Is Video Therapy Really Effective?
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Seeking the support of a therapist or another mental health professional can make a significant difference in a person’s life, whether they’re facing challenges related to a mental health condition like depression or anxiety or a situation like relationship conflict, grief, or low self-esteem. For some people, however, attending traditional in-person therapy sessions is not feasible. Some are unable to regularly travel to and from in-office appointments, while others simply feel more comfortable engaging with mental health professionals virtually from home. Either type of counseling may be an effective way to seek mental health services.
Video therapy in particular is a form of online counseling that many people find more convenient than traditional, in-person formats. It involves clients speaking with a therapist via virtual sessions using a smartphone, tablet, computer, or laptop. That way, the client and the online therapist can still see each other face to face and form a strong therapeutic relationship, but the client never has to leave their home if they don’t want to or aren’t able to. Read on to learn more about how online counseling sessions work and what the research says about their efficacy.
Efficacy of online and video therapy services
In face-to-face talk therapy, clients and licensed therapists, clinical social workers, family therapists, or other licensed mental health professionals will engage in a conversation that aims to address the individual’s needs. Depending on the particular therapy modality being practiced, the client will usually be invited to discuss their thoughts and feelings and will then be guided toward a deeper understanding of their challenges and improved thinking patterns over time by the therapist. During each counseling session, the client may receive mental health support regarding any challenges they’re experiencing.
Virtual counseling works in just the same way in general, except that the therapist and the client are in separate locations and connecting through an internet-based app, website, or online counseling platform. Just as with in-person counseling, virtual therapists are required by law to be licensed to practice. Online therapy platforms may have a wide range of professionals available, such as online therapists, licensed clinical social workers, marriage and family therapists, and more.
Online therapy uses
Just like in-person therapy, online counseling may be used to allow mental health professionals to help individuals with a variety of mental health conditions and challenges, from diagnosable illnesses to other obstacles and difficulties that may arise in life.
Some examples of conditions or situations that can typically be addressed through online therapy can include but are not limited to:
- Depression
- Anxiety disorders
- Eating disorders
- Substance use disorders
- Grief
- Significant life changes (birth, death, divorce, moving, job loss)
- Relationship troubles
- Past trauma and post-traumatic stress disorder
Note, however, that online therapy is not appropriate in every case. For example, some individuals with moderate to severe eating disorders or substance use disorders may require inpatient care. Any mental health emergency should also be treated in person, and you may also need to see a provider in person for them to prescribe medication or help with medication management in some cases.
It’s also valid for a person to simply prefer to meet with a provider face to face, regardless of the challenge that they may be facing. Online therapy simply represents an alternative option for those who are interested in it and who do not require inpatient or in-person care. Note also that any online modality isn’t recommended for emergency care, as an online therapy provider may not have the necessary resources to help with emergencies.
Benefits of online counseling
Of course, not having to commute to and from each appointment is one key element of convenience that comes with virtual therapy. In general, you can log on to virtual sessions from home, work, or elsewhere as long as you have a smart device, an internet connection, and some quiet. That means people in certain situations may find it easier to consistently attend these appointments, such as those who:
- Have a busy schedule
- Don’t have reliable transportation
- Have a physical illness or disability that makes travel difficult or impossible
- Are experiencing symptoms of mental health diagnoses like depression or social anxiety that makes leaving home difficult
- Live in a rural area without mental health care providers nearby
- Prefer to control their own surroundings during therapy
- Feel intimidated at the thought of speaking with a therapist in face-to-face therapy
Online therapy or counseling can save time
Online counseling sessions can also save time, since you don’t have to get dressed up and drive or take public transportation to attend appointments, which could add as much as an hour or two to the process in some cases. In general, online counseling services tend to offer a higher level of convenience and availability.
Counseling sessions online are cost-effective
It’s also worth noting that online counseling like virtual sessions is often more cost-effective than traditional in-person sessions as well. This is because providers who do video therapy don’t necessarily need to have a brick-and-mortar office space, so they can save significantly on overhead costs and pass those savings along to clients through reduced rates. With online therapy services like BetterHelp, for example, session costs are comparable to that of most insurance co-pays. However, online therapy providers do not always accept health insurance, and your insurance may not cover online therapy, which can affect the overall online therapy cost. Still, the best online therapy platforms typically have lower costs per session than in-person therapy, even when insurance doesn’t cover online therapy.
