How Text Counseling Works: Online Therapy For Better Mental Health

Medically reviewed by Melissa Guarnaccia, LCSW and Majesty Purvis, LCMHC
Updated February 15th, 2025 by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Many individuals experience a mental health condition at some point during their lives, whether due to a significant life change, stressful event, depression symptoms,or genetic factors. Approximately one in five adults in the United States is diagnosed with a mental illness in any given year, which include depression, eating disorders, and many more.  

Finding a licensed therapist or crisis counselor for mental health supportcan be a significant support and can assist in making progress during these times when someone has mental health symptoms. However, not everyone can utilize traditional face-to-face therapy, and some individuals feel most comfortable partaking in online therapy through a text messaging format. Although a more modern treatment, text counseling can offer unique benefits to clients seeking support from licensed mental health professionals. A counselor will assess your needs and come up with therapy goals and a treatment plan. Virtual therapy has been found in some cases to be as effective as face to face therapy.

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Is texting your favorite way to communicate?

How text counseling works 

Although the specifics of various service providers may vary, text-based therapy is often provided similarly. After you sign up for an online or text therapy service, you may complete a screening questionnaire to express your preferences for a provider. 

You may then be matched with a therapist or choose one to text with. Once you've selected a provider, you might be prompted to choose between phone, video, or live chat sessions. If you want a live chat session, select that option when scheduling with your therapist. 

Seeking online therapy for specific mental health conditions

Some online therapy providers might offer counselors who specialize in specific topics, symptoms, or forms of therapy. For example, a therapist may specialize in post-traumatic stress disorder (PTSD), eating disorders, anxiety disorders, or depression. If a particular therapist is not a fit, you may be able to request a new one. 

How to communicate with your therapist 

How you communicate or message your therapist may vary depending on your schedule and your therapist’s schedule. You may choose to communicate with your therapist via online counseling chat or text messaging or schedule a virtual appointment for a phone call or live video chat on the platform. You might not be limited to one format, which could increase convenience compared to in-person sessions. On some platforms, you may also have the option of sending therapist messages or questions to your therapist at any time. In this case, your therapist may respond when they are able. 

Text counseling and text-based therapy step-by-step

If you have scheduled a live chat messaging session through a site like BetterHelp, your therapist will start the session when you log on to the BetterHelp app or website and have an internet connection. You can select the prompt to enter the chat room and start your session. You may send messages back and forth, and there may be an option for you to see what your therapist is typing before it is sent. If your therapist takes a long time to respond or you'd prefer another support method, you can switch to a phone or video session during the live chat session. Online or text therapy can be scheduled in the same way as traditional therapy, through weekly sessions or meetings more than once per week if needed. 

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The effectiveness of text counseling and text therapy

In certain circumstances, text counseling and therapy may be more effective than in-person counseling because it allows people an opportunity not possible with face-to-face counseling. For example, those who experience social anxiety and struggle to open up while talking to someone in person may feel more comfortable and ready to impart through a messaging platform. Those who need immediate support from a crisis counselor can also benefit from text therapy.

That said, if you require medication management, it may be preferable to have face to face or video conference meetings with your psychiatrist.

Crisis text line: Why text therapy and online therapy work

Additionally, messaging therapy may be preferable to those who live in rural areas, cannot commute, or struggle to attend regular appointments in their local area. Some people may need to text or talk with a trained crisis counselor. Try texting crisis text line counselors for support, where you can talk with a trained volunteer or professional.A recent report from The Trevor Project states that 76% of LGBTQ+ youth are more likely to reach out via text or chat when struggling, which is why resources such as the crisis text line have been created. To reach a crisis counselor 24/7, text “HOME” to 741741 to text with a mental health care professional. Having these services available can support any level of comfort. 

The mental health benefits of chat-based therapy

Text therapy for anxiety, depression, and PTSD

Individuals experiencing a mental health condition or chronic illness like depression, social anxiety disorder, or post-traumatic stress disorder (PTSD) may struggle with making or keeping appointments because of the complexity of tasks required to attend an in-person meeting. For example, self-care and hygiene, coordinating transportation, dealing with public environments like waiting rooms, and talking face-to-face with a stranger in an unfamiliar place can all be stressful or overwhelming for someone with a mental health condition. For individuals experiencing these obstacles, text-based therapy could be a solution. 

Text therapy for other circumstances

Text-based communication may also feel more thoughtful to some. Specific individuals could find it easier to communicate profound feelings through writing if they struggle with verbal processing or social anxiety. Text therapy can provide an added level of processing to the conversation, allowing a person to work through their emotions and experiences before or as they describe them. One study found that online social communication can reduce symptoms of social anxiety in some individuals. 

Many major insurance plans cover mental health appointments with medical providers, but you need to check your policy to find out if you are covered.Online therapy can also be effective for individuals who do not have health insurance coverage for mental healthcare. Through online services, a flat monthly rate may allow unlimited text messaging, ongoing support, and weekly live sessions. This contact differs from traditional therapy, which is charged per live session, may not offer frequent communication options, and may be cost-prohibitive if your therapist doesn’t accept insurance. Additionally, through messaging, your therapist may send you resources, questionnaires, or worksheets to check after sessions. Although online therapy is available anywhere with an internet connection, it is important to note that all online communications are subject to your standard data rates if you are not on wi-fi. 

Finally, text therapy can be helpful for those not connected with a mental health provider but who need immediate support from a crisis counselor.

Who can benefit from text-based therapy and online therapy?

Anyone who has considered pursuing traditional therapy may benefit from online counseling. Research shows that online and text therapy services can effectively treat the same symptoms and conditions often addressed in traditional therapy. 

Online chat with a licensed counselor or therapist

Online therapy, like that provided by BetterHelp or Talkspace therapists,is a flexible solution for mental health treatment. Approaches like cognitive-behavioral therapy (CBT), which targets unwanted thoughts and behaviors, can be utilized online. A recent study of over 1,100 individuals partaking in online CBT found that 89% of the participants would recommend online therapy to others.

If you are looking for treatment or support for your mental health, a chat-based therapist may provide the services you seek in a comfortable format.  

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Is texting your favorite way to communicate?

Takeaway

Therapy over text can often be an effective and client-based model to allow those who face barriers to in-person therapy to find support from a licensed counselor. You may also partake in phone or video sessions through many platforms. If you're interested in talking to someone, consider reaching out to an online therapist or platform for further guidance and support in signing up. 

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