"You know you can do therapy outside, right?"
My friend, Daniel Herd, a therapist in Michigan, told me this in 2018. I was doing research in preparation for starting my startup, Airapy. Daniel was one of the many therapists who consented to let me interview them during that summer and fall. The initial business model for Airapy was built around therapists making house calls, but I quickly realized that would make therapy more expensive, not less. That was a problem.
Daniel went on to explain to me about this thing called "walk and talk" therapy. The name says it all: the client and therapist walk together during therapy. Clients sign a waiver consenting to participate, and both parties establish guidelines before initiating the session (for example, deciding what to do or say if they run into someone either of them know). Many practitioners have found this technique particularly useful with teenagers. In fact, there are "walk and talk"-based therapy practices all over the country. An American Psychological Association article from 2013 estimated that about 18% of U.S. therapists practice some sort of "walk and talk" and added the following:
Besides exercise's proven ability to combat depression, anxiety, insomnia, weight gain and other health and mental health conditions, combining it with therapy has benefits of its own.
For one, it can model good exercise behavior for clients... It can also provide a bridge to help people actualize their exercise resolutions and ease rapport with certain types of clients, she and others say.
Thanks to Daniel, today Airapy is an online marketplace where patients can book with therapists for meet-anywhere appointments. Airapy helps new therapists start their own private practice by allowing them to list multiple public meeting locations in their profiles, eliminating the need to rent expensive office space. Therapy usually takes place in parks and coffee shops, and booking is made simple and transparent through our online booking calendar. By taking therapy out of the traditional office setting, therapists save money on overhead and pass those savings onto the patients. Therapists are all licensed or under the supervision of a licensed therapist.
Is this legal and ethical?
Airapy reached out to the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors, whose representative stated that "this Board does not regulate practice locations." In fact, there is no direct mention of "walk and talk" therapy in the American Counseling Association's Code of Ethics, the code that the Pennsylvania Board subscribes to. However, Section B.3.c (Confidential Settings) states that counselors "discuss confidential information only in settings in which they can reasonably ensure client privacy."
A reasonable interpretation of the Pennsylvania Code does not suggest that public or semipublic therapy is unlawful or unethical to perform. Airapy encourages all of its participating therapists to discuss confidential information only in settings in which they can reasonably ensure client privacy in compliance with this code. A park, empty coffee shop, or apartment lobby can provide sufficient privacy for many patients.
The amount of clients using these nontraditional services tells us that we are filling an unmet need. Bringing therapy into the community, reducing the stigma of mental health issues, and increasing accessibility is something all therapists support, no matter what methods they employ in their work.
In April 2020 Airapy launched a new HIPAA-compliant platform where potential patients can search for a new therapist in their area and make an online appointment, quickly and easily. Therapists can set up their profile for free. Instead of the current monthly subscription model, therapists pay a small service charge on each appointment. This means we have to ensure that we continue to provide value to the therapists throughout the therapy journey, which naturally ebbs and flows as circumstances change. Beyond initiating that first appointment, we have a long list of planned practice management features that we will begin incorporating into the platform in subsequent iterations. (Progress notes and appointment reminders, anyone?)
Airapy currently has over 60 therapists licensed in over 13 states on our website who can be booked online. We also have a HIPAA-compliant videochat to enable telehealth appointments while social isolation continues– and beyond. Telehealth will always be an option, at no extra charge.
Our mission statement
Starting therapy is the first step of a transformative journey. Too often we are prevented from taking this step by forces outside of our control.
Airapy makes therapy more accessible, affordable, and transparent—lowering the barriers for patients and providers alike, allowing the journey to begin.
Let’s get started.