With the rise of online therapy services, there is now more awareness around mental health treatments that have reduced the stigma associated with mental health and therapy. Even so, it’s important to acknowledge that therapy is not a one-size-fits-all solution. Understanding the pros and cons of online therapy versus in-person therapy can offer beneficial insights so that you can make the best decision for your needs.
Personally, having used online therapy via BetterHelp for the past seven years, I find it highly effective and have no intention of switching back to in-person sessions. However, this might not be the case for everyone. Some people may feel better in the comfort of their homes during therapy sessions, while others might feel a stronger connection and benefit more from face-to-face interactions.
Our goal for this article is to help you navigate the pros and cons of online therapy and provide insights that will help you make the best decision for your mental health needs.
Be sure to check out our article about the common excuses people use to avoid therapy.
What is Online Therapy?
Before we dive in, let’s dissect what exactly online therapy is.
Online therapy, sometimes called teletherapy or e-therapy, is when someone receives psychotherapy or counseling services through the Internet. Many years ago, this would seem strange and unappealing to partake in. But with the advancement of technology and the rise of online therapy services, it’s now a convenient alternative for those who aren’t able to do in-person therapy. This form of therapy allows people to connect with licensed therapists and counselors using computers, tablets, and smartphones. Not to mention, it can be an extremely convenient option for those who are extremely busy or might use the “I don’t have time to go in” excuse. Does that sound like you?
Online therapy includes video conferencing, phone calls, and text messages. That’s right! These days, you can just chat with someone online or via text rather than through video or calls. However, video therapy is often considered one of the most effective modalities other than in-person therapy.
It’s important to note that while online therapy can address many mental health conditions, much of the current research focuses on anxiety and depression, particularly with cognitive behavioral therapy (CBT).
Personally, I use BetterHelp, which offers a range of features including weekly therapy sessions via phone call or video call, text-based messaging with the option to attach files and label messages as “urgent” if needed, and audio messaging. Since I started online therapy, my mental health has improved significantly as I’ve learned effective strategies to support myself, especially through challenging times.
Pros of Online Therapy
Ideal for Digital Nomads and Frequent Travelers
One of the greatest benefits of online therapy is that it removes geographical barriers to access. For digital nomads and frequent travelers like myself, online therapy has provided consistent support regardless of location. Being able to maintain online therapy sessions no matter where I am allows me to progress in my mental health goals without interruptions.
Traditional in-person therapy can be challenging for travelers. It creates a barrier if you have to find a new therapist each time you move. It also helps those who live in or travel to regions with limited mental health resources. With online therapy, you can still get high-quality care from anywhere in the world.
I have had my therapy sessions while living in over 10 different countries since I first started 7 years ago. The ability to schedule therapy sessions around my travel itinerary helps maintain a sense of routine and support, even when I’m far from home. Consistency, especially when seeking therapy, is so crucial to the entire treatment process. Online therapy has made it easier and more convenient to get the help we need when we need it while sustaining it.
Expanding Access in Rural and Remote Locations
Similar to the first point of removing location barriers, online therapy can expand access to those living in rural or remote areas where mental health clinics may be scarce. For those who have to travel far just to see a therapist, regular in-person visits would be impractical and perhaps an added challenge on top of the mountain of issues someone might be dealing with. Online therapy eliminates the need for long, often arduous, travel to access care.
The convenience of online therapy reduces the time and logistics it would take to travel to a therapist or practitioner and can be easily integrated into your daily life, no matter where you are. As long as you have reliable internet access, you can transform any space into your therapeutic space.
Expanding Access for Individuals with Disabilities and Limitations
Online therapy opens doors and increases accessibility for those with physical disabilities, mental health conditions, or those who are housebound. Sometimes, traditional clinics or offices can lack the necessary accommodations for clients with various abilities, presenting a significant barrier to access. Online platforms offer a solution by allowing individuals to participate in sessions from the comfort and safety of their own homes.
For those who experience severe social anxiety, agoraphobia, or other psychological conditions that make leaving home challenging, online therapy can be a lifeline that connects someone to a professional without the added stress of leaving home.
