ReferMe
Improving Online Tools For Finding Suitable In-Person Psychotherapy Services
Thesis Examination / December 2020
Introduction
In a culture where technology is widely available, psychotherapeutic services should provide better, easier ways for users to find appropriate in-person psychotherapeutic services. There are many websites and apps available to help people find online therapy, but comparatively few offer in-person therapy. The few platforms that do aid in finding in-person therapy sessions are poorly designed, cold, and unduly complicated. Many of those platforms also serve up far too many irrelevant options after completing both the survey and filtering. This experience can be overwhelming. Options that would be a good fit for the user are often buried deep in a long list, and the user may not be able to discern their best match.
Thesis Objective
To design a service platform that gives users the confidence to find an in-person psychotherapist using their mobile phone, tablet, or computer. The platform should offer a search experience that narrows the pool of options into a discrete, manageable list and guides the user’s journey with easy, step-by-step directions and guidance. Through a process of research, discovery, and analysis, this author will recommend an improved platform design for finding the psychological help they need.
Research Questions
How does a service-finding platform filter and present information in a way that makes the user feel like the list is specifically created for them?
When there are many options, what questions need to be asked in order for the final items to be narrowed and specific to the user?
How many psychotherapists should be presented to the user in order for them to feel like they have a good but not overwhelming selection?
How does a site make the user feel comfortable and build the user’s trust?
Understanding the Problem
According to National Alliance on Mental illness, suicide has become the 10th leading cause of death in America, with 1 in 5 Americans struggling with a mental illness. Even though suicide is the most extreme outcome, it is not the only negative outcome from mental illness. People who suffer from depression have a higher risk of developing cardiovascular disease, experience substance abuse, are more likely to be unemployed, and have a higher education dropout rate compared to peers. (National Alliance on Mental Illness, 2020)
According to Mental Health America, 46% of Americans will meet the criteria for a diagnosable mental health condition sometime in their life, and half of those people will develop conditions by the age of 14. This statistic implies that almost half of people would need to see a psychotherapist at some time in their life, but only 44% of people with mental illness receive mental health treatment. (National Alliance on Mental Illness, 2020) There are many reasons why Americans are not receiving the help they need. Acknowledging one needs help, the stigma behind mental health, financial constraints, and making time in a busy life for appointments are all obstacles in receiving the help one needs. (Wagner, 1994) There is nothing worse than finally finding a psychotherapist, making an appointment, and then leaving the appointment feeling like it was a waste of time or feeling like nothing was gained from the experience.
Many who finally attend therapy but do not get the sense of fulfillment start to question if seeking help is truly worth their money and time. According to a research study at Brigham Young University, 20 to 57% of people do not return after their first initial therapy session. (Lambert & Barley, 2001) There are many reasons someone might not return to therapy, but a personal connection with the patient and professional is a large factor.
Design Methods
Survey & Interviews
Understanding people's activities, behaviors, and attitudes about the topic I created an online survey that 58 participants completed, both male and female with an age range of 20 to 60 years old. They answered 9 questions that were either multiple choice or a rating scale.
Findings From Survey
Out of the 58 participants more than half have never been to therapy.
When asked if they would be able to help someone find a psychotherapist only 40% said they would feel comfortable helping them find the right one
while 33% would have no idea how to help them find a right therapist and 26% would have recommendations or suggestions.
These numbers show that people in therapy would still struggle to help others find the treatment they need.
Participants were then asked if they would feel comfortable reviewing or benefit from reviews given by past clients or patients of mental health professionals. 81% said they would rate or review the professional they saw as long as it was completely anonymous. 88% of participants would feel more comfortable seeing a professional they found online if they had rating or reviews from past patients or clients.
Out of the 58 participants, only the ones who had been to therapy answered the remaining questions.
53% saw a professional that was recommended to them by a peer or family member, 31% had a doctor or nurse help them find a psychotherapist and only 16% found someone online.
Moving to the graphic on the top right: 40% of participants saw multiple professionals till they found the right one and 31% liked the first one they saw while 30% still have not found the right one or have gave up all together.
The bottom graph shows on a scale of 1 to 10 how helpful each participant felt their therapy or treatment was.
Personas
Based on the survey’s findings, I created three user personas. These three user personas give me insight into what different users’ priorities might be and how the final solution could benefit them and meet their needs. Each persona adds value and insight to the design of the final solution.
Card Sorting
A way to sort, order, and pair ideas. Taking ideas written on cards and categorizing them. When using this method I visited many different psychotherapy finding platforms, both in-person and online and saw the questions they ask users and the filters used during the search process. I then took my findings and categorized them from most important to least important based on what questions and filters I felt would be most helpful to my three personas.
