1 00:00:01,360 --> 00:00:09,900 Speaker 1: I'm Daniel James, and you're listening to 7am. If you 2 00:00:09,920 --> 00:00:11,820 Speaker 1: listen to podcasts, and let's be honest, there's a fair 3 00:00:11,880 --> 00:00:14,560 Speaker 1: chance that you do, it's likely that you've heard ads 4 00:00:14,610 --> 00:00:18,150 Speaker 1: for a thing called BetterHelp. It's an app offering flexible, 5 00:00:18,230 --> 00:00:21,650 Speaker 1: affordable therapy whenever you need it. Kind of an Uber 6 00:00:21,710 --> 00:00:24,670 Speaker 1: for therapy. Since we first brought you this story two 7 00:00:24,710 --> 00:00:28,600 Speaker 1: years ago, app-based therapy has continued to grow and And 8 00:00:28,640 --> 00:00:31,980 Speaker 1: now AI chatbots are increasingly becoming used for mental health 9 00:00:32,010 --> 00:00:34,970 Speaker 1: support too. So are we actually better off with better 10 00:00:35,010 --> 00:00:37,990 Speaker 1: help and apps like it? Today we're returning to our 11 00:00:38,030 --> 00:00:42,710 Speaker 1: conversation with clinical and forensic psychologist Dr Ahuna Gua on 12 00:00:42,729 --> 00:00:45,599 Speaker 1: the uberfication of mental health care and why a gig 13 00:00:45,640 --> 00:00:49,440 Speaker 1: economy for psychologists isn't the answer to our struggling mental 14 00:00:49,479 --> 00:00:57,160 Speaker 1: health system. It's Sunday, October 4. This episode first aired 15 00:00:57,340 --> 00:00:58,000 Speaker 1: in August 2024. 16 00:00:57,980 --> 00:00:58,040 Speaker 2: Dr. 17 00:00:58,040 --> 00:01:04,160 Speaker 1: Ahona, when did you first start hearing about BetterHelp? 18 00:01:04,880 --> 00:01:07,720 Speaker 3: I think I'd say I first heard about BetterHelp about 19 00:01:07,720 --> 00:01:09,459 Speaker 3: 10 years ago, and that was just when I was 20 00:01:09,520 --> 00:01:13,440 Speaker 3: listening to a range of podcasts back in my pre-psychology 21 00:01:13,480 --> 00:01:14,550 Speaker 3: days when I had more time. 22 00:01:17,060 --> 00:01:18,600 Speaker 2: This show is sponsored by BetterHelp. 23 00:01:18,640 --> 00:01:21,220 Speaker 4: You know, Mitch, I have some self-care non-negotiables. 24 00:01:21,300 --> 00:01:24,260 Speaker 2: I never skip leg day, and I never skip therapy day. 25 00:01:24,580 --> 00:01:25,980 Speaker 1: Wow, Wags, good for you. 26 00:01:26,040 --> 00:01:30,259 Speaker 2: BetterHelp is an online counseling service. It offers licensed professional 27 00:01:30,340 --> 00:01:31,619 Speaker 2: counselors who specialize. 28 00:01:31,240 --> 00:01:36,440 Speaker 1: In issues like depression, stress, anxiety, relationships, sleeping, anger, family conflict, self-esteem, 29 00:01:36,459 --> 00:01:39,100 Speaker 1: and more. And I didn't have a boyfriend to text anymore, 30 00:01:39,180 --> 00:01:41,280 Speaker 1: so I was like, might as well text a therapist. 31 00:01:41,810 --> 00:01:44,570 Speaker 3: And it was really, really a great experience. 32 00:01:44,610 --> 00:01:48,450 Speaker 2: So We have an awesome offer for people who listen 33 00:01:48,470 --> 00:01:49,470 Speaker 2: to the Daily Detectives. 