Is Online Therapy Right For You?

If you think you could benefit from speaking to a counselor, but it’s difficult to make time for office visits or you can’t find anyone in the area you like,, you may have thought about trying online therapy.

Telepsychiatry has been growing rapidly in the past few years, with a number of companies offering platforms to find and consult with trained counselors by phone, video call, or even text.

But how does online therapy actually work, and is it really as effective as seeing a counselor face to face? Here’s what you need to know.

Pros of Online Therapy

Online therapy is a form of telemedicine, or remote health care. With online therapy, you are matched with a therapist or counselor, and talk with them at a place and time that’s convenient for you. You can communicate with your counselor through text, audio, or video messaging, or schedule a live session to talk. In most cases, online therapy isn’t covered by insurance, but it can still be affordable. While each service has a different fee structure or payment plan, rates can be relatively inexpensive. Some platforms charge per session, while others have a weekly or monthly subscription fee that covers a range of services.

Pro #1

It’s not hard to see why online therapy is attractive to many people. It’s convenient, and you can talk to your therapist without having to leave your house or even make an appointment.

Some people may feel less inhibited chatting online, so they may be more comfortable opening up to their therapist if they’re not face-to-face. It can also feel more private — there’s no chance of running into a person you know in the waiting room.

Pro #2

If you live in a rural area or somewhere without many options for mental health services, an online platform gives you access to a much wider network of counselors to choose from. And online therapy can be an affordable option for people who don’t have medical insurance, or whose insurance doesn’t cover counseling.

Cons of Online Therapy

At the same time, online therapy has some important downsides to keep in mind. First and foremost, it’s not appropriate for all mental health conditions, like psychosis or suicidality. Most online therapists can’t prescribe medication, and without meeting in person they may miss some of the subtle cues that help in making an accurate diagnosis, like body language.

Con #1

Some sites limit therapists’ access to the client’s personal information, making it hard to intervene in a crisis. While some people are more comfortable opening up online, others may feel like it’s harder to make a strong personal connection with their therapist.

It’s also worth noting that the credentials of the counselors you speak to can vary significantly from platform to platform. While some sites provide access to licensed therapists or social workers, others match you with “trained listeners” who may have no credentials at all. Therapists who are credentialed may not be licensed to practice in your state. Also, not all sites provide the same level of security, so while your online chats may feel private, you should take steps to make sure you’re confident that your personal information will be protected.

Con #2

Online therapy usually isn’t covered by insurance, so it may be more affordable to see a provider in your network — even if that means going into the office for an appointment.

Finally, if you or someone you care about is in crisis or suicidal, get help immediately by calling 911, the National Suicide Prevention Lifeline, or the National Domestic Violence Hotline.

Does Online Therapy Actually Work?

Online therapy is still new, so there’s not much research yet into how well it works compared to traditional, in-person therapy. Still, some early studies have been encouraging. One small study found that internet interventions were as beneficial as face-to-face treatment for patients with depression. Another study found that cognitive behavioral therapy provided online worked as well as when it was delivered in a group setting for a small group of patients with panic disorder. And a large, four-year study by the U.S. Department of Veterans Affairs found that participating in telemental health services decreased patients’ rates of psychiatric hospitalization by 25 percent.

How Do I Find The Right Online Therapy Program?

Online therapy is booming, so there are a wide variety of sites and platforms available, including specialized services, like counseling for teens, couples therapy, and therapists trained to support people in the LGBTQ+ community.

When choosing a provider, look for one that is reputable, secure, and will meet your needs. Ask about the credentials and qualifications of the therapists in the network, and find out if they’re licensed to practice in your state. Make sure that the site or app, at minimum, meets health information privacy requirements, and that it has the ability to verify the identities of both the patient and the therapist. Finally, think about how you plan to pay for your counseling, and check with your insurance provider about whether it reimburses for online therapy.

Popular Online Therapy Platforms

Talkspace

One of the oldest telepsychiatry providers on the market, Talkspace has been around since 2012 and offers a large network of more than 5,000 licensed therapists, many of whom are specialists in particular areas of concern, like trauma, addiction, anxiety, and depression. You fill out a questionnaire, then choose from a list of recommended therapists. Once you’re matched with a therapist, you can communicate via text, audio, video messaging, with a guarantee that your therapist will respond within a specific time. You can choose plans that let you schedule a live call once or four times a month. Pricing starts at $260 per month for unlimited messaging, or up to $396 for messaging plus up to four live sessions per month.

BetterHelp

BetterHelp offers a variety of options, including counseling for individuals, couples, and teens. All of its more than 5,000 counselors are either licensed psychologists, licensed marriage and family therapists, clinical social workers, or licensed professional counselors, and the platform requires all providers to have at least three years and 2,000 hours of experience. You’re matched with a therapist automatically based on your responses to a questionnaire, but you have the option of changing therapists if it’s not a good fit.

In addition to messaging your counselor or chatting live on the app, you have the option of talking on the phone. While you can remain anonymous by providing a “nickname,” once you start counseling you’re asked to provide emergency contact information your therapist can use if they believe you or someone else may be in danger.

Cost ranges from $160 to $280 per month.

Amwell

In addition to providing other telemedicine services, Amwell offers access to counselors and therapists online. And since its network includes licensed psychiatrists, it can be a good option for people who may need medication to help manage their mental health issues. Therapists are trained to deal with a wide variety of concerns, including PTSD, grief, depression, and panic attacks. The platform is accredited by the American Telemedicine Association, which means it follows best practices for keeping patient information safe, including not recording sessions between you and your therapist. Costs range from $59 to $99 per session, depending on the experience and credentials of the therapist, although it could be less with insurance —  Amwell is one of a few online therapy providers to accept insurance (you’ll need to check with your insurance provider to make sure it’s a covered benefit).

Doctor on Demand

Doctor on Demand is another site that provides mental health treatment alongside a wide variety of telemedicine services, including psychiatrists who can prescribe medication. It’s also accredited by the American Telemedicine Association and provides treatment for concerns like anxiety, depression, postpartum issues, relationships, addiction, and trauma/PTSD. The site provides a quick, free mental health screening for depression and anxiety, to help determine if you could benefit from counseling.

Cost ranges from $129 for a 25-minute call or $179 for a 50-minute call with a psychologist to $299 for an initial consultation with a psychiatrist and $129 for a 15-minute follow-up. Like Amwell, Doctor on Demand accepts insurance.

Online therapy isn’t right for everyone, but for some people, it can be a convenient and cost-effective alternative to traditional, face-to-face counseling. By taking the time to learn about different services, and checking up on their security and credentials, you can find a therapist to help you work on your mental health concerns from the comfort of your own couch.