Online Therapy

Online therapy, also known as teletherapy or telehealth, provides counseling services to individuals remotely via phone or video calls, emails, or in-app chats using a HIPAA-compliant format.

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What Is Online Therapy?

With the expanding world of technology and the growing need for accessible mental health care, more and more people are finding therapy services at their fingertips through online therapy every day. Online therapy, also called telepsychology or teletherapy, provides individuals with professional counseling via video or phone call, email, or text. As many individuals could not attend their in-person counseling sessions due to COVID-19 restrictions and related health risks in recent years, online therapy provides an opportunity for individuals to connect with qualified professionals safely and routinely from their homes.

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How Does It Work?

Like traditional, in-person therapy, online therapy is talk-based, with online or over-the-phone sessions taking place either weekly, bi-weekly, or at a frequency agreed upon between the client and therapist. Some online therapy platforms have individuals pay for each session with a therapist, while others may require a monthly subscription. Subscription-based therapy session plans usually include one video therapy session a month and access to unlimited text messaging with a therapist. “Unlimited messaging” means that an individual can text their therapist as much as they like, but their therapist might respond only once or twice a day on weekdays.

Online therapy apps usually offer a combination of services, including matching individuals with a therapist, 24/7 access to therapy via messaging, and remote therapy sessions.

What Issues Can Online Therapy Address?

Online therapy, like traditional counseling, can address a wide array of topics, including relationship concerns, stress, anger management, bereavement, and trauma. Additionally, teletherapy can address mental health disorders like depression, anxiety, eating disorders, and can be implemented in substance abuse treatment. Another form of therapy that individuals can access online is Eye Movement Desensitization and Reprocessing (EMDR) therapy. This psychotherapy treatment was initially designed to alleviate the distress associated with traumatic memories. EDMR is also recognized by the Department of Defense and Veterans Health Administration for helping treat post-traumatic stress disorder (PTSD).

Online therapy isn’t suitable for all conditions or situations. According to a study published in the Journal of the American Medical Association (JAMA), situations or conditions deemed unsuitable for online therapy include:

  • Suicidal thoughts
  • Homicidal thoughts
  • Severe substance use disorders
  • Severe eating disorders
  • Borderline personality disorder (BPD)
  • Thought disorders (like schizophrenia), which may include delusions, hallucinations, and disorganized thinking

The Benefits Of Online Therapy

Accessibility

Teletherapy provides a readily available option for those who live in an area without any therapist offices or counseling centers, or in instances where these services are present but require a long commute. More so, if one has a chronic illness, mobility issues, social anxiety, or any condition that makes it difficult to leave the house, traditional therapy may not be attainable. Online therapy reduces this barrier to treatment. Additionally, online therapy allows individuals to access a broader range of therapists who may specialize in different areas of mental health than those in their local area.

Convenience And Availability

In the same vein as accessibility, teletherapy is convenient for those with full-time jobs or other responsibilities that may impede their availability for in-person therapy sessions. No additional planning needs to be considered like transportation, childcare, requesting time off from work, etc., for remote therapy. Individuals potentially save time and money when they choose online versus in-person therapy. Additionally, in-person counseling options often garner a significant waiting list, but online therapy sites and apps can often quickly link people with therapists and rarely have wait times.

Similar Outcomes

According to several studies, online cognitive behavioral therapy (CBT) is as effective as in-person treatment for mental health disorders like depression and panic disorders. According to the National Center for Health Research, “online therapy can be effective at treating anxiety, depression, and trauma. There is no difference in patient satisfaction depending on whether therapy is online or in-person, and for either method of receiving therapy, the outcomes are better the more sessions someone attends.”

Destigmatizing Mental Health Care

One benefit of pursuing counseling sessions online is that it adds a layer of privacy for the individual. While stigma is still present for many when it comes to mental health, teletherapy provides a discrete option for treatment The individual does not have to worry about running into someone they know on the way to an in-person therapy session. Some online therapy sites even allow users to use aliases for their identity.

The Drawbacks

Lack Of Privacy During Online Sessions

In-person counseling offers individuals a private space to explore challenging topics. However, since many individuals partake in online therapy from their own homes, finding an area separate from distractions, personal stressors, or other people (like roommates, children, spouses, etc.) may be challenging.

