Teletherapy: How Does Online Therapy Work?

Medically reviewed by Julie Dodson, MA, LCSW and Majesty Purvis, LCMHC
Updated October 15, 2024by BetterHelp Editorial Team

All kinds of activities and services that used to exclusively be available in person can now be reached online as well, and that includes mental health counseling and mental health care. Especially since the pandemic, there has been a growing wave of people that have begun using therapy through telebehavioral health or telemental health counseling to get the support they need. If you’re new to this format, you may wonder how exactly it works, how it is different from traditional therapy, and whether it’s effective. We’ll examine these questions in depth below.

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How teletherapy for mental health works

Teletherapy refers to receiving mental health care in a virtual format. This term typically applies to online talk therapy sessions, which are usually conducted by phone call or video call with therapists. Exactly how teletherapy works depends somewhat on the platform or service you go through. In most cases, however, you’ll move through the following steps in your initial sessions:

  1. Sign up for the platform or service
  2. Provide information about the mental health challenges you’re seeking help with 
  3. Provide information about your needs and preferences in a provider (e.g., someone experienced in LGBTQIA+ issues, someone trained in trauma-informed therapy, etc.)
  4. Get matched with a licensed therapist
  5. Meet with them regularly via phone or video to set treatment goals and receive treatment

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

If your therapy appointments take place via phone calls, a working device and a quiet room are all that you need. If your therapy appointments take place via video call, you’ll need a working device (smartphone, tablet, or computer) that can connect to the internet and has a camera, you may also need video software depending on the platform. Traditional therapy sessions often last for a set amount of time, usually 30 to 60 minutes in length.

Benefits of online therapy

Everyone should feel empowered to choose the type of therapy that’s best for them, whether they choose telemental health care or in-person health care. There are certain advantages to teletherapy that may make it a more attractive option than in-person sessions for some; let’s take a closer look at these.

You likely don't need to travel for teletherapy

One of the key advantages of virtual therapy is that it can be done from almost anywhere, which can be less stressful than commuting to therapy. If you have a device and an internet connection, you can sign on to sessions with your therapist and receive high-quality care from home.

That means teletherapy allows people who might not have the ability to get mental health care otherwise to get the treatment they may need. For example, some teletherapy users live in rural areas, meaning there might not be in-person providers anywhere near them. Others have a physical disability or a mental illness like social anxiety that may make it difficult or impossible for them to leave their home to get to their sessions. Still others may not have reliable transportation, or may have too busy a schedule between caring for children and work to allow for commuting back and forth to appointments. In situations like these, online therapy can be a much more convenient option.

You can control your environment during the therapy session

Some people choose teletherapy because they prefer to receive the high-quality support of a therapist from the comfort of their own home. They can wear whatever they like, sit comfortably, and change the lighting and the temperature of their space as desired, etc. For those who have specific needs or preferences around these types of environmental elements, being able to control them can put them at ease and in the right frame of mind for therapy.

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Virtual counseling may be more cost-effective

Mental health professionals who provide in-person guidance generally have significant costs to cover, such as rent for their space. However, those who conduct teletherapy tend to have fewer such costs and may therefore charge less for their services. The average cost of an in-person therapy session in the United States is between $100 and $200. The average cost of a teletherapy session tends to be much lower. With an online therapy platform like BetterHelp, for instance, costs range from $65–100 per week (based on factors such as your location, referral source, preferences, therapist availability and any applicable discounts or promotions that might apply) to have sessions with a qualified therapist. Although BetterHelp in particular doesn’t accept insurance, this cost is comparable to most insurance co-pays. In other words, those who can’t afford regular in-person therapy sessions may find that online therapy is a better fit for their budget.

You may have more mental health service provider options with teletherapy

For those who live in remote areas where there aren't a lot of therapist options, teletherapy can also represent a viable alternative. Unless you live in a major metropolitan area, you may have trouble locating a provider who suits your needs or preferences, who is accepting new clients, and who is located within a reasonable distance of where you live. With teletherapy though, these limitations can be solved as you can choose from a much wider range of providers since geographic location is not a factor. This can be especially helpful for those who are seeking a specialist or someone with a specific type of expertise. It also allows people to switch therapists more easily if they find that the first one they try isn’t the right fit.

Effectiveness of teletherapy or virtual counseling

There’s a growing body of research that suggests that online therapy can be as effective as in-person sessions in many cases. It’s important to note that in-person treatment may be best in certain situations, such as for more severe mental illnesses or any circumstance where the individual’s safety may be at risk.
Research suggests that for the majorityof general mental health conditions and concerns, however, virtual therapy may be able to provide a meaningful impact. Peer-reviewedstudies that suggest this include the following:
  • A 2020 study reports that online cognitive behavioral therapy—one of the most common types of talk therapy today—is “at least as effective” as in-person CBT in reducing symptoms of depression.
  • Another study suggests that virtual therapy is an “effective and cost-effective” treatment method for symptoms of anxiety, with another that found the same for symptoms of depression.
  • A study conducted at the University of Zurich found that individuals who received virtual therapy were more likely to describe their care as “personal”. This finding is meaningful since a positive therapist-client relationship is typically highly important for treatment efficacy.
  • Finally, couples who attended relationship counseling together via video reported that they felt safer and “less intimidated and judged” by their therapist, according to one study.
According to a 2016 study, online CBT “offers numerous benefits to both the patient and the practitioner” and “allows treatment of patients with many different psychiatric conditions, at lower cost than traditional CBT”.
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How to get started

In general, you’re likely to get the best results from pursuing therapy in the format or medium that feels most comfortable for you. If you’re interested in trying online therapy, you might consider using a platform like BetterHelp. All BetterHelp therapists are licensed and have a minimum of three years and 1,000 hours of hands-on experience in clinical practice. You’ll be asked to fill out a brief questionnaire about your needs and preferences and will be matched with a provider in as little as a few days. You can then meet with them via phone or video call, and you may also use in-app messaging to reach out in between sessions. 

"I’ve had two sessions with her and already feel like I’ve made some progress. She’s very straightforward which I haven’t had in other counselors and while it can a bit uncomfortable to be pushed, it’s also exactly what I need."
— BetterHelp member’s review of their therapist

Takeaway

Teletherapy can be a more convenient and affordable option for many people, and studies suggest that it can be effective in treating a variety of mental health conditions and challenges.
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