Is the end near for psychotherapists?

From depression to obsessive-compulsive disorders: online therapies are booming. Will it soon be possible to heal mental illnesses without a human counterpart? We’ve found an expert who thinks so!

Text: Ruth Jahn; photo: Stefan Vladimirov/Unsplash

For a long time, Professor Andreas Maercker, full professor of psychopathology and head of the Psychological Institute at the University of Zurich, believed that psychotherapy couldn’t work without a therapist. Today, one of the focal points of his work is developing online services for post-traumatic stress disorder, phobias and other psychological disorders. “I’ve become a fervent advocate of online therapies because almost all scientific studies show that this particular type of psychotherapy works.”  

Still place for traditional therapies

However, online therapies aren’t designed to replace human psychologists, stresses Andreas Maercker: “Traditional consulting room therapy will still be available in the future, but online therapies are an essential addition to this.” Although they can’t pick up on patients’ non-verbal signals and no relationship can be established as with a human therapist, computer-based therapies are ideal for both young and old people who struggle with the thought of going to a psychologist or whose psychological illness, such as depression, makes it impossible for them to attend sessions.  

In Maercker’s opinion, this is a key argument, because around a third to half of people with depression, anxiety, obsessive-compulsive or personality disorders in Switzerland go untreated – partly out of a false sense of shame at being helped by a psychologist or doctor.  

Different forms of online therapy

There are all kinds of computer-assisted therapies available. At one end of the scale, you have therapists who communicate with their clients via e-mail or Skype, and at the other, pure apps or computer programs (so-called low intensity treatments), where users click through from question to question and from tip to tip. And for around the last five years, chatbots have also been tested on the market. They use synchronous communication and appear to address users personally.   

The most promising programmes combine virtual and real assistance. In other words, online solutions supported by therapists. This is essential, especially in cases of severe mental illness. For example, these programs ask users to keep a diary periodically or write letters which the therapist then reads and uses as a basis for the psychotherapy.  

A new form of exchange

Most online solutions are based on behavioural therapy. This means that users receive specific tips that help them to change their behaviour and reverse negative thoughts. For example, the purely online tool Deprexis uses text-based and audio resources to help users alter thinking habits and behavioural patterns. And they find out more about depression. “The online content is just one aspect of this solution,” says Maercker. “Just as important is the imaginary relationship with a virtual counterpart. The programs are deliberately designed so it seems that there is someone clever listening to you and understanding your needs,” Maercker explains. The drop-out rate for online therapies is high. But those who stick with it stand a good chance of success.