6 ms·

Kip (YC W16) is using data to make therapy better for patients and therapists

108 points by RoboTeddy 9y ago

anandkulkarni 9y ago
I've referred a few folks to Kip who were looking for a therapist after struggling to find one elsewhere (in one case, I downloaded the app on their phone and just sent the person to the first meeting). So far, they're reporting positive things about the app and the experience. One of the interesting things that Kip solves is discovery: it seems like they have a roster of prequalified therapists who follow evidence-based strategies. That's pretty interesting – the basic process of finding a qualified therapist who's a good fit via the usual methods (Google, asking people) isn't easy.
- erinfrey 9y ago
  Yep–we have a really high bar for therapists. We also look at outcomes data (de-identified, in aggregate) and can use that to evaluate therapist performance over time. There was a really cool article in the Atlantic a couple weeks about why outcomes data is so crucial to making therapy more effective. It mentions an study where they used outcomes data to see which therapists treated clients more effectively: https://www.theatlantic.com/magazine/archive/2017/04/what-your-therapist-doesnt-know/517797/ https://www.theatlantic.com/magazine/archive/2017/04/what-yo...
kwindla 9y ago
What Kip is doing is great. I'm a big fan of the company. And the founders are super thoughtful. Improving access to therapy is a positive thing. That's relevant in particular ways to our community. Startups are hard. If you think you might benefit from talking to a therapist, you should try it.
- erinfrey 9y ago
  Thanks! I'm one of the Kip founders and I go to therapy. It's been critical for me and I hear that from a lot of founders who work with us, too. Therapy helps me be mentally stronger so I can manage the stress and ups and downs that come with startups. I've also seen a huge jump in my ability to think strategically and clearly. My productivity is so much higher, too.
chaostheory 9y ago
Unless I missed it there's one thing Kip doesn't seem to currently address: privacy. I don't even see it mentioned.
- erinfrey 9y ago
  Good question. Everything you share with your therapist in the app is private and visible to the two of you. We host your data on HIPAA-compliant servers (Aptible). We care a lot about this and should probably add a bit more on the website. Good call!
  - anigbrowl 9y ago
    Add a lot more. there is no way I would consider using your service right now, even trusting that you are completely HIPAA compliant. Honestly, I'd need an assurance that you cannot get at (or give away access to) my records without the cooperation of me or my therapist.
    - lod723 9y ago
      Yeah, this is important. Therapist-client privilege has a specific legal definition, and it'd be very bad to loophole that away due to some inadvertent implementation detail.
anigbrowl 9y ago
I'm a bit troubled by this phrase in the article: As someone who is seeking to overcome a certain amount of anxiety and depression — and really, what human isn’t dealing with some amount of anxiety or depression? This makes it sound more like life coaching or therapy for episodic mental health problems than for people who deal with chronic mental illness. It's hard to tell how much of this is the article author's voice and how much of it stems from the way the service is structured and marketed. This isn't necessarily bad - people suffering minor or acute depression need help too and if this improves their outcomes at lower cost then that's a wonderful thing. But since it is profit-driven, there's a natural economic incentive to orient it around the needs of the easiest customers to deal with, rather than the ones with the most severe problems, for whom outcomes are much harder to optimize: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219058/#__sec2title https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219058/#__sec2...
- maxerickson 9y ago
  How do you measure outcomes?
  - erinfrey 9y ago
    Our therapists use standard surveys like the DASS-21, PHQ-9, GAD-7, etc. to track treatment progress over time. Standard measures like these are really good at measuring changes in an individual's symptoms over time. A therapist usually assigns these surveys every week or every other week. The surveys have questions such as, "Rate how much the statement applied to you over the past week: I found it hard to wind down." or "I felt I wasn't worth much as a person.' And then your answers contribute to a 'score' for whatever the survey is measuring (e.g. level of anxiety). You can google any of the form names to see the full question list–the ones we use are open source. As an example, DASS-21 measures stress, anxiety, and depression levels in a individual at a scale of 0-34. Let's say that in the beginning of treatment, a client measures at 18-16-30 (18 depression, 16 anxiety, 30 stress). Overtime, you'd want to see a reduction in those scores. Research shows that routinely tracking outcomes with measures like these leads to better outcomes but most therapists don't do it! This is one thing we're trying to change at Kip. Here are some good articles on why using standard measures to track outcomes makes care more effective: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910387/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910387/ https://www.thekennedyforum.org/news/measurement-based-care-issue-brief https://www.thekennedyforum.org/news/measurement-based-care-... https://www.theatlantic.com/magazine/archive/2017/04/what-your-therapist-doesnt-know/517797/ https://www.theatlantic.com/magazine/archive/2017/04/what-yo... ( linked to it in an earlier response)
Geeek 9y ago
Very interesting idea. I am curious what the data will show about the differences in outcome vs traditional therapeutic interactions. As as side note, you shouldn't have the "What Kip partners are saying" with only one person, and that person being someone that has Kip as her employer on linkedin. But not as a therapist but as a "Chief Clinical Officer" AKA chances are she does not see clients directly...
- erinfrey 9y ago
  Whoops that is an old page, before she became our CCO. Good catch – thank you!
11thEarlOfMar 9y ago
Is there a way that patients can 'on board' their current therapist to Kip?
- erinfrey 9y ago
  Not right now. There used to be and it's something we're thinking of adding back in the future. We are always looking for more great therapists to join Kip and they can do so on the website.
bjshepard 9y ago
Data suggests shrooms, DXM and/or massive ketamine can reset deep traumatic patterns. Also we recommend checking out internal family systems therapy.
sonink 9y ago
Very cool idea. Is $165/session competitive with what one would pay outside of Kip ? Seems too high to me, though I don't stay in US.
- erinfrey 9y ago
  Thanks! It's actually on the more affordable end for CBT therapy in the Bay Area. We see a range of $130-300+.
  - sonink 9y ago
    Wow, thats a lot of money - I am guessing for a lot of Americans too ? What you guys think about getting therapists over skype from India ? It would be a lot cheaper for sure, if it works.

