Introducing Practice

Context

Trite but true, from the moment we are born, we are participants in a battle for our mind. Initial opponents are our environment, our families and friends, and the social institutions we participate in. Eventually, the written word enters the fray. Fast forward and the internet, smartphones, algorithmic content feeds, etc while all deeply positive contributions to society, are the natural evolution of a paradoxical trend: as humanity advances, we find ourselves more deeply entangled in a world where our attention is under siege. A battle that, if we recognize at all, we feel we are helplessly unwilling participants in.

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Modern capitalism, meanwhile, is not only aware of the battle, but studies it and sharpens its weapons. Top business school professors write, and Silicon Valley executives dogear, books with titles like "Positioning: The Battle For Your Mind." The ideas taught in Stanford's Persuasive Technology Lab are directly responsible for more GDP than many countries. Against such formidable opponents, it’s no surprise that everyday people  are underprepared for and overwhelmed by the battle for their attention.

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What's to be done about it? Thankfully, there are ways to defend your mind. Unfortunately, up to this point, they have not been credible to the everyday individual both from a product and marketing perspective, perhaps because the answer to the paradox of human progress is itself paradoxical: to win the battle for your mind, one must disengage rather than fight at all.

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Interestingly, we have known this truth all along. Ancient practices such as meditation are one method for disengaging. Modern psychotherapy techniques like Cognitive Behavioral Therapy (CBT) are another. Stoicism offers a framework for how to approach life that allows one to disengage. Modern psychiatry, even in its infancy, is a medical marvel that chemically helps one to disengage more easily. Alternative therapies like MDMA-assisted psychotherapy are promising. Exercise, diet, and the quality of our personal relationships (with others and ourselves) are all incredibly important. Yet, individually, none of these tools alone is enough - we need all, or some large combination, of them.

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Yet from a technology perspective, there is no offering on the market that attempts to address mental health holistically, leaving consumers in a state where they alone are responsible for tying together all of the disparate elements that contribute to their mental health, often (and ironically) jumping between countless apps that suck up mindshare and add little individual value. Indeed, although it has progressed from its former state of nonexistence, the current mental health technology space is a disaster.

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Where We Are Today

The current mental health landscape lacks vision. Many of the tools on the market are either general psychotherapy/telehealth services or are tools built for those who are acutely suffering, with messaging focused almost entirely on ailments like acute anxiety, depression, PTSD, psychiatric disorders, etc. Yet the vast majority of people do not identify with these symptoms, and psychotherapy suffers from atrocious dropout rates.

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Moreover, the reality is that the average person may not even understand what such an abstract idea like "anxiety" is, much less want to identify with the social stigma associated with needing or wanting assistance to govern their own mind. Yet this does not mean they should not work on their mental health, it just means we need to meet them where they’re at.

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But rather than simply messaging better, the more interesting and defensible solution is to build software that helps patients see value in taking care of their mental health. Today's major telehealth incumbents are doing the bare minimum for their patients– they are basically simple marketplaces with basic review features. Meanwhile, the market for software-based meditation, CBT exercises, Stoic philosopher quotes, etc is rich, but disjointed and only somewhat effective. 

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In general, as a consumer, the feeling is that you are doing what you would have done prior to the Internet - bouncing between therapists until you find one you like, with the only differentiating trait being that you can find therapists online and video chat them on your phone, and maybe you're using apps rather than reading books or listening to cassettes. This is not what the Internet aspires to be. We can do better.

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Introducing Practice

There is a different path forward.

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Imagine a world where accessing mental healthcare was as easy as buying an iPhone: in-person or online; you have access to your entire customer history; any discounts (ahem, insurance) are handled on the backend; any accessories (e.g. medication) can be purchased right there; it's easy, rather pleasant, and just works. This is where we are going - a single place where patients can go to take care of their mental health.

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The first step in this direction is to build a Patient Profile that gives Patients the ability to track their mental health over time and, if they choose, share it with their provider(s). As a first step, the Patient Profile will be a simple tracking app, with the concept of Topics, Sessions, and Notes. Each Session or Note on the profile will have the option to be associated with a Topic. You’ll be able to score your progress across Topics, as well as for each Session. Think of a much better version of the current Satisfaction with Therapy and Therapist surveys you currently get. There will be some basic analytics to help you make sure you’re always aware of the context for how things are going - basically, helping you zoom out a bit and put yourself in context. This is just the first step. Eventually, the Patient Profile will be home to all of your mental healthcare data - prescriptions, meditation sessions, therapy sessions, etc - a place where you will find a holistic view of your mental health.

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After the Patient Profile, the next step is introducing Therapists. This is tricky because, from a regulatory perspective, many therapists are covered entities, which means that in order for them to use Practice, we also need to be HIPAA compliant, which requires development effort and thoughtfulness around security and privacy (which we’re excited to talk more about in a future post). We're working on building a version of the app that will meet these requirements, but are still a few months away.

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The final feature of Practice's minimum viable product (MVP) will be a new paradigm for therapy. We’re calling it Structured Therapy, and it’s meant to take someone who is brand new to therapy, and help them see immediate value. We’ll be taking best practices and ideas, and standardizing them into a kind of curriculum so that each beginner gets a similar experience, which makes it easier for us to fix and refine things over time. Of course, if you’re still interested in unstructured therapy (i.e. the current state of affairs), there is no requirement that you participate in Structured Therapy, and you can still benefit from the improved discovery and feedback mechanisms mentioned above.

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The end result of this initial MVP buildout will be a tool that provides a remarkably improved discovery, onboarding, and feedback experience for psychotherapy. It is the first step in building a much larger suite of tools and experiences that will help you be able to disengage from the battle for your attention and take care of your mental health.

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How You Can Help

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Right now, we’re at the very beginning of this journey, and we need your help. Specifically, we are looking for two key people as either cofounders or first hires:

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1. Clinician Lead - This person would be responsible for all things provider-related, including discovery, the development and rollout of Structured Therapy, and the updated feedback mechanisms. This person would help counter the bias toward patient experience on the founding team. Ideally, this person has a background as a therapist or psychologist and is looking to make a difference in the mental health space in a different way.
2. Technology Lead - This person would lead the software development effort that will make Practice such a seamless experience. This person is an experienced engineer that has a passion for privacy and security and is excited to build a new model for applications that handle sensitive personal information.

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If you know someone who might be interested, please share this post with them. If you are one of these people, send me an email at drake@practice.health - I’d love to hear from you. And if you're a patient or mental health advocate that's curious about what we're working on, join the waitlist and we'll notify you when we launch our waitlist app, or just follow us on Instagram.

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Strive on, untiringly.

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Drake

Founder, Practice Health