Teens With Anorexia Seek Help On Mondays, And Other Lessons From Big-Data Counseling

Crisis Text Line, the hotline for a text-dependent generation, is reaching troubled teens in new ways and using the data it collects to be more effective in times of trouble. Here are some surprising findings.

Teens With Anorexia Seek Help On Mondays, And Other Lessons From Big-Data Counseling
[Image: Flickr user Jhaymesisviphotography]

Hoping to appeal to teens, who (generally) spend their days in school, most crisis centers are open in the afternoons and evenings, say, from 4 p.m. to 7 p.m., an idea that made sense until Crisis Text Line started collecting data on when teens reach out for help. It turns out, these centers are doing it wrong.


After three months, 6,400 conversations, and a quarter-million messages, Crisis Text Line, an SMS-based counseling service, has started to amass its data to learn things about the way young people talk about their problems with professionals. One early, and revealing, lesson: “We found that it’s really those overnight hours and weekends that teens are reaching out the most,” Jen Chiou, CTL’s executive director, told Fast Company.

Despite sounding somewhat logical–late nights are when young people can be alone with their thoughts–those hours don’t match up with how centers currently serve young people dealing with serious issues like anorexia, depression, sexual abuse, and suicide. The theory goes that after-school hours work best–but really, that’s only true for staffers at call centers. “That’s often the easiest way to staff the program, not when teens are the most acute in need,” added Chiou. CTL, on the other hand, provides a 24-hour service and plans to use that information to improve staffing at facilities.

That’s just one of the many interesting and useful trends CTL has learned during its pilot period of the program, which launched over the summer. The team has also seen patterns emerge about when teens text most about certain issues. And while some issues tend to come up midweek, others spike at the end of the weekend. “Most people assume eating disorders flair up during lunchtime and right after school,” founder Nancy Lublin said in an email. “Nope. We’ve found that high-volume eating disorder trouble is Sunday, Monday, Tuesday. Think about what this information means for schools, counselors, eating-disorder organizations, families.” The most common issues that teens text about are depression, self-harm, and sexual relationships.

As time progresses and data piles up, the organization hopes to use its trove of information to improve current, and somewhat outdated, counseling techniques. “Let’s say we see a particular issue on Mondays and Tuesdays; we can talk to other people in the space, other organizations working on that issue, and make sure they’re offering services especially during that time of the week,” Bob Filbin, CTL’s chief data scientist, explained.

Unlike phone calls–the traditional mode of communication for these situations–texting, in addition to being a better way to reach teens, enables more research and data collection. Texting is also a more intimate medium, so the counselors find teens sharing more and more quickly than with a call. In fact, the motivation for the service came from a particularly alarming text that came via Do Something, the teen volunteering organization where the idea originated. It read: “He won’t stop raping me, it’s my dad, are you there.” That’s the type of thing a teen might not share via phone, at least not on the first call.


From a research standpoint, that’s powerful. While calls end, text conversations can continue, allowing counselors to get follow-up information on a case. That means CTL and the counselors it works with can learn what leads to success or follow patterns. For example, CTL wants to track language cues to help assess when emergency intervention might be needed. Or, conversely, look at what counseling tactics helped a teen in need.

Much of that research will involve natural language processing, for which CTL has teamed up with the MIT Media Lab. The initiative has started with the basics, tagging conversations with the issues that come up. “That allows us to do data analysis at scale that hasn’t been possible,” explained Chiou. “We already have over a quarter-million messages to analyze.” Another idea is to do sentiment analyses. The counselors have started asking teens how they felt a text conversation went. With enough responses, researchers can see what phrasing from counselors shifted the emotions one way or another.

And that is only the beginning. Right now, CTL has three text-counseling centers–in Boston, Miami, and Seattle–and the pilot program only focused on outreach in El Paso and Chicago. The organization is hoping to expand and get even more data to disrupt counseling and better help teens.

About the author

Rebecca Greenfield is a former Fast Company staff writer. She was previously a staff writer at The Atlantic Wire, where she focused on technology news.