UX RESEARCH | STREATEGY
Exploring the Lived Experiences of Online Mental Health Therapy
Team
Tammy Yan
Katrina Zhang
Mitchelle D'Souza
Natalie Yuan
My Role
● Interviews (develop interview guides and conduct interviews)
● Qualitative data analysis with affinity diagramming
● Provided insights and resources as a prior mental health professional
Duration
Sep - Dec 2023
(3 month)
Imagine the vulnerability of baring your soul to a best friend, only to have the screen freeze at the most pivotal moment.
Imagine the heart-wrenching moment of expressing love to a distant partner, only to plunge into the abyss of lost connections.
Imagine revealing your deepest inhibitions to your mom, only to find out that she was distracted by her phone the whole time.
We are living in a life increasingly mediated by technology. Online mental health therapy has brought us with so much convenience, and sometimes it even become our only solution such as during the covid period. However, what if the only solution doesn't work out so well?
This project delves into people’s experience with online mental health therapy, examining the complex relationship between opening up emotionally and the uncertainties of the digital space.
Overview
01 Introduction
TL;DR
Online therapy provides an easy and accessible solutions to many people, but there are many factors that affect people’s experience with online therapy. These factors include: the sense of security, environment settings, technical difficulties, magnified feelings, and humanized interactions.
02 Objective
Through this research, we hope to
● Improve the experience of online mental health therapy
● Enhance feeling of connectedness and willingness to open
● Inform the design of telehealth platforms to improve connection and service
Research Question
How does online mental health therapy impact the feeling of connectedness and emotional disclosure?
UX RESEARCH | STREATEGY
Exploring the Lived Experiences of Online Mental Health Therapy
Team
Tammy Yan
Katrina Zhang
Mitchelle D'Souza
Natalie Yuan
My Role
● Interviews (develop interview guides and conduct interviews)
● Qualitative data analysis with affinity diagramming
● Provided insights and resources as a prior mental health professional
Duration
Sep - Dec 2023
(3 month)
Imagine the vulnerability of baring your soul to a best friend, only to have the screen freeze at the most pivotal moment.
Imagine the heart-wrenching moment of expressing love to a distant partner, only to plunge into the abyss of lost connections.
Imagine revealing your deepest inhibitions to your mom, only to find out that she was distracted by her phone the whole time.
We are living in a life increasingly mediated by technology. Online mental health therapy has brought us with so much convenience, and sometimes it even become our only solution such as during the covid period. However, what if the only solution doesn't work out so well?
This project delves into people’s experience with online mental health therapy, examining the complex relationship between opening up emotionally and the uncertainties of the digital space.
Overview
01 Introduction
TL;DR
Online therapy provides an easy and accessible solutions to many people, but there are many factors that affect people’s experience with online therapy. These factors include: the sense of security, environment settings, technical difficulties, magnified feelings, and humanized interactions.
02 Objective
Through this research, we hope to
● Improve the experience of online mental health therapy
● Enhance feeling of connectedness and willingness to open
● Inform the design of telehealth platforms to improve connection and service
Research Question
How does online mental health therapy impact the feeling of connectedness and emotional disclosure?
UX RESEARCH | STREATEGY
Exploring the Lived Experiences of Online Mental Health Therapy
Team
Tammy Yan
Katrina Zhang
Mitchelle D'Souza
Natalie Yuan
My Role
● Interviews (develop interview guides and conduct interviews)
● Qualitative data analysis with affinity diagramming
● Provided insights and resources as a prior mental health professional
Duration
Sep - Dec 2023
(3 month)
Imagine the vulnerability of baring your soul to a best friend, only to have the screen freeze at the most pivotal moment.
Imagine the heart-wrenching moment of expressing love to a distant partner, only to plunge into the abyss of lost connections.
Imagine revealing your deepest inhibitions to your mom, only to find out that she was distracted by her phone the whole time.
We are living in a life increasingly mediated by technology. Online mental health therapy has brought us with so much convenience, and sometimes it even become our only solution such as during the covid period. However, what if the only solution doesn't work out so well?
