Mental Health Benefits Of Online Therapy: Reviews To Guide You

Do online therapy services really work?

Multiple studies indicate that online therapy is just as effective as in-person sessions for many people with a variety of mental healthcare needs. Here are some recent meta-analyses, reviews, and studies of published research supporting online therapy services and online mental health services:

• Psychiatric Quarterly published a 2021 review that found telepsychiatry was a feasible, appropriate alternative to face-to-face treatment during the COVID-19 pandemic, according to patients and providers alike.

• Counselling Psychology Quarterly published a 2021 review describing telepsychotherapy as a “trustworthy alternative to be adopted, which can be used efficaciously to treat common mental health disorders such as anxiety, depression, and post-traumatic distress.”

• The Journal of American College Health published a 2022 study indicating that internet-delivered solution-focused brief therapy (SFBT) is equally effective at reducing anxiety as an in-person treatment for some populations. 

• The Journal of Clinical Psychiatry published a 2019 meta-analysis measuring the results of 40 studies and found that internet-delivered cognitive behavioral therapy (CBT) was effective in treating most patients with depression. One study included in the review indicated that online CBT was just as effective as in-person treatment for reducing depression.  

Statistics also suggest that many people find online therapy an effective treatment option. The American Psychiatric Association’s 2020 nationwide poll on telehealth services during the COVID-19 pandemic revealed: 

• Almost six out of 10 adults in the US said they would use online therapy services for mental health treatment

• 43% said they wanted to continue using online therapy after the pandemic was over

• 34% of Americans said they would prefer to attend virtual counseling over in-person visits 

What are the drawbacks to online therapy sessions?

Although online therapy has become increasingly popular and offers a wide range of benefits, including convenience and accessibility, it might come with certain drawbacks. Here are some common potential disadvantages to online mental health services:

• Technical issues: Connectivity problems, platform glitches, and poor audio/video quality are a few issues faced by people seeking therapy and mental health treatment online. Such barriers can disrupt sessions and impact the therapeutic process, unlike in-person therapy sessions. 

• Lack of non-verbal cues: Most online therapy platforms and online sessions may hinder a therapist’s ability to read and interpret critical non-verbal cues, such as subtle facial expressions and body language.

• Comfort concerns: Guaranteeing a client’s secrecy online can be challenging, especially if the client is in an environment where others can hear the discussion.

• Limited capacity for treating some types of conditions: Online therapy might not be suitable for all mental health conditions, particularly severe disorders or those requiring medication management or specialized interventions. 

• Limited in crises:  Online therapy may be less effective or appropriate in handling severe mental health crises that require immediate, in-person intervention. 

• Challenges with building rapport: Some clients and counselors might find it harder to develop and maintain a therapeutic alliance through online therapy than through traditional in-person treatment.  

• Insurance coverage: Some platforms don’t accept insurance, and some major insurance providers don’t cover those who are seeking therapy under online therapy, which could limit access for some individuals. There are some that accept insurance, and that insurance covers online therapy.

What is the best online platform for mental health therapy services?

The best online therapy services can differ depending on the individual’s needs and expectations. When selecting a virtual therapy platform, consider the flexibility of their scheduling options, accessibility to treatment, and pricing structure. Make sure to use an online platform with a wide variety of vetted, accredited, licensed professional counselors and mental health professionals with diverse backgrounds. The therapist licensed should meet the educational and clinical requirements for licensure and adhere to ethical guidelines and codes of conduct established by organizations like the American Psychological Association (APA). 

Many online therapy platforms and companies offer online mental health solutions and mental health care in individual therapy services, couples therapy, and others, so consult reputable and unbiased sources when researching which is best for you. BetterHelp is one of the largest and most recognized platforms, providing access to over 30,000 licensed mental health professionals (as of 2023), including psychologists,  marriage and family counselors, licensed clinical social workers, licensed therapists, and online therapists with specialized training in certain areas. 

How safe is online therapy?

Online therapy is as safe as in-person therapy, provided the platform uses solid services and adheres closely to the Health Insurance Portability and Accountability Act guidelines. For client safety, mental health professionals and online therapists must obtain written informed consent for treatment and work within guidelines established by organizations like the APA and the National Board for Certified Counselors (NBCC).

