Increasing mental health awareness in recent decades has helped the general population grow more receptive to mental health interventions like therapy, but the process of obtaining such services in person remains inaccessible for many people.
The reasons for this inaccessibility are many: the client may be in a remote area where such services are unavailable, may have mobility issues that make travel difficult, or may simply prefer the flexible hours offered by a remote therapist.
In any case, online therapy, also known as teletherapy or e-therapy, has helped bridge this gap.
How Does Online Therapy Work?
Traditional therapy involves a 1:1 clinical session between the therapist and the client. Online therapy uses the same model, except it uses technology to connect the two parties via digital platforms, including video calls, phone conversations, text messages, or email, depending on the medium the parties choose. The most common video conferencing tools used for this purpose nowadays are Google Meet, Zoom, and Microsoft Teams.
Therapists who provide online therapy are required to possess the same qualifications, training, and professional credentials as those offering face-to-face treatment. The adoption of this mode of delivery increased significantly during and after the COVID-19 pandemic, when many therapists were forced to shift their practices online.
Ways to Access Online Therapy
There are different ways to approach (or find) an online therapist. One way to do this is to contact an independent therapist practitioner who offers their services virtually. This can be done by browsing directories such as the Psychology Today Therapist Directory or Headway, choosing a therapist whose specializations align with the client’s needs, and contacting them. Directory platforms also allow clients to filter therapists based on factors such as insurance, licensure, language, therapeutic approach, availability, or gender.
Another common–and arguably more convenient–way to find a therapist is by signing up for a therapist-matching service or platform. These services collect the client’s information, including symptoms, preferences, and treatment goals, and connect them with a licensed therapist within their network.
There are also other online mental health care services that people opt for, such as online support groups, where clients may find individuals experiencing similar mental health conditions; mental health apps, such as 7cups.com, that connect people with listeners and chatbots; and self-help resources that guide individuals toward betterment. These services don’t replace therapy in the traditional sense, but they can offer complementary support while clients find or receive therapeutic support.
Cost of Online Therapy
Cost is one of the biggest barriers to accessing mental health services, whether in-person or online. In fact, one report stated that 42% of Americans reported cost as a barrier to pursuing mental health care. Fortunately, insurance coverage plans have expanded over the years by including mental health care.
The cost of online therapy, in particular, can depend on several factors, but it is generally considered more budget-friendly than traditional in-person therapy. This is because with online therapy, clients also save on travel costs they would otherwise incur. Additionally, some in-person therapists do not accept insurance, without which, many Americans cannot afford their services at all.
Online therapists who offer specialized mental health care for specific mental health conditions tend to offer higher rates than general practitioners who offer care for a variety of conditions. Additionally, therapists with more experience, training, and/or education tend to have higher rates.
The pricing model that a client opts for can also greatly influence the cost. If a client pursues a subscription-based model, in which they reach out to a service that connects them with a therapist, the cost may be billed weekly or monthly. This is in contrast to a session-based model, where charges are incurred per session.
Subscription-based models generally cost less in the long run–typically $70 to $110 per week–due to the bulk discount that clients receive. They also include messaging services, video sessions, and other workshops. A per-session model, on the other hand, offers more flexibility, but can become costly–around $185 to $195 per session without insurance, particularly if the sessions are being taken more frequently. Some therapists even offer sliding-scale fees, where session costs are adjusted according to a client’s changing financial circumstances.
Many online therapy platforms accept health insurance, although coverage can vary by platform, provider, state, and insurance plan. In the case of out-of-network therapy, some insurance plans reimburse clients through reimbursement claims, also known as a superbill. Clients might also be able to use funds from a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for eligible online therapy services. These accounts allow clients to utilize their pre-tax money for qualifying healthcare expenses.
Is Online Therapy As Effective As In-Person Therapy?
Many studies have analyzed the results of online therapy and demonstrated its effectiveness. One study, for example, analyzed online Cognitive Behavioral Therapy in routine clinical practice and found it highly effective for treating several common mental health conditions. The researchers concluded that therapist-assisted online CBT works just as well in everyday clinical practice as it did in previous randomized clinical trials.
As stated earlier, online therapists must meet the same education, training, and licensing requirements as therapists who provide in-person care, as mandated by the country’s legal and regulatory requirements. Thus, any differences between online and in-person therapy are generally related to the delivery format rather than the therapist’s qualifications or expertise.
What to Expect When Receiving Online Therapy
Similar to in-person therapy, it often takes time–and multiple trials–to find an online therapist who is a good fit. This can be discouraging, but it is a normal part of the process, and once clients find the right therapist, it is often worth it to have gone through it.
Clients can also expect to discuss thoughts, feelings, and experiences that may be difficult to talk about. This openness is necessary because it helps the therapist develop a therapeutic intervention that addresses the client’s specific concerns and goals.
With therapeutic interventions, there’s a saying that goes, ‘you get what you put in.’ So, clients can only get the most out of their sessions via active participation. This means they must fully engage through verbal communication, assignments, or practicing new coping strategies.
Challenges in Online Therapy
Speaking of openness, despite the effectiveness of online therapy, there are some barriers to being open and communicating online. A therapist’s office is designed to help clients relax, with elements such as candles, soothing fountains, warm lighting, calming essential oils, and all the works. At the very least, the place is private and quiet. A client’s space may not have the same luxury. For one, they might share their space with roommates, or the space may just not be calming. In such cases, they may need to find their own peaceful space where they can easily participate in the therapeutic process.
The use of technology has certainly increased the adoption of therapeutic services, but it has also simultaneously introduced some challenges. In order to receive online therapy, clients must have a reliable internet connection, a microphone, a camera, and speakers. There are also technical challenges that may arise from time to time, and though they’re not in either party’s control, they’re nonetheless frustrating.
Finally, online communication is not a perfect alternative to in-person communication. It’s generally easier to read body language and cues in a traditional, in-person therapeutic setting, and this is part of the rapport-building that therapists and clients must establish during the therapy plan. Therefore, in online therapy, it might take longer to establish rapport due to the limited visibility of body language and other cues. In sessions conducted via voice calls or text messages, both the therapist and the client miss out on the facial expressions, gestures, and other visual cues that can help them develop trust.