This project delves into people’s experience with online mental health therapy, examining the complex relationship between opening up emotionally and the uncertainties of the digital space.
Overview
01 Introduction
TL;DR
Online therapy provides an easy and accessible solutions to many people, but there are many factors that affect people’s experience with online therapy. These factors include: the sense of security, environment settings, technical difficulties, magnified feelings, and humanized interactions.
02 Objective
Through this research, we hope to
● Improve the experience of online mental health therapy
● Enhance feeling of connectedness and willingness to open
● Inform the design of telehealth platforms to improve connection and service
Research Question
How does online mental health therapy impact the feeling of connectedness and emotional disclosure?
Methods
Methods
01 Data Collection
01 Data Collection
Our research involves 2 phases
Our research involves 2 phases
Phase 1
Phase 1
Netnography
(Reddit & Review website for mainstream telehealth platforms)
Netnography
(Reddit & Review website for mainstream telehealth platforms)
To understand general trends in people’s experience with online mental health therapy
To understand general trends in people’s experience with online mental health therapy
Phase 2
Phase 2
Semi-Structured Interview
Semi-Structured Interview
To gain deeper insights on individual experiences with more details and elaboration
To gain deeper insights on individual experiences with more details and elaboration
02 Netnography Site / Participants
02 Netnography Site / Participants
Phase 1
Phase 1
Reddit: We collected posts and sharing about people’s experience with online therapy. The high levels of subjectivity and authenticity of Reddit posts made it easy for us to draw out patterns and themes in people’s experiences.
App review: We selected several mainstream online therapy platforms and gathered information by reviewing and grouping user feedback for each platform, including Doxy.me, TheraPlatform, Zoom for Healthcare, VSee, and Betterhelp.
Reddit: We collected posts and sharing about people’s experience with online therapy. The high levels of subjectivity and authenticity of Reddit posts made it easy for us to draw out patterns and themes in people’s experiences.
App review: We selected several mainstream online therapy platforms and gathered information by reviewing and grouping user feedback for each platform, including Doxy.me, TheraPlatform, Zoom for Healthcare, VSee, and Betterhelp.
Phase 2
Phase 2
In our interview phase, 6 participants were recruited to get ample data with the limited time we have. They were selected based on the following criteria:
Age: 18 years old and older
Experience: Attended both online & in-person therapies
Consent: Willing to provide informed consent
We used purposive sampling by proactively reaching out to individuals who meet the study's criteria. We also involved convenience sampling by recruiting individuals who are readily accessible and willing to participate.
In our interview phase, 6 participants were recruited to get ample data with the limited time we have. They were selected based on the following criteria:
Age: 18 years old and older
Experience: Attended both online & in-person therapies
Consent: Willing to provide informed consent
We used purposive sampling by proactively reaching out to individuals who meet the study's criteria. We also involved convenience sampling by recruiting individuals who are readily accessible and willing to participate.
03 Analysis Procedure
03 Analysis Procedure
Phase 1
Phase 1
Data from Reddit and Telehealth app reviews represented a diverse range of user interactions and feedback. Using the affinity diagram approach, we carefully organized the cross-sites data and identified recurring patterns, observations, and user interactions within 4 overarching themes:Technicality, Spatial Issues, Emotional/Vulnerability, and Contextual Factors
Data from Reddit and Telehealth app reviews represented a diverse range of user interactions and feedback. Using the affinity diagram approach, we carefully organized the cross-sites data and identified recurring patterns, observations, and user interactions within 4 overarching themes:Technicality, Spatial Issues, Emotional/Vulnerability, and Contextual Factors
Phase 2
Phase 2
Data from interviews involved more complexity and deeper insights. Therefore, we spent some time transcribing and familiarizing ourselves with the data. Then we used affinity diagramming again to reveal the underlying factors that may explain people's experiences with online mental health therapy.
Data from interviews involved more complexity and deeper insights. Therefore, we spent some time transcribing and familiarizing ourselves with the data. Then we used affinity diagramming again to reveal the underlying factors that may explain people's experiences with online mental health therapy.