Doing therapy online can also be an essential support for those recovering from medical procedures or surgeries when mobility is temporarily reduced and traveling to a therapist’s office is not feasible. People are not able to go to a physical place for all sorts of reasons; online therapy provides a safe outlet and option to pursue mental health care without added challenges.
Convenience and Cost-Effectiveness
Convenience is probably the number one benefit of online therapy. You can have therapy sessions in the comfort of your own home and schedule sessions at times that work best for you and your schedule. The convenience of therapy also includes reducing the time and costs associated with transportation, such as driving long distances, traffic delays, and the expenses of public transportation.
The best part is that online therapy alleviates logistical challenges associated with in-person therapy—such as arranging childcare or adult care, dealing with limited appointment availability, and lengthy wait times at the therapist’s office. If you’re a busy parent, this is for you!
It’s also a cost-effective option since many online therapists incur lower overhead costs because they don’t need to maintain physical office spaces. Many therapists now work from home, turning their home space into a therapy space to host sessions with clients. This cost-saving can be passed on to clients, making online therapy a more affordable option, particularly for those without health insurance coverage.
Increasing Comfort
Online therapy increases our comfort levels while we address the hard stuff. Being in a comfortable space or the comfort of our homes when we’re engaging in therapy truly helps us to feel more secure and relaxed, which can lead to more open and honest communication. For some, like myself, the physical separation of online sessions can reduce feelings of vulnerability that some may experience in face-to-face meetings. It can be a lot less intimidating to share such personal stories through a screen.
Being in a comfortable and private space can also eliminate the discomfort we might feel in clinical settings, making it easier to discuss sensitive topics. At least for me, the environment in which I share and express my thoughts is very important. As clients, online therapy can empower us to set up a space that feels safest for us, whether that involves specific seating arrangements, lighting, or having elements of personal comfort within reach.
Reducing Stigma
We all know too well the stigma that persists around mental health challenges and treatments. Online therapy can reduce this stigma and make mental health treatments more approachable due to the privacy and discretion of doing therapy at home. Removing all of the mentioned barriers can really encourage people to take the first step toward receiving care.
Teletherapy has allowed people to seek help without fear of judgment and feelings of shame and discomfort. It is a crucial tool and resource in raising awareness and understanding mental health issues. Online therapy services offer people a chance to learn about psychological health, coping strategies, and health behaviors that can improve their overall well-being.
Online therapy isn’t just for those with clinically diagnosed conditions; it’s a resource for anyone who wants to improve their mental health. This accessibility makes it easier for people to seek help early and prevent more severe issues from developing later on.
Cons of Online Therapy
Limitations from Insurance Companies and Some States
A major barrier to online therapy is insurance. Insurance coverage for online therapy varies widely depending on the state and each insurance policy. Since the COVID-19 pandemic, some insurers have expanded coverage for teletherapy, but many others still have restrictions or do not cover online therapy at all. It’s important to check the policies regarding insurance coverage for online therapy in your state and with your employer.
Many states have specific licensing requirements that restrict practitioners to providing services only within the state where they’re licensed. This is quite common. This limitation can be a significant barrier for those seeking to continue therapy with a preferred therapist if they move between states and countries.
There’s also the difficulty of inconsistency in regulations and insurance coverage. If you’ve ever dealt with medical insurance and trying to figure out your coverages, then you know the common frustration that people have when seeking any kind of medical care. This makes it difficult for patients to find and continue care with suitable providers. Again, check with your state, workplace, and insurance company to avoid unexpected expenses and ensure continuous care.
Challenges in Handling Crisis Situations
Another limitation of online therapy is how effectively and quickly therapists can address an urgent mental health crisis. In situations where a client may experience intense psychological distress or emergencies, online communication (whether through messaging, calls, or video chats) is not enough to provide immediate and intensive support.
Of course, therapists can offer guidance and support during crises and even help to coordinate emergency services, they are not present to intervene directly, which can lead to delays in critical situations where time is of the essence.
This means that those using online therapy services should have a clear crisis plan in place, developed in collaboration with their therapist, that includes local emergency contacts and procedures. This preparation is crucial and can mean the difference between life and death.
