What is online therapy?

MSW

The pandemic flipped our lives upside down, but it also catapulted therapy right into our living rooms. As therapists now shift their practices to online and telehealth platforms surge in popularity, online therapy is rapidly becoming the go-to option for mental health care.

But what exactly is online therapy? Often referred to as telehealth, this virtual therapy involves psychotherapy sessions conducted by video, audio or text messaging. While studies generally back its effectiveness for various mental health conditions such as anxiety and depression, online therapy may be an unfamiliar concept to many. That's why we're here to explain this evolving and increasingly prevalent form of therapy.

Before we delve deeper, rest assured that we've done our homework. The author of this article is a licensed psychotherapist who provides online therapy. Furthermore, we evaluated 16 platforms and directories and spoke with a practicing psychotherapist to bring you the most accurate information. Read on to learn more about online therapy and explore its benefits and limitations.

Content concerning mental health is for informational purposes only and is not intended as professional medical or health advice. Consult a medical professional for questions about your health. If you are experiencing a mental health emergency, call 911, local emergency services or 988 (the Suicide and Crisis Lifeline).

Online therapy is psychotherapy delivered by audio, video or text message-based sessions. It is a departure from traditional in-person talk therapy, where you attend sessions in the provider’s office.

Research supports online therapy for various mental health issues.

For example, a 2023 study compared online therapy to traditional face-to-face therapy for depressive disorders. The authors concluded that the two modalities were equally as effective.

Another 2023 study suggests telehealth services can be effective for clients with personality disorders.

Research even supports text messaging-based therapy as an effective modality. Despite this, our own tests with text platforms were underwhelming, leaving us to recommend audio or video sessions, instead.

The primary benefit of online therapy is the convenience. "Working with a therapist virtually has many advantages, such as saving time and money by not having to drive to an office, being able to do therapy in a familiar space and having the flexibility to meet with a therapist while traveling," explains Resha Altai, an associate clinical social worker based in Los Angeles.

For some clients, the opportunity to undertake the intense, transformative work of therapy at home is a significant advantage.

While online therapy is a fantastic option for many, it’s not for everyone. "Some things to be aware of are potential privacy concerns if you have roommates or live at home with family, internet connection interruptions and interruptions from pets or children," explains Altai.

Additionally, it's essential to consider the privacy practices of the online therapy company. For instance, BetterHelp, one of the largest online therapy platforms, has faced criticism for misusing client data. In 2023, the Federal Trade Commission announced a settlement with the company for sharing users' sensitive health data with third parties for advertising purposes without obtaining proper consent. BetterHelp agreed to pay $7.8 million and implement more stringent privacy practices to protect consumer data as part of the settlement.

Therefore, if you're considering online therapy, it's crucial to read through its privacy policies so you understand your rights. You can also ask your therapist about their confidentiality policies if you prefer traditional therapy.

In video-based online therapy, the experience is much like an in-person session. You receive a confidential link to your session to sign into the platform. You then discuss your concerns with the therapist, and they work with you using techniques and interventions to address your symptoms.

Audio sessions are conducted over the phone and follow a similar process. Text messaging therapy, however, differs significantly. You type out your concerns and await the therapist's replies. These are usually accompanied by resources such as worksheets and virtual handouts.

Want to ace your online therapy sessions? Follow these tips:

  • Get settled in a private space with a strong internet connection

  • Place your device on a stable surface to avoid shaky video

  • List what you want to discuss beforehand

  • Have a notepad and pen ready to jot down thoughts

  • Keep a blanket, tissues and some water handy for added comfort; you may want to consider having a fidget toy or a weighted blanket nearby if you find these tools help keep you calm

  • Be open about what’s working and what’s not with your therapist

Lastly, don’t attempt to attend sessions while driving. Ethically, therapists can't provide services while you're driving, as it's unsafe.

Choosing the best online therapy platform can be daunting, but considering your specific needs can make the process smoother.

Whether you're looking for online therapy for couples, affordable options, culturally sensitive therapists or access to an online psychiatrist for prescription medication support, identifying your top priorities will guide your decision.

Many online therapy platforms provide filtering options based on price, therapist specialization and specific concerns, ensuring you find a therapist who meets your unique requirements. Don't hesitate to explore different platforms and use these tools to connect with the most suitable therapist.

The cost of online therapy can vary significantly, much like traditional in-person therapy. Some affordable options offer sessions for as low as $40, while others may offer monthly plans that total several hundred dollars. Fees for individual therapists often range from $100 to $250 or more, depending on their experience and specialization.

Insurance coverage for online therapy varies depending on the platform and your specific insurance plan. Some online therapy providers accept certain insurance plans, while others may not.

When considering an online therapy service, review their accepted insurance plans. Then, call your insurance provider for a list of in-network online therapy providers and confirm any co-pays, deductibles or limits on the number of covered sessions.

By doing this research beforehand, you can better understand your options and potentially reduce out-of-pocket costs for online therapy.

Many online therapy platforms offer specialized services for couples, providing licensed therapists who are trained in relationship counseling.

Look for online therapy providers who specifically offer couples counseling, and ensure the therapist you choose has experience and credentials in this field.

  • Resha Altai, MSW, ACSW, associate clinical social worker, Los Angeles

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