Many online therapy companies, like BetterHelp, offer coded therapy sessions to ensure discretion and exclusivity. Some platforms provide online options for talk therapy sessions, couples therapy, teen counseling, and family therapy, making it more convenient and accessible. Before choosing online therapy, you must check or ask them whether they accept insurance or have other options, such as financial aid and an affordable online therapy service that they can offer to you. 

Is it better to see a therapist in person or online?

The choice between seeing a licensed therapist in person or through an online therapy provider depends on several factors, including personal preference, the nature of the issues you're addressing, and practical considerations. For example, some people feel more comfortable discussing personal issues face-to-face in a therapist’s office, while others prefer the distance that online or video sessions provide. Many people like online therapy's scheduling flexibility, while timing isn’t a factor for others. Some types of treatment, such as trauma therapy, teen therapy, talk therapy, and specialized psychiatry services, might be more effective when delivered in person. In contrast, others are just as effective when delivered virtually, if not more so. When deciding which type of therapy session is best for you, consider the following:  

• Can you establish a solid connection with your own therapist through virtual interaction, or do you need face-to-face interaction and physical presence in the therapist’s office?

• How much support do you need in between weekly sessions? While some counselors will return emails outside of office hours, you’ll typically need to wait until your next therapy appointments or therapy sessions to speak with them. Some online therapy platforms may offer clients unlimited messaging or text outside regular sessions to provide the therapy they need.  

• Do you think you might be more prone to distraction in online therapy sessions at home, or will you focus better in your own environment?

• Do you have access to a sufficient pool of therapists, clinical social workers, licensed professional counselors, and psychiatry services in your area, or are your options limited?

• Is it easy (or possible) to commute to an in-person therapy session, or do you have limited accessibility options? 

• How flexible is your schedule? Can you coordinate with a counselor who might not see clients outside of office hours, or are you available for video sessions at any time?

• Do you need to see a therapist who accepts insurance? If you need it, will your insurance cover online therapy?

• What can you afford? In-person therapy sessions can be more expensive than some virtual options, such as video sessions, due to overhead costs associated with maintaining a brick-and-mortar therapist’s office, while some affordable online therapy services and financial aid options make virtual therapy more accessible and weekly video sessions more cost-effective, especially if it is only a few hours.

• Are you comfortable working with technology? Services with an online therapy provider typically require at least some knowledge of using online therapy platforms for weekly video sessions or text-based support. 

The best choice between online and in-person therapy services depends on your situation, weekly sessions, comfort, budget, insurance coverage, and specific mental health care needs. 

What happens during online therapy?

Online therapy services and therapeutic approaches are technically the same as traditional treatments apart from the virtual interface. The process of initiating treatment through an online therapy platform involves signing up and creating an account via the website. Once you’ve registered, you’ll need to complete an assessment, which will include questions about your mental health, your goals for therapy, and what type of therapist you’d feel most comfortable seeing. Some online therapy companies and platforms also ask about specific areas like relationship issues, eating disorders, or teen counseling experience to match you with a therapist who specializes in those areas and will provide the therapy and other online therapy services you need. Based on your answers, the service will match you with the therapists that best meet your needs. 

Sessions typically occur via video call or weekly video sessions, but you might also text, chat online, or talk on the phone. During your first therapy session, you and your own therapist will likely discuss your goals for therapy and the type of symptoms you’re having to design a plan according to your needs. Some online therapy companies and platforms also offer additional support for couples therapy, family therapy, and teen therapy. 

Depending on the client's needs, therapists of some online therapy companies might incorporate talk therapy or discuss whether medication management services are needed for your treatment plan. Other online therapy services of some online therapy companies work with psychiatrists and can prescribe medication only when necessary. Suppose you are thinking of taking medication as part of your healing; it is important to check first whether your online therapy provider can accommodate this kind of need. 

Before you make your final decision, it is also a good thing to consider the possible online therapy cost. You may inquire whether they accept insurance or if you need to pay out-of-pocket costs. Some of the best online therapy platforms provide financial help and assistance for their clients experiencing mental health disparities. 

Your therapist will likely assign you “homework” to complete between a standard therapy session to complement your treatment plan. Whether you are seeking professional help and therapy for depression or anxiety, you may find online therapy effective as its methods can provide a flexible way to provide therapy that matches your schedule and lifestyle. 