Popular Media Search
Find new developments taking place tied to the same context.
What Psychotherapist Finding Platforms Exist Today?
Through a popular media search, I examined four existing psychotherapist-finding platforms. As you can see, they all vary in how one searches for the right treatment they need whether that be a symptom-based search or selecting the type of professional they are wanting to see. Most of the sites are international, have filters and a good variety of professionals, but have poor navigation and do not follow up with the user after the search is completed.
SWOT Analysis
Identify strengths, weaknesses, opportunities, and threats related to business competition.I believe Psychology Today is the most popular and well-known platform in this area. Through the SWOT Analysis, I identified the strengths, weaknesses, opportunities, and threats of the competition.
Strength is a large network
Weakness is poor search engine
With its large network, it has the opportunity to be a great connection platform for users and professionals but turns users away with its hard-to-use filters and long lists of results.
What I learned from the design methods conducted:
Learn how to make the filters meaningful.
Make the filters more personal to narrow down the list.
Make sure changing the filters, results in different options.
Focus more on what the user wants out of their interaction.
Pair users to professionals based on compatibility.
Ask what is the user struggling with and what type of treatment are they looking for?
Ask the user more questions.
By being more specific, the user will get more personalized results.
Follow up with the user
Did they have success with the professional?
Can the new solution help the user if they did not have success?
Research Subjects
Paradox of Choice
When presented with too many options, a user can feel unsatisfied and frustrated. In a time of need, users seeking psychotherapeutic services need to feel comfortable and safe when searching for in-person help and not be turned off by a gauntlet of in-depth personal questions or be required to wade through an inordinately long list of options. Through extensive research, Dr. Helen Fisher, a biological anthropologist, found that after nine options, our brains go into cognitive overload, shutting down our brain’s capability of making a choice.
(Mears, 2020) (Hanna & Piasecki, 2011)
Understanding Platforms and Algorithms
Types of Online Platform
There are 10 different types of platforms: Technology Platforms, Computing Platforms, Utility Platforms, Interaction Networks, Marketplaces, On-Demand Service Platforms, Content, Crowdsourcing Platforms, Data Harvesting Platforms, and Content Distribution Platforms.
For this study, I focused on two for the final solution, Interaction Networks, and Marketplace platforms.
Interaction Networks Platform
Facilitates interactions between specific participants. Digital interactions can take the form of a message, voice call, image, or money transfer. Users join the platform to connect with other users.
Marketplaces Platform
A two-sided platform connecting supply with demand. Marketplaces enable transactions between demand-side participants (buyers) and supply-side participants (sellers).
(Platform Hunt, 2016)
Types of Algorithms
Another element that is important to understand is a site’s algorithm. An algorithm is a way a problem is solved. Companies and platforms have made their own algorithms in order to stand out from the competition and make themselves successful, but here are 6 popular “umbrella” algorithms. Similar to the online platforms, I will focus on two, the Greedy Algorithm and the Divide and Conquer Algorithm.
Greedy Algorithm
Builds up a solution piece by piece, always choosing the next piece that offers the most obvious and immediate benefit.
Divide and Conquer Algorithm
Divide: This involves dividing the problem into different sub-problems.
Conquer: Repeating the subproblems until they are solved.
Combine the subproblem solutions to then get the final solution.
(Geeks For Geeks, 2018)
Example of a Successful Marketplace Platform
Airbnb is a Marketplace Platform that connects users with sellers. Allow travelers to find a place to stay, provided by an independent person. Airbnb’s search engine is tailored to each user allowing one of a kind experience.
“The goal of the Airbnb search ranking algorithm is to help guests find the perfect listing for their trip—and help hosts find guests who are a great fit for their space. We study nearly 100 different factors for every listing in every search. The exact list of features are confidential, but here are the basic categories:
Guest needs: We review factors related to the guest, including where they’re searching from, their previous trips, which listings they’ve added to their Wish List or clicked on, and more.
Listing details: We consider things like the number of five-star reviews, price, location of the listing.
Trip details: We note how many guests will be traveling, how long the trip will be, how far in the future the trip is if they have set a minimum or a maximum price, and a variety of other factors.
Airbnb’s search algorithm is secret as it is a large part of their success, but they talk a little bit about the aspects of it on the Airbnb website. I believe their algorithm follows the divide and conquer strategy as it divides problems into subproblems through guest needs, location, and trip details.”
Adapting a version of the AirBnB’s approach in the Final Solution:
Use the idea of a marketplace platform
Pair users with psychotherapists
Tailor the search to each user.
Will have a personalized list based on individual needs and wants.
Follow up with the user after the connection has been made.
