Mental health on your mobile: does Prince Harry's BetterUp app work?

Online therapy is booming, and the results are surprising

Mobile phone technology has spawned a growing industry providing access to mental health services via the internet. PA Images via Getty Images

Prince Harry, Duke of Sussex, has landed a top job at BetterUp. This Silicon Valley tech start-up offers online coaching and mental health services. Harry will be joining the leadership team as the Chief Impact Officer. This is a role that typically involves input on strategic decisions, charitable funding and fostering community relationships. Harry's history of mental health advocacy makes him a good match for a company committed to helping people discover their inner strengths and reach their full potential.

BetterUp claims to use evidence-based psychological coaching to help individuals with their professional development and personal growth. "When your team thrives, so does your business" runs one of the company's enticing one-liners. It offers psychological assessments and interventions for individuals committed to becoming their "best selves". A unique selling point is these services can be accessed by anyone with an internet connection anywhere in the world. This is applied positive psychology elegantly meshed with state-of-art information technology.

It's not only coaching services, like those offered by BetterUp, that have moved online. There has also been a growing trend in online psychotherapy services and a burgeoning digital self-help industry. The online help and personal development sector was already expanding steadily before the Covid-19 lockdowns began. For example, Talkspace, a New York-based online therapy service, reported rapid growth in its traffic back in February 2020. Since the pandemic, however, this growth has become exponential. Many people, unable to access traditional services due to the lockdown or due to a lack of services in their locality, can now book online appointments with licenced professional counsellors at any time. That is an extremely useful a proposition if one is depressed, lonely and socially isolated.

But there has to be a quality issue here, doesn't there? Looking at a person framed by a little box and talking online must surely degrade the coaching or therapeutic relationship. The critical question, however, is: degraded by how much? Not as much as one might think, it turns out. Are these online experiences still helpful? In the realm of psychotherapy, the research evidence suggests that yes, they are.

For some types of psychotherapy, the online version is at least as helpful as its face-to-face counterpart. A review of studies published in World Psychiatry in 2014 concluded that cognitive therapy, online and in person, were equally effective for a range of mental health problems, including depression and anxiety.

I recently experienced this for myself when I participated in an online, mindfulness-based cognitive therapy retreat. This, essentially, is a course in which therapists practice their skills while being observed and getting feedback. I have previously undertaken similar retreats in the traditional in-person manner, so I am well placed to compare experiences. Face to face is better, but I was astonished by just how little was actually lost to the online experience.

I have also delivered mindfulness-based stress-reduction programmes, a type of group intervention, both online and in-person. I'm slowly getting used to running the online version, but I still prefer delivering it in person. Online, we lose a lot of body language and the sense of a shared environment.

There are, of course, many upsides to accessing and offering psychological services online, such as reduced travel time and cost, as well as added convenience, choice and privacy. For many people, it is the privacy afforded by online services that seals the deal. For some, the prospect of being seen entering a psychotherapy centre or psychiatric clinic remains daunting due to the unwarranted social stigma surrounding mental health problems. For such individuals, it might be online or nothing. Similarly, if we live in a place where there are limited in-person options, then online looms large.

Accessing coaching, counselling and psychotherapy online has been an option for a while. Soon, though, it might become a preference. The pandemic has driven more of us online for more extended periods. We have slowly started to adapt and habituate to technologies such as Zoom. Many of us have become quite adept at holding nourishing conversations in this two-dimensional digital world. We are learning how best to compensate for the missing elements of in-person interactions.

Prince Harry throwing his weight behind BetterUP will certainly raise further awareness about the availability and effectiveness of online help. One impact of this will be to nudge more of us in the direction of using such services. Helping people find meaning and purpose on a journey towards healing, self-growth and betterment is a job well done, regardless of whether it's done online or in person.

Justin Thomas is a professor of psychology at Zayed University and a columnist for The National