I offer free online therapy to teens. This is what I'm seeing and why it matters

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Before the pandemic, the idea of ​​communicating with a therapist via text message seemed unthinkable. Then COVID closures and an unprecedented increase in mental health problems in adolescents changed everything.

I know what a difference it makes for teenagers because I talk to them almost every day.

I am a therapist who works for New York Teen SpaceNew York City's free mental health service that connects youth with licensed multilingual therapists through a secure (and HIPAA Compliant) Talkspace platform. This effort is breaking down barriers to mental health care, especially for those who may have difficulty finding a therapist who meets their needs.

The program, launched a year ago this month by Mayor Eric Adams and the New York City Department of Health and Mental Hygiene, is available to anyone ages 13 to 17 who lives in New York City, regardless of your school, immigration status, income level, or insurance status. No payment or insurance information required.

While we ask all teens to share their parents' or guardians' information so they can give consent, in special circumstances, State Law allows that requirement to be waived, for example when the youth is emancipated, incarcerated, or if notification is considered detrimental to his or her well-being. That is something that the licensed therapist values.

For many teens, it's the first time they've talked to a therapist. And my goal is to create a space where teenagers feel like they can be themselves. Asking questions, staying curious, and not making assumptions are key to helping young people feel supported.

While many of our interactions are asynchronous and via text, I always recommend a face-to-face live video session or offer to send asynchronous audio or video messages. I want them to know that it's okay to ask questions that can help them better understand therapy, mental health, themselves, and how to advocate for their needs.

They are often curious to learn about depression, ADHD, PTSD, and other diagnoses they may have heard of. on social networks or your friends. Sometimes I get asked if I'm a real human being or if I'm ai. They like to hear that I grew up in New York, in the Bronx and Yonkers, that I have a cat, and the types of music I enjoy.

Teens may be experiencing anxiety or depression, or may be distressed. But they don't have to experience symptoms of mental illness or live with a loss to participate. They may be going through a new relationship or breakup, adjusting to changes in their family dynamics, or experiencing uncertainty about what they want to do after high school.

We talk about what causes them stress and what will improve their quality of life. It is gratifying to hear from a teenage client who has tried a technique we have practiced, such as deep breathing, progressive muscle relaxation, stop thinkingor communication skills, and I found that it works. In my experience, teens are more likely to share their progress as it happens, rather than reflecting on it several months later, than adults.

How effective is NYC Teenspace? So far, more than 16,000 teenagers have signed up for the service. The first data show That 65 percent of users reported an improvement in their mental health, and that number is growing. The underserved neighborhoods of Brooklyn and the Bronx lead the city in registrations, and 60 percent of users identify as black or Hispanic.

In the future, I hope to see even more teens using it, especially boys. City data shows that teenage girls are more than three times more likely to seek help on the platform. We have work to do to increase outreach to teenage boys, who can find more stigma around seeking help.

Still, I'm amazed by telehealth's ability to foster strong connections with users, particularly Generation Z. These digital natives communicate effortlessly through text and other online media. They express themselves in a way that an adult patient normally would not. They share photos of their pets, selfies, memes, audio clips (and, yes, lots of emojis) that offer glimpses into their world that enrich the therapeutic process.

NYC Teenspace therapists can communicate in 13 different languages ​​and the platform uses translation support in 120 languages.

No matter what their language, teens tend to find on-demand messaging a more comfortable and accessible option to talk openly about their challenges in ways they might find difficult in real life. Between school, commuting, extracurricular activities, and other responsibilities, some teens have avoided therapy because they found it difficult to get to an in-person appointment. Having a private space can often be a challenge for any New Yorker, and this is no different for teenagers. More than half of all users prefer to interact exclusively with their therapist through messages.

The current proportion of New York City public school school counselors it is 1 for every 272 students, and there are even fewer licensed mental health professionals. Last year, almost half of the adolescents surveyed in New York City reported experiencing mild to severe depressive symptoms. They worry about the future or that something bad will happen to them or their families, which can be a sign of anxiety.

Skeptics of therapy in a digital space may say that the in-person treatment experience cannot be replicated. In some cases, this is true. However, therapy that can be done via telehealth can connect with teens in a way that meets their needs. As any teenager today can tell you, messaging is how they communicate with their closest friends. Online therapy is also much easier to scale than in-person appointments amid unprecedented teen mental health needs.

As with any treatment, it is important to know the limitations. NYC Teenspace therapists are responsible for assessing clients' risks, including risks to themselves or others. If a teen presents with significant concerns, such as self-harm or suicidality, their therapist is expected to share resources, make appropriate referrals, and intervene as necessary to ensure safety.

For most teens who are not in crisis, NYC Teenspace offers a living space where they can explore their emotions, develop coping strategies, and build resilience. These are skills they can bring with them as they grow into adulthood.

chalk beat is a nonprofit news site covering educational change in public schools.

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