
Kip (YC W16) is using data to make therapy better for patients and therapists - RoboTeddy
https://techcrunch.com/2017/04/19/kip-therapy-app/
======
anigbrowl
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/#__sec2...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219058/#__sec2title)

~~~
maxerickson
How do you measure outcomes?

~~~
erinfrey
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-...](https://www.thekennedyforum.org/news/measurement-based-care-issue-
brief)

[https://www.theatlantic.com/magazine/archive/2017/04/what-
yo...](https://www.theatlantic.com/magazine/archive/2017/04/what-your-
therapist-doesnt-know/517797/) ( linked to it in an earlier response)

------
kwindla
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
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.

------
anandkulkarni
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
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-
yo...](https://www.theatlantic.com/magazine/archive/2017/04/what-your-
therapist-doesnt-know/517797/)

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

~~~
erinfrey
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
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
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.

------
11thEarlOfMar
Is there a way that patients can 'on board' their current therapist to Kip?

~~~
erinfrey
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.

------
Geeek
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
Whoops that is an old page, before she became our CCO. Good catch – thank you!

------
sonink
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
Thanks! It's actually on the more affordable end for CBT therapy in the Bay
Area. We see a range of $130-300+.

~~~
sonink
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.

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

