What Is Online Psychotherapy?

Psychotherapy (talk therapy) services can help people with a range of emotional challenges, stressors, and mental illnesses. Therapy aims to help clients manage symptoms and control the effect that they may have on mental health, overall wellbeing, and lifestyle. In-person or online talk therapy is often used to help improve a person’s overall well-being and cope with their daily life. 

Online psychotherapy is generally very similar to traditional psychotherapy except that you are not physically present with the counselor. Sessions are typically conducted online in a live, telehealth format. Unlike text-therapy, most online therapy sessions are conducted synchronously through videoconferencing or phone calls, which research suggests can improve its effectiveness.

What can online psychotherapy help with?

There is a broad range of mental health concerns that online therapy can help individuals or couples manage. Some of these include:

• Long-lasting issues from trauma, such as post-traumatic stress disorder (PTSD)
• Getting through the death of a loved one (grieving)
• Anxiety and depression disorders
• Mental disorders, such as bipolar disorder, mood disorders, or schizophrenia
• Online marriage counseling

What do online therapy sessions look like?

Traditional talk therapy is between a patient and a therapist. The therapist usually guides the patient through a series of activities, exercises, or conversation points to facilitate their treatment by effectively addressing their concerns and offering them ways to cope with or alleviate their symptoms.

While most offices will have their own online sites and apps, the general goal of online psychotherapy is to provide sessions to patients in a comfortable and open environment. For some people, home is the best place to hold their initial sessions.

Medication with psychotherapy can be effective

Often, online therapy and medications are used simultaneously to manage the disorder and treat any symptoms. This combination is recommended for many conditions by the American Academy of Psychoanalysis and Dynamic Psychiatry, Academy of Cognitive and Behavioral Therapies, and American Psychological Association.

When combining medication and online therapy services, the patient needs to be honest with how the prescribed medicine makes them feel or act. Not all treatments are appropriate for all people, so it is critical to be upfront about any side effects.

Medication is often used in conjunction with online psychotherapy to improve the individual’s overall life, not make it more challenging or uncomfortable. Healthy lifestyle improvements, such as exercise, rejuvenating sleep, and proper nutrition, are also key elements of improving a person’s overall mental and physical health.  Medications are not prescribed by the online counselor but rather by the individual’s psychiatrist, online psychiatrist, or qualified family doctor.

What are the benefits of online psychotherapy?

For some individuals, attending psychotherapy online is a more suitable option than in-person psychotherapy services. This may be due to physical limitations, such as a disability limiting a person’s ability to leave their house or a fear of leaving their home, or geographic limitations such as a lack of qualified or experienced therapists in their area, or financial limitations such as in-person therapy being too expensive. Online therapy is designed to help the individual overall, regardless of circumstances.

If the patient travels for work but still needs their weekly online therapy session, they can have it from their phone or laptop. The hours that online therapy can take place can also extend past regular business hours. If your chosen online therapist has a home office, a session at an unusual hour can often occur for those with an atypical work schedule or living situation.

The goal is to find an online therapy provider whom you can trust and open up to; if you don’t feel comfortable around your counselor, therapy might not be as comfortable or effective for you. But finding the right psychotherapist online does not have to be any more challenging than finding the right in-person counselor.

Finding a psychotherapist online may actually be easier because you will not spend time driving from office to office finding a counselor who you connect with and can trust, or being put on long waitlists. While most people do not switch counselors, on occasion, you may find that you would benefit from a different therapist if you are experiencing complex issues. Since there are online therapy specialists for different realms of psychotherapy, finding a specialist is sometimes needed. For example, not all counselors are trained to conduct online therapy with individuals seeking gender affirmation surgery. Pre- and post-surgical transgender therapy is a specialized field and requires specific components of understands, so transgender individuals may benefit more from attending therapy with a counselor who specializes in these matters.

Does online therapy work?

Research shows that psychotherapy works best when it is consistent and the client is open to online therapy. Approximately 75% of people who begin online therapy show improvements in their mental health.  Psychotherapy works by improving an individual’s emotional reactions, behaviors, and responses to challenging situations.

  Online therapists’ goals are usually to have their clients show improvements throughout their sessions and not plateau with treatments. The best online therapists can get their clients to a point where they do not require therapy to continue or have fewer therapy sessions as time goes on.

