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 Pros and Cons of Online Couples Therapy By Wendy Rose Gould Wendy Rose Gould LinkedIn Wendy Rose Gould is a lifestyle reporter with over a decade of experience covering health and wellness topics. Learn about our editorial process Updated on September 15, 2021 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 Carly Snyder, MD Medically reviewed by Carly Snyder, MD Facebook LinkedIn Twitter Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments. Learn about our Medical Review Board Print Verywell / Madelyn Goodnight Table of Contents View All Table of Contents Overview Benefits Effectiveness Potential Drawbacks Finding a Therapist Online Platforms Cost Next in Working With a Therapist Guide The Pros and Cons of Online Therapy Virtual health services have become more commonplace over the last decade. Even from the confines of our homes, we have access to one-on-one conversations with medical doctors, dermatologists, and therapists. While most telehealth services focus on individual care, online couples therapy is also available, either through a therapist or counselor with an online practice, or one of a number of subscription-based programs that provide access to therapy through text, email, or chat. This article discusses how a couples therapy session might differ from in-person counseling, the benefits of couples therapy, and potential drawbacks. It also includes guidance on how to find the best therapist for you. What Is Teletherapy? Overview Online therapy goes by many names, including e-therapy, teletherapy, telecounseling, e-counseling, and even cyber counseling. In many ways, it's the same as therapy you’d get from an in-person session, only your conversations take place through text, email, or video chats. Online therapy for couples is similar, only both you and your partner are present and the goal is to improve your relationship dynamic together. "In the session, your therapist will guide you through exercises and communication practices. The goal is to help you improve the quality of your relationship, increase or renew the friendship factor, enhance your intimacy through deeper emotional connection, and navigate and resolve conflicts effectively," explains Jennie Marie Battistin, a licensed marriage and family therapist (LMFT) based in Burbank, California. In terms of structure, usually each person is given a chance to speak so they can air their concerns and complaints while the other person actively listens. The therapist facilitates these sessions, guiding the conversation by asking questions and helping the couple reach agreement and understanding. As is the case with all forms of therapy, how many sessions you decide to participate in is up to you and your partner, informed by your therapist’s recommendation. Some can resolve in a few months while others benefit from ongoing sessions over the course of years. 40 Questions to Help Build Intimacy in a Relationship Benefits In general, couples therapy opens the door of communication and can strengthen what many would consider their most important relationship. "Sessions can reveal hidden worries and underlying patterns, set the tone for ongoing communication, and help you create goals and modify behaviors into the future," says Sanam Hafeez, PsyD, a New York City-based neuropsychologist. "Additionally, couples might feel they can hang on to their grievances until their session, so their day-to-day also gets better because there’s a place they can bring their disagreements." In terms of the benefits of online couples therapy versus in-office sessions, there are a handful to consider: It’s convenient: Having no commute to a therapist’s office often allows for easier scheduling, especially in cases where work schedules might collide or if you have children. When something meshes well with your schedule, it’s easier to stay the course.You may feel more comfortable: Walking into a foreign space with someone you’ve never met and airing personal details is hard to do. Though it’s still a difficult process when at home, being in the safe cocoon of your space might make it easier.Learned skills may translate easily: "Practicing communication skills in your home may help to translate the skill to real life, which can help increase the accessibility of using the skill day to day," says Battistin.It opens the door to long-distance relationship counseling: If you’re in a long-distance relationship and unable to consistently participate in traditional therapy, online couples therapy is a viable alternative. A Verywell Report: Americans Find Strength in Online Therapy "To ensure your session goes well, being open-minded and accepting is the first step," says Hafeez. "It also helps to write out your individual and shared goals, as well as your complaints or worries, so you don’t spend your time being sidetracked and later feeling you never got to say the important things." Note that in some cases the goal or outcome of couples therapy is to help you determine whether it makes sense to remain in the relationship. In cases where you’re in a relationship that’s not demonstrably unhealthy but otherwise might be better ended, couples therapy can help you amicably separate. 3 Key Factors in Healthy Relationships Is Online Couples Therapy Effective? In general, couples therapy has been shown to be an effective evidence-based treatment that can help couples with relationship problems including communication, intimacy, and psychological distress. Research suggests that online therapy can be as effective as traditional face-to-face counseling. In a 2019 study published in Frontiers in Psychology, the majority of couples who tried online therapy reported finding the experience both beneficial and positive. One concern associated with delivering couples therapy online is the challenges of forming a therapeutic alliance. Previous research has suggested that the therapeutic alliance—which is the relationship clients have with their therapist that helps them feel safe and understood—is