Psychotherapy Online Therapy Working With a Therapist Guide Working With a Therapist Guide Overview Getting Started Pros and Cons Will My Insurance Cover It? Is Online Therapy Secure? Common Uses Depression Anxiety Stress Addiction Relationships Online Therapy for Anxiety By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on May 11, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Online Therapy Options Types of Anxiety Treated In-Person vs. Online Building a Rapport Transitioning to Online What to Expect What to Look For Benefits Limitations Next in Working With a Therapist Guide Can Online Therapy Help with Stress? Online therapy for anxiety might be an option for you if you are looking for an accessible and affordable therapy alternative. There are a number of reasons you might be interested in online therapy, ranging from lack of access to traditional therapy to difficulty leaving your home due to anxiety. Whatever the reason for your choice, it's helpful to learn more about this therapy option before diving headfirst into your first session. Online Therapy Options First of all, it's helps to know what type of therapy you can expect to receive from an online therapist for anxiety. This will, of course, depend on the therapist whom you choose; some therapists stick to one form of treatment, while others might mix or blend treatment modalities depending on your specific needs or issues. Some forms of therapy that you might be offered include cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and dialectical behavioral therapy (DBT). These forms of therapy help you to manage anxious thinking, face troubling situations gradually so that they eventually don't provoke as much anxiety, and learn how to manage and tolerate distress. Together with your therapist, you'll work on changing how you perceive external events and how you react to them, as well as work on coping strategies that you can use outside of therapy and when you finish therapy. Best Online Therapy for Anxiety Types of Anxiety Treated What types of anxiety can be treated through online therapy? Pretty much anything that you would see an in-person therapist for could also be handled by an online therapist. Exceptions might include diagnostic testing that requires you to see a psychologist or psychiatrist face-to-face. If you've already been diagnosed with an anxiety disorder such as panic disorder, social anxiety disorder (SAD), a specific phobia, obsessive-compulsive disorder (OCD), or generalized anxiety disorder (GAD), chances are that an online therapist can help you manage your symptoms and give you strategies to cope. Online therapy will employ the same types of strategies that you would learn from an in-person therapist, such as how to manage negative thinking, how to set achievable goals, how to overcome obstacles, and how to build your confidence. You would also learn strategies for managing stress and anxiety to improve your overall wellness. Most people who live with anxiety have difficulty managing thoughts, emotions, and feelings, and may have habitual ways of responding or acting that make their anxiety worse. Your online therapist would help you to see the patterns in your life that need changing and to learn how to make better decisions and take control. While anxiety is often an innate response to stressful situations, also known as the fight or flight response, it is possible to re-learn your ways of responding to gain control. In addition, if you experience physical symptoms of anxiety such as headaches, fatigue, feeling sick, or a pounding heart, your therapist may be able to suggest relaxation strategies that you can use to calm your body. In-Person vs. Online Therapy What are the differences between in-person and online therapy? The obvious difference is that you won't be seeing your therapist at their office; rather, you will be communicating over the Internet, either through video conferencing, text messaging, or email. Some therapists may also offer therapy over the telephone. Beyond these obvious physical differences, you can also expect to have a different level of contact with your therapist. Whereas an in-person therapist would only communicate with you once per week, many online therapy packages include text communication outside of regular meetings. This means that you have an additional level of support. Best Online Text Therapy Companies Building a Rapport Do you think it will be hard to trust or build rapport with an online therapist? Research has shown that the therapeutic alliance in online therapy does not suffer; in fact, it may be just as good as during in-person therapy. This means that if you show up and do the work, you should feel equally supported by your online therapist. If you are struggling to feel connected during online therapy, make sure that you are taking advantage of video conferencing and not just text or chat-based options. Being able to see your therapist's face and allowing them to see yours will increase the level of connection and should help you to feel more supported. Transitioning to Online Therapy What if you are already seeing a therapist and need to or want to transition to online therapy? In that case, it is best to ask your current therapist about your options. If they are able to offer you online therapy, that would probably be the easiest solution. On the other hand, you could seek out your own online therapy through a service such as Betterhelp or Talkspace if your current therapist is not offering these services. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. What to Expect Your first session with your online therapist will involve clarifying the areas of your life that are most important for you to focus on. Prior to the first session, find out what type of communication methods your therapist offers and choose the one that works best for you. Try to find a quiet spot in your home free of distractions and hang a sign on the door that says you are in a meeting for the length of the session. It's natural to feel nervous during your first session. Just try to do your best to make an initial plan based on the questions that are asked and the answers that you provide. What to Look for in a Therapist What should you look for in an online therapist? Your therapist should be a licensed professional preferably with a graduate degree (Master's, Doctorate, or MD) such as a psychologist, family therapist, clinical social worker, or licensed professional counselor. You should also look for a therapist who has experience treating the particular type of anxiety you are experiencing. Finally, your therapist should be following evidence-based practices and be trained in the treatment and diagnosis of anxiety disorders. And it goes without saying, that they should be contacting you through a secure platform that protects your personal information. Benefits of Online Therapy What are the benefits of online therapy? Some of these are listed below: The option to have sessions at non-standard times (outside regular working hours)The ability to have therapy from the comfort of your home, which can be especially important if you have social anxietyGreater affordability than in-person therapy if you do not have insurance coverageFlexibility and ease of access if your schedule does not allow you to drive to a therapist's office or you live in a remote area Limitations of Online Therapy When is online therapy not appropriate? There are several situations that are outlined below, in which online therapy would not be considered appropriate: If you are having suicidal thoughts or are in crisisYou can't afford the costYour anxiety is severe and debilitating, and you require in-person support for any reasonYou struggle to communicate through video conferencing or other online methodsYou are too young to access a service on your ownYou don't have the necessary technology or would struggle to learn how to use online services (in other words, it would cause you much more stress vs. seeing a therapist in person) The Pros and Cons of Online Therapy A Word From Verywell Whether you are considering online therapy for the first time or you are being asked to move to online therapy by your current therapist, if you are living with anxiety this can be a challenging time. Be sure to check in with yourself throughout the process to recognize when your anxiety might be interfering with the therapy process. It's normal to feel anxious about trying something new or having to change routines. Do what you can to maintain other areas of your life to support you during this challenging time, and you will be better equipped to show up to therapy ready and willing to be supported and make improvements. Can Online Therapy Help with Stress? 1 Source Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Sucala M, Schnur JB, Constantino MJ, Miller SJ, Brackman EH, Montgomery GH. The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review. J Med Internet Res. 2012;14(4). doi:10.2196/jmir.2084 Additional Reading McCall HC, Helgadottir FD, Menzies RG, Hadjistavropoulos HD, Chen FS. Evaluating a Web-Based Social Anxiety Intervention Among Community Users: Analysis of Real-World Data. J Med Internet Res. 2019;21(1). doi:10.2196/11566 Naidu VV, Giblin E, Burke KM, Madan I. Delivery of cognitive behavioural therapy to workers: a systematic review. Occup Med (Lond). 2016;66(2):112-117. doi:10.1093/occmed/kqv141 Saddichha S, Al-Desouki M, Lamia A, Linden IA, Krausz M. Online interventions for depression and anxiety – a systematic review. Health Psychol Behav Med. 2014;2(1):841-881. doi:10.1080/21642850.2014.945934 Stjerneklar S, Hougaard E, Nielsen AD, Gaardsvig MM, Thastum M. Internet-based cognitive behavioral therapy for adolescents with anxiety disorders: A feasibility study. Internet Interv. 2018;11:30-40. doi:10.1016/j.invent.2018.01.001 By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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