Are therapy apps the key to making counselling more accessible for a lot of South Africans?

Search the word “therapy” in the iTunes Store and 16 of the top 20 results you’ll return are adult colouring apps, a soothing music app, a meditation app, two popular therapy apps: BetterHelp and 7 Cups. On both of these apps, the user is paired with an actual – that is, human – counsellor who can listen to your concerns and help you to work through them.

You’ve probably seen a few ads for a few sites and applications like these popping up on your Facebook or Instagram feed: therapy apps that promise to provide emotional support and counseling for a fraction of the cost of therapy sessions with a psychologist. 

It can seem a little creepy: many therapy apps’ ads make interactions seem highly artificial, even though both BetterHelp and 7 Cups are pairing you up with real people – qualified, board-accredited professionals on BetterHelp, and trained volunteer listeners on 7 Cups.

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Initially, you’ll chat to a bot on 7 Cups. Mine is named Noni, and offers a friendly and supportive welcome, as well as the option to transfer me to a human volunteer, while group chats and personalised paths are also on offer.  Another concern is privacy – with data theft often in the news of late, disclosing your innermost thoughts over an unfamiliar app might cause more stress than it relieves, but both BetterHelp and 7 Cups promise impressive levels of encryption and security. 

Cape Town counselling psychologist Walter Bradley points out that there are many ways in which technology can be used to positively impact mental health. Meditation apps, for example, are a good way for the average person to be a little more mindful and take a break from the pressures of a busy lifestyle. Bradley also highlights an important aspect of the therapy app upsurge that many of those in favour of traditional counselling are likely to overlook.

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“Not everybody has the luxury of having access to a therapist, so these apps are helpful in their own way,” he says, and of course it’s true that paying someone by the hour to listen to your concerns is the preserve of a very privileged few.

When it comes to the free counselling services that provide invaluable help to those dealing with grief and trauma, access can still be an issue: for those whose problems aren’t considered urgent enough to warrant time off work, or who live outside of city centres, just the time and cost of getting to and from a counsellor can be a deterrent from seeking help for mental health issues like anxiety and depression.

In a country in which therapy can be extremely inaccessible to the majority (on average an hour session with a psychologist is about R895) the benefits seem obvious: affordability, accessibility, and an added feeling of security that comes from avoiding potential judgment face-to-face. 

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A chat with a bot is free. Conversing with a ‘real person’ is not, and it may not even be considered affordable for the majority, but a flat fee does allow for a previously unimaginable level of access: gone are the days of waiting for next week’s session or running out of time during your 45-minute appointment. Finding a therapist to suit your own needs can be extremely tricky: not only do your personalities need to ‘click’, but as a bare minimum the therapist needs some degree of expertise in your concern, be it body image, relationship trouble or healing from trauma.

Then, there are the matters of intersectionality that we as a society are only just beginning to grasp: how does a black, genderqueer patient who feels alienated in the workplace discuss their concerns with a white, heterosexual male without feeling that they’re labouring to explain their situation or validate their concerns?

It certainly isn’t impossible to find the right therapist to understand your unique needs, but finding that person, in the right area, with space for you in their schedule, can be a costly exercise in trial and error if you’re paying for a series of first appointments. With an app, the initial ‘shopping around’ phase becomes quicker and less costly, and the chances of success seem almost certain to increase once you receive geographic boundaries.

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As is the case in many fields that are changing thanks to tech innovation, therapy is becoming available to more people, but there are still clear benefits to the original approach that comes at a price. Ultimately, Bradley says, “people are looking for a “human connection”. In real life therapy, it is the actual relationship (and the consistency thereof) that holds a big part of the healing process. No application can mimic that.”

Importantly, counselling apps are not intended for those in crisis: as their disclaimers state, they’re unable to provide the support that someone in a suicidal state needs. If you’re having thoughts of self-harm, contact The South African Depression and Anxiety Group on their 24-hour helpline on 0800 12 13 14