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Photo credit: Justin J. Wee

These three friends published their real text therapy sessions in an insightful look into mental health care

December 7, 2018

What if your secrets—perhaps, secrets you told a therapist—were published on the internet for everyone to read? That is exactly what three artists and friends are doing through their project Friends with Secrets.

Friends with Secrets is a project created by three friends—Robyn Kanner, co-founder of MyTransHealth and former designer at Amazon; Timothy Goodman a designer who has created art for companies like Apple and Airbnb; and Akila Hughes a comedian and writer featured in projects for MTV and Elle Magazine. The project discloses real conversations between these friends and real online therapists.

Why? The project brings awareness to mental health issues, demonstrates revolutionary vulnerability and builds a sort of mutual empathy between the creators and readers of the project.

Online therapy is trending lately. If you haven’t tried it yourself, you probably know someone who has. This is likely because of its ease and accessibility. Like Uber with cars, Airbnb with housing and Seamless with food, many online therapy providers offer instant services with minimal or no in-person contact.

Having a raw inside look at real online therapy conversations is insightful in ways previously unexplored. It feels sort of like being a fly on the wall—like you’re seeing something you aren’t supposed to. That’s why the project is so impactful.

Marginalized people—LGBTQ or otherwise—are still being failed by healthcare systems, especially in mental health. Additionally, they may not be able to pay for often-expensive in-person therapy. Online therapy could be a very viable alternative to traditional therapy for these people. 

More about online therapy

People seeking treatments to better their mental health is becoming more commonplace. In 2018, there was a 2.5 percent decrease in the number of uninsured adults with a mental health condition—meaning, those who need care are accessing it at a higher rate than last year. But, there are still over 9 million U.S. adults who report having an unmet need.

It is likely that the existing rise in prominence of digital therapy will contribute to the rise in Americans accessing mental health care. Telehealth has been around in the U.S. for the over 20 years now. Previously, this technology was primarily used by the Military but, with smartphones and home computers now in the hands of most Americans, telehealth care is becoming quite common.

Patients can now meet with their therapist via video call, phone call, email or asynchronous messaging (like the therapy being examined in Friends with Secrets).

Researchers at the University of Zurich report that therapy sessions conducted by instant messaging were as effective, if not more effective, than standard in-person therapy. Another study found that therapy via asynchronous messaging was potentially more effective than in-person sessions because patients could return to the written texts at any time after the initial session.

Kanner’s experience, however, did not necessarily reflect the same conclusion.

“I feel like the only way text therapy worked for me, was when I drew hard lines about what I wanted to talk about and what I expected,” Kanner said. “In text therapy, it is very hard to get to the root of a person when compared to an in-person therapist.”

At the very least, it is likely that text therapy can work as an avenue for participants to eventually receive in-person psychological care. This concept is not widely studied, but a 2014 study showed that college students needing a higher level of care for an eating disorder were more likely to seek it after having completed a form of group text therapy sessions and an online body-image program.

Goodman shared that he had this same experience.

“I’d say it really propelled me to go to in-person therapy,” Goodman said. “I did it for years after college and this encouraged me to get back into it.”

Mental health is a queer concern

Mental health problems plague the queer community because LGBTQ people are more likely to confront stigma and discrimination in our daily lives.  

This falls under the umbrella psychological term “minority stress.” Minority stress is the term for mental health issues in minority communities caused by issues like social stigma, discrimination, denial of human rights, denial of civil rights, abuse, harassment, victimization, social exclusion and family rejection.

A 2009 study reported that, “Minority stress has been linked to psychological distress among gay men and lesbians and may contribute to elevated rates of distress frequently observed among LGBTQ youth,” and the Canadian Mental Health Association says that LGBTQ people experience higher rates of depression, anxiety, obsessive-compulsive & phobic disorders, suicidality, self-harm, and substance use. Additionally, a 2014 study published by The Williams Institute found that over 22 percent of surveyed LGBTQ youth had attempted suicide within the past year and noted that the rate of suicide attempts is higher in LGBTQ youth of color.

The impacts of minority stress in LGBTQ people can extend beyond our sexuality or gender expression. Additional marginalizations or disadvantages—like race, skin color, economic status, or disability status—may further impact how someone experiences minority stress. This is the concept of intersectionality.

Friends with Secrets is honest

Text therapy is not going to be right for every situation and certainly is not a good fit for every queer person. Maybe it is right for you. Maybe it isn’t. Regardless, it is so important that creators make a way for these options to be made visible to those who need them most.

Hughes echoes this sentiment. Though skeptical at first, she recognizes that everything counts when it comes to mental health.

“The reality is that therapy is very expensive. I feel like, as probably the most affordable therapy option, even though many probably can’t afford this, it is helpful in some ways” Hughes said. “Everything considered—it is not a bad thing. Having someone to talk to when you need is never a bad thing.”

Those struggling with their mental health are often the last person to ask for help, so having an inside look at text therapy without judgement or bias could literally save lives.

That’s what lends the potential for Friends with Secrets to be helpful for so many. The project isn’t fiction. The “characters” are real people, and the therapists are real therapists (though their identity is hidden for privacy reasons). Kanner, Hughes and Goodman certainly don’t shy away from their own realities. The three friends confront abuse, addiction, existence, loss and heartbreak.

Friends with Secrets launched online at friendswithsecrets.com on Monday, December 3rd, 2018. The first text therapy session was made available to view on that day. Then, a new therapy session is available every day for the following four days.

Occasionally, mental health issues transmute into a physical concern—like in the case of addiction. Physical health concerns should be treated by a doctor legally qualified to handle them. Additionally, very severe cases of mental illness will likely require more help than a text therapist can provide.

The creators of this experience stress that they are not promoting online therapy. Instead, they aim to document their own experiences in a way that is helpful for those considering therapy of any kind. Kanner confronts abuse that she didn’t even initially realize was abuse, Hughes battles with familial conflicts and Goodman details a past relationship—all problems that almost any of us could face. A reminder that we are all in this together is a welcome reminder.

Tim Harris is a GLAAD Campus Ambassador and junior at University of New Mexico studying communication and journalism. He is a freelance writer and digital marketing professional who aims to inspire progress towards equity with his words for all underrepresented and oppressed groups of people.

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