Hello, readers! I am disappointed to say that I am not only late on publishing this week, but I have skipped a week entirely. This was not due to lack of progress, as you’ll see below, but more than the tradeoff of late nights for publishing a post didn’t seem to justify what it did to my next day…

With that; onwards!

Goal & Identity Alignment (Research)

Perhaps the biggest realization I’ve had over the past ~ 2 weeks is moving beyond goals, as a parent to habits, but looking more critically at identity; how it’s formed and how it changes for the average person.

You’ll note that in my last post, I mentioned how our routines are dictated by our basic needs and the goals that we most want to achieve. Let’s put a pin in that for a second and ask: What enables us to accomplish a goal?

Here are some of the variables that I’ve found:

1. Social Sharing & Interaction

   1. Sharing your goals and progress towards those goals has a clear improvement on your ability to accomplish them, up to 33% more likely.

   2. This is more pronounced if the person you are sharing your goals with is someone you respect and hold in high authority.

2. Choosing Habits

   1. Starting small and having achievable goals is a great way to increase the likelihood that you accomplish a big goal. This is a core concept in Atomic Habits, the book by James Clear (and covered here).

3. Reflection / Introspection

   1. Reflecting on the goal achievement process and framing goals as intrinsic VS extrinsic were both variables in the ability for someone to accomplish a goal.

From a product landscape, most solutions tend to focus on #2. Structured is geared around consistently completing habits so that they can build on each other, and fit into your daily schedule. Atoms, the eagerly anticipated habit tracking app from James Clear, focuses on starting small and compounding, using streaks and gameification as a way to increase the likelihood that you stick with a habit.

In a separate investigation, I found many apps that fall into #3. Some do this indadvertedly, i.e. successful apps like Headspace and Calm, whereas there are TONS of apps that focus on mood tracking, reflection, gratitude, etc. The issue is that these are largely not connected to one’s goals, but I can see how using an app would prompt more general reflection than the average person would get. I won’t bore you with details, but I’ll highlight some of them:

• What’s Up — A combination of a diary and simple games that follow Cognitive Behavioural Therapy (CBT) methods to disrupt thinking patterns that are counterproductive. 500k downloads.

• How We Feel — iOS app built as a non-profit by a tech team in San Francisco. Do check-ins, spot patterns, and follow strategies to improve your wellbeing. 12.7k ratings.

• Daylio — Very popular app that records mood while tagging your activities and other inputs. I think this is closer to the holistic view on mood, and makes it easier to understand the interconnectedness of what drives your mood. 20M+ users.

  • Of these, I think Bearable is one of the best. I think it’s one of the few that looks at the impacts on mood (i.e. caffeine, apps, exercise), track symptoms over time, and build new habits to improve on them.

All of these apps have #1 (social interaction) to some extent, more as an avenue for driving virality and sharing of the app than accomplishing the goal itself. Some of these products like Sanvello offer community groups & discussions to build camaraderie within a given focus (i.e. reducing anxiety).

Despite the range of options, I started to zoom out from goals, habits, and routines, and look at wellbeing as a broader topic. I think it’s common knowledge that while all these activities are helpful, following them doesn’t guarantee happiness.

I’m currently going through a course on The Science of Wellbeing, but in a recent conversation with a good friend & mentor, I got exposed to positive psychology and the PERMA model.

This holistic view made a lot more sense; your happiness isn’t a derivative of good habits, but rather how aligned you are with those habits and the decisions you make.

I touched on this a bit in my last post, but didn’t call out the issue directly: you need to have a strong understanding of your identity and Self to:

1. Understand what sparks positive emotion

2. Gauge what will be an engaging activity

3. Make decisions that drive towards an overall purpose (meaning)

4. Accomplish goals that are meaningful to you

In the goal setting example, having intrinsic alignment with your goals only addresses #4. I could make the argument that emotions, activities, and decisions all stem from overarching goals, but I think that’s a simplification of a very complex landscape.

Why do therapists exist? (Think)

With the emergence of AI and LLMs, there’s a huge movement questioning whether AI is a great alternative to therapy. I would highly recommend reading that article from The Guardian; it’s shocking that it’s seen as a win that a bot can talk down someone from committing suicide, when there’s so much regulation on the duty to report for licensed therapists. This is, of course, an extreme, but it begs the question: how much of this process - healing, growth, etc. - can we do by ourselves?

