Posted on May 05, 2020
Wondering if online therapy works? Discover what you can expect when you attend online therapy sessions.
Like most treatments, the efficacy of online therapy truly depends on what you need. It’s not crazy to entertain the idea that online therapy might even be more successful than in-person methods for certain conditions. Technology can impact how people receive psychotherapy or work with a psychologist, which is why researchers are interested in teletherapy and telehealth, evaluating how well it works, especially compared to in-person, in-office psychotherapy sessions. But, the research is still new, and there is a lot that science doesn’t yet know. However, people are still wondering does online therapy work?
For the most part, teletherapy does seem to work, whether it’s the only treatment, or in tandem with in-person sessions. But remember, online therapy isn't for everyone, especially those whose treatment requires therapist-accompanied behavioral therapy like exposure therapy, for instance.
It should be noted that online therapy is not the same as newer technologies and platforms that conduct therapy through chat messaging with a licensed therapist instead of scheduled sessions. There are major red flags with this type of self-help, most notably with patient anonymity. Therapists might be unable to help a client who may be in danger of hurting themselves or others since the patient can request to remain unknown or not give their contact information.
Of course, this new unvetted type of virtual therapy doesn't mean all online therapies are as risky. It’s just a matter of finding the right therapist who is a qualified professional who behaves just as professionally as in person. Luckily, there are now a number of therapy matching service options, like Advekit available to help you find that online therapist.
Approximately one in five Americans will experience a mental health condition in a given year, and only a fraction will receive the care they need. Having instant and inexpensive access to a therapist from the comfort of home can help more people than just in-person services alone. Studies show online therapy requires 7.8 times less of a therapist's time than face-to-face treatment—meaning therapists can often treat more people online than they can in-person.
Online therapy can be convenient for many people who are comfortable using the Internet and looking for help.
Since mobility can be a major issue when it comes to accessing mental health care, online therapy also provides accessibility to individuals who are disabled or housebound.
Individuals who are unable to leave their homes for various reasons, such as physical or mental illness, may find the benefits of online therapy to be better than traditional psychotherapy settings. Access to mental health information and treatment for people in rural or remote areas is also opened up when online therapy comes into play. Even those who have to commute and take significant time out of a busy schedule to seek therapy can find this to be a burden. All online therapy requires is reliable internet access.
But before you sign up, or rather log on, there are points to consider about telepsychology.
Though you may hear it called web therapy, phone therapy, text therapy, or online therapy, psychologists commonly refer to any therapy delivered by telecommunication tools or devices as telepsychology or teletherapy. Really, anytime you’re interacting with a psychologist using a website, a phone, or a mobile app, you could be considered taking part in telepsychology services.
The nice thing about online therapy is that each session is really what you make of it. Your online therapy visit is all about you and what you’d like to discuss. It’s just like going in to get traditional therapy except you stay on your couch instead of traveling to sit on your therapist’s. Like in-person therapy sessions, your therapist will ask you questions and allow you space to discuss any issues that have arisen since the last time you spoke, in addition to continually working through past trauma.
Like most talk therapy, how long you pursue treatment is within your control, but it’s typical to commit to a minimum 6-months, and more likely much longer. While there are other modalities of therapy that work on a set time frame to resolve very specific problems, an online therapist who will work with you on a deeper level to help uncover and understand the full range of your thoughts and feelings. Frame this for yourself as part of your ongoing self-care practice, just like committing to a workout plan for your physical well being. Virtual therapy is no less impactful than in-person sessions, so treat it like an investment in yourself.
Unlike popular talk therapy chat apps, you will need to schedule an online therapy appointment ahead of time. Once you have done this, you can virtually show up to your appointment with a specific concern you’d like to discuss or let your therapist guide the way.
Your “visit” will most likely be between 45 minutes to an hour. During that time, your therapist may ask initial diagnostic questions to better understand your emotions and past experiences. They may also ask you about your medical history and about what you’d like to accomplish in therapy. Using all of this, your therapist will come up with personalized care recommendations to share with you at the end of your visit. Your information is both confidential and secure.
Online therapy can happen over the phone or video chat. Enabling video can help simulate an in-person experience, but a phone call is also effective. It’s also possible to do a combination of the two mediums. That said, it’s important to pick a good spot to engage with your therapist. It should be somewhere that is private, quiet, and comfortable enough to be there for 45 minutes to an hour. If you are using video conferencing, make sure that your environment is not distracting.
