Therapick lets patients choose a therapist online

Lisa Marchiano is wearing a black pantsuit with a purple shirt carefully selected for her potential audience. Her long, salt-and-pepper hair has settled into a cascade of ringlets framing her face. She wants to appear professional but chic. She moistens her lips, glances at the klieg lights to her right, looks at the camera, and without hesitation starts to speak.

Marchiano is not an actor or a television talk-show host. She is a licensed clinical social worker and Jungian analyst who is "selling herself" on Therapick, a website where prospective patients can learn, in two minutes, whether the psychotherapist they are watching might have the right chemistry for them.

While patients have long relied on doctors or friends to find therapists, Therapick seems to draw inspiration from dating sites and provides video introductions by zip code. Since its launch in 2010, the service at www.therapick.com has grown to cover 15 areas; Philadelphia, the most recent expansion, has 28 therapists listed so far. Many are psychologists and social workers.

Several experts are intrigued by the idea, saying it could help. No psychiatrists have yet signed up in the Philadelphia region, perhaps because the idea is so new or because talk therapy is rarer among psychiatrists.

The concept for Therapick was hatched in Los Angeles three years ago by David Brundige, a filmmaker who says he started - appropriately enough - by "trying to help my mother."

At the time, Nancy Brundige, David's mother, says she was out of control. She was 25 pounds overweight, and her 3,000-square-foot house was jammed with hundreds of books and countless news articles she might want to refer to someday. She was helplessly entangled in caregiving for her husband of 35 years and her two children, even though both - a son and daughter - were in their 20s. "There was no time for me," she says. "And I had no idea how to take hold of my life."

Nancy knew she needed to be in therapy, but finding the right psychotherapist was "too daunting." She had tried 18 months earlier, and after spending nearly $1,000 auditioning five therapists, she still hadn't found one with whom she felt comfortable.

"I knew there had to be a better way," says Brundige, Nancy's son, then 26. "What would make you go for help?" he quizzed his mother. "If you could see the person, observe her body language, hear him talk about his approach, would that make a difference?" His mother said it would.

That talk sparked Brundige's vision for Therapick, an online video site where therapists can list their education and fees and describe their specialties. "It made sense to me because so much can be gleaned from just the first few seconds of seeing someone via video," he says. In 2009, Brundige conducted his first 30 video interviews in L.A.; the next year, two college buddies helped him gather 150 more. Another friend helped build the website, and in July 2010 the site, organized geographically, was launched.

"I like to work with people going through transitions," Marchiano tells Kelly Gricol, the young graduate student Brundige has hired to help with the interviewing here, "people who are questioning critical aspects of their lives. 'Do I want to stay in this primary relationship? Is this the job for me?' I don't know what's right for them . . . but some part of them knows what's right. My job is to listen for that and help them hear it."

"What does it mean to be a Jungian analyst?" Gricol asks.

"Jung believed not that we are ill, but that we are all trying to become the fullest versions of ourselves," Marchiano says. "Along the way we become blocked."

"That's good," Gricol says. "Can you elaborate on that?"

"Anxiety, depression, or addiction," Marchiano says, "can be symptoms of where we are blocked. We need to look underneath to search for the broader meaning underlying our suffering. Change happens as we get to rewrite the stories we tell ourselves."

Gricol will collect 30 to 40 minutes of tape, which will be sent to Brundige for editing. Within three weeks, the edited version - down to two minutes - will come back to Marchiano via a You Tube link for her approval. "This is a collaborative process," Brundige says. Each therapist can give Brundige two free rounds of editing notes, which he incorporates and returns. Once approved, the cost for signing on is $299 a year, with a $50 discount in a new region such as Philadelphia. "Getting one additional client will more than justify the cost," Brundige says.

Ellie Sherber, 32, a financial adviser in Los Angeles, says she found her "perfect" therapist on Therapick.

Sherber had scanned the list of specialists from her insurer. Then she tried Google but found nothing that made her feel comfortable. Then the Therapick video of Lea Roussos, a Santa Monica marriage and family therapist, resonated for her. "She had a mindfulness approach," says Sherber. "It was very specific and I liked her style. Even if I had read reviews about her, I wouldn't have been able to feel her vibes. But the video was so on-target. This is what technology should be used for, to give people access to information through which they can improve their physical and mental health."

