Why Therapy Apps Don't Work for Complex Conditions

Over the past decade, therapy apps raised enormous sums on the premise that the mental health care crisis has to do with the lack of access to providers. For someone with mild, situational distress, comfortable with technology and able to clearly say what they need, that may be true, as they are helped by faster, more convenient care. But this type of access remains the easiest part of a much more complex problem, and it does very little for the people whose difficulty is not finding a therapist, but finding one who is willing to see them.

Therapy Apps: The people the model does not reach

The people who tend to suffer the longest in the mental health field are the ones with more complex concerns, like depression layered onto chronic illness, bipolar disorder, personality structures that tend to end treatments early, and long-standing suicidal thoughts. They have usually already tried a brief protocol, a rotation of platform therapists, or an app, and concluded that treatment has little to offer them, because there is a mismatch between the help on offer and the problem they actually have.

App-based care is designed for difficulties that ease with information, structure, and light contact. Complex conditions are a different kind of problem, and they call for a much more structured approach.

What complex conditions actually require

Therapy apps do not work for complex conditions because these concerns require continuity: the same clinician, over time, willing to hold the difficulty of a case. These cases also require much deeper, structured training: differential diagnosis, the assessment and management of risk, and clinical judgment developed over years of supervised practice, not reliance on premade protocols alone. And, most of all, they require a clinician who stays, including through the moments of treatment when staying is very hard. Given the conditions that often end most treatments early, the willingness to remain steady is often a large part of the treatment itself.

Continuity is one reason Real Talk accepts major insurance plans. Depth-oriented care that a person can actually sustain, financially, over the length of time the work requires, is a kind of access that matters immensely for complex conditions.

If brief care has not helped

If you have tried apps or short-term treatment and find yourself roughly where you started, the reasonable conclusion is that the care was not built for that problem.

We are an outpatient practice, but even when someone needs a higher level of care, we help coordinate it, and we continue the therapy when outpatient treatment is appropriate. For us, this is what access to care actually means.

More About Real Talk

Doctoral-level clinicians, covered by major insurance plans, in English, Spanish, Portuguese, and Farsi. In person in Houston and via telehealth across Texas.