34 00:01:50,170 --> 00:01:52,790 Speaker 3: So kind of vaguely been aware of them for a 35 00:01:52,810 --> 00:01:55,070 Speaker 3: while and certainly known that they've been a very, very 36 00:01:55,150 --> 00:01:58,860 Speaker 3: big digital mental health provider in the States because they 37 00:01:58,880 --> 00:02:01,100 Speaker 3: don't have the same health care system as we do here. 38 00:02:04,490 --> 00:02:07,330 Speaker 3: But in terms of when I realized or started to 39 00:02:07,370 --> 00:02:09,530 Speaker 3: see them more in the Australian market, look, I'd say 40 00:02:09,570 --> 00:02:12,400 Speaker 3: that was probably about two to three months ago. I 41 00:02:12,840 --> 00:02:16,380 Speaker 3: started to just see ads coming up both on LinkedIn 42 00:02:16,480 --> 00:02:19,380 Speaker 3: because they were trying to advertise for clinicians and then 43 00:02:19,500 --> 00:02:22,990 Speaker 3: also on my social media where it looked like they 44 00:02:23,010 --> 00:02:26,850 Speaker 3: were trying to target clients. So I was quite alarmed, honestly, 45 00:02:26,910 --> 00:02:29,389 Speaker 3: to see it start to creep into the Australian market. 46 00:02:30,180 --> 00:02:33,810 Speaker 3: I was starting to wonder whether this would be attractive 47 00:02:33,889 --> 00:02:37,570 Speaker 3: to clients who wouldn't really be stopping to maybe think 48 00:02:37,610 --> 00:02:42,390 Speaker 3: through the implications of signing up for a tech entrepreneur 49 00:02:42,990 --> 00:02:44,090 Speaker 3: based app like this. 50 00:02:44,900 --> 00:02:49,980 Speaker 1: So from a patient's perspective, what's the difference between logging 51 00:02:50,020 --> 00:02:53,859 Speaker 1: onto this app and seeking treatment through that app as 52 00:02:53,900 --> 00:02:56,820 Speaker 1: compared to going and seeing someone like yourself? 53 00:02:57,660 --> 00:03:00,660 Speaker 3: So I'm a clinical psychologist, and I work in both 54 00:03:00,690 --> 00:03:04,870 Speaker 3: the public and the private mental health spaces. And obviously, 55 00:03:04,930 --> 00:03:07,970 Speaker 3: I can't speak for the entire public mental health system. 56 00:03:08,270 --> 00:03:12,840 Speaker 3: But effectively, when you come into either of these services, 57 00:03:12,880 --> 00:03:17,380 Speaker 3: you're typically referred by someone else, usually a GP, sometimes 58 00:03:17,419 --> 00:03:20,960 Speaker 3: another healthcare provider, you come in, you'll do a range 59 00:03:21,100 --> 00:03:24,090 Speaker 3: of assessments, maybe get a really good history as well. 60 00:03:24,919 --> 00:03:29,840 Speaker 3: So it's quite detailed. It's quite intensive. It's usually assessment 61 00:03:29,910 --> 00:03:32,869 Speaker 3: based initially, because it's not that I'm trying to diagnose 62 00:03:32,910 --> 00:03:35,650 Speaker 3: and slap labels onto people, but it's more that that 63 00:03:35,690 --> 00:03:39,030 Speaker 3: helps me provide better treatment once I've identified what a 64 00:03:39,070 --> 00:03:43,490 Speaker 3: person's issues are. So my understanding of BetterHelp, what you 65 00:03:43,510 --> 00:03:47,670 Speaker 3: do is you sign up, you fill out a questionnaire, 66 00:03:47,710 --> 00:03:50,270 Speaker 3: just like, you know, I've done for my dog's pet 67 00:03:50,330 --> 00:03:53,440 Speaker 3: food delivery, but slightly, slightly different. 68 00:03:54,530 --> 00:03:57,450 Speaker 5: Starting your therapy journey has never been easier with BetterHelp. 69 00:03:57,910 --> 00:03:59,790 Speaker 5: When you first come to the site, we'll ask you 70 00:03:59,830 --> 00:04:02,430 Speaker 5: some questions about yourself and what you're looking for in therapy. 71 00:04:03,810 --> 00:04:05,850 Speaker 5: We use this information to match you to one of 72 00:04:05,890 --> 00:04:06,930 Speaker 5: our licensed therapists. 73 00:04:07,930 --> 00:04:10,570 Speaker 3: I don't really know how they actually match and triage, 74 00:04:10,610 --> 00:04:12,690 Speaker 3: but I can say that both in the public and 75 00:04:12,710 --> 00:04:16,110 Speaker 3: the private mental health systems, you're thinking through things like 76 00:04:16,230 --> 00:04:20,450 Speaker 3: the complexity for clients' needs, the seniority of a clinician, 77 00:04:20,630 --> 00:04:23,730 Speaker 3: the type of intervention and whether you're well matched and 78 00:04:23,750 --> 00:04:24,870 Speaker 3: well suited to each other. 