Effectiveness of virtual therapy with licensed counselors
You may be wondering, “Is online therapy effective?” Since the advent of online counseling in recent years, researchers have conducted a variety of studies to examine its effectiveness. In general, they have found that it may be as effective as in-person sessions in many cases and for many conditions and challenges. For example, consider a 2021 study on the topic that suggests that video is “an effective modality for counseling delivery” and that it’s “no less efficacious” than in-person methods. This can make the best online services comparable to in-person services.
Consider also research from 2019 that reports that virtual therapy for couples counseling in particular may be a viable alternative to in-office sessions as well. It indicates that participants in the study who engaged in video-based couples therapy reported feeling “less intimidated” and “less judged” than in in-person sessions, a factor that may help clients and providers form strong, healthy relationships for better therapeutic outcomes, which can be vital for effective mental health service in therapy.
Seeking online counseling for support with mental health conditions
If you’re interested in virtual therapy, you might consider a platform like BetterHelp for individuals or ReGain for couples. With either, you can get matched with a licensed therapist according to your preferences as indicated in a brief questionnaire. Then, you can meet with them via video or phone, depending on which is more comfortable or convenient for you. You can also contact them via in-app messaging between appointments and receive a response at their earliest convenience. Again, research suggests that online therapy via video or audio can be as effective as in-person sessions in many cases, so it may be worth exploring if you're interested in this format. Either way, the best online or in-person therapy option is usually the one you’re most comfortable with.
Takeaway
How does video therapy compare to traditional in-person psychotherapy?
Online therapy has changed exponentially since the first therapists used the medium in the mid-1990s. Although video therapy has been around for several decades, its popularity grew during the COVID-19 pandemic. Now, millions of people worldwide use online video therapy as an alternative to traditional in-person psychotherapy. For many clients and conditions, video therapy can be as effective as in-person; however, it may not suit everyone. Here are some of the primary ways video therapy compares to in-person psychotherapy:
Effectiveness
Research has consistently shown that video therapy can be as effective as in-person therapy for a wide range of mental health issues, including anxiety, depression, PTSD, and certain types of traumas. Meta-analyses and randomized controlled trials have demonstrated that video therapy can yield comparable treatment outcomes, especially when evidence-based interventions, like cognitive-behavioral therapy (CBT), are used. However, it's important to note that online therapy may be less effective for people requiring more direct and intensive interaction.
Accessibility and convenience
Video therapy significantly increases access to mental health care for many who would otherwise face barriers to treatment, such as those in rural or underserved areas. In such regions, access to mental health professionals may be limited. It also provides a lifeline for individuals with physical disabilities, caregivers, and those with busy schedules, making mental health care more accessible and convenient.
Connection and therapeutic alliance
Research indicates that the therapeutic alliance (the relationship and bond between therapist and client) can be successfully maintained through video therapy. While some clients report feeling more comfortable and open in their own space, others may initially find the virtual medium less personal. One may find it easier to evaluate and vet a potential therapist in person before committing to an extended treatment program.
Treatment adherence
Some studies suggest that individuals in video therapy are more likely to stay engaged in the treatment process. This may be largely influenced by online therapy’s enhanced convenience and accessibility. On the other hand, technological issues, such as poor internet connection, can disrupt sessions, potentially impacting engagement.
Comfort and boundaries
Video therapy may offer more convenience than in-person treatment—an attractive feature for those who feel uncomfortable visiting a therapist's office. Being in a familiar environment and avoiding contact with individuals one might ordinarily encounter in an in-person setting, such as office staff or other clients, can make individuals feel more at ease. However, it might present distractions or concerns if others are at home.
Affordability
Sometimes, video therapy may be more affordable than traditional methods, particularly for those with insurance plans that accommodate online treatment. Additionally, eliminating the need to commute to and from sessions and overhead costs often associated with in-office treatment can cut costs considerably.
What are the benefits of video therapy for clients who prefer online counseling over face-to-face counseling?
For clients who prefer online therapy, video therapy offers several unique benefits. It’s often more discreet and comfortable. The ability to attend sessions from home can provide a level of comfort that enhances openness, especially for clients who feel self-conscious or anxious in a therapist’s office. This option can also reduce the stigma some may feel about seeking mental health care.
Video therapy eliminates travel time, making it a bit easier for clients to fit sessions into busy schedules. This convenience can significantly benefit clients with demanding jobs, childcare responsibilities, or other logistical constraints. Online therapy also offers improved accessibility. For example, clients with physical disabilities, chronic health issues, or compromised immune systems benefit from video therapy. Additionally, this flexibility allows people who may otherwise find in-person therapy inaccessible due to location or other variables to engage in regular sessions.