For those with known severe mental health conditions that can lead to frequent and severe crises, hybrid models of care combining online and in-person check-ins should be considered for the client to receive the most effective support and safety.
Missing Non-Verbal Cues in Communication
Missing non-verbal cues is an issue with any type of online communication. Take video chats with friends or text messaging with family; it’s so easy to misinterpret or not pick up on certain cues simply because you’re not in person with the people you’re communicating with. This is also true for online therapy and can be a significant setback.
Therapists miss out on observing non-verbal cues such as facial expressions, body language, and vocal tones, which are crucial elements in understanding your emotional state and nuances in behavior. These behaviors say a lot about a person.
The lack of these visual and auditory signals can be a challenge for therapists in trying to fully grasp the depth of a client’s feelings. This can lead to misinterpretations or a slower process if more time is needed to clarify emotions or reactions. Some types of therapy rely heavily on interpreting physical responses as part of the diagnostic and treatment process, such as trauma therapy or therapies involving somatic experiences. For these, in-person sessions might be more beneficial.
Online therapy platforms and therapists need to recognize these limitations and explore ways to improve the communication of emotions and expressions. Encouraging the use of video calls when possible and training therapists to navigate and compensate for these gaps in digital communication are actionable steps that online therapy platforms can take.
Privacy and Technology Concerns
There are always risks to confidentiality and privacy when it comes to any form of digital communication, online therapy included. Because information is being transmitted online, the situation makes privacy leaks and hacks more of a concern. This can include concerns over data breaches or unauthorized access to your personal therapy records.
While most reputable online therapy platforms use secure, encrypted communication protocols to protect client data, the risk of privacy leaks and hacking incidents can still occur, and as we know, often do. This can certainly make people nervous and anxious about committing to online therapy and sharing such personal information online.
Issues with technology can further complicate access to online therapy. Unreliable wifi connectivity, software glitches, or hardware malfunctions can disrupt therapy sessions, leading to delays in treatment or loss of critical therapy time. Some clients may not be technologically savvy or may lack access to the required technology and stable internet connections, making it challenging to benefit fully from online therapy services.
The Need for a Private Space
Not everyone has the luxury of having a sacred private space in their homes dedicated to therapy sessions. Some rarely get any privacy at all. Issues of personal space can definitely affect how comfortably and freely people express themselves. Without adequate privacy, clients may feel restricted in discussing sensitive topics, which defeats the purpose of online therapy altogether.
Finding public places like a quiet park or coffee shop is also not ideal. These places can be disruptive and uncertain situations can arise that will affect therapy sessions. This is where traditional in-person therapy can be appealing. In-person therapy provides a secure and private setting as a standard, which is prepared and maintained by the therapist to ensure that the focus remains solely on the therapy session without concerns about interruptions.
When Jess and I were living together last summer, we would have to coordinate our online therapy call times. For example, I would have my call while she is at the coffee shop, or she would have her call and I would go out for a morning run, or we schedule our calls at the same time but we both have noise-canceling headphones on while being in different rooms. It’s possible to do this with limited space. All it takes is a little effort and some coordination.
Is Online Therapy as Effective as In-Person Therapy?
Research shows that online therapy can be as effective as in-person therapy, especially for treatments like cognitive behavioral therapy (CBT) for depressive disorders. Just as in-person therapy can be beneficial for those with a wide range of mental health issues, teletherapy can provide the same support, including depression, anxiety, chronic stress, burnout, relationship problems, grief, traumatic experiences, and significant life changes.
In my personal experience, the convenience of online therapy, particularly the ability to engage from the haven that is my home, has led to my consistent attendance and ongoing commitment to therapy. I also find that video sessions can provide therapists with insights into my home environment. For some people, this might include potential stressors and the presence of pets, which can be instrumental in understanding and supporting the client’s progress.
Ultimately, individual preferences play a significant role in the effectiveness of therapy. Therapy is not a one-size-fits-all solution and needs to be tailored to the specific person. Some people may prefer one mode of therapy over another based on personal comfort and needs.
Regardless of the format—online or in-person—I highly encourage anyone doing therapy to take some time either before and after sessions for reflection and note-taking to maximize the benefits of therapy, rather than immediately resuming daily activities or work.
