How does online therapy work?

Online therapy, sometimes also referred to as distance therapy or tele therapy, might become the new normal in these times of corona crisis and social distancing.

Johanne Konnerup Schwensen
Life-is-complicated
4 min readMar 26, 2020

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Perhaps you were doing regular face-to-face therapy, but the current corona crisis forces you to meet your therapist online. Or maybe you’ve never had therapy, but the reality of self-isolation is beginning to take its toll and you want to look into doing online sessions. No matter the reason, these times make it particularly pertinent to get the facts about online therapy straight, so let’s explore what we know.

What the research says

The risk that is most often mentioned about online counselling is that the counsellor can’t be properly attuned to the client. And seeing that accurate observation is crucial to assessment and treatment, this is a valid concern. Visual cues, body language and overall demeanour provides the therapist with important inofrmation about the individual’s well-being.

Studies suggest that the single most important factor for succesful therapy is the therapeutic alliance, which is a fancy way of saying: A good match between the therapist and the client leads to effective therapy. Therefore, many people are concerned that online counselling is just too distant and impersonal to offer appropriate containment for a good therapeutic relationship. Put bluntly the question seems to be: Can staring at a screen ever be healing?

But if we take a look at the research, the findings show that online treatment can actually be very effective for many mental health issues. For instance, an article in Inc. gathered the results of the following newer studies:

A 2014 study published in the Journal of Affective Disorders found that online treatment was just as effective as face-to-face treatment for depression.

A 2018 study published in the Journal of Psychological Disorders found that online cognitive behavioral therapy is, “effective, acceptable and practical health care.” The study found the online cognitive behavioral therapy was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.

A 2014 study published in Behaviour Research and Therapy found that online cognitive behavioral therapy was effective in treating anxiety disorders. Treatment was cost-effective and the positive improvements were sustained at the one-year follow-up.

Does Online Therapy Work? Here’s What Science Says, Inc.

Most convenient aspect of online treatment

Besides being provenly effective, online counselling also has some clear advantages that traditional face-to-face treatment doesn’t entail. It’s accessible to people living in remote or rural areas, those with limited or no transportation, and those who have mobility issues. And right now, in the midst of the coronavirus panic, online therapy might be the only way we can take measures to protect our emotional health, while also protecting our physical health.

Then there is the convenience that platforms offering online counselling allow its users anonymity, which can entice people who might otherwise have been embarrassed to seek support. Also, many online therapy services cost less than face-to-face treatment, and scheduling is more convenient for most people, because you can more easily fit in a session at odd hours — like right after you’ve woken up, or just before you go to bed.

Then there are seemingly small advantages, like therapy seekers not having to worry about seeing people they know in the waiting room. It can also be easier for some people to reveal private information when they’re sharing it online from the comfort and security of their own home.

Studies find that individuals with anxiety, especially social anxiety, are more likely to reach out to an online therapist. Plus, the degree of distance provided by video therapy — in contrast to in-person — has been shown to mitigate feelings of intimidation or loss of personal control that may be more prevalent in traditional therapy settings.

The eventual drawbacks

While online therapy has a wide variety of potential benefits, it’s not for everyone and not without challenges. For instance, online therapy isn’t suitable for high-risk individuals, such as those suffering from psychosis or suicidal intent.

Also, like mentioned in the beginning of this article, without being able to interact face-to-face, therapists might miss out on body language and other cues that can help them arrive at an appropriate assessment and treatment plan. Then there are possible technological pitfalls, which can become a barrier. Dropped calls, frozen videos, and trouble accessing chats aren’t conducive to treatment.

Finally, some might find it more difficult to form a therapeutic alliance with someone when meetings aren’t face-to-face. The screen-to-screen of video sessions might feel inauthentic and too impersonal, for some.

How to find an online counsellor

For many of us, there might never have been a more important time than now to nurture our mental health. If you are interested in online therapy to assist you in getting through this time of increased uncertainty, there are many options to choose from. Think about what type of services you want most — video chats, phone therapy, live chats, audio messaging, text messaging. You may find a local therapist who offers online services or maybe you prefer a platform who offers a wide variety of online counsellors to choose from.

It’s Complicated also has therapists who offer online services. It’s worth remembering that with remote video therapy, you are able to leverage the benefit of a more extensive selection of therapists. This can be particularly beneficial if you are looking for a counsellor with specific experience — say anxiety — or with a particular language or cultural knowledge. Then you can try filtering these different preferences and find your perfect match.

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