At first, Brundige approached therapists mainly by cold-calling after checking to ensure they were licensed practitioners in their state or held master's degrees in psychology or education and worked under a licensed professional. About 5 percent were enthusiastic about participating in the online video directory, which Brundige says is a high response. "Some people have a full practice and don't want or need more clients; some are camera-shy and the idea of video doesn't appeal to them. And, of course, there are some who think it violates ethics and privacy. We respect that."

That number may be dwindling. Even among psychoanalysts, where the traditional mantra has been anonymity, there is greater acknowledgment of the need for promotion. "In today's world, prospective patients look therapists up on the Internet no matter what," says Lawrence D. Blum, a psychiatrist and psychoanalyst who practices in Center City. "Anonymity [of a psychoanalyst] was never as anonymous as some people thought anyway." Blum says he is not in a hurry to make a video, but is not averse to it, either.

In fact, he cowrote a letter sent to members of the Psychoanalytic Center of Philadelphia, urging that a listing "through an online directory is an opportunity to offer your own services . . . and to expand the presence of psychoanalysis."

Psychology Today offers such a listing service at www.psychologytoday.com, and www.Goodtherapists.org is a directory for psychoanalysts and psychoanalytic candidates. Half of its 200 members are in the San Francisco area, but there are clusters across the country, including in Philadelphia. Therapick says it is the nation's only full video directory.

Still, some therapists aren't sold. Paul Fink, professor of psychiatry at Temple University and past president of the American Psychiatric Association, doesn't see anything wrong with Therapick's videos, but he doesn't think it's the best way to choose a therapist. "I don't prefer to be selected by someone by being observed without a give-and-take. I like to talk with a person, answer questions, and begin to establish a relationship."

"If you can't get a referral from your family doctor or your internist or from a friend or family member, a site like this might be helpful," adds Philip Muskin, professor of clinical psychiatry at Columbia University. "But it is not a substitute for the more traditional, interpersonal feedback you get when talking with someone you trust about a referral to a professional."

In his video debut, psychologist Ameet Ravital, who practices in the city's Mount Airy and Fairmount sections, is dressed casually: a dark jacket, tan pants, and white shirt with an open collar. He smiles warmly and says his approach is holistic. "When someone comes in with a problem, it is not isolated," he says. "I look at the interconnectedness of thoughts and feelings with physical health, the person's livelihood, and relationship with the community. When we work on one issue, we find a thread. . . . When we unravel that thread, it leads to other things."

Ravital seems totally relaxed, but that is not always the case. "For some people, talking into a camera makes them feel self-conscious," Brundige says. "They think they have to be actors, so it is the first thing we address. We ask each one to introduce himself by name, and that is the only scripted part. We have a conversation."

Sarah Walzer, who sells art in a Manhattan gallery, was drawn to Todd Bresnick, a clinical psychologist, because she perceived him as being friendly, open, and a good listener. In his video, Bresnick described therapy as a "collaborative process. It's the two of us here and together we're going to work this thing out." Walzer was intrigued by Bresnick's knowledge of how light and sound affect brain waves that can translate into feeling happier. She has been seeing him since February and says she has gained confidence and feels more in control of her emotions.

Nancy Brundige found the "right fit" in Nancy Sisti, an L.A.-based marriage and family therapist, after scrutinizing seven men and women on her son's site. "I liked her personality and her approach," Nancy says. " She seemed to be a down-to-earth natural person, not New Agey. I didn't want someone talking about energy this or energy that. I wanted someone to talk about real things."

When Nancy met Sisti face-to-face, her impression was confirmed. "I felt at ease and comfortable, and we had a lot of give-and-take, unlike with a previous therapist who just sat there and said almost nothing."

Since seeing Sisti, Nancy says she has become more self-aware, has rearranged her priorities, and is paying more attention to herself. A bonus is that her husband has taken over the cooking.

She is proud that she contributed to the vision that has become Therapick and grateful that it introduced her to Sisti. "One shoe doesn't fit everyone," she says. "But I'm lucky. I found the one that fit me."