Can we trust therapy platforms?

In our hybrid ecosystem, composed of both online and offline realities, we have witnessed the digitalization of services we could have never imagined would be available online, ready to use directly on our devices. Among these are psychotherapy platforms and, more broadly, all tools that allow us to receive medical consultation and assistance remotely. These new possibilities have revolutionized the way psychotherapy is conducted, giving many more users the opportunity to access care or begin a journey dedicated to well-being and mental health at more affordable prices and in shorter timeframes. However, in recent times, an investigation aired on Rainews24 sparked heated public debate. At the heart of the matter lies the concept of patient trust in these online platforms and, consequently, in the specialists who operate on them.

Today, we no longer only possess a real identity but also a digital one, similar yet distinct, which carries with it our privacy and personal data, which we expect to be protected at all times. The investigation touches on this very point, raising concerns about online psychology companies engaging in digital marketing and monitoring patient activity even during therapy sessions. This issue has alarmed and confused users. As a result, industry giants like Unobravo and Serenis have distanced themselves from the narrative that emerged in recent days, emphasizing that the treatment of their users' data is conducted in compliance with applicable laws and with a strong focus on privacy protection.

The difference between standard cookies and sensitive data tracking

The two platforms have emphasized the difference between using standard tracking tools and sensitive data tracking without patient consent. Cookies are small text files that websites send to your device during browsing. They contain information that allows the site to recognize you on subsequent visits, enhancing user experience, such as remembering preferences or items in a shopping cart. The GDPR (General Data Protection Regulation) is a European law introduced in 2018 to protect the personal data of EU citizens. It also applies to cookies, as they may contain personal information, even if anonymous or pseudonymized. The regulation requires users to be informed about the use of cookies and to give consent before they are installed, except for technical cookies essential to the website's operation. It is important to distinguish between standard cookies and sensitive data tracking. Standard cookies collect general browsing data, such as pages visited, while sensitive data tracking involves more delicate information, such as political preferences or health data, which is governed by stricter regulations and requires explicit consent. Cookies enhance navigation, but it is essential that they are used transparently and in compliance with GDPR, ensuring data protection and user control. Unobravo and Serenis have stated that they have always adhered to these regulations, protecting their users and professionals.

The psychologists’ perspective: Is the generated mistrust a missed opportunity to make mental health accessible to all?

"Potentially yes, as online platforms provide a way to overcome geographical, economic, and social barriers. However, the discovery of a hypothetical lack of transparency and adequate ethical standards risks undermining their credibility, transforming them from an inclusive resource into a commercial tool. To fully exploit their potential, greater clarity is needed. The focus should be on the respect for professional ethics, ensuring privacy, service quality, and patient centrality. This way, such controversies can be avoided": explains psychologist Sara Cutrale, when asked for her opinion on the issue. Psychologist Federica Casùla—also known as psicologasocial—shares her perspective, which leans away from using these services: "In my opinion, online platforms have never truly been an opportunity to make mental health genuinely accessible. They are businesses and, as such, have identified a need to generate revenue. Sometimes I wonder if this need arises from the users or the psychologists working on these platforms: there are so many of us, too many, and starting an independent practice can be challenging," she explains, offering food for thought. "These systems ensure work, but they promote a capitalist logic that should not exist in matters of health. Making mental health accessible means, first and foremost, not considering it a product to sell and discount like a mattress. It also means prioritizing it in political measures, investing funds in public services, and establishing roles such as primary care psychologists: accessibility should apply not only to treatment but also, and especially, to prevention. A frequent criticism I encounter is that, if I am so anti-capitalist, I should work for free. No, I don’t work for free, but I would be much happier if a patient chose me for my expertise and not because I am the only option available."