79 00:04:25,490 --> 00:04:27,969 Speaker 5: You'll get an email once you've been matched. This usually 80 00:04:28,010 --> 00:04:29,429 Speaker 5: takes less than 48 hours. 81 00:04:29,950 --> 00:04:33,110 Speaker 3: So you're matched and then you have a shorter session 82 00:04:33,150 --> 00:04:35,990 Speaker 3: a week, 30 to 45 minutes, based on how much 83 00:04:36,029 --> 00:04:38,789 Speaker 3: you're paying. Their charges at this point in time are 84 00:04:38,850 --> 00:04:43,600 Speaker 3: Australian $ 90 or $ 120. And if you pay the higher rate, 85 00:04:43,630 --> 00:04:48,060 Speaker 3: you get the capacity to basically text your psychologist In 86 00:04:48,100 --> 00:04:50,740 Speaker 3: quite an unlimited capacity, and you're told that they'll log 87 00:04:50,779 --> 00:04:52,020 Speaker 3: in twice a day to respond. 88 00:04:52,500 --> 00:04:55,150 Speaker 5: As soon as you're matched, your therapist will introduce themselves 89 00:04:55,290 --> 00:04:57,210 Speaker 5: and ask you some questions to get to know you better. 90 00:04:58,150 --> 00:05:00,370 Speaker 5: This is your chance to get acquainted with your therapist. 91 00:05:00,850 --> 00:05:05,229 Speaker 3: So it's really subscription-based. Kind of like Netflix for mental health. 92 00:05:05,870 --> 00:05:07,510 Speaker 1: Netflix is good for mental health, isn't it? 93 00:05:07,710 --> 00:05:10,659 Speaker 3: Well, I suppose it depends on what you're watching, but 94 00:05:10,720 --> 00:05:14,580 Speaker 3: from the... perspective of a clinician. It's more like Uber 95 00:05:14,620 --> 00:05:18,200 Speaker 3: or Psych. It's really starting to bring the gig economy 96 00:05:18,420 --> 00:05:23,400 Speaker 3: into what is traditionally not a gig economy space at all. 97 00:05:23,820 --> 00:05:26,430 Speaker 1: Yeah, right. It's pretty easy to see why a gig 98 00:05:26,470 --> 00:05:30,630 Speaker 1: economy around mental health has opened up. Affordable and timely 99 00:05:30,670 --> 00:05:34,110 Speaker 1: access to mental health professionals is a pretty appealing proposition, 100 00:05:34,150 --> 00:05:34,430 Speaker 1: isn't it? 101 00:05:34,890 --> 00:05:37,010 Speaker 3: Look, I do agree. I think we have a very, 102 00:05:37,070 --> 00:05:40,630 Speaker 3: very tricky mental health landscape across the world. You're in 103 00:05:40,650 --> 00:05:44,280 Speaker 3: a reasonably... unique situation here because we do have access 104 00:05:44,320 --> 00:05:48,520 Speaker 3: to Medicare. Look, we certainly know that waitlists are spiralling 105 00:05:48,680 --> 00:05:51,779 Speaker 3: and especially for more specialty services, but I do note 106 00:05:51,820 --> 00:05:55,560 Speaker 3: that Absolute Better Help can't actually provide services to people 107 00:05:55,610 --> 00:05:58,750 Speaker 3: who are seeking assessments and things like that. In the 108 00:05:59,290 --> 00:06:03,349 Speaker 3: fine printers bury the caveat that they can't write letters 109 00:06:03,410 --> 00:06:06,610 Speaker 3: for court, they can't do medical legal reports and they 110 00:06:06,650 --> 00:06:11,099 Speaker 3: obviously can't prescribe medication. Now, when you see a psychologist here, 111 00:06:11,160 --> 00:06:14,660 Speaker 3: we also can't prescribe medication. But what often happens is 112 00:06:14,720 --> 00:06:18,620 Speaker 3: we