Findings
Findings
Phase 1 Affinity Diagramming
Phase 1 Affinity Diagramming
Phase 1
Phase 1
General trends in people’s experience with online therapy are reflected in
- Technical access: the impact of technology on session quality
- Spatial issues: online and offline space generates different feelings
- Sense of vulnerability: sense of vulnerability alter in different settings
- Contextual factors: online therapy may not be appropriate for some conditions
General trends in people’s experience with online therapy are reflected in
Technical access: the impact of technology on session quality
Spatial issues: online and offline space generates different feelings
Sense of vulnerability: sense of vulnerability alter in different settings
Contextual factors: online therapy may not be appropriate for some conditions
Phase 2
Phase 2
Individual experience with online therapy by the following factors:
Individual experience with online therapy by the following factors:
Sense of Security
Sense of Security
Environmental Setting
Environmental Setting
Technical Difficulties
Technical Difficulties
Magnified Feelings
Magnified Feelings
Humanized Interaction
Humanized Interaction
01 Sense of Security
When people feel insecure, what would they do?
Participants may develop self-protection coping mechanism to be less focused and less engaged when feeling insecure.
Anonymous Racoon
“I feel like I'm not that committed online.”
Anonymous Pumpkin
“Because when there's a screen, the other person not in the same room might prevent me from saying what I want to say at the moment. I might hold it back or convince myself since they're looking at the screen.”
01 Sense of Security
When people feel insecure, what would they do?
Participants may develop self-protection coping mechanism to be less focused and less engaged when feeling insecure.
Anonymous Racoon
“I feel like I'm not that committed online.”
Anonymous Pumpkin
“Because when there's a screen, the other person not in the same room might prevent me from saying what I want to say at the moment. I might hold it back or convince myself since they're looking at the screen.”
01 Sense of Security
When people feel insecure, what would they do?
Participants may develop self-protection coping mechanism to be less focused and less engaged when feeling insecure.
Anonymous Racoon
“I feel like I'm not that committed online.”
Anonymous Pumpkin
“Because when there's a screen, the other person not in the same room might prevent me from saying what I want to say at the moment. I might hold it back or convince myself since they're looking at the screen.”
02 Environmental Setting
02 Environmental Setting
How do factors like room layout, cleanliness, decor, and lighting influence a client's experience?
How do factors like room layout, cleanliness, decor, and lighting influence a client's experience?
Therapists' efforts in office decor create a comfortable treatment environment, fostering a sense of safety and making it easier for clients to open up about their feelings. Online psychotherapy may not replicate these effective methods.
Therapists' efforts in office decor create a comfortable treatment environment, fostering a sense of safety and making it easier for clients to open up about their feelings. Online psychotherapy may not replicate these effective methods.
Anonymous Buffalo
Anonymous Buffalo
“In person environment is very comfortable and relaxing, can't see and feel the comfortable and relaxing atmosphere online.”
“In person environment is very comfortable and relaxing, can't see and feel the comfortable and relaxing atmosphere online.”
Anonymous Otter
Anonymous Otter
“Offline, the comforting scent soothes the participant, and the environment is comfortable too, with cozy pillows to hug.”
“Offline, the comforting scent soothes the participant, and the environment is comfortable too, with cozy pillows to hug.”
On the other hand, online sessions enable clients to receive therapy in their familiar environments. Some clients tend to create a personal refuge in their surroundings, using items like blankets and cozy pillows. These comforting behaviors, facilitated by the comfort of their own space, is a more timely, natural, and discreet compromise for clients who lack a professional office setting.
On the other hand, online sessions enable clients to receive therapy in their familiar environments. Some clients tend to create a personal refuge in their surroundings, using items like blankets and cozy pillows. These comforting behaviors, facilitated by the comfort of their own space, is a more timely, natural, and discreet compromise for clients who lack a professional office setting.