The Benefits of Online Psychotherapy

Today, a growing number of psychologists and mental health professionals value the benefits of telepsychology platforms. Online psychotherapy offers unparalleled flexibility, allowing sessions to be scheduled around individual commitments and conducted in the comfort of one's home. This translates into significant time savings and removes barriers related to commuting, making therapy more accessible to a wider audience. Additionally, the ability to choose from numerous professionals, even remotely, can facilitate finding the therapist best suited to individual needs. Online psychotherapy is not only convenient but has also proven effective for a wide range of issues. By using tools and techniques specifically tailored for online sessions, therapists can provide personalized, high-quality support. The continuity of treatment is assured, even in cases of unexpected circumstances or physical limitations.

The Drawbacks of Online Psychology

Psychologist Federica Casùla shares her concerns about algorithms and the practice of matching psychologists with patients: "Regarding patients’ perception of their problems, from the earliest stages of our education, we are taught that the request for help is just the tip of the iceberg. For instance, you might think you only have relationship issues, only to discover that these are manifestations of an anxiety disorder. Of course, as psychologists, we should be able to address various patient issues. However, if an algorithm assigns patients based on professionals’ specializations, claiming to find the best fit while likely excluding those who might actually be more suitable after a deeper clinical analysis, it becomes clear that the system is flawed from the outset. This also happens outside of platforms; I often end up referring patients to colleagues who are more specialized in certain areas."

Sara Cutrale also shares her perspective on advantages and disadvantages, drawing on her experience and training: "I believe these platforms have undeniable benefits, such as overcoming geographical distances and reducing costs, making psychological support accessible to more people. However, they also come with significant logistical issues. This isn’t due to the online medium itself, which I value and use as a professional, finding it a valid tool for reaching patients who might otherwise struggle to access therapeutic support. Instead, the problem lies in the commercial approach adopted by some platforms, prioritizing the quantity of patients over the quality of care. When the main goal becomes maximizing patient numbers rather than ensuring high-quality therapeutic processes, the effectiveness of treatment is at risk. Another significant issue is the standardization of therapy, which tends to offer uniform approaches poorly suited to the specific needs of individual patients. This conflicts with the very nature of psychological work, which requires personalization, flexibility, and attention to individual differences."

Are We Oversimplifying Psychology?

Another hot topic among psychologists, Casùla reveals, is the practice of offering a free initial consultation: "This is not well-received by most of my colleagues. Meeting a patient for the first time requires even more effort than subsequent sessions—it’s about getting to know the person, analyzing their history, and beginning to formulate potential diagnoses and treatment plans. Payment is also a crucial element of the motivation to embark on a therapeutic journey and fully engage in it. Often, potential patients take advantage of the free consultation out of curiosity or, at times, to have a casual chat." Memes, advertisements, and some overly superficial posts, she adds as a social psychologist, "have trivialized psychology, turning it into a pop service rather than a health necessity. Many professionals, trying to keep up with these strategies, have started communicating poorly on social media. Patients frequently demand free sessions or lower prices because these platforms do so."

Our Conclusions

"The relationship built with a professional is based on a therapeutic alliance and the perception of a safe environment where one can open up," emphasizes Casùla. This is why public controversies can generate distrust and confusion, jeopardizing this relationship. In conclusion, online psychotherapy is a potentially valid alternative to traditional therapy, offering numerous advantages in terms of flexibility, accessibility, convenience, and effectiveness. However, it is important to underline that it is not suitable for every case and that individuals must choose the approach that suits them best. "I’m saddened that many people, after this public debate, will avoid a service that could benefit them, fearing that their sensitive data might be disclosed or sold when that’s not the case," someone commented under one of the many online posts. The key? Informing oneself and understanding personal needs. Ensure that the platform you are using complies with all privacy laws and ethical guidelines, and consider whether it is the right fit for you. Consult multiple professionals, listen to yourself, and don’t give up on your mental health and therapeutic journey. Try and try again until you find the right and perfect approach for you. Meanwhile, demand a collective, government-led approach that guarantees mental health services for you and everyone else.