Yes, “Text Message Therapy” is Real
In 2011, Stephanie Shih and Nancy Lublin formed something called the Crisis Text Line. The nonprofit is a 24/7 crisis intervention hotline. It’s also, as the name suggests, conducted solely through text message.
The Crisis Text Line (or CTL) traces its history back to DoSomething.org. Shih was an employee there and Lublin is the current CEO. They were galvanized into founding CTL after receiving a heart wrenching message during a routine, text based announcement.
Shih was on the receiving end of a text that said, “He won’t stop raping me.” She brought the text to Lublin and, after some brainstorming, the two decided to form CTL. The rest, as they say, is history.
I learned about the organization after reading an incredible New Yorker profile. I’ll admit, at first a “text message therapy” line sounded strange. As I read on, though, I was soon a believer in the CTL’s mission. This was due, in no small part, to some interesting facts and some unique strategies the Crisis Text Line is employing.
Texting Has Therapeutic Benefits
If “text message therapy” sounds strange to you, well, you’re not alone. The idea of something as abbreviated as a text being able to offer meaningful therapeutic benefits is foreign to many. There are some serious benefits to text based crisis intervention, though.
Consider that a single teenager sends, on average, two thousand texts each month. Consider that teenagers maintain contact with friends through text more than any other means, including face-to-face conversations.
Consider that almost all text messages are opened. The official number stands at 98%. Consider that people are four times more likely to read a text than an email.
Consider that hard research has shown writing to have therapeutic benefit. Consider that “According to Fred Conrad, a cognitive psychologist and the director of the Program in Survey Methodology at the University of Michigan Institute for Social Research, people are ‘more likely to disclose sensitive information via text messages than in voice interviews’” (The New Yorker).
Consider that the Crisis Text Line has received over five million texts. Consider that it receives, on average, 15,000 texts each day. Consider that they’ve received texts from each and every area code in the United States.
Keeping the above facts and statistics in mind, a therapeutic technique that’s able to tap into texting seems obvious. In fact, I’m left scratching my head and wondering why no one thought of this sooner.
Add into the mix the Crisis Text Line’s approach to “text message therapy” and there’s a lot of potential for positive outcomes.
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CTL’s Unique Methods
The CTL has two unique approaches to crisis intervention. The first is how their staff actually corresponds with those who text in. The second is their research and analysis methods.
CTL counselors are trained through a seven-week course which, appropriately enough, can be done online through video conference. During their training period, counselors are taught to echo the language of those texting in. This helps put the texter at ease, as well as gain additional information about their situation.
Counselors are trained to ask open-ended questions, validate emotions/experiences, practice empathy, and point out various positive attributes. They’re discouraged from asking questions involving “why,” using overly formal language, and jumping to conclusions about a texter’s sex or sexuality.
In short, they’re trained like traditional therapists. They’re also trained in more internet savvy protocols, like using first person statements, avoiding typos, and not overusing acronyms.
Then, we come to the CTL’s data gathering techniques. These start at the interface that counselors use. It’s laid out similar to Facebook and highlights texts that contain words like suicide, kill, etc. It also has a helpful feature that lets counselors contact other, more experienced/specialized counselors without having to get up.
The sheer volume of texts the Crisis Text Line has received (five million) make it a goldmine for analyzing mental illness trends. Thanks to the CTL, new facts and statistics have come to light. These include things like:
- Depression is highest in teens at 8pm
- Anxiety is highest in teens at 11pm
- Self-harm is highest in teens at 4am
- Drug use is highest in teens at 5am
- Arkansas has more teens struggling with eating disorders than any other state
- Vermont has more teens struggling with depression than any other state
- Montana has more teens experiencing suicidal thoughts than any other state
- New Hampshire has fewer teens experiencing suicidal thoughts than any other state
And that’s just what the CTL has figured out so far! Imagine the mental illness information they’ll learn as they grow! More to the point, imagine the implications this information will have on treating mental illness. The New Yorker reports,
“The organization is working on predictive analysis, which would allow counsellors [sic] to determine with a high degree of accuracy whether a texter from a particular area, writing in at a particular time, using particular words, was, say, high on methamphetamine or the victim of sex trafficking.”
In the world of evidence-based, mental health therapies, this level of information gathering is invaluable. It’s truly a revolution in mental illness treatment. It would allow counselors, CTL and otherwise, an unheard of opportunity to help patients.