unethical,” says Andrew Flynn, a therapist who worked with the company. Clients pay around £70 a week, but Flynn says he only received £18 of this.
Therapist Janine Hayter also had concerns: “If you realise during the first session [with a new client] that you are not a good fit for each other, you can’t refer on – the work can only be terminated by the client. To me this felt really uncomfortable and unprofessional.” One Financial Times piece published last year featured interviews with four people who had worked at Betterhelp as therapists, but without having any accreditation. Betterhelp conceded to the FT that its therapists may be registered with the BACP rather than accredited (a much shorter process).
Is the UK going to do anything about this? “Statutory regulation has been discussed in parliament several times over the years – but as yet, no government has ever pursued bringing it in,” Dr Lisa Morrison Coulthard, director of professional standards, policy and research at BACP told me.
Therapy ‘for everyone’
Undoubtedly many people with trauma or serious health issues benefit from therapy. But not any therapy: it must be with the appropriate professional. Obsessive Compulsive Disorder, for example, requires very specific treatment. Not every situation should be therapised. Let’s be honest, most breakups don’t necessitate a medical professional, rather a weekly trip to the pub with friends. Leaving university shouldn’t require many graduates to seek a psychiatrist.
Are people replacing friends with therapists? “People still have friends. Maybe it’s more about the expectation that painful emotions can or should be eliminated,” one senior psychiatrist tells me. “So there’s less stoicism, less acceptance of emotional pain. In the past people might have seen misery as a consequence of sin or of displeasing god(s) – so nothing could be done about it.”
Betterhelp, however, promises us more: “You deserve to be happy,” it claims. But that’s not always a reasonable expectation; if you’re sad after a breakup, that’s probably just a sign you’re a human being: embrace it. You shouldn’t be pressured into paying to see a professional, and certainly not an unlicensed one.