FAQ: Online Therapy Questions and Answers

What to expect, how to pay, and how to get started

When most people think about therapy, they envision themselves sitting in an office speaking to a therapist face-to-face. They might even picture the “couch” that’s so often depicted in cartoons and movies that portray therapy offices.

While many therapists still use that traditional mode of delivery, online therapy has grown in popularity over the past few years. In fact, it’s become an essential service during the coronavirus pandemic. 

Some people are still a bit wary of online therapy, however. And others want to sign up but don’t know where to start. Here are answers to some of the most common questions about online therapy.

Is Online Therapy Effective?

Studies show that online therapy can be just as effective as in-person therapy in many cases. Here’s what some of the research has found:

  •  A 2014 study published in Behaviour Research and Therapy found that anxiety disorders can be effectively treated via online cognitive behavioral therapy. Participants in the study reported that their improvements were sustained at the one-year follow-up.
  • A 2014 study published in the Journal of Affective Disorders found that online therapy is just as effective as face-to-face treatment for depression .
  •  A 2018 study published in the Journal of Anxiety Disorders determined that online cognitive behavioral therapy is "effective, acceptable, and practical health care." The study found that online cognitive behavioral therapy was just as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.

What Are the Potential Benefits?

Many people enjoy the convenience of online therapy. They find it saves time since they don’t have to commute to appointments.

Scheduling can also be more convenient. Live therapy appointments may be available during evenings and weekends. If you choose to communicate with a therapist via chat or messenger, you can usually do so at any time of day or night.

Are There Any Drawbacks?

Some people may feel that online therapy is a bit impersonal compared with face-to-face treatment. In addition, therapists aren’t able to read body language in the same way (even if video chats are used).

How Do I Choose a Website or App?

There are many online therapy websites and apps available. When choosing one, consider how you’d like to communicate with your therapist. Would you rather have live video appointments? If so, you may want to look at sites like MDLIVE. If you prefer ongoing text communication that can occur at any time, consider a service like Talkspace or BetterHelp.

You may also want to look at price points. Would you prefer an ongoing subscription service that allows unlimited messaging? Or would you rather pay for live therapy appointments that can be scheduled as needed?

Check out the reviews of various sites so you can learn what users liked about them as well as what they didn’t like. Then, you can choose the service that best meets your needs.

How Do I Communicate With an Online Therapist?

Some sites offer multiple ways to communicate, such as text messaging, audio messaging, and video messaging. Others allow for phone calls and video calls.

How Do I Pay?

Some insurance companies cover the cost of online therapy, but they may only contract with certain therapists or websites. Most major teletherapy sites do not accept insurance. Usually, you can pay via credit card online.

Are Therapists Actually Licensed Professionals?

Online therapists should be licensed to provide in-person treatment as well as online therapy. Any reputable site will explain what type of license the mental health professionals hold. 

Is Online Therapy a Good Idea for Everyone?

Most online therapists give information on their website about who is a good candidate for their services and who isn’t. Online therapy typically isn’t recommended for individuals who are actively suicidal or those who are experiencing psychosis.

Are All Types of Therapy Available Online?

No. Some types of therapy aren’t offered online. Play therapy, sand tray therapy, or EMDR, for example, are usually only available at in-person sessions. Most other types of therapy can be delivered online, however.

Can I Choose My Online Therapist?

It depends on the website. Some sites give you a few therapists to choose from, and you can read their photos and bios before selecting which one you’d like to work with. Other sites match you with a therapist based on a brief survey about your needs and preferences.

Can I Access Online Therapy From My Phone?

Most online therapy services and websites can be delivered via an app on a phone. But you’ll need to check with the website about the services and any limitations they have.

Is Couples Therapy Available Online?

Yes. There are websites, such as Regain, which specifically provide couples therapy.

Can I Get Online Therapy for My Child?

Many websites offer online therapy for teenagers. Online therapy for younger children may be more limited. You’ll likely need to check with your provider.

Can I Get Medication Online?

Yes. Some websites, such as MDLIVE, Amwell, and Doctor On Demand offer psychiatry services. They are typically able to prescribe medications, such as antidepressants or anti-anxiety medication that can be picked up at your local pharmacy.

How Long Will I Be in Therapy?

It depends on your treatment needs. Some people only exchange messages for a short time or only attend a few appointments. Other people use online therapy as a long-term resource.

How Often Will I Talk to My Therapist?

This varies greatly depending on your needs, preferences, and the therapy site you choose. You might exchange messages with an online therapist several times per day. Or you might attend one video chat per month. It all depends on your therapist’s recommendations and what works best for you.

What Types of Issues Can Be Treated Online?

Most mental health issues can be treated online. Depression, anxiety, stress-related issues, panic disorder, and even substance abuse problems are usually appropriate for online therapy.

Is Online Therapy Secure and Confidential?

Licensed mental health professionals must follow laws and ethical codes that ensure confidentiality. You’ll want to check with your provider on how they ensure your information will be kept secure. Some websites allow you to use a nickname when you sign up so you don’t have to give your full name.

Will I Always Get the Same Therapist?

Most online therapy websites will allow you to communicate with the same therapist each time you log in. If you prefer to change therapists, you can usually request to do so as well.

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  1. Nordgren LB, Hedman E, Etienne J, et al. Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: A randomized controlled trialBehaviour Research and Therapy. 2014;59:1-11. doi:10.1016/j.brat.2014.05.007

  2. Wagner B, Horn AB, Maercker A. Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trialJournal of Affective Disorders. 2014;152-154:113-121. doi:10.1016/j.jad.2013.06.032

  3. Wagner B, Horn AB, Maercker A. Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trialJournal of Affective Disorders. 2014;152-154:113-121. doi:10.1016/j.jad.2013.06.032