What's the Deal with Online Therapy?
At first glance, online therapy easily raises a lot of questions. How does it work? DOES it work? Is therapy worth it anyways?
All valid questions. We’ll get to that in a moment…
It’s safe to say that more interaction occurs on the internet than ever. Everything is moving online, including the medical field. It is now common for medical doctors to assess patients over the phone, send in prescriptions, and never actually see the patient in person. It saves a lot of money too. And who really wants to go to the doctor when feeling terrible? Getting in a car and sitting in a waiting room is the last thing I want to do when I am sick.
Mental health professionals are now following suit. There is a slow and steady move to provide online therapy, also known as ‘teletherapy” leading the question to be asked:
Many believe that the intimacy of the therapeutic connection can be lost when located in different places. Researchers are heeding the call and studying the efficacy of online counseling, considering with different therapeutic techniques and conditions.
People have become very creative in the process. To put current trends in perspective… there are literally robots that are providing effective therapeutic interventions right now. People report feeling understood, and like they can actually speak about what’s really going on (not a lot of shame or stigma from a robot!). There are also therapeutic services that will text or call you, with positive outcomes reported by those using the services.
As a licensed therapist, I am in favor of any intervention that is researched and proven effective to people seeking help. Different options work for different people. My focus, for the purpose of this article, and my career, is to explore the role of video chat counseling in the therapeutic landscape. I’ve spent some time reviewing every article I could find that assesses the effectiveness of online video therapy in comparison to in-person therapy. Here’s what I learned…
Does Online Therapy Work?
Every single research article I read found that online therapy was a successful intervention.
Compared to in-person therapy, online therapy was equally effective.
In a few studies, there was a small difference in results, but they were not statistically significant, meaning that researchers could not directly attribute the differences to the type of therapy. But that small discrepancy in effectiveness was still found worthwhile according to researchers. The added convenience, accessibility, and reduced cost more than made up for any differences in reported outcomes. The researchers also consistently mention that online counseling is far better than no treatment at all, which may be the case for those that live far from mental health professionals, or are resistant to the many logistics of traveling to an in-person therapist.
The good news is that these research articles are going for gold. They tested the efficacy on online Cognitive Behavioral Therapy for people suffering panic attacks and depression, as well as treatment for those with Schizophrenia. Both of these conditions are widely known to be very challenging diagnoses that are difficult to treat… and online approaches were found to be helpful!
Online Therapy Literature Review
Andersson, G., & Cuijpers, P. (2009). Internet-based and other computerized psychological treatments for adult depression: A meta-analysis. Cognitive Behaviour Therapy, 38(4), 196-205
Barak, Azy, et al. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services 26.2-4: 109-160.
Wantland, D. J., Portillo, C. J., Holzemer, W. L., Slaughter, R., & McGhee, E. M. (2004). The effectiveness of Web-based vs. non-Web-based interventions: a meta-analysis of behavioral change outcomes. Journal of Medical Internet Research, 6(4).
Nagel, D. (2011). The future of online therapy. Psychotherapy Networker Symposium, Washington, D.C.
Per Carlbring, Gerhard Andersson, Pim Cuijpers, Heleen Riper & Erik Hedman-Lagerlöf (2018) Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis, Cognitive Behaviour Therapy, 47:1, 1-18, DOI: 10.1080/16506073.2017.1401115.
Harrison, Virginia et al. “Mobile mental health: review of the emerging field and proof of concept study.” Journal of mental health 20 6 (2011): 509-24.
Acierno, R., Knapp, R., Tuerk, P., Gilmore, A. K., Lejuez, C., Ruggiero, K., et al. (2017). A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth. Behaviour Research and Therapy, 89, 57-65. doi: 10.1016/j.brat.2016.11.009.
Epstein, Robert. “Distance Therapy Comes of Age.” Scientific American Mind, vol. 22, no. 2, 2011, pp. 60–63., www.jstor.org/stable/24943317.