work as a care team, especially for more complex 113 00:06:18,680 --> 00:06:22,080 Speaker 3: mental health issues. You know, if you're thinking something like PTSD, 114 00:06:22,520 --> 00:06:27,740 Speaker 3: serious major depressive disorder, psychosis, bipolar, we all work together 115 00:06:27,839 --> 00:06:32,400 Speaker 3: to effectively coordinate some of our interventions. And my understanding 116 00:06:32,480 --> 00:06:36,960 Speaker 3: is that app-based platforms like BetterHelp just don't allow access 117 00:06:37,290 --> 00:06:40,820 Speaker 3: for that because there's no contact outside of session with 118 00:06:40,860 --> 00:06:43,800 Speaker 3: a person's treating team. And indeed, I believe that users 119 00:06:43,880 --> 00:06:48,080 Speaker 3: can remain anonymous, which I think is very ethically problematic 120 00:06:48,180 --> 00:06:51,180 Speaker 3: because if there's a crisis, you know, therapist is left 121 00:06:51,220 --> 00:06:52,930 Speaker 3: holding that and doesn't know who to contact. 122 00:06:53,810 --> 00:06:57,089 Speaker 1: So there's a series of alarm bells related to these 123 00:06:57,170 --> 00:06:59,849 Speaker 1: type of apps, but the mental health system that we 124 00:06:59,910 --> 00:07:03,250 Speaker 1: have isn't perfect either and people are continually falling through 125 00:07:03,310 --> 00:07:06,750 Speaker 1: the cracks. Shouldn't we embrace the disruption of it all? 126 00:07:07,310 --> 00:07:11,000 Speaker 3: So I'm not saying that app-based services don't have their place. 127 00:07:11,660 --> 00:07:15,190 Speaker 3: There's been very little research into the actual effectiveness of 128 00:07:15,260 --> 00:07:19,070 Speaker 3: most app-based services and most that have been assessed for 129 00:07:19,150 --> 00:07:22,510 Speaker 3: effectiveness in terms of reducing symptoms with things like text 130 00:07:22,550 --> 00:07:25,810 Speaker 3: messages have been shown that they don't actually work. So 131 00:07:25,830 --> 00:07:30,300 Speaker 3: there is hope to try new approaches and absolutely acknowledging 132 00:07:30,340 --> 00:07:34,300 Speaker 3: that the mental health state in Australia is terrible and 133 00:07:34,360 --> 00:07:37,220 Speaker 3: I don't feel like there's a lot of federal political 134 00:07:37,280 --> 00:07:41,040 Speaker 3: will at this point in time to improve that. But 135 00:07:41,070 --> 00:07:43,239 Speaker 3: therapy is not one in a hundred phone a friend. 136 00:07:45,040 --> 00:07:47,980 Speaker 3: You know, it's really about helping you talk through your 137 00:07:48,020 --> 00:07:51,400 Speaker 3: symptoms when you're there in session and building ways to 138 00:07:51,440 --> 00:07:54,420 Speaker 3: cope outside of therapy. And I really do worry that 139 00:07:54,440 --> 00:07:58,540 Speaker 3: that kind of constant possible contact leads to a level 140 00:07:58,580 --> 00:08:03,220 Speaker 3: of dependence and people just never exploring or actually using 141 00:08:03,260 --> 00:08:05,960 Speaker 3: the skills. You know, we have to be cautious. We 142 00:08:06,000 --> 00:08:07,880 Speaker 3: have to test. We have to work based on the 143 00:08:07,900 --> 00:08:10,630 Speaker 3: data and not on what sounds like a good idea 144 00:08:10,810 --> 00:08:13,190 Speaker 3: or on what's going to help this app make money. 145 00:08:15,170 --> 00:08:17,750 Speaker 1: Should you be worried about your data when using one 146 00:08:17,770 --> 00:08:30,780 Speaker 1: of these apps? That's coming up. Dr Ahona, patient data 147 00:08:30,800 --> 00:08:33,740 Speaker 1: and its privacy is paramount in any sort of healthcare setting. 