108 points by RoboTeddy 9y ago

I've referred a few folks to Kip who were looking for a therapist after struggling to find one elsewhere (in one case, I downloaded the app on their phone and just sent the person to the first meeting). So far, they're reporting positive things about the app and the experience. One of the interesting things that Kip solves is discovery: it seems like they have a roster of prequalified therapists who follow evidence-based strategies. That's pretty interesting – the basic process of finding a qualified therapist who's a good fit via the usual methods (Google, asking people) isn't easy.

erinfrey 9y ago
Yep–we have a really high bar for therapists. We also look at outcomes data (de-identified, in aggregate) and can use that to evaluate therapist performance over time. There was a really cool article in the Atlantic a couple weeks about why outcomes data is so crucial to making therapy more effective. It mentions an study where they used outcomes data to see which therapists treated clients more effectively: https://www.theatlantic.com/magazine/archive/2017/04/what-your-therapist-doesnt-know/517797/ https://www.theatlantic.com/magazine/archive/2017/04/what-yo...

kwindla 9y ago

What Kip is doing is great. I'm a big fan of the company. And the founders are super thoughtful. Improving access to therapy is a positive thing. That's relevant in particular ways to our community. Startups are hard. If you think you might benefit from talking to a therapist, you should try it.

erinfrey 9y ago
Thanks! I'm one of the Kip founders and I go to therapy. It's been critical for me and I hear that from a lot of founders who work with us, too. Therapy helps me be mentally stronger so I can manage the stress and ups and downs that come with startups. I've also seen a huge jump in my ability to think strategically and clearly. My productivity is so much higher, too.

chaostheory 9y ago

Unless I missed it there's one thing Kip doesn't seem to currently address: privacy. I don't even see it mentioned.