Video therapy enables continuity of care even during life transitions, such as moving to a new area, changes in work schedules, or travel, preventing disruptions in treatment that might occur with in-person sessions. Virtual therapy can reduce anxiety and enhance comfort because it's held in a familiar environment. Some clients, especially those with social anxiety or agoraphobia, feel more at ease in their own space. This can lead to greater openness, allowing them to address complex topics more comfortably.
Because it removes geographical limitations, online therapy allows clients to access specialists who may not be available locally. This can be particularly valuable for those seeking a therapist with specific expertise or cultural understanding. Online platforms may also remove limitations in situations where more than one person participates, such as group or marriage therapy.
For some clients, video therapy is a low-cost alternative to traditional therapy without in-network insurance coverage. Online therapy may help individuals save on travel costs and reduce missed appointments, possibly lowering costs in the long run. Additionally, video therapy may allow therapists to minimize fees by saving on office space and overhead.
How can therapists ensure that the quality of counseling remains high when delivered through videos?
Therapists can maintain high-quality care in video therapy by adopting specific strategies and adjustments tailored to the virtual environment. For example, a secure, HIPAA-compliant video platform in a quiet, safe space allows counselors to provide higher-quality services.
Therapists should ask clients if they are comfortable with the technology and address any concerns. If technical issues do arise, having a backup plan, such as switching to a phone call if video fails, can prevent disruptions. Additionally, high-quality audio and video can make the interaction feel more natural, as can a well-lit, uncluttered background.
Establishing expectations around etiquette issues like conducting sessions in a quiet, non-distracting environment (e.g., turning off the TV and finding a safe space) and refraining from multitasking during therapy (e.g., not checking emails or doing household chores) can help. Therapists should also pay extra attention to how they read and deliver nonverbal cues such as eye contact (looking into the camera), using clear facial expressions, and maintaining a warm, empathetic tone.
What challenges might arise in online therapy, and how can both therapists and clients overcome them?
Video therapy offers many advantages, but it also brings unique challenges. Here are some of the most common issues and how therapists and clients can work together to address them:
Technical issues
Poor internet connections, software glitches, or device issues can disrupt live sessions, making it harder to maintain a natural flow. To minimize such problems, therapists and clients can test their tech setup before sessions, checking internet speed, audio, and video quality. Both parties should have a backup plan, such as switching to a phone call if the video connection fails.
Limited non-verbal communication
Subtle non-verbal cues like body language, posture, or small gestures are more challenging to perceive on video, potentially limiting emotional attunement and understanding. Therapists can make an extra effort to observe facial expressions and tone, encouraging clients to express their feelings verbally. Therapists might also occasionally “check in” to ensure that they accurately perceive clients’ emotions and reactions.
Environmental distractions
Clients and therapists may face distractions at home, such as household noises, pets, or interruptions by others, which can detract from the focus of therapy. To combat distractions, clients are encouraged to find a quiet, safe space and minimize potential interruptions, ideally using headphones to help block out noise. Setting session boundaries—like keeping doors closed or informing others of the session time—can also help.
Boundary concerns
Some clients might feel uncomfortable discussing sensitive topics if they lack boundaries at home or worry about others overhearing them. Therapists can work with clients to find strategies for safe space, like using headphones or scheduling sessions when others aren't home. To ensure a safe environment, they can also explore creating a safe space in less traditional areas (such as a parked car).
Severe or crisis situations
Some clients experiencing extreme distress or crises may require the in-person presence of a therapist for adequate support, which can be more difficult when operating virtually. Therapists can develop a crisis plan with clients, ensuring that emergency contacts and local resources are available. Therapists may arrange shorter, more frequent check-ins for clients in high distress to maintain support.
Barriers to affordability
In some cases, insurance covers online therapy—but in many cases, it doesn't—even if an individual's plan includes mental health services. Although online therapy may be less expensive than traditional treatment, cost may present a barrier to treatment. In such cases, online mental health professionals might offer a sliding-scale fee dependent on the individual's income.
How does the convenience of online therapy through videos impact client engagement and therapeutic outcomes?
Studies indicate that online therapy can significantly impact client engagement and, in turn, therapeutic outcomes. For example, participants in a 2021 focus group attended sessions with a Talkspace therapist and then completed a survey about their treatment experience. The survey findings reveal that the clients’ decision to continue or discontinue therapy was largely impacted by the quality of their therapeutic relationship. External factors like social support, financial costs, and platform usability also significantly influenced engagement patterns.