148 00:08:34,140 --> 00:08:34,880 Speaker 3: Absolutely. 149 00:08:35,460 --> 00:08:38,920 Speaker 1: When it comes to mental health particularly, there's differently an 150 00:08:38,980 --> 00:08:41,760 Speaker 1: expectation that what you say is private between you and 151 00:08:41,780 --> 00:08:45,400 Speaker 1: your practitioner, what does the app actually do with the 152 00:08:45,420 --> 00:08:46,520 Speaker 1: information that you give it? 153 00:08:47,000 --> 00:08:50,089 Speaker 3: I don't know. So I know that there's been a very, 154 00:08:50,150 --> 00:08:52,670 Speaker 3: very big case brought against BetterHelp. 155 00:08:52,690 --> 00:08:57,090 Speaker 2: All right, we're keeping an eye on your wallet tonight. 156 00:08:57,270 --> 00:08:59,480 Speaker 2: You may be entitled to a refund if you used 157 00:08:59,770 --> 00:09:04,220 Speaker 2: online therapy through BetterHelp because they're accused of selling information 158 00:09:04,440 --> 00:09:05,280 Speaker 2: about your mental health. 159 00:09:05,500 --> 00:09:09,370 Speaker 4: The company agreed to a $ 7. 8 million settlement. This is 160 00:09:09,410 --> 00:09:13,010 Speaker 4: what the FTC, the agency says BetterHelp, promised to keep users' 161 00:09:13,050 --> 00:09:17,510 Speaker 4: information private, but the FTC says your information was given 162 00:09:17,550 --> 00:09:21,180 Speaker 4: to Facebook, Snapchat, Pinterest for advertising purposes. 163 00:09:21,540 --> 00:09:25,020 Speaker 3: They sold consumers' private data, so we're talking things like 164 00:09:25,160 --> 00:09:28,840 Speaker 3: email addresses and responses to the mental health questions that 165 00:09:28,880 --> 00:09:32,209 Speaker 3: people receive. complete as part of the intake. So they 166 00:09:32,290 --> 00:09:35,590 Speaker 3: sold that to third party advertisers so that they could 167 00:09:35,630 --> 00:09:36,830 Speaker 3: better target ads. 168 00:09:37,290 --> 00:09:40,790 Speaker 4: BetterHelp says the settlement with the Federal Trade Commission is 169 00:09:40,890 --> 00:09:44,469 Speaker 4: not an admission of wrongdoing and adds that what they 170 00:09:44,530 --> 00:09:46,790 Speaker 4: did is a standard for the industry. 171 00:09:49,950 --> 00:09:54,170 Speaker 3: Data privacy is absolutely paramount in health care. Who owns 172 00:09:54,170 --> 00:09:58,370 Speaker 3: the data? Things like case notes. Who has access to it? 173 00:09:58,370 --> 00:10:01,510 Speaker 3: These are all things that when you attend a psychology-led 174 00:10:01,580 --> 00:10:05,380 Speaker 3: service are thought through very, very carefully. If you are 175 00:10:05,600 --> 00:10:09,960 Speaker 3: a registered health practitioner here, you're bound by an entire 176 00:10:10,080 --> 00:10:13,480 Speaker 3: host of laws, effectively meaning that you can only share 177 00:10:13,520 --> 00:10:17,719 Speaker 3: information either with consent for the purposes of providing healthcare 178 00:10:17,740 --> 00:10:22,130 Speaker 3: or or in certain key situations where you're mandated to, 179 00:10:22,150 --> 00:10:25,340 Speaker 3: like if a court asks for access to information. So 180 00:10:25,380 --> 00:10:28,599 Speaker 3: there's so many protections. And when you're giving your data 181 00:10:28,700 --> 00:10:34,720 Speaker 3: to a third party, non-clinically led company that operates overseas, 182 00:10:35,320 --> 00:10:38,740 Speaker 3: you have very, very few data privacy provisions. 