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What Is Online Therapy?

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Are you considering online therapy? While the internet has opened up new avenues for mental health treatment, there are some pros and cons you should consider before you decide if online therapy is right for you.

Press Play for Advice On Online TherapyThis episode ofThe Verywell Mind Podcastshares the pros and cons of online therapy. Click below to listen now.

Press Play for Advice On Online Therapy

This episode ofThe Verywell Mind Podcastshares the pros and cons of online therapy. Click below to listen now.

Online therapy refers topsychotherapyor counseling services conducted over the internet. In contrast to in-person therapy, online therapy allows you to connect with a licensed therapist or counselor from the comfort of your own home using any device that has an internet connection, such as a computer, tablet, or smartphone.

Other terms that are often used interchangeably with online therapy are teletherapy or e-therapy.

2:13What Is Online Therapy?

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Pros of Online Therapy

There are many reasons people opt for online therapy over in-person therapy. The following are some of the biggest advantages of online therapy.

Online Therapy May Be as Effective

Research shows that online therapy can be just as effective as in-person therapy for various mental health conditions.

One literature review of studies found onlinecognitive behavioral therapy(CBT) to be just as effective as in-person therapy in treatingmoderate depression.Another review found that online CBT was equally effective as a face-to-face treatment forpanic disorder,social anxiety disorder, andgeneralized anxiety disorder.Online therapy is even shown to be effective in reducing problem gambling behaviors.

Get Help NowWe’ve tried, tested, and written unbiased reviews of thebest online therapy programsincludingTalkspace,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 programsincludingTalkspace,BetterHelp, and ReGain. Find out which option is the best for you.

Good Option for Remote Areas

Online therapy offers access to mental health treatment to people in rural or remote areas. Those who live in rural areas simply might not have access to any other form of mental health treatment because there are few or no mental health practices in their area - these are known as “therapy deserts.”

Having to drive long distances and take significant time out of a busy schedule to seek in-person therapy can be a burden for people in need of help. If you have reliable internet access, online therapy gives you relatively quick and easy access to treatment that might not have been readily available to you otherwise.

Accessibility for People With Physical Limitations

Online therapy provides accessibility to individuals who are disabled or housebound. Mobility can be a big issue when it comes to accessing mental health care. A therapist practicing out of their own home, for example, may not be set up to accommodate clients of all abilities.

People who are unable to leave their home for various reasons, such as physical or mental illness, may find online therapy a useful alternative to traditional in-person psychotherapy settings.

The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.

Convenience and Affordability

Online therapy is usually fairly affordable and convenient. Since you will be attending therapy sessions online in the comfort of your own home, you can often schedule your therapy sessions for times that are the most convenient for you.

Verywell Mind’sCost of Therapy Surveyfound that many Americans currently in therapy face issues with accessing mental health treatment, or additional costs associated with therapy:31% have to pay for either childcare or adult/elder care in order to attend their sessions30% say they’ve encountered a lack of appointment availability or flexibility of the mental health professional27% have had difficulty finding a mental health professional who is taking new patients

Verywell Mind’sCost of Therapy Surveyfound that many Americans currently in therapy face issues with accessing mental health treatment, or additional costs associated with therapy:

Treatment Can Be More Approachable

The internet makes mental health treatment more approachable.People may feel comfortable talking to friends and family about physical health care issues, but may not feel the same discussing mental health concerns that are just as important. Online access makes it easier to overcome the stigma that has historically been attached to mental health issues - you won’t be seen at a therapist’s office or have to explain to someone why you’re taking two hours out of your day to attend therapy in person.

Teletherapy can be an important tool to help people learn more about mental health. Even if you feel like your mental well-being is strong, online therapy can help you become psychologically stronger.You can learn more about health behaviors and coping strategies that will lead to better psychological health.

You don’t need to have a clinically diagnosed condition to benefit from talking to a professional, and online therapy can provide an easy avenue for getting started.

Cons of Online Therapy

While online therapy can potentially be very helpful for people in certain situations, it does not come without some risks and disadvantages over traditional therapy options.

Insurance Companies May Not Cover It

Insurance coverage for e-therapy can depend upon the state where you live and the insurance that you have. Some insurance policies don’t cover online therapy and some online mental health professionals don’t accept insurance as payment. Paying for psychotherapy services out-of-pocket can add up quickly.

The 8 Best Online Therapy Services that Accept Insurance, Tried and Tested

Some States Don’t Allow Out-of-State Providers

Many states do not allow out-of-state psychologists to provide services. In such cases, your provider would need to be licensed in both their home state as well as your home state.