While online therapy has been proven to be just as effective as in-person treatment in most cases, there are some things that cannot be done virtually. In many cases, online therapists cannot see facial expressions, vocal signals, or body language –– signals that can often be quite informative in giving a clearer picture of your feelings, thoughts, moods, and behaviors.
Voice-over-Internet technology and video chats can provide a clearer scope of the situation, but they often lack the intimacy and intricacy that real-world interactions possess. The physical feeling of being in a room with another person is impactful, and should not be dismissed as totally replaceable. However, some people may feel more comfortable undergoing therapy in a digital setting, especially younger, digital-native generations who are more familiar and comfortable using technology to be vulnerable in their communication.
There are several studies looking at telemedicine for different kinds of disorders and they tend to see encouraging success.
Research shows that cognitive behavioral therapy, a type of talk therapy that has you engage in a certain number of sessions with a counselor to spur the awareness of negative thinking patterns, is as effective via telephone or over video chat as it is face-to-face for some mental health conditions. Using online cognitive behavioral therapy is definitely an option in learning how to respond to challenging situations or negative thoughts in a more effective way to reduce emotional distress.
A small 2014 study also found that teens who were counseled over the phone for obsessive compulsive disorder found just as much success in treatment as their peers who met therapists in person. And more recently, researchers in South Carolina found that veterans who experience post-traumatic stress disorder respond just as well to online therapy as treatment received in office. Another common issue treated by talk therapy is disordered eating, and studies have shown online therapy could potentially work for those patients as well. In a small study from 2008 that assessed 128 adults experiencing bulimia nervosa, adults who were counseled by trained therapists via telemedicine were able to stop disordered eating habits just as much as the adults treated in person.
Online therapy has many benefits, but there are some potential drawbacks to consider.
An essential consideration with any therapy treatment is therapy insurance. With online therapy, coverage can depend upon the state you live and the plan you have. Some insurance policies do not cover online therapy, so make sure you check with your provider before committing to an online session. Paying for online therapy cost out-of-pocket can add up quickly, even when it’s online.
Another factor to consider is if you are looking to do online therapy with a licensed therapist who doesn’t live in your state. Many states still do not allow out-of-state psychologists to provide services virtually, and some states allow psychologists to provide out-of-state mental health services for a limited amount of time, usually 10 to 30 days per year. If this happens to be your situation, your provider needs to be licensed in both their home state and your home state.
Additionally, keeping your personal information private is a major concern in all psychotherapy treatments, but online treatment adds a layer of complexity. Confidentiality is just as important in online therapy as it is in more traditional forms of treatment delivery, but since information is being transmitted online, the situation makes privacy leaks and hacks of higher concern. This doesn’t even factor in issues with technology access or quality. Troubleshooting an application or a bad internet connection can easily burn through the majority of an online therapy session.
Of course, since online therapists are physically distant from the client, it is difficult to respond quickly and effectively when a crisis does happen. If a client is experiencing suicidal thoughts or has suffered a personal tragedy like an unexpected death in the family, it can be difficult or even impossible for the therapist to provide direct assistance. If you have a serious addiction or have more severe or complex symptoms of a mental health condition, online therapy may not be recommended unless other local and accessible therapies or treatments are also involved in your plan. The scope of online therapy can be limited, so it is typically not effective in more complex situations.
With the recent pandemic guidelines and remote communication becoming more in demand, and even necessary, more psychologists are exploring online sites and apps just as more patients are interested in using them. If you’re looking to find a therapist online, Advekit can help match you with a provider that meets your needs.
Alison LaSov, LMFT
Alison LaSov is a Licensed Marriage & Family Therapist with experience treating clients struggling with anxiety and depression. She predominantly focuses on mental health intervention for children and adolescents, particularly those who are in crisis. She has worked within the Los Angeles education system treating students with Individualized Education Plans (IEPs), as well as supervised a non-profit Teen Crisis Hotline out of Cedars-Sinai Hospital. Alison earned her B.A. from UCLA and M.A. from Pepperdine University. She is a native to Los Angeles and co-founder at Advekit.