Why Online Therapy Platforms Like BetterHelp Miss the Mark: A Psychodynamic Perspective
As a psychotherapist specialising in trauma and attachment, I’ve been watching the rise of online therapy platforms like BetterHelp with growing concern. While increasing access to mental health support is crucial, these platforms often overlook the fundamental aspects of what makes therapy transformative.
At the heart of psychodynamic and relational therapy lies the therapeutic relationship itself – that unique space where healing occurs through authentic human connection and attunement. This isn’t something that can be commodified or reduced to a series of quick text messages or sporadic video chats with rotating counsellors.
The issue with BetterHelp’s model isn’t just about the online delivery – many of us successfully transitioned to telehealth during COVID-19 and continue offering it. Rather, it’s about the corporatisation of therapy and the implicit suggestion that therapeutic relationships are interchangeable.
Consider attachment theory: we know that secure attachment develops through consistent, reliable, and attuned caregiving. The same principles apply in therapy. When clients constantly switch between different therapists or rely primarily on text-based communication, they miss the opportunity to develop the deep therapeutic alliance necessary for meaningful change.
The platform’s business model prioritises accessibility and convenience, which, while important, shouldn’t come at the expense of therapeutic depth and containment. Therapy isn’t meant to be a quick fix or a casual chat. It’s a profound journey of self-discovery that requires commitment, consistency, and a safe, bounded therapeutic frame.
From a trauma-informed perspective, the lack of consistency and containment can be particularly problematic. Trauma work requires a stable, predictable therapeutic environment where clients can gradually build trust and process their experiences. The casual, consumer-driven approach of these platforms risks replicating attachment wounds rather than healing them.
Moreover, the platform’s emphasis on immediate responses and 24/7 availability might seem supportive but actually undermines the therapeutic process. Part of therapy involves developing internal resources and learning to sit with difficult feelings between sessions. The instant gratification model doesn’t allow for this crucial developmental work.
There’s also the concerning issue of privacy and commodification of mental health data. When therapy becomes a tech product, client confidentiality and therapeutic boundaries can become compromised by corporate interests and data mining practices.
While I appreciate the intention to make mental health support more accessible, we need to be thoughtful about how we achieve this. Perhaps instead of rushing to digitalise and commodify therapy, we should focus on addressing the systemic barriers that make traditional therapy inaccessible for many.
For those seeking therapy, I encourage you to prioritise finding a consistent, qualified therapist who can offer a stable therapeutic frame – whether online or in person. Look for someone who understands the importance of the therapeutic relationship and can provide the containment and attunement necessary for deep therapeutic work.
True healing happens in relationship, through consistent, boundaried, and attuned therapeutic encounters. You can listen to Prof. Allan Schore talk about this on the Huberman Lab Podcast. While technology can support this process, it shouldn’t replace the fundamental human connection at the heart of therapeutic work.
