If you’ve been around the internet for more than a minute, you’ve likely heard of Talkspace and BetterHelp. If you’re a practitioner, there is certainly an attraction to not having to source your own clients, however is the loss of autonomy worth it? What are the benefits and downsides to working as the therapy equivalent of an Uber driver?



The business model of Uber Talkspace and BetterHelp

The basic business model of companies like BetterHelp and Talkspace is that you’re an independent contractor — which in itself isn’t a bad thing at all. However, your success at BetterHelp and Talkspace is outside of your control — you’re at the mercy of not only their marketing, but their policies, and fee structure. Talkspace is a subscription online therapy service for consumers and your pay is dependent on clients staying with the service, which, for a subscription service like Talkspace, the churn rate can be very high. You also aren’t in complete control of the clients you do decide to work with.

Pay rate at Talkspace

You could potentially make $15-25 per hour at Talkspace, however remember that you aren’t guaranteed any specific number of hours. An UberX driver’s average pay? $21.92 per hour. My comparison with Uber isn’t so ridiculous after all is it?

Pay rate at BetterHelp

Here’s what you get paid at BetterHelp (data accurate as of late 2017)

  • 1000 words of texting: $10
  • Phone/Video session: $10 for 20 minutes (so in a hypothetical hour session, that’s $30)
  • Capped at a maximum of $120 per client per month
  • If you maintain clients for 3 months, you’ll get a bonus. For example, if you retain 10 clients for 3 months, you get paid a $200 bonus. $500 for retaining 20 clients. $1000 for retaining 30 clients, $2000 for retaining 40 clients.
  • You are also required to respond to clients within a tight deadline — failure to do so can result in being frozen from the platform.

The Talkspace Controversy

There have been some seriously concerning exposés written about Talkspace. Read an extremely detailed account here at The Verge. Here’s another report. While at the time, the Talkspace CEO denied many (but not all) of the charges, there is certainly are troubling issues that aren’t disputed at all. For example, Talkspace can freeze therapists from the system, thus making it impossible to end a therapeutic relationship responsibly.

Talkspace users are also anonymous, which raises considerable ethical issues, such as preventing the reporting of threats or suicidal intent. There’s also the issue of Talkspace being able to read the full chat transcript between a patient and a practitioner. There are also certain scripts a therapist might be required to use with clients.

Should a therapist work for BetterHelp or Talkspace?

That’s entirely up to you! For those earlier in their career or struggling, or those who want a little extra money on the side, those platforms can be a good way to earn some extra money. Making a career out of it or building your your private practice strategy around BetterHelp or Talkspace is a bad idea however. The reason? You aren’t building equity in your own practice but instead are building someone else’s business. If the pay rates were higher, then it might be a more attractive option, but considering you’re making literally less money than an Uber driver, it’s not the best longer-term financial plan!

Alternatives to BetterHelp or Talkspace for your online therapy practice

You’re not going to like this answer if you’re interested in “easy.” But if you’re interested in actually building a sustainable business, pay attention!

The best alternative to BetterHelp or Talkspace? Building your own business. That’s going to take some hard work. It’s not the right path for everyone. But, if you think like a therapist entrepreneur, you can do it!

How do you build your business in online therapy?

I’ve written extensively on this topic over the years. Check out the following three articles for a starting point:

You can also check out the Therapist Marketing topic on this blog for a treasure trove of help on building your business.

The other bit of advice, especially if you want to start an online therapy practice is to start slow. I’ve seen far more success from practitioners with an existing office-based practice who slowly integrate online counseling into their business than those who attempt to jump into a fully-online business. Read How to add online counseling to your therapy practice for more insight on how to start adding this modality to your existing business.

Online or in-person, a good technology platform is important to getting organized and getting paid. Of course, this is the official iCouch blog, so we’d be remiss if we didn’t recommend iCouch for your practice management and HIPAA-compliant video conferencing system! 😉

A small disclaimer…

We have no ill-will towards BetterHelp or Talkspace. In fact, many iCouch practitioners also work for those companies. The CEO of Teladoc (the parent company of BetterHelp) was a very early mentor to iCouch. However, the question of if you can build a sustainable business on those platforms is pretty clearly answered: no, you can’t.

That doesn’t mean that you shouldn’t work for those companies, just be under no illusions that you’re going to be well paid or build anything of lasting value when it comes to your own business goals. Other than my ethical concerns with Talkspace, I have no opinion on the quality of care. As an early pioneer in this industry, I’m glad to see online therapy is getting more and more mainstream. However, at iCouch, our business is helping practitioners elevate their behavioral health business (both the online side and the in-person side,) so of course, we’re biased towards the best interests of practitioners.

Have you had experience with Talkspace, BetterHelp or any of the other direct-to-consumer mental health systems? How did it go? Leave your insights in the comments!

Published by Brian Dear

Brian is the cofounder and CEO of iCouch, Inc. He has an extensive background in software engineering, inbound marketing and mental health practice management.

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