Make sure the user was happy with the options provided.
Have the user select keywords to rate their experience.
Example of a Successful Interaction Network Platform
The dating app Tinder is an example of an interaction network platform because each action the user makes affects the next suggestion given by the platform. When creating a Tinder profile, one selects an area radius, gender, and age range they are interested in. Once the profile is complete, there are no more filters or actions required by the user. Tinder connects users based on prior filters and preferences. Once connections have been made, (meaning each user swiped right on each other) users can then message one another.
“Tinder is an online dating app that works by allowing you to browse through profiles where you can like (swipe right) or dislike (swipe left). If that particular profile has liked your profile, the two of you will ‘match’ meaning that you are now able to send messages to each other.” (Morley, 2020)
I believe the Tinder algorithm falls under the idea of the greedy algorithm because each piece or profile shown to the user is based on the user’s last action. With a large user database, Tinder can predict who will like whom solely based on similar users’ actions. One user’s behavior can predict another’s, without ranking people in a competitive way. As the user continues to swipe left or decline match options, the options will become less likely to be a match since the first options are meant to be the strongest connections. (Tiffany, 2019)
Adapting a version of Tinder’s Approach in the Final Solution
Connect compatible users and professionals
Not only is it important for the user to connect with the professional, but the professional also has to feel capable of treating the user
Focus on what similar users choose
Use an algorithm that gives options based on similar users’ choices
Getting feedback from previous users on what professionals helped them or not
Use building a profile to create boundaries and filters for the search
Instead of setting filters while one is searching, the profile would set the filters for the user and no further preferences would have to be made
Design Solution
Homepage
The Homepage allows new users to create a profile, existing users, and psychotherapists to log in.
Confidentially Pop-up
Alerting the user that all answers will be confidential.
About You
When the user starts creating their profile, they will be taken through a survey. The first section is basic user contact information.
About You- Continued
The next part in the About You section dives into more personal information like insurance coverage, out-of-pocket price range, location, and prior diagnosis. It is important to ask the user what their out-of-pocket price range is because a lot of great psychotherapists are not covered by insurance but can still be affordable.
What Are You Struggling With?
Symptom Checklist- This section helps narrow down what and who the user is looking for based on their wants and needs in a broader sense by narrowing down the disorders the user might be struggling with.
If the user selects the checkbox mentioning medication, the search engine knows to show professionals with the capability to proscribe.
What Are You Struggling With? Continued
This section goes into a deeper dive on symptoms by asking the user if they have specific symptoms or struggles.
Who Are You Looking For?
This section focuses on the compatibility of the user and the psychotherapist. It allows the user to select characteristics they would want in a mental health professional through selecting keywords.
These Keywords are very important. They are not only used in the onboarding processes but continuously throughout the user’s workflow. The keywords will end up affecting the algorithm and other users.
Personalized List
After completing the survey, the user is given 9 options of psychotherapists that are tailor to their wants and needs. The list consists of basic information on each professional’s card.
Individual Psychotherapist Option
After selecting a professional from the list given to the user, they will then be taken to a page where the user can learn more about the psychotherapist. It will have their contact information and location, 5 Keywords other uses have stated about them, and a list of symptoms other users have had when seeking treatment from them.
The keywords and list of symptoms are based on other users who have seen this professional for treatment.
Reaching Back Out
A week after the user creates a profile and completes the survey, the platform would reach back out and re-engage the user.
“No, I didn’t” Workflow
If the user did not meet with 1 of the 9 psychotherapists provided to them and they select “No, I did not” on the re-engagement email, they will be asked a few questions. These questions can help alter the list given to the user and help users in the future receive a better list from the platform.
“Yes, I did” Workflow
If the user selects that they did have success finding a psychotherapist, they will be brought to a page where they can select the psychotherapist they saw out of the 9 options they were given.
“Yes, I did” Workflow Continued
After selecting the professional the user saw, they will be asked to select the keywords that describe the professional. There would not be a required amount or limit allowing the user to answer freeingly.
These keywords play a role in the algorithm when a user is searching for a psychotherapist.
Conclusion
The Final Design Solution
● Allows for a personal experience with each end result tailored to that user
● A reliable place where others can tell peers and patients in need to go to
● Helps users who do not know what type of psychotherapists to see for treatment
○ Example: If a user is wanting to talk to someone about psychological medication, they should not schedule an appointment with a Social Worker
● Users select keywords to describe their treatment with the professional instead of reviewing them
○ The keywords are then used to connect users with professionals
○ Idea of users helping users
● Follows up with users after they create their profile, checks in to see if they got in contact with a professional, and offer the next step for those who did not find what they were looking for