erinfrey 9y ago
Good question. Everything you share with your therapist in the app is private and visible to the two of you. We host your data on HIPAA-compliant servers (Aptible). We care a lot about this and should probably add a bit more on the website. Good call!
- anigbrowl 9y ago
  Add a lot more. there is no way I would consider using your service right now, even trusting that you are completely HIPAA compliant. Honestly, I'd need an assurance that you cannot get at (or give away access to) my records without the cooperation of me or my therapist.
  - lod723 9y ago
    Yeah, this is important. Therapist-client privilege has a specific legal definition, and it'd be very bad to loophole that away due to some inadvertent implementation detail.

anigbrowl 9y ago

I'm a bit troubled by this phrase in the article: As someone who is seeking to overcome a certain amount of anxiety and depression — and really, what human isn’t dealing with some amount of anxiety or depression? This makes it sound more like life coaching or therapy for episodic mental health problems than for people who deal with chronic mental illness. It's hard to tell how much of this is the article author's voice and how much of it stems from the way the service is structured and marketed. This isn't necessarily bad - people suffering minor or acute depression need help too and if this improves their outcomes at lower cost then that's a wonderful thing. But since it is profit-driven, there's a natural economic incentive to orient it around the needs of the easiest customers to deal with, rather than the ones with the most severe problems, for whom outcomes are much harder to optimize: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219058/#__sec2title https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219058/#__sec2...

maxerickson 9y ago
How do you measure outcomes?
- erinfrey 9y ago
  Our therapists use standard surveys like the DASS-21, PHQ-9, GAD-7, etc. to track treatment progress over time. Standard measures like these are really good at measuring changes in an individual's symptoms over time. A therapist usually assigns these surveys every week or every other week. The surveys have questions such as, "Rate how much the statement applied to you over the past week: I found it hard to wind down." or "I felt I wasn't worth much as a person.' And then your answers contribute to a 'score' for whatever the survey is measuring (e.g. level of anxiety). You can google any of the form names to see the full question list–the ones we use are open source. As an example, DASS-21 measures stress, anxiety, and depression levels in a individual at a scale of 0-34. Let's say that in the beginning of treatment, a client measures at 18-16-30 (18 depression, 16 anxiety, 30 stress). Overtime, you'd want to see a reduction in those scores. Research shows that routinely tracking outcomes with measures like these leads to better outcomes but most therapists don't do it! This is one thing we're trying to change at Kip. Here are some good articles on why using standard measures to track outcomes makes care more effective: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910387/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910387/ https://www.thekennedyforum.org/news/measurement-based-care-issue-brief https://www.thekennedyforum.org/news/measurement-based-care-... https://www.theatlantic.com/magazine/archive/2017/04/what-your-therapist-doesnt-know/517797/ https://www.theatlantic.com/magazine/archive/2017/04/what-yo... ( linked to it in an earlier response)

Geeek 9y ago

Very interesting idea. I am curious what the data will show about the differences in outcome vs traditional therapeutic interactions. As as side note, you shouldn't have the "What Kip partners are saying" with only one person, and that person being someone that has Kip as her employer on linkedin. But not as a therapist but as a "Chief Clinical Officer" AKA chances are she does not see clients directly...

erinfrey 9y ago
Whoops that is an old page, before she became our CCO. Good catch – thank you!

11thEarlOfMar 9y ago

Is there a way that patients can 'on board' their current therapist to Kip?

erinfrey 9y ago
Not right now. There used to be and it's something we're thinking of adding back in the future. We are always looking for more great therapists to join Kip and they can do so on the website.

bjshepard 9y ago

Data suggests shrooms, DXM and/or massive ketamine can reset deep traumatic patterns. Also we recommend checking out internal family systems therapy.

sonink 9y ago

Very cool idea. Is $165/session competitive with what one would pay outside of Kip ? Seems too high to me, though I don't stay in US.

erinfrey 9y ago
Thanks! It's actually on the more affordable end for CBT therapy in the Bay Area. We see a range of $130-300+.
- sonink 9y ago
  Wow, thats a lot of money - I am guessing for a lot of Americans too ? What you guys think about getting therapists over skype from India ? It would be a lot cheaper for sure, if it works.