183 00:10:39,300 --> 00:10:42,700 Speaker 1: You mentioned earlier that they're recruiting psychologists in Australia. I'm 184 00:10:42,720 --> 00:10:46,120 Speaker 1: just looking at one of these ads now. They're saying 185 00:10:46,260 --> 00:10:51,050 Speaker 1: that you can be, quote, An independent contractor and earn 186 00:10:51,270 --> 00:10:56,860 Speaker 1: between $ 111, 000 and $ 135, 000 a year, offering flexibility with no overheads. 187 00:10:57,960 --> 00:11:00,440 Speaker 1: What do you make of that as someone who knows 188 00:11:00,500 --> 00:11:03,000 Speaker 1: the inside of the industry? Is it tempting for someone 189 00:11:03,040 --> 00:11:04,490 Speaker 1: like you? Yeah. 190 00:11:04,910 --> 00:11:08,170 Speaker 3: Look, there's absolutely nothing about that that is tempting for 191 00:11:08,210 --> 00:11:11,500 Speaker 3: me in the current Australian landscape. I suppose my view, 192 00:11:11,559 --> 00:11:14,160 Speaker 3: just looking at the pay that they offer, they have 193 00:11:14,200 --> 00:11:16,760 Speaker 3: a bit of a tiered model. So it looks like 194 00:11:16,880 --> 00:11:20,270 Speaker 3: it's 30 USD if you do under 30 hours a week. 195 00:11:20,330 --> 00:11:23,930 Speaker 3: And that's not 30 hours of overall work. That is 196 00:11:23,929 --> 00:11:28,650 Speaker 3: 30 hours of clinical work. So clinical engagement with a client. 197 00:11:29,190 --> 00:11:31,910 Speaker 3: And if you're over that, then you make the higher 198 00:11:31,950 --> 00:11:35,910 Speaker 3: rate of 45 USD, which is similar to what clinicians 199 00:11:35,970 --> 00:11:39,209 Speaker 3: and public mental health get. But we also have access 200 00:11:39,230 --> 00:11:43,400 Speaker 3: to and will leave sick leave, professional development, and quite 201 00:11:43,420 --> 00:11:46,360 Speaker 3: a host of other entitlements. And all of our time 202 00:11:46,420 --> 00:11:49,700 Speaker 3: is not clinical time. So if you're working 30 to 203 00:11:49,700 --> 00:11:52,180 Speaker 3: 45 hours a week and just seeing clients back to 204 00:11:52,220 --> 00:11:54,920 Speaker 3: back for that, as appears to be the model, you 205 00:11:54,960 --> 00:11:58,520 Speaker 3: will burn out very, very quickly. It might be attractive 206 00:11:58,559 --> 00:12:01,040 Speaker 3: to clinicians who might just be starting out, who might 207 00:12:01,080 --> 00:12:04,079 Speaker 3: be trying to build up a bit of a referral base. 208 00:12:04,240 --> 00:12:06,679 Speaker 3: But honestly, if I was going to have to work 209 00:12:06,760 --> 00:12:09,520 Speaker 3: for that amount of time, I'd probably be finding work 210 00:12:09,559 --> 00:12:10,459 Speaker 3: in a different industry. 211 00:12:10,790 --> 00:12:11,510 Speaker 1: Podcast host. 212 00:12:11,650 --> 00:12:15,410 Speaker 3: Podcast host, except that also sounds like very hard work 213 00:12:15,429 --> 00:12:17,090 Speaker 3: where you're talking to people all of the time. 214 00:12:18,630 --> 00:12:21,120 Speaker 1: So can I ask about your work then? Because you 215 00:12:21,150 --> 00:12:24,400 Speaker 1: work in both the private and public sectors, you would 216 00:12:24,440 --> 00:12:27,100 Speaker 1: never work for a platform like BetterHelp. But do you 217 00:12:27,140 --> 00:12:30,219 Speaker 1: worry about the impact this sort of tech disruption could 218 00:12:30,260 --> 00:12:34,730 Speaker 1: have on clinicians less experienced than yourself and the industry overall? 