However, some individuals find online therapy much more effective and experience better treatment outcomes than others. For example, the flexibility of video therapy allows clients to attend sessions without the added burden of travel time, which can be especially valuable for those with demanding schedules or logistical constraints. Studies have found that clients are more likely to stick with therapy consistently, resulting in fewer missed sessions and lower dropout rates, which is critical for effective treatment outcomes.
Because online therapy removes some barriers to access, such as commuting and time away from work or family, clients are often more likely to commit to the therapeutic approach, frequently leading to faster or more sustained progress. Further, video therapy provides essential access that may not otherwise be available for individuals with disabilities, chronic health conditions, or those living in rural or underserved areas.
Many clients feel more at ease in their own environment, leading to a greater willingness to share personal or difficult information. This comfort level can lead to deeper self-exploration and more effective therapy sessions, enhancing therapeutic outcomes. Additionally, clients who feel stigmatized by attending therapy in person may prefer the convenience and discretion offered by online sessions. This can encourage people who may otherwise hesitate to seek help to engage in therapy, broadening access and fostering a sense of acceptance toward treatment
What are 4 types of therapy?
There are many types of therapy rooted in different theoretical concepts. Here are four common types of treatment, each with unique approaches and applications:
Cognitive behavioral therapy (CBT)
CBT is a goal-oriented, structured form of therapy that focuses on identifying and changing negative thought patterns and behaviors. CBT is widely used for conditions like anxiety, depression, PTSD, and phobias. CBT helps clients develop skills to manage their thoughts and actions more effectively, often through homework assignments and skill-building exercises. CBT is suitable for many treatment modalities, including marriage and family therapy.
Eye movement desensitization therapy (EMDR)
EMDR is primarily used to treat trauma and post-traumatic stress disorder (PTSD). It integrates cognitive-behavioral therapy (CBT) elements with rhythmic eye movements or other forms of bilateral stimulation, such as tapping or audio tones. During EMDR sessions, individuals recall distressing memories while focusing on these movements, which is believed to reduce the emotional intensity of the memories and help reprocess them more healthily.
Humanistic Therapy
This client-centered approach, developed by Carl Rogers, emphasizes self-exploration, personal growth, and self-acceptance. Humanistic therapy, which includes Gestalt therapy and existential therapy, focuses on helping clients achieve their fullest potential by understanding their values and goals. It’s often applied to clients dealing with self-esteem issues, life transitions, or a desire for personal development.
Dialectical Behavior Therapy (DBT)
Originally developed to treat borderline personality disorder, DBT combines cognitive-behavioral techniques with mindfulness practices. It focuses on four primary skills: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT is used to help individuals with intense emotions, self-harm tendencies, and relationship challenges, and it has also been adapted for other conditions, such as depression and eating disorders.
What's virtual therapy?
Virtual therapy, also known as online or teletherapy, is a form of mental health counseling conducted via the Internet or other digital communication platforms. It allows individuals to connect with licensed therapists through various methods, such as video calls, audio calls, text-based therapy, or chat-based systems. This approach provides accessibility to mental health care, especially for people who face barriers to in-person therapy, such as geographic distance, physical disabilities, or time constraints.
Virtual therapy offers many benefits for mental health professionals who use an online platform—such as BetterHelp, ReGain, and Talkspace therapists. For example, online therapists may enjoy more flexible scheduling options and a broader clientele base. Additionally, therapists licensed in different states might appreciate the broader reach. Like their clients, one therapist may have better outcomes with online platforms, while another prefers in-person interactions.
Do therapists cry in therapy?
Many therapists do cry in therapy; in fact, several surveys indicate more than half of therapists cry at some point during sessions throughout their careers.
What are therapy videos?
Therapy videos may refer to clinical psychology training tools for mental health professionals or informational and educational materials for individuals interested in learning more about types of therapeutic modality. For psychology students, therapy videos may give them a firsthand look at case studies for different types of mental health conditions.
What is the most successful type of therapy?
Currently, cognitive behavioral therapy (CBT) is considered the gold standard in psychotherapy and is often the first-line treatment for many mental health disorders such as depression, anxiety, phobias, and obsessive-compulsive disorder (OCD). CBT is evidence-based and is supported by a considerable amount of scientific data. Many therapies, such as dialectical behavior therapy (DBT) and mindfulness-based cognitive therapy (MBCT), are modified versions of CBT used in different circumstances. CBT can also be modified for relationship therapy. However, other types of treatment might be more effective for different people and situations. For example, humanistic therapies, such as gestalt and person-centered, focus more on individual experiences and challenges. These therapies might be a good fit for individuals who prefer exploring emotions and identifying goals over more structured and directive methods.
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