Are you considering online therapy? The internet has opened up new avenues for mental health treatment, but 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 Therapy
Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares the pros and cons of online therapy. Click below to listen now.
What Is Online Therapy?
Online therapy refers to psychotherapy or counseling services conducted over the internet. In contrast to in-person therapy, online therapy allows you to connect with a licensed therapist or counselor 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.
What Is Online Therapy?
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 online cognitive behavioral therapy (CBT) to be just as effective as in-person therapy in treating moderate depression.
Another review found that online CBT was equally effective as a face-to-face treatment for panic disorder, social anxiety disorder, and generalized anxiety disorder.
Online therapy is even shown to be effective in reducing problem gambling behaviors.
Get Help Now
We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, 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.
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.
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.
Today, many states require insurance providers to cover online therapy just as they would traditional therapy sessions. Contact your insurance company to learn more about how e-therapy treatments will be covered by your policy.
Therapists who only treat patients online likely have fewer overhead costs such as renting office space. Online therapists, therefore, can often offer affordable treatment options for those who are not covered by health insurance.
Verywell Mind's Cost of Therapy Survey found 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 sessions
- 30% say they’ve encountered a lack of appointment availability or flexibility of the mental health professional
- 27% have had difficulty finding a mental health professional who is taking new patients
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.
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.
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's Monitor 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.
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 a crisis happens.
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.
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, 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 is may not effective for more complex situations.
Overlooks Body Language
If using text-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 intimately familiar with such methods of communication, but others—therapists and patients alike—may get more out of therapy that utilizes more direct human contact.
Ethical and Legal Concerns
Online therapy eliminates geographic restraints, making the enforcement of legal and ethical codes difficult. Therapists can treat clients from anywhere in the world, and 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 an
online 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.
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
Baumel A. Online emotional support delivered by trained volunteers: Users' satisfaction and their perception of the service compared to psychotherapy . J Ment Health . 2015;24(5):313-320. doi:10.3109/09638237.2015.1079308
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