219 00:12:35,380 --> 00:12:38,339 Speaker 3: Look, so I work in quite the pointy end across 220 00:12:38,400 --> 00:12:41,400 Speaker 3: both of my roles. So within my public mental health role, 221 00:12:41,800 --> 00:12:45,780 Speaker 3: we assess and we treat people who have been identified 222 00:12:45,840 --> 00:12:49,090 Speaker 3: as possibly being at high risk of re-offending. You know, 223 00:12:49,120 --> 00:12:51,870 Speaker 3: the types of behaviours that they might be engaging in 224 00:12:51,890 --> 00:12:56,390 Speaker 3: are things like arson, stalking, intimate partner violence, sex offending, 225 00:12:57,030 --> 00:13:01,380 Speaker 3: general violence and making threats. And then in my private work, 226 00:13:01,830 --> 00:13:05,710 Speaker 3: I see a lot of trauma and complex trauma, as 227 00:13:05,750 --> 00:13:10,790 Speaker 3: well as mood and anxiety disorders. I usually see, you know, 228 00:13:10,870 --> 00:13:15,670 Speaker 3: anywhere between five to seven clients a day. And outside 229 00:13:15,710 --> 00:13:18,830 Speaker 3: of that, I do things like obviously making session notes, 230 00:13:18,890 --> 00:13:22,350 Speaker 3: spending some time reflecting on session, tracking how we are going. 231 00:13:22,370 --> 00:13:25,310 Speaker 3: So all of this is outside of session work that 232 00:13:25,679 --> 00:13:29,840 Speaker 3: you know, usually happens after hours. So the mental health 233 00:13:29,920 --> 00:13:34,780 Speaker 3: profession is in flux. I think I'm certainly post-COVID noticing 234 00:13:34,820 --> 00:13:38,880 Speaker 3: a lot of almost a moral injury, a lot of burnout, 235 00:13:38,920 --> 00:13:41,540 Speaker 3: a lot more people trying to find passive income and 236 00:13:41,610 --> 00:13:44,589 Speaker 3: ways of trying to move into other spaces. And I 237 00:13:44,650 --> 00:13:47,109 Speaker 3: think I am concerned about things that I'm seeing, even 238 00:13:47,130 --> 00:13:50,650 Speaker 3: outside BetterHelp, things like using AI, where we are starting 239 00:13:50,850 --> 00:13:54,560 Speaker 3: to rely more on machines and There's a couple of 240 00:13:54,640 --> 00:13:59,300 Speaker 3: patient note-taking software things that would actually listen in to 241 00:13:59,340 --> 00:14:02,120 Speaker 3: your sessions and then just transcribe a note for you. 242 00:14:02,800 --> 00:14:04,870 Speaker 3: And I know a fair few people in private practice 243 00:14:04,890 --> 00:14:07,530 Speaker 3: starting to use that, but just all kinds of implications 244 00:14:07,570 --> 00:14:12,809 Speaker 3: from a privacy perspective. But I also think fundamentally as psychologists, 245 00:14:12,850 --> 00:14:15,490 Speaker 3: we have to have a good grasp of why a 246 00:14:15,530 --> 00:14:17,510 Speaker 3: person behaves the way that they do. And if we 247 00:14:17,550 --> 00:14:21,400 Speaker 3: are relying on machines to give us those answers, we're 248 00:14:21,420 --> 00:14:24,480 Speaker 3: going to lose some really essential case conceptualization skills. 249 00:14:25,120 --> 00:14:27,730 Speaker 1: So finally, given what we do know and what we 250 00:14:27,910 --> 00:14:31,630 Speaker 1: don't know, what advice would you be giving anyone that's 251 00:14:31,650 --> 00:14:33,470 Speaker 1: considering signing up for one of these apps? 252 00:14:34,210 --> 00:14:38,080 Speaker 3: I would say buyer beware. Know what you're signing up for. 253 00:14:38,630 --> 00:14:44,430 Speaker 3: I would ascertain whether your mental health are mild to moderate. 254 00:14:44,610 --> 00:14:47,790 Speaker 3: So if you're not hugely distressed, if there's maybe the 255 00:14:47,950 --> 00:14:51,340 Speaker 3: one issue that you want to talk through and it 256 00:14:51,460 --> 00:14:54,940 Speaker 3: isn't overly severe, then that might be okay. But I'd 257 00:14:54,960 --> 00:14:58,580 Speaker 3: be looking through carefully the fine print and I'd also 258 00:14:58,620 --> 00:15:02,770 Speaker 3: be asking questions about the person you're seeing and what 259 00:15:02,810 --> 00:15:07,080 Speaker 3: their qualifications are like. So approaching with a lot of caution, 260 00:15:07,320 --> 00:15:10,900 Speaker 3: if you do choose to approach, would probably be my suggestion. 