Anonymous Mink
Anonymous Mink
“I would create a pleasant personal environment (using blankets, decorations) to alleviate the feeling of insecurity”
“I would create a pleasant personal environment (using blankets, decorations) to alleviate the feeling of insecurity”
Anonymous Dragon
Anonymous Dragon
“I'm aware of my use of comfort items like plushies or pillows when feeling insecure in online environments”
“I'm aware of my use of comfort items like plushies or pillows when feeling insecure in online environments”
03 Technical Difficulties
03 Technical Difficulties
How does technology affect clients' experience with online therapy?
How does technology affect clients' experience with online therapy?
Participants reported a deep sense of disconnect from their therapists since the only thing visible to them, their faces, got stuck mid-session, leading to missing trail of thoughts and distractions. Some also felt that a few essential parts of in-person therapy like activities and exercises cannot be effectively translated into online sessions.
Participants reported a deep sense of disconnect from their therapists since the only thing visible to them, their faces, got stuck mid-session, leading to missing trail of thoughts and distractions. Some also felt that a few essential parts of in-person therapy like activities and exercises cannot be effectively translated into online sessions.
Anonymous Buffalo
Anonymous Buffalo
“The software experience is terrible - the image quality is unclear and there is lag.”
“The software experience is terrible - the image quality is unclear and there is lag.”
Anonymous Otter
Anonymous Otter
“For me, when in in-person sessions, there are a few activities that my therapist makes me do, which I don't think we'll be able to do online.”
“For me, when in in-person sessions, there are a few activities that my therapist makes me do, which I don't think we'll be able to do online.”
Anonymous Mink
Anonymous Mink
“There were other constraints like network issue…video getting stuck and also face was the only thing that was visible.”
“There were other constraints like network issue…video getting stuck and also face was the only thing that was visible.”
04 Magnified Feelings in In-person Settings
04 Magnified Feelings in In-person Settings
How the same feelings can be different in different settings?
How the same feelings can be different in different settings?
Feelings tend to be magnified in in-person settings. On the one hand, positive feelings like connection and ease of communication were magnified, leading to more positive experience in-person. On the other hand, negative feelings such as discomfort, self-consciousness, and pressure could also be magnified and experienced more intensely in-person.
Feelings tend to be magnified in in-person settings. On the one hand, positive feelings like connection and ease of communication were magnified, leading to more positive experience in-person. On the other hand, negative feelings such as discomfort, self-consciousness, and pressure could also be magnified and experienced more intensely in-person.
Anonymous Racoon
Anonymous Racoon
“When I started meeting him online, I would rate my nervousness at about a 7. However, when I met him in person, even though we had already met twice, my level of nervousness was an 8.5.”
“When I started meeting him online, I would rate my nervousness at about a 7. However, when I met him in person, even though we had already met twice, my level of nervousness was an 8.5.”
Anonymous Dragon
Anonymous Dragon
“When meeting in-person, the waiting area is nice and fancy. This made me feel I am spending all my parents’ money on mental health therapy. I just feel guilty, I guess.”
“When meeting in-person, the waiting area is nice and fancy. This made me feel I am spending all my parents’ money on mental health therapy. I just feel guilty, I guess.”
Anonymous Pumpkin
Anonymous Pumpkin
“With the phone, it's easier to disconnect; in person, there’s more awkwardness when leaving.”
“With the phone, it's easier to disconnect; in person, there’s more awkwardness when leaving.”
05 Humanized Interaction
05 Humanized Interaction
How does the feeling of humanization affect clients' feelings with online therapy?
How does the feeling of humanization affect clients' feelings with online therapy?
In in-person settings, participants reported that they would be more likely to regard in-person counseling as a relationship, care about the therapist, and want to know more about them personally. This is because clients were in the therapists’ environment, can see entire body and gestures, as well as clear facial expressions, rendering more humanized interactions.
In in-person settings, participants reported that they would be more likely to regard in-person counseling as a relationship, care about the therapist, and want to know more about them personally. This is because clients were in the therapists’ environment, can see entire body and gestures, as well as clear facial expressions, rendering more humanized interactions.