Researchers have shown that brain changes in individuals who attend online therapy have similar brain scans as those who only took medication. For those who do not want to depend on medication, online therapy is a good alternative when possible.

People who benefit the most from online therapy are those who are actively engaged in their treatment. They follow through with assignments given for “homework” between sessions, journal their thoughts or feelings, and consistently practice what is discussed in sessions. The best online therapy is as effective as the patient wants it to be; the more they put into it, the more they will get out.

Why are there different types of online therapy?

Different specialists treat heart issues and broken bones; similarly, there are different types of online therapy to help with specific needs and circumstances. The best online therapy for you will depend on your specific needs and preferences, but here are some types of online therapy that research tends to support:

Cognitive behavioral therapy

One of the most commonly recommended types of therapy online is cognitive behavioral therapy (CBT). Online CBT helps individuals to change their thinking and behavior patterns from negative, unhealthy ones to more rational and healthy ones. Online CBT can help a person to manage issues and solve their problems.

Cognitive behavioral therapy is often most effective in treating:

• Anxiety
• Depression
• PTSD
• Trauma Disorders
• Eating disorders
• Certain mood disorders

Much of the scientific research on online therapy focuses on cognitive behavioral therapy. One meta-analysis published in NPJ Digital Medicine found that internet-based CBT effectively improves symptoms of depression, anxiety, and both mental and physical distress.

Interpersonal therapy

Another type of online therapy is interpersonal therapy (IPT). IPT is most effective when treating clients with unresolved grief, socialization issues, conflicts with partners or family, or those needing assistance with self-expression.

Psychodynamic therapy

Psychodynamic therapy helps patients to work through issues that may have occurred during their childhood and improve their self-awareness. This form of online therapy, often in conjunction with psychoanalysis, works toward helping individuals take back control of their lives. The best online psychoanalysis therapies are run several times a week and may include individual and group sessions.

Dialectical behavior therapy

Dialectical behavior therapy (DBT) is a form of online therapy that helps clients manage their emotions. People with mood disorders, such as borderline personality disorder, benefit the most from DBT.

Other forms of online therapy

In addition to the therapy types mentioned above, supportive online therapy is also a form of counseling that helps patients work through an issue or traumatic event and realize their self-worth. Some forms of supportive therapy include:

• Creative art therapy
• Play therapy
• Animal therapy
• Music therapy

What are the risks of psychotherapy online?

While some of the best therapists never see a client in-person, there are still some risks associated with it, including:

• Therapy of any kind can bring up painful memories, emotional discomfort, and fear.
• Therapists are people, too. They should be unbiased and non-judgmental, but some therapists will be better at this than others.
• Unlike in-person therapy, some people find it more difficult to communicate or express their body language in an online format (particularly if they’re not using online videoconferencing). Additionally, people may experience interruptions from poor internet connection, lags, or other technological challenges.
• There may be an increased risk that videoconferencing sessions could be hacked or corrupted in some way.

You can work with your therapist to minimize these risks, and you may find therapy more successful and enjoyable when you work with a therapist you feel comfortable with.

When you’re looking for the best online therapist for your needs. Consider their education, background, experience, therapeutic modality, and personality. The same licensure is required for both in-person and online therapy, but either way, you’ll want to make sure that you look into the types of therapy and challenges that a therapist has clinical experience with.

Ultimately, learning the coping skills necessary to manage your feelings, battle negative energy, and work through challenging issues is the goal. Whether you are working through anger issues or are a survivor of abuse, online therapy can be extremely successful.

What other factors should be taken into consideration with online therapy?

Health care costs can be difficult and confusing to navigate for both physical and mental health needs. Cost is a valid concern that should be discussed before you attend any counseling or therapy sessions, and you should note that you may be covered for certain types of therapy, and not others, such as couple’s therapy. If your health insurance does not cover in-person therapy or online therapy, you will want to talk to your insurance company to find out who is in their network. Once you get the contact information for the therapists covered by your insurance, most patients can get an appointment within one week.

If you have an urgent issue that needs to be discussed with a new therapist, it is best to call their office and explain what is happening. Most offices will be able to accommodate your needs.