261 00:15:11,380 --> 00:15:15,000 Speaker 3: And then if you do have maybe slightly more severe 262 00:15:15,040 --> 00:15:18,800 Speaker 3: difficulties or if there's a lot of distress or more 263 00:15:18,880 --> 00:15:23,260 Speaker 3: complex issues, say you have PTSD, understanding that what better 264 00:15:23,300 --> 00:15:27,080 Speaker 3: help offer are only 30 or 45 minute sessions, you know, 265 00:15:27,100 --> 00:15:30,920 Speaker 3: the capacity to do things like cognitive processing therapy for 266 00:15:31,120 --> 00:15:34,890 Speaker 3: PTSD or maybe EMDR. You can't do any of that 267 00:15:34,910 --> 00:15:40,260 Speaker 3: in a 30 or 45-minute session. So you're better off, 268 00:15:40,400 --> 00:15:44,160 Speaker 3: I would say, trying to establish whether you can see 269 00:15:44,200 --> 00:15:48,080 Speaker 3: a practitioner, even if it's via telehealth within a more 270 00:15:48,200 --> 00:15:51,580 Speaker 3: traditional therapeutic setting where you are offered, I guess, the 271 00:15:51,640 --> 00:15:55,390 Speaker 3: longer sessions, which are usually 50 to 60 minutes, and 272 00:15:55,510 --> 00:15:58,530 Speaker 3: also continuity of care and maybe more wraparound care. 273 00:16:00,130 --> 00:16:01,910 Speaker 1: Dr. Ahona, thank you very much for your time. 274 00:16:02,330 --> 00:16:03,470 Speaker 3: Pleasure. Thanks for having me. 275 00:16:15,380 --> 00:16:18,040 Speaker 1: 7am, we'll be back tomorrow with a very special episode. 276 00:16:18,500 --> 00:16:19,600 Speaker 1: I like Al Bowen. 277 00:16:20,420 --> 00:16:22,000 Speaker 6: I think he gets a pretty hard rap a lot 278 00:16:22,040 --> 00:16:24,140 Speaker 6: of the time. I think Pauline Hanson's in a slightly 279 00:16:24,180 --> 00:16:27,140 Speaker 6: different position to Nigel Farage because Nigel Farage is slightly 280 00:16:27,180 --> 00:16:29,780 Speaker 6: on the skits. The feeling is there that he's slightly 281 00:16:29,820 --> 00:16:31,840 Speaker 6: on the skits. Trump would imagine he was laughing at 282 00:16:32,080 --> 00:16:34,040 Speaker 6: Joe Biden. I don't think he was. I think he 283 00:16:34,070 --> 00:16:36,130 Speaker 6: was looking at that thinking, this is really wacky. 284 00:16:37,130 --> 00:16:40,290 Speaker 1: My conversation with former Tony Blair advisor and co-host of 285 00:16:40,310 --> 00:16:43,470 Speaker 1: The Rest Is Politics, Alastair Campbell. On the future of 286 00:16:43,510 --> 00:16:47,220 Speaker 1: the centre-left... the challenge of populist politics and a global 287 00:16:47,280 --> 00:16:49,920 Speaker 1: order being reshaped by Donald Trump and China. 288 00:16:50,280 --> 00:16:52,780 Speaker 6: So I think you need these smart leaders who can 289 00:16:52,900 --> 00:16:56,330 Speaker 6: mobilise people to feel that they're going somewhere with them. 290 00:16:56,770 --> 00:16:59,110 Speaker 6: And much as I despise Trump, you know, he has 291 00:16:59,210 --> 00:17:01,690 Speaker 6: shown that he has the ability to do that, just 292 00:17:01,790 --> 00:17:04,840 Speaker 6: in a way that I think does massive damage to 293 00:17:04,859 --> 00:17:05,170 Speaker 6: the world. 294 00:17:05,670 --> 00:17:07,540 Speaker 1: I'm Daniel James. Thanks for listening. 295 00:17:10,619 --> 00:17:12,250 Speaker 3: Thank you.