Anonymous Buffalo
Anonymous Buffalo
“I go to the counselor's office, and I get a chance to understand what kind of person my counselor is. "
“I go to the counselor's office, and I get a chance to understand what kind of person my counselor is. "
Anonymous Otter
Anonymous Otter
“Offline you have more personal connections, the person you see has temperature. You can feel that she isn’t a black screen when calling you”
“Offline you have more personal connections, the person you see has temperature. You can feel that she isn’t a black screen when calling you”
Anonymous Mink
Anonymous Mink
“When I speak in person, I will be more engaged in expressing my emotions, and then my speech will be more entertaining and animated.”
“When I speak in person, I will be more engaged in expressing my emotions, and then my speech will be more entertaining and animated.”
However, participants reported less commitment with a causal mindset and more likelihood to ghost meetings in online therapy. This is because factors such as only seeing a portion of the body, the lack of additional information, and limited video quality create a less humanized experience with the therapist. Clients tend to perceive the therapist as a tool, not a whole person, leading to less willingness to open during a session.
However, participants reported less commitment with a causal mindset and more likelihood to ghost meetings in online therapy. This is because factors such as only seeing a portion of the body, the lack of additional information, and limited video quality create a less humanized experience with the therapist. Clients tend to perceive the therapist as a tool, not a whole person, leading to less willingness to open during a session.
Anonymous Racoon
Anonymous Racoon
“Online, you can only see her face, maybe half of her body at most, right? While offline you see her whole person.”
“Online, you can only see her face, maybe half of her body at most, right? While offline you see her whole person.”
Anonymous Dragon
Anonymous Dragon
“There are many details, like online, it's hard to see facial expressions clearly. It's challenging to capture more subtle expressions. "
“There are many details, like online, it's hard to see facial expressions clearly. It's challenging to capture more subtle expressions. "
Anonymous Pumpkin
Anonymous Pumpkin
“When you have something unhappy, you talk to the fireplace. I feel like online, she's just that fireplace, a tool with AI functionality.”
“When you have something unhappy, you talk to the fireplace. I feel like online, she's just that fireplace, a tool with AI functionality.”
Reflection
Reflection
01 Recommendations
01 Recommendations
Design Recommendations
Design Recommendations
Using VR/AR to create an immersive therapy space that brings clients and therapists closer, reinforces positive feelings, and make therapists more humanized.
Using VR/AR to create an immersive therapy space that brings clients and therapists closer, reinforces positive feelings, and make therapists more humanized.
Assure time-sensitive technical support and user-friendly issue reporting system.
Assure time-sensitive technical support and user-friendly issue reporting system.
Enhance privacy-protection measures to ensure digital privacy and foster a sense of security.
Enhance privacy-protection measures to ensure digital privacy and foster a sense of security.
Research Recommendations
Research Recommendations
What are elements of an immersive space for online therapy?
What are elements of an immersive space for online therapy?
How can telehealth platforms address privacy concerns in online therapy?
How can telehealth platforms address privacy concerns in online therapy?
How do people’s mental health conditions or needs affect their experience with online mental health therapy?
How do people’s mental health conditions or needs affect their experience with online mental health therapy?
02 Impact
02 Impact
How can we measure the impact in future research?
How can we measure the impact in future research?
Pre- and post- survey
compare participants’ experiences before and after changes implemented.
Quantitative analysis
conduct statistical analysis on participants’ behaviors of using telehealth platforms
Focus group
discuss findings and get feedback with a focus group
Longitudinal follow-up
follow-up surveys and interviews with participants to measure long-term changes.
03 Learnings
03 Learnings
If I were to do this research again, I would...
If I were to do this research again, I would...
Include therapists' voices
Include therapists' voices
Our current research focuses on clients’ voices. It would be interesting if we could have included therapists’ voices to gain a more comprehensive view.
Our current research focuses on clients’ voices. It would be interesting if we could have included therapists’ voices to gain a more comprehensive view.
More diverse participants
More diverse participants
Our current research include 6 female participants. For better external validity, we should have recruited more male and non-binary participants.
Our current research include 6 female participants. For better external validity, we should have recruited more male and non-binary participants.