In an article for the APA’sMonitor on Psychology, Deborah Baker, a legal expert for the American Psychological Association, explained that some states allow psychologists to provide out-of-state mental health services for a limited amount of time.This usually consists of only 10 to 30 days per year.

This can especially pose problems for those living in therapy deserts, who might not be able to find services in their area or even far beyond it.

Confidentiality, Privacy, and Unreliable Technology

Keeping your personal information private is a major concern in psychotherapy, 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.

Since information is being transmitted online, the situation makes privacy leaks and hacks more of a concern. Technology problems can also make it difficult to access treatment when you really need it.

Lack of Response to Crisis Situations

Since online therapists are distant from the client, it can be difficult for them to respond quickly and effectively when acrisishappens.

If a client is experiencing suicidal thoughts or has suffered a personal tragedy, it can be difficult or even impossible for the therapist to provide direct assistance.

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.For more mental health resources, see ourNational Helpline Database.

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.

For more mental health resources, see ourNational Helpline Database.

Not Appropriate for Serious Psychiatric Illnesses

E-therapy can be useful for a variety of situations,but not when it comes to people that require close and direct treatment or in-person intervention.

For example, if you have a serious addiction or have more severe or complex symptoms of a mental health condition, such as psychosis, online therapy may not be recommended unless other in-person therapies or treatments are also involved in your plan. The scope of online therapy can be limited, so it may not be effective for more serious situations.

Overlooks Body Language

On a video call, most of your body is obscured; and especially if usingtext-based therapy, your therapists cannot see facial expressions, vocal signals, or body language. These signals can often be quite telling and give the therapist a clearer picture of your feelings, thoughts, moods, and behaviors.

Some delivery methods such as voice-over-internet technology and video chats can provide a clearer picture of the situation, but they often lack the intimacy and intricacy that real-world interactions offer.

Some people may feel more comfortable undergoing therapy in a digital setting, especially younger people who are more familiar with such methods of communication, but others—therapists and patients alike—may get more out of therapy that utilizes more direct human contact.

Online therapy eliminates geographic restraints, making the enforcement of legal and ethical codes difficult.Online therapists can, theoretically, treat clients from anywhere in the world, but they have to be licensed in both the state in which they are and the state in which you are. Many states have different licensing requirements and treatment guidelines. It is important to confirm your therapist’s qualifications and experience before you begin the treatment process.

A Word From Verywell

Online therapy can be an effective and convenient way to access mental health services. But that doesn’t mean that it is right for everyone. Whether or not online therapy may be appropriate for you depends on your condition and the severity of your symptoms.

If you are interested in trying online therapy, research your options before choosing anonline therapy service. Read the reviews, and don’t be afraid to ask questions. Finding the right online therapist can take some time, but it’s well worth the effort.

10 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.

Kocsis BJ, Yellowlees P.Telepsychotherapy and the therapeutic relationship: Principles, advantages, and case examples.Telemed J E Health. 2018;24(5):329-334. doi:10.1089/tmj.2017.0088

Pescatello MS, Pedersen TR, Baldwin SA.Treatment engagement and effectiveness of an internet-delivered cognitive behavioral therapy program at a university counseling center.Psychother Res. 2021;31(5):656-667. doi:10.1080/10503307.2020.1822559

Luo C, Sanger N, Singhal N, et al.A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis.EClinicalMedicine. 2020;24:100442. doi:10.1016/j.eclinm.2020.100442

Andrews G, Basu A, Cuijpers P, et al.Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis.J Anxiety Disord. 2018;55:70-78. doi:10.1016/j.janxdis.2018.01.001

van der Maas M, Shi J, Elton-Marshall T, et al.Internet-based interventions for problem gambling: Scoping review.JMIR Ment Health. 2019;6(1):e65. doi:10.2196/mental.9419

MacDonell KW, Prinz RJ.A review of technology-based youth and family-focused interventions.Clin Child Fam Psychol Rev. 2017;20(2):185–200. doi:10.1007/s10567-016-0218-x

Andersson G, Titov N.Advantages and limitations of internet-based interventions for common mental disorders.World Psychiatry. 2014;13(1):4–11. doi:10.1002/wps.20083

DeAngelis T.Practicing distance therapy, legally and ethically.Monitor on Psychology.2012;43(3):52.

Christensen H, Batterham P, Calear A.Online interventions for anxiety disorders.Curr Opin Psychiatry. 2014;27(1):7-13. doi:10.1097/YCO.0000000000000019

Hannah Owens, LMSW

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