Selfapy founder Farina Schurzfeld discusses the disadvantages of psychotherapy in Germany.
It just came from a conversation with an investor. Good mood and full of energy. This is followed by a hearty welcome and, on the way to the chat room, brief kisses with a friend. Farina Schurzfeld, co-founder of the psychotherapy company Selfapy, reaffirms her reputation for always pressing hard. Not the same as the founder. Especially not if you want to achieve something in healthcare.
Mrs. Schurzfeld, how does one come up with the idea of curing people with mental health problems online?
In Germany, there is a difference in pensions for patients with mental stress. On average, you wait three to six months until you find a place for psychotherapy. And even the inhibition of seeking help is pretty great. Ultimately, roughly, only 50 percent of people with mental stress get help. That's a relatively small number when you see that every fifth person struggles with mental stress in life.
You felt a supply gap when your mother had cancer …
… and I thought it was crazy that you were completely alone with an absolutely serious physical diagnosis. For three months we waited for a place for therapy. My co-founder Nora comes from a family of therapists who have always been full of secretaries. And Katie, like Hiwi from Charité, was tasked with refusing therapy applicants. So, we all had our own personal shortcomings in supply.
Now you could say you're fighting for more psychotherapists to solve the problem. But you said we do it online. Why?
We have not reinvented the wheel. Digital therapy offerings have been in existence for over ten years. In countries like Australia, where I worked for five years, it is pretty well established. Otherwise they can hardly do this because of the huge distances and low population density.
A common picture of psychotherapy is: lying on the couch and talking to a therapist to explore his problems and possible solutions.
There are different therapeutic approaches. However, behavioral therapy we offer has always been about taking courses – once with books – to strengthen your personal resources. A good therapist gives homework to help you deal with your situation at home. You can't expect him to be a miracle healer, to make you healthy if you lie on the couch with him for an hour a week. He also needs his own motivation.
What do you learn at Selfapy in courses?
We offer programs for depression, anxiety disorders, eating disorders, chronic pain and stress. And depending on the subject area, this is, of course, a little different. Initially, you set goals, for example: I want to strengthen my self-esteem. Or: I want to improve my sleep behavior. You will then receive a course geared toward it. And of course, the content may change over time. And then you learn, for example, very important in the mentally disturbed, structure of the day.
It starts with writing daily protocols. When is one good? The classics of depressed patients find that they are always in a bad way. It's nothing. These are the correct events. You need to find out when you felt good and what those situations were. We try to work it together. Then you see that you incorporate more of these positive elements into the day. We help you find more positives. Patients with anxiety express expressive writing. They write letters that are evaluated by psychologists. Eating disorders involves learning how nutrition and nutrition regulation work. We give the patient a tool box, five, six tools that will help us in the long run if things don't go well again.
Does Selfapy know how patients' health develops?
We constantly monitor symptoms through standardized questionnaires. We also have an app to measure your mood, which we also take. I say, it would be no more if our program did not work. We did a few studies, now just a big one with Charité, which shows that it works.
And if not?
We intervene when the patient is feeling unwell. We are responsible for that person. As the curve moves down, our therapists hold personal conversations to see what can be improved.
In other words, self-restraint really gives a glimpse into the mental life of customers.
It's a crazy relationship of trust.
Farina Schurzfeld co-founded Selfapy. The 31-year-old from Detmold, after studying Business Administration, moved to Australia, where she helped establish Groupon Discount Portal. It was followed by the USA and Berlin.
Initial Selfapy was founded by Schurzfeld 2016 with Katrin Bermbach and Nora Blum. Today, it employs 30 employees and offers courses against anxiety, bulimia and depression. IT
In our case, the content can only be viewed by a supervising psychologist. And you can't imagine what kind of data protection requirements we have. This means that even if we work with health insurance that bears the cost to the beneficiaries, they never hear anything about the patient's personal situation.
Do you substitute for personal therapist therapy?
General: no. In mild cases, we can make them obsolete. Our goal is to bridge the waiting time to a treatment site and provide follow-up care when someone comes to the clinic or to therapy. That's about one-third of people. And we are especially there for those who seek help at the low threshold because it is difficult for them to become a psychotherapist.
How to deal with someone who is ashamed to go to a therapist who starts with you and shows you that you need personal therapy.
Our psychologists who are in contact with the beneficiary are tasked to contact and assist in the search for a therapist. But that does not mean we can be skilled. In structurally weak areas, finding solutions can be difficult. We can't do magic.
Your psychologists only talk to customers. Can anyone help at all?
You can create a high degree of intimacy with your voice. Making a phone call can create a great relationship of trust, a strong personal connection. Many, many people in our country, over 90 percent, just want to make phone calls, for example, they don't want video calls.
How do you measure your performance?
Based on recent research we have done, 35 percent of symptoms decrease with our therapy within nine weeks. This is comparable to classic psychotherapy.
Such accomplishments are usually heard in the environment: How are your customer numbers developing?
Honestly, the first two years were really, really tough. Although they were recommended to us. We always received about a third of customer referrals. But you can't live in the self-payment market in Germany. Because only seriously ill people pay, for which we were paying 300 euros for twelve weeks. It does not pay off financially. More importantly, we are not the right offer for these people.
How did you solve the problem?
With our commitment, we have made a name for fighters for people with mental health issues. It must be okay to get mental support. It can't be embarrassing, it can't be embarrassing. We also did a lot of political marketing. Much has changed politically with the new Minister of Health, Jens Spahn, and last year we were able to enter into the first contract with a health insurance fund. Meanwhile, 15 to 20 million could potentially use our offer for free. It has been affecting us ever since.
Even with investors, it seems to be going pretty well. Selfapy raised just over three million euros. What expectations do investors bring with them?
That's interesting. There are still relatively few investors in Germany investing in healthcare. You need to be patient and have an understanding of health processes. As an investor, you first need to feel comfortable investing in a market where a large number of stakeholders have their say in the medical profession, health insurance funds and politics and slowly grind mills.
Where do you see your business in three or five years?
Then we would like to be there for people across Europe who need a low threshold solution with a low psychological burden.
And what if politics suddenly made sure there were a lot more therapists?
I think that's great first. And I don't think that could make us obsolete. On the one hand, we could even work with psychotherapists to offer patients standard treatments. Because if we can do something, it is to maintain a certain level of quality through the content we continue to improve. And the second is: The demand is so high that even with a larger spectrum of therapists we would not lose our jobs.
Interview: Daniel Baumann