Who is not suitable for online therapy?

Online therapy is typically an inappropriate option for individuals with severe mental health disparities, such as schizophrenia, severe bipolar disorder, or people experiencing active psychosis. These types of conditions often require more intensive care and in-person monitoring than an online therapist can provide. Additionally, people who are in immediate crisis, such as those experiencing suicidal thoughts, self-harm, or other urgent mental health emergencies, require immediate, in-person intervention rather than talk therapy delivered virtually. 

Individuals who lack reliable internet access, don’t have access to a computer or smartphone, or aren’t comfortable using technology might find online therapy challenging. It can be difficult for someone who doesn’t have a personal, quiet space for a therapy session to talk openly. Such barriers can hinder the effectiveness of clinical psychology interventions and therapy and discourage treatment adherence. 

People who need medication management services for complex psychiatric conditions may find that online therapy is not suitable for them unless the platform offers psychiatric support. An online therapist who works alongside a psychiatrist may be able to provide medication management through the psychiatrist, but not all online therapy platforms offer this to their clients. 

Some people may not be able to afford out-of-pocket costs for online therapy, especially with platforms that don’t accept insurance. Some platforms do accept insurance for online services, such as medication management services, but the coverage is limited. 

Lastly, people seeking professional help, such as teen counseling for their children or couples therapy, should always ensure that their chosen therapist directory includes licensed therapists with expertise in those areas. If you need more structured and in-person support, traditional clinical psychology approaches in a face-to-face setting can be more effective. 

What is a negative effect of therapy?

While therapy, such as talk therapy, is generally beneficial for most, some people experience challenges that can make it a negative experience. For example, treatment often involves exploring painful emotions and experiences. This process can create emotional distress or comfort as unresolved issues are brought to the surface. 

In some cases, a client may develop a strong dependency on their counselor that can hinder the development of self-reliance and coping skills. If there is a poor fit between the client and the therapist, unrealistic expectations on behalf of the client, or the therapist’s approach don’t resonate with the client, it can lead to frustrations and a lack of progress. Out-of-pocket costs can hinder some individuals from getting the help they need,, especially if their provider or online platform doesn’t accept insurance for mental health services. 

Are there therapy risks?

There is a potential for risks involved in the therapeutic process, particularly in cases of severe mental illness or when a client is at risk of re-traumatization. Sometimes, discussing traumatic or deeply upsetting experiences can temporarily worsen symptoms before improvement occurs. In rare cases, boundary issues or unethical behavior on the therapist's part (e.g., inappropriate relationships, dual roles) can harm the client.  

Financial concern is another problem when you want to have consistent treatment. This involves the total online therapy cost and out-of-pocket costs. It is also difficult for others to find a service provider that will accept insurance for their therapy services or medication management. If you seek professional teen counseling or couples therapy, it is important to choose a therapist with experience in those areas to avoid possible therapy problems and risks. You may use a therapist directory to find the right professional or therapist who matches your needs. 

How do I know if I need therapy for my mental health?

Deciding if you need therapy is a personal choice; however, there are a few signs to look for that might suggest you need guidance from a mental health professional. Couples therapy might be a good choice if relationship challenges are adding to your stress, while teen counseling can be beneficial for younger individuals struggling with emotional difficulties.  Therapy might be a good choice if you or someone you love is experiencing the following symptoms: 

• Persistent feelings of sadness, hopelessness, or anxiety that do not seem to improve over time

• Difficulty coping with stress such that it affects your daily functioning

• Significant changes in sleep patterns or appetite that are unrelated to a physical health condition

• A loss of interest in activities you once enjoyed

• Feeling overwhelmed or unable to manage your emotions

• Trouble concentrating, making decisions, or functioning in daily activities

• Problematic use of alcohol, drugs, food, or other behaviors to cope with emotions or situations

• Frequent, recurring negative thoughts, self-doubt, or low self-esteem

You may check a therapist directory to find a professional therapist for your therapy needs. Medication management is also being offered by some professional therapists for psychiatric support. Additionally, it is best to consider out-of-pocket costs and whether that service provider would accept insurance to help cover the overall therapy expenses.