Skeptics were quick to criticize rapper Travis Scott’s offer of a single month of virtual therapy to those who attended his fatal Astroworld concert last week, but psychology and trauma experts were hesitant to dismiss his approach.
Scott announced Monday that those who attended the concert, where nine people were killed, would be eligible for a free month of BetterHelp, an app that offers counseling through text, phone and video conversations. Those who were unimpressed by the offer equated it with a brand deal, noting that BetterHelp is frequently advertised by celebrities and influencers.
But mental health experts were cautious about throwing the offer away without more information, saying even a few counseling sessions could do a lot of good.
Not many organizations can offer widespread therapy and counseling services to 50,000 people, some of whom could have traveled to the event from other states, said Dr. Saumya Dave, a psychiatrist and author in New York.
“It’s the licensing also that tends to be tricky, because, at least for me as a psychiatrist, I get licensed by the state,” Dave said. “And so those qualifications and things vary state to state to state. I actually can’t see people even in the next state over unless I was to be licensed in their state.”
As a practicing clinician, Dave understands the concerns that the length of time is inadequate. The first few sessions might just be working on a rapport with new clients, evaluating their symptoms and building their trust.
“It’s really important for me to make sure that that person is comfortable in that appointment, that I am also meeting them where they’re at,” Dave said. “So a lot of times if someone’s not ready to actually explore the nuances of what happened during that event, then we will not go there in that first or second appointment.”
BetterHelp will not charge users who sign up through Scott’s offer after a month, and it will offer “extended therapy support” after that time, the company said in an update Thursday. It also clarified that Scott would not be paid for the partnership.
Neither Scott nor BetterHelp responded to requests for comment.
Experts expect only a small fraction of the 50,000 Astroworld attendees to need long-term mental health care.
Research has repeatedly shown that the majority of people who experience trauma are resilient and may not develop larger mental health issues, such as post-traumatic stress disorder, depression and anxiety, said Anka A. Vujanovic, the director of the Trauma and Stress Studies Center at the University of Houston.
“The distress that people would experience in that immediate aftermath dissipates gradually, over the days and weeks following the trauma for most people,” Vujanovic said. “So usually within days or weeks after a trauma most people recover. If the symptoms are sustained for usually about a month or more following a trauma, that’s usually a good marker for the need for professional support.”
For those who do need longer care, it is most important that they get the proper evidence-based care specific to trauma.
“Most of those evidence-based protocols, if we’re looking at cognitive behavioral therapy, which tends to be the most effective type of treatments for any of these conditions, treatment programs generally are 12 to 16 sessions with a licensed mental health professional who’s trained in those approaches,” Vujanovic said.
BetterHelp says it has more than 20,000 providers with different licensing and specialties, with weekly video sessions and unlimited access to text conversations. It's unclear how effective supplemental text conversations might be; but Vujanovic encouraged anyone who takes advantage of the offer to ask questions about the type of care they are getting.
Telehealth sessions have proven to be just as effective as in-person therapy sessions, but technology is evolving faster than guidelines and regulations are able to keep up with, said Lynn Bufka, the senior director of practice transformation and quality at the American Psychological Association.
“This is a question that we just don’t, we don’t know, right? We haven’t had this kind of technology deployed in this fashion after a traumatic experience,” Bufka said. “It could be taking advantage of something like BetterHelp right now may provide enough of an experience for individuals that fewer people go on to develop long-term adverse effects.”
Therapists are expected to adhere to federal privacy regulations, such as the Health Insurance Portability and Accountability Act, and make sure their platforms are secure, Bufka said.
“It’s less clear when you’re using some of these text-based platforms whether or not it’s considered health care, whether or not that product then falls under federal regulation,” Bufka said. “That’s one of the questions: Do they have to adhere to the same standards that your physician needs to adhere to, that your psychologist you see in their office needs to adhere to?”
“These are companies. ... Every company wants to make a profit. So what does it mean to make a profit? How do they handle data?” Bufka said. “We know that most people using tech just click on the ‘I Agree’ and don’t really read the fine print. This is an area where you should read the fine print.”