Lack Of Connection

While online therapy excels in accessibility, one element that may be potentially dampened through technology-imposed distance is emotional connection. Meeting in person with a certified counselor instead of virtually allows the therapist to quickly pick up on nonverbal cues like body language and facial cues that may be lost via phone calls or instant messaging. Also, it may be difficult for a client to pick up on tone through in-app chatting or text messaging, which may impact the client-therapist relationship and connection. Additionally, in-app chatting or texting may present challenges for those who have a harder time writing than speaking.

Lack Of Computer Knowledge, Experience, Or Access

Online therapy may be complex for the older generation or those who do not have a general understanding of computers and applications. Teletherapy chats or emails can also be challenging for individuals who cannot type quickly. Additionally, it may be difficult for some who do not have access to the devices needed to participate in online therapy.

What To Look For Before Choosing Online Therapy

Regulation of teletherapy services and apps is ever-evolving, with the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) regulating some, but not all, medical apps. With this in mind, it is essential to research and compare online counseling options thoroughly. Additionally, there are several questions that one can consider while researching options for online counseling.

Are The Therapists On This Site Licensed?

A quick way to see if a site offers legitimate professional counseling services is to check if their listed therapists are licensed. According to the American Psychological Association (APA), in some states, the terms “therapist” and “psychotherapist” are not “legally protected,” meaning that some who promote themselves as these terms are not licensed. However, legitimate online therapy providers often clearly state that their therapists are licensed.

Will My Insurance Cover These Services?

Due to the pandemic limiting in-person services, more insurance companies are starting to cover online therapy services. Usually, the company offering online therapy services will be able to run a verification of benefits to see if an individual’s insurance company will cover these services. Private and government-sponsored health insurance doesn’t always cover telehealth services, including online therapy, but most private health insurance covers at least some offerings. Additionally, Medicare and Medicaid cover telehealth in some cases. If an individual’s insurance company does cover online therapy services, it is often more affordable than an in-person therapist or counselor. Comparing prices across online therapy sites is also helpful in finding affordable options.

Common Questions About Online Therapy

How Often Will I See My Therapist, And How Long Is Each Session? 

The number of days a person will see a therapist is generally up to the client. However, a discussion will occur between the client and therapist regarding each person’s availability, their budget, and if insurance covers counseling sessions. Regarding the length of sessions, therapy sessions are typically around an hour long. Most companies charge by the hour, and sessions usually must be a particular length for insurance companies to cover the session.

Do The Therapists Have Experience With The Issues I Am Seeking Counseling For?

Just because a therapist is licensed does not mean they have experience in all aspects of counseling. Just like doctors have specialties, so do therapists. Some specialize in addiction-related issues, some in trauma, some in grief or loss, etc. It is essential to ensure that the company or therapist you chose specializes or has experience with your specific issues. 

Will I Be Able To Choose My Therapist? 

Many online therapy sites match clients with a counselor versus having the client choose their therapist; however, clients can be rematched with a different counselor if they request to do so.

Will I Receive A Diagnosis Or Be Prescribed Medication? 

Some online therapy sites have psychiatrists on their staff who can diagnose and prescribe medication via telehealth; however, most do not allow the therapist to diagnose a client online. Additionally, mental health therapists are not licensed to prescribe medications. 

Are These Platforms Confidential And Private? 

Privacy is essential when participating in therapy, regardless if it is done online or in person. According to the National Association of Social Workers, “Normally, all video conferencing platforms used for telemental health are required to be HIPAA compliant, and their companies are required to sign a Business Associate Agreement (BAA). However, in light of the COVID-19 public health emergency, the Office of Civil Rights has agreed not to enforce these technical requirements for the duration of the emergency.” While federal laws protect your health information, it is good to be proactive and always ensure that you participate in online therapy using a private HIPAA-compliant format. 

Resources Are A Click Away

Online therapy sites and apps bring licensed, professional counseling to one’s fingertips. While there are multiple factors to consider before choosing teletherapy, these services can make treatment accessible for many. Get matched with a therapist today and discover your online counseling options.

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Published:

Author

Carmen McCrackin

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  • Carmen McCrackin earned a B.A. in Journalism from the University of Auburn and has over 3 years of professional writing experience. Her passion for writing and educating others led her to a career in journalism with a focus on mental health and social justice topics. Her main mission is to be a platform for all voices and stories, and to provide tangible resources to those seeking recovery for themselves or loved ones.

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Reviewed by Doctor of Addiction Medicine:

Amber Biello-Taylor

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  • Amber Biello-Taylor is a Certified Addiction Professional (CAP) with over 10 years of professional addiction treatment experience.

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