So, you’ve seen headlines highlighting the convenience of telemental health services, or better known as online therapy. You’ve heard the same ads while playing your favorite podcast boasting various online therapy platforms, all claiming to be the best option for online therapy; yet, you may still have questions. What is online therapy? What are the pros and cons? Is online therapy as effective as in person therapy? How will I know if online therapy is right for me?

Types of Online Therapy
Telemental health, also known as online therapy or teletherapy, involves a Master’s or Doctoral level mental health clinician providing mental health services and support over the internet or phone. This can be done synchronously which is live/in real time, or asynchronously which is time delayed. Synchronous services are live therapy sessions that take place between the therapist and client, most commonly through a two-way audiovisual link. Therapist and client can have a face-to-face live session by clicking a link via a HIPAA compliant platform to ensure privacy and confidentiality. While many clients have their video session within the comfort of their own home, some may choose to do so between work meetings in their office, or in their parked car between appointments, errands, picking up kids, etc. Another form of synchronous, or live online therapy, can be conducted through a phone call. Asynchronous services, or time delayed online therapy, is conducted through email, text, or another messaging service. Similar to live online therapy, therapists should provide time delayed services through a HIPAA compliant platform.

Benefits of Online Therapy
The following are just a few benefits of online therapy:

  • Scheduling flexibility- schedule your session at a time that is convenient for you like between meetings, classes, errands, etc.
  • No time spent commuting
  • Reduced cost- no leaving work early, no need for extended childcare, no transportation costs
  • One can be in the comfort of their own home- couch, bed, yard, etc.
  • Pets can join and be an added source of comfort
  • Accessibility- no need for transportation, and many clients with disabilities or chronic illness/pain conditions can more easily access a therapist from the comfort of their own home
  • Privacy- no risk encountering someone in your community at an office

Limitations of Online Therapy
While many people like the flexibility that online therapy provides, some clients may struggle with the online format. Here are a few limitations of online therapy:

  • Poor internet connection or limited data
  • Lack of privacy- interruptions from someone within the setting of your session
  • Inability to read one another’s full non-verbal cues like body language
  • Consumer Reports investigations indicate that well known mental health apps may share your data before being matched with a therapist as they can evade HIPAA compliance

Effectiveness of Online Therapy
Therapists have been providing online therapy services since the mid/late 1990s. In 1997, the International Society for Mental Health Online (ISMHO) was formed to deepen the understanding and development of online therapy around the world. Since then, research has been conducted internationally and the findings show that online therapy is just as effective as seeing a therapist face to face in their office.

Online therapy is effective for individuals, couples, and groups. Common presenting concerns for clients that want online therapy are no different than client’s presenting concerns for in person therapy. This can include anxiety, depression, obsessive compulsive disorder, post-traumatic stress disorder, eating disorders, identity exploration, adjustment to life issues, performance enhancement, deepening connections and strengthening relationships, and many more. Online therapy might not be effective for clients that are easily distracted like young children.

Is Online Therapy Right for You?
There are many factors one should consider when determining if online therapy is right for them. If a client is discharged from hospitalization or an intensive inpatient/rehabilitation center, online therapy might not be the proper level of support for that client. They may benefit more from in person therapy or a higher level of support like an intensive outpatient program. Online therapy might not be a good fit for a client who fosters a greater sense of connection by being within physical proximity of their therapist. Clients who would feel more comfortable in an office setting and not engaging in therapy at home, work, or on the go might not feel as comfortable with the online therapy format.

There are many reasons why online therapy would be a good fit for a client. If someone’s daily schedule fluctuates but they don’t have the time to commute to and from an office, online therapy would allow more flexibility in scheduling. Some people find it easier to connect and open up if they struggle with social anxiety or discomfort being in the physical presence of others. Online therapy would be a good fit for someone who benefits from predictability and familiarity in their environment. For example, dealing with unpredictable factors like traffic, changing weather conditions, driving to a new place or along an unfamiliar route can be overwhelming for some. In this case, a client might feel more comfortable knowing they can have an established routine, place, and setup for their online therapy session (a client can grab a hot cup of tea, blanket, and have their session on their couch for each individual session).

Providing online therapy in different formats, synchronous (live) and asynchronous (time-delayed), is necessary to meet the demands of our constantly changing and evolving world. While there are limitations of online therapy, and it might not be a perfect fit for everyone, more and more clients are moving towards online therapy as the benefits allow for increased accommodations to everyday living and improvements in overall life balance.