As the daughter of a clinical social worker and a social psychologist, I read with interest the findings of a recent study assessing the effectiveness of Internet-based psychotherapy. While the approach will likely overcome barriers for some patients, the potential impact on non-consumers seems limited.
The authors conducted a randomized trial of online, real-time cognitive-behavioral therapy in which each patient was assigned to a single therapist and communication took place via typed free text. At eight months, 42 percent of the intervention group had recovered from depression compared with 26 percent in the control group.
That online therapy can be effective is good news, as this approach can overcome barriers of convenience and access for the patient. Web-based counseling might also minimize the stigma of going to a public setting for mental health care and could cut down on a provider’s overhead costs. But a disruptive innovation? Not so fast. Unless online therapy is offered by a less-skilled provider at a lower cost, I’d wager that some current consumers of care will transition to this new channel but few non-consumers of therapy will be swayed to partake. My assumption is that cost and stigma are the biggest barriers to consumption, and that the largest portion of care costs derives from the compensation required by highly-educated providers. In the online model, these provider costs remain high. Additionally, the stigma of therapy that comes from simply participating in mental health care, regardless of the location, is not addressed by the online approach.
A truly disruptive offering might look more like the model employed by Cogito Health (full disclosure: the founder is a classmate and friend of mine … but that doesn’t make the business any less wicked cool). Using voice-recognition technology to identify and monitor the progress of people who could benefit from behavioral health support, the company improves diagnosis while cutting out the cost of a psychologist in screening people for depression. Lower-cost, decentralized care without the involvement of an expensive expert? Now we’re talkin’.

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When making a pitch for your idea be sure to describe how the business will become big and be specific in your ask.
I love books. I love going to bookstores, browsing through the shelves, feeling the paperbacks conform to the curve of my hand or the weighty strength of hardcovers as I lift them off the display tables. I love getting home and cracking the spine of a book, tracking my progress with dog-eared pages or used boarding passes, and filing the book away on one of my many bookshelves like the trophy it is.