I’m naturally biased; I’ve seen numerous therapists and I’m currently dating one. However, I think there are some great parallels to general medicine. As I rewatch Community, I found this quote from Abed particularly hilarious:

No one tries to operate on themselves. Even if you could, and had a doctor assisting you, you wouldn’t feel comfortable doing it. Why do we not extend the same affordances to mental health?

I’ve found personally that even a simple question like “I want to better handle stress” can open up a can of worms around value systems, family upbringing, and internal conflict. These are areas that can be very difficult to navigate yourself.

I’ve found that internal conflict, especially, is the root of unhappiness. I can set and achieve goals but, as I mentioned with the PERMA model, if I’m not aligned with the goals and understand what drives me, then I won’t be satisfied when I complete the goal.

I have a hypothesis that, for certain populations, the majority of results come from the work they do independently (via reflection, journalling, social support, etc.) and not just from the 1-to-1 therapy session. The issue is that therapists aren’t paid to support you outside of those sessions, and it’s not scalable for them to do so. They can give you tools (i.e. workbooks to fill, videos to watch, etc.) but even that has its limitations.

In contrast to the multitude of apps I mentioned above, there isn’t a lot when it comes to ‘therapist support’. The vast majority are around practice management, where there are countless options like Jane, Vagaro. TheraNest, etc. Several of these (like Vagaro - but also Practice, Honeybook, etc.) are not just for therapists but practitioners of all kinds, like coaches, medical spas, etc. I’ve personally worked on growth for some of these products, like Homecoming and Moxie.

To date, I’ve only come across two solutions that touch both areas:

1. Quenza — Build and deploy modules for your clients and monitor how they are doing. Geared towards solutions-based practitioners, hence the focus on exec coaches, career coaches, etc.

2. Noble — Leaning into the Remote Therapy Monitoring (RTM) topic, where you send assessments and check-ins to your clients and, as of 2023, tapping into new insurance coverage around remote treatment.

My theory is that if you can enable clients to do some of the ‘work’ themselves, outside of the 1-to-1 sessions, and have them be more prepared for the conversations with their clinician, they will see better outcomes. I think there is also an opportunity to expand the clinician’s revenue, by tapping into RTM and other avenues (even paid out-of-pocket by the client) because they’re getting value beyond the 50-60 minute sessions.

Of course, there are a multitude of questions on this, such as:

1. Duty to Report — How much of this data will be shared with the clinician, and how does real-time affect this?

   1. Clinicians wouldn’t have the same context they have in a live session; how do they interpret statements that imply harm to the client or others, abuse, etc. that they are required to report?

2. Extent of Discovery — In a parallel to general medicine, you can do work to improve your health metrics via diet, exercise, etc. but you can’t run blood tests yourselves (for the most part). How does this work with copiloting with a therapist?

   1. How much should the client be reflecting, discovering, etc. by themselves VS in a structured session? What is ‘safe’ in this context?

3. Presenting Concerns / Co-morbidities — This will be a result of testing to find Product Market Fit, but I’m aware that therapists deal with a wide variety of clients. Certain people with depression can put themselves in a suicidal spiral by journalling their thoughts (they become real). Those with task avoidance would see prompts and ‘homework’ as causing more stress / harm than good.

   1. This is actually a good concern, as I’m a strong believer that apps need to be very focused on the problems they solve and populations they focus on to be successful. This will not work for all therapists and all clients.

What needs to be validated? (Build)

I’m currently in the process of reaching out to a variety of therapists to conduct research interviews and try to better understand how they view intake, client relationships, what happens outside of sessions, etc. If you know of any therapists who would be open to a 20-min chat, please ping me!

In tandem, I’m also looking to talk to the end user (clients / patients) to understand more about their respective experiences with therapy, how they viewed the ‘work’ outside of sessions, and what leads to successful engagements. If you have done / are doing therapy, please get in touch with me!

My goal is to do the following:

1. Validate the key problem areas + target populations, via user research

2. Shape the product + MVP to pilot this out

3. Get initial data and feedback to build a case for a full build-out

And for those of you that are wondering, I’m still exploring a working relationship with Potential and other projects, but given my particular excitement about this current repetition, I want to make sure I can see it through over 2-4 weeks before looking at other / past areas.

Stay tuned for next week’s post with more details on my findings and what I’m working on, thanks!