Online Therapy for Addiction

Substance and behavioral addictions can have a physical, emotional, social, and financial impact on a person’s life. Fortunately, effective treatments are available—including online options. Online therapy can be a viable option for people who are dealing with addictions.

Research has found that people who have online therapy for the treatment of substance use disorders show improvement over those who do not receive any treatment.

Online Therapy Options for Addiction

Some evidence-based therapeutic approaches are easier to adapt to an online format than others:

  • Cognitive-behavioral therapy (CBT) is typically used most often and focuses on helping people recognize and avoid negative thoughts and actions. CBT may be used to help people learn how to recognize triggers that lead to substance cravings and then learn how to avoid such triggers.
  • Motivational interviewing is another approach that can work in an online format. In this therapy technique, therapists lead structured conversations that help people learn how to recognize how their lives could be different and better if they stop their substance use.

Potential Benefits

Online therapy may actually provide some benefits over traditional therapy. In the context of addiction treatment, online therapy may help you:

Stick With It

Research on online addiction treatments suggests that this approach may help people stick with their treatment. In some cases, online treatments have even been shown to be more effective. Methadone treatments that incorporate online tools, for example, might be more effective in reducing opioid use than traditional approaches.

Reduce Your Substance Use

Online help and tools may help you cut back on your substance or alcohol use. For example, one study found that people who used an online self-help CBT program were able to reduce their alcohol consumption significantly.

Access Therapy More Easily

An estimated 10% to 12% of people with substance use problems never seek help. The availability of online therapy may help improve access to mental health services and make it more likely for people to get treatment.

Online options are available anytime. Whenever you are feeling an urge or craving, you can reach out to your therapist, work on a self-help module, find educational materials, or connect with a friend who is there to offer support. 

Online therapy can help people who may not be physically capable of attending individual treatments or group meetings get the help that they need.

For example, the COVID-19 pandemic has led to an increased demand for telehealth and online therapy options. Many therapists have moved their practice to online-only options in the wake of social distancing guidelines and stay at home orders.

Give You More Options

Online therapy can sometimes serve as an important first step toward more intensive interventions. In some cases, people who try online therapy first may be more likely to seek out traditional, face-to-face treatment services in the future.

Studies have shown that people may also be more likely to stick with face-to-face therapy when it is supplemented with online treatment.

Address Barriers to Treatment

Research has shown that people often fail to seek treatment due to issues associated with going to rehab, including the cost, time required, and feelings of shame. Online therapy can be a more affordable option that does not require significant life disruptions.

Potential Drawbacks

Online therapy may not be a good choice for all forms of addiction. For example, some research has found that e-therapy showed no benefit over no treatment for gambling addictions.

Some people benefit from the social support that traditional treatments provide, which is often lost in the online therapy experience. One potential way to address this is to combine online therapy with an in-person support group.

If you are unable to attend traditional group meetings, however, online support groups are also an option. It can be a great way to get support and advice from peers who are going through or who have experienced the same things you are facing.

Tips and Strategies

There are some ways to help get more out of your online therapy experience:

  • Build a rapport with your therapist. It is important to feel that your therapist is genuine and empathetic so that you feel comfortable, safe, and respected. Talk to your therapist about what you can do to build this rapport in an online format.
  • If you are transitioning from face-to-face therapy to online treatment, talk to your therapist about how the process will work and how you will deal with any issues that arise.
  • If you are transitioning from a traditional support group to an online group, spend some time researching what’s available to determine what might be right for you and your needs. How will the group meet? How many people are in the group? What level of participation is required? All of these factors might play a role in determining what you get out of the group, so focus on finding something that you know you will be comfortable with.

What to Expect

Online addiction treatment relies on technology to deliver or enhance psychotherapy. There are a number of different online therapy options available for addiction treatment. These include:

  • Therapist-led online therapy: Therapists can use online video, phone calls, emails, and chat to meet with clients virtually. Therapy sessions might occur much as they would in a regular office setting, but occur online using various tools. FaceTime and Skype are not HIPAA compliant and once COVID-related allowances are removed, a therapist or doctor will have to have a HIPAA compliant platform such as VSee, Doxy.me, or Zoom.
  • Computer-assisted therapy: People can also follow interactive, online curricula that guide them through a treatment process with little to no interaction with a therapist. You might watch instructional content, take computerized assessments, follow tutorials, and complete homework assignments as you work through a predefined set of lessons.
  • Web-assisted therapy: This approach may utilize mobile apps or online therapy websites to guide people through sessions or activities.
  • Technology-supplemented therapy: This process may combine traditional face to face therapy with technology such as text messaging, phone calls, video chats, or mobile apps.

The approach that works best for you depends on a variety of factors. The severity of your symptoms may dictate the intensity of the treatment you need. If you require hospitalization, long-term residential treatment, or supervised detox, for example, then online therapy would not be an appropriate choice.

Your access and comfort with technology can also play a role in which option will work best for you. Your therapist’s comfort with technology can also determine how the treatment is delivered.

One important thing to remember is that you don’t necessarily need to choose just one type of delivery. In many cases, you might end up with a combination of therapist-led, computer-assisted, and web-assisted therapy. 

Limitations

Online therapy can be affordable and convenient, but that doesn’t mean that it’s right for everyone or every situation.

Some possible limitations:

  • Therapists may find it more difficult to read body language when working with people online, particularly if they are not using video conferencing.
  • People may feel that it is more impersonal.
  • Technology glitches and related obstacles can sometimes complicate the process.
  • If you are experiencing thoughts of suicide or self-harm or experiencing psychosis, online therapy may not be appropriate. However, online hotlines, chat lines, and text resources can put you in touch with professionals who are trained and prepared to help.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Effectiveness

Traditional addiction treatments tend to be underutilized and have a high dropout rate. This suggests that such options may not be meeting the people’s needs for a variety of reasons. Online therapy may help fill this gap for people who are not seeking out or sticking with traditional treatment approaches.

Just how effective is online therapy for addiction? How does it compare to face-to-face treatment?

  • Research has shown that computer-assisted cognitive behavior therapy showed both short-term and more enduring effects on drug use that were still present on a 12-month follow-up.
  • Another review of studies found that online therapy led to positive effects immediately after treatment and in long-term follow-up. However, the authors of the study suggest that further research is needed, particularly to explore and compare the effectiveness of different online options.
  • Some research has indicated that online therapy may actually outperform traditional therapy in a few different ways. Findings reported in the American Journal of Psychiatry found that participants in a web-based treatment had higher success rates and were less likely to drop out of treatment than those who were treated with individual or group counseling.

A Word From Verywell

Online therapy for addiction is not the exact same as traditional treatments, but that doesn’t mean that it is inferior. It can be an essential and effective tool in your treatment arsenal. Talk to your doctor or therapist about whether this approach to treatment is appropriate for your needs.

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