Table of ContentsView AllTable of ContentsTypes of TherapyOnline vs. In-PersonTips and StrategiesLimitationsNext in Working With a Therapist GuideOnline Therapy for Anxiety
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Table of Contents
Types of Therapy
Online vs. In-Person
Tips and Strategies
Limitations
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An estimated 21 million adults in the United States experienced at least one major depressive episode in 2021.This equates to 8.3% of all adults in the country, which makesmajor depressionone of the most common mental health disorders in the United States.
Psychotherapyis a proven treatment for depression. Many therapists,psychologists,psychiatrists, and other mental health professionals shifted gears to provide remote or online therapy to new and existing clients during the pandemic, and have continued to use these platforms. Additionally, there are a number ofapp-based online therapy programsthat can quickly connect you with credentialed therapists.
Online therapy or “teletherapy,” as it is often called, operates much the same as traditional, in-person therapy, but with a twist. Rather than visiting a therapist’s office, you stay home and conduct a session via video on your computer, tablet, or phone with your therapist. If video is not an option, your therapist may offer a session on a conference call, a regular telephone call, email, or text messaging.
Here, we cover the types of online therapy available for depression, how online differs from in-person therapy, tips for getting the most out of your online session, and limitations of online therapy for depression.
The Best Online Therapy Services for Depression We Tried and Tested
Depression Therapies Available Online
Cognitive behavioral therapy(CBT) andinterpersonal therapy(IPT) are two of the most common evidence-based therapies for treating depression.
Withcognitive behavioral therapy, a therapist will help you learn to better identify negative or unhelpful thinking that is leading to your depression and then work with you to change those beliefs and behaviors that are contributing to your symptoms.
Cognitive behavioral therapy and interpersonal therapy are only two examples oftherapies your counselor may useto treat your depression. Your therapist may choose a different modality to deliver treatment, but ultimately, their goal is to work with you to create a treatment plan to address your needs.
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Online vs. In-Person Therapy
As many people are discovering, the differences between online and in-person therapy may not be that significant. If you have an existing relationship with a counselor, you may find that the only adjustments are learning the technology and creating a space at home for regular sessions.
If you’re new to counseling or working with a new therapist, you also have the issue of buildingrapportand trust, which may come easier for some people online. On the other hand, that can create problems for people who thrive on in-person contact.
For example, when doing in-person therapy, Sean Paul, MD, a board-certified psychiatrist and owner of NowPsych.com, says you have the opportunity to look your therapist in the eyes and watch their body language—and they can do the same with you. While this is still possible with live teletherapy sessions, it does not have the same effect as an office session.
Also, Paul says you may be more likely to come out of the first session with a live therapist with a more robust feeling that you connected. Again, this can happen online, but in-person often creates a better connection for building initial rapport.
That said, he points out that meeting your therapist virtually can significantly reduce the anxiety of physically leaving the comfort of your own home and going into a new place to meet a therapist.
In some cases, people are also relieved not to risk seeing a co-worker or acquaintance at a therapist’s office. Also, a patient who is oversensitive to eye contact and other non-verbal communication may react more positively to an online session.
Getting the Most Out of Online Therapy
Whether you’re transitioning from in-person therapy toonline sessionsor you’re seeking help for new depressive symptoms, knowing how to prepare for your sessions can help you get the most out of your online therapy appointments.
Designate a Space for Therapy Sessions
To make the most out of online sessions, the first step is to find a place in your home strictly dedicated to therapy. Ideally, this should be a space you can close off and have to yourself. You want to be free of distractions such as family members, electronics, and other household noise. This also gives you privacy and keeps your sessions confidential.
Do Your Homework
If part of your treatment includes exercises outside of the therapy session, such asjournaling,mindfulnesstraining, or relaxation exercises, carve out time between sessions to work on these tasks. Then, come prepared to discuss what you worked on with your therapist.
What Is Mindfulness-Based Cognitive Therapy (MBCT)?
Prepare Yourself for Each Session
Depending on what you’re doing right before seeing your therapist, Paul says you may want to do some breathing exercises to change your frame of mind prior to starting an online session.
Treat the Session Just Like an Office Visit
One way to set yourself up for success is to treat an online session just like an office visit.Ryan Soave, a trauma and mental health therapist and clinical director of telehealth services at APN Lodge, says to rise up out of bed, shower, and get dressed just like you would do on a normal day where you’re heading to an office.
“Make a ritual around this and set an intention for your session,” he says. Soave also recommends carving out time before the session to get centered and prepare, and then allowing yourself some time after the session to process and reintegrate.
Schedule a Time That Works Best for You
Soave says it’s important to work with your therapist to find the best time of day during the week that will most support you. He also recommends discussing the frequency of sessions with your therapist. For example, maybe it would be better to have two half-hour sessions at different points in the week in lieu of a single one-hour session.
Go Easy on Yourself
Rachel O’Neill, PhD, LPCC-S, therapist, and director of clinical effectiveness forTalkspace, says there is no right or wrong way to approach online therapy. However, to the extent that you can, she says to try and stay consistent with your engagement—even through your more difficult depressive symptoms.
“If you’re using an app-based service, consider enabling push notifications so that you know when your therapist has messaged you, or set daily reminders in your phone to take time to interact with your therapist,” O’Neill says.
Be Honest With Your Therapist
This may require more time than in-person sessions, so be patient and ask your therapist for help if you’re struggling with the process.
Opt for Audio and Video When Possible
“The closer the approximation to face-to-face, the better,” says Saltz. So, speaking on the phone is better than texting, and video chatting is better than speaking on the phone. But Saltz also reminds patients that something is better than nothing.
The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
Limitations of Online Therapy
Although online therapy is generally an appropriate form of treatment for most mental health issues, including depression, O’Neill says it may not be the right approach for all. “Those with neurocognitive disorders, which are disorders that result in decreased mental function due to a medical disease (Alzheimer’s disease, traumatic brain injury, etc.), may not benefit as much from online therapy,” she says.
Similarly, if you’re experiencingactive psychosisorfeeling suicidal, O’Neill says these may also require more intensive services than are able to be provided via virtual counseling.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911
Online therapy is also not well suited for people who need a team of professionals, such as those with complicated issues likepersonality disorders,chemical dependency, and someeating disorders.
Milder forms of some of these disorders may be amenable to online therapy, says Paul, but only if you have access to other local specialists such as substance abuse counselors, dietitians, and specialized group therapies such asdialectical behavior therapy.
And, if you are in crisis or immediate physical danger, Soave says you need to call 988 or 911 immediately. “Do not try to work through it yourself,” he says. If you’re not in immediate danger, then Soave says online therapy can help just like any other therapy.
However, it’s important to know that with both 988 and 911, but especially 911, the first responders are likely to be police.
Paul stresses the importance of letting your therapist know your address and phone number in case they do ever need to call emergency services. “And remember, it will only be helpful if you’re completely honest with your therapist—this is not any different than if you were sitting in their actual office,” he adds.
Additionally, Paul says a large percentage of patients with depression have suicidal thoughts or present in some stage of a crisis. Because of this, your therapist may want to check in with a loved one to make sure you can call on someone outside of a session, especially if you’re having an acute crisis.
A Word From Verywell
If you’re experiencing symptoms related to depression, being able to access mental health services is critical. If you’re currently receiving treatment for depression, work with your provider to coordinate online therapy. And if you’re new to counseling, talk with your doctor about referrals for online mental health services, use an online therapy directory to find an online therapist, or look into an online therapy company that has providers who specialize in depression (such asBrightside). Reaching out to a professional could be the key to managing the symptoms of depression.
Get Help NowWe’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.
Get Help Now
We’ve tried, tested, and written unbiased reviews of thebest online therapy programsincluding Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.
2 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Department of Health and Human Services. (n.d.-b).Major depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depressionAmerican Psychological Association.Overcoming depression: How psychologists help with depressive disorders.
2 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Department of Health and Human Services. (n.d.-b).Major depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depressionAmerican Psychological Association.Overcoming depression: How psychologists help with depressive disorders.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
U.S. Department of Health and Human Services. (n.d.-b).Major depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depressionAmerican Psychological Association.Overcoming depression: How psychologists help with depressive disorders.
U.S. Department of Health and Human Services. (n.d.-b).Major depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depression
American Psychological Association.Overcoming depression: How psychologists help with depressive disorders.
Hannah Owens, LMSW
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