Plan sponsors looking to improve their mental-health benefits should consider offering online psychotherapy treatment programs for members, says Peter Gove, former innovation leader in health management at Green Shield Canada.
“Just increasing the amount of coverage is a good thing, but probably insufficient,” he says. “The problem with just increasing the level of coverage is that you have no idea what that person is spending that money on . . . because, let’s say you increase the coverage to $5,000, somebody could get $5,000 worth of bad psychotherapy, right?”
Not all psychotherapy treatments are created equal, notes Gove, and it’s key to provide plan members with access to the right type of psychotherapy. “I think the problem with a lot of psychotherapy is that it’s not evidence-based and includes eclectic kinds of things. When we say we want people to get access to psychotherapy, we want them to get access to an evidence-based psychotherapy.”
Among the several types of psychotherapy treatments, Gove lists cognitive behavioural therapy, interpersonal therapy and behavioural activation therapy as three of the most common evidence-based options.
CBT is one of the most commonly prescribed psychotherapy treatments because it addresses several conditions, including depression, anxiety, post-traumatic stress disorder and, in some cases, psychosis. It also focuses on developing tools to help people change their thought patterns, which in turn positively impacts their behaviours and moods. This type of therapy includes a lot of homework the patient must complete between sessions.
Interpersonal psychotherapy, on the other hand, looks a lot more like traditional therapy. The goal is to understand interpersonal relationships and work on improving them. In this therapy, most of the work is done in session.
Unlike CBT and interpersonal psychotherapy, behavioural activation therapy simply focuses on getting people to do activities they like. It’s about prescribing activities that bring them joy and pleasure, since people with depression often stop doing those things.
“There are a number of [psychotherapy treatments], but it’s different than general psychotherapy because we don’t know if that stuff works,” says Gove. “We really want them to get access to stuff that works.”
While treatments can be done in-person, they’re expensive, and mental-health benefits don’t often cover the required number of in-person treatments required to be effective. They’re also highly intensive and very few psychologists actually measure patient outcomes.
These online programs are more affordable, accessible and measure patient outcomes, which isn’t just beneficial for the patient, but also offers plan sponsors more transparency so they can understand what they’re paying for.
“We know that psychotherapy benefits a lot of people,” says Gove. “What we would like to see is people with mild to moderate symptoms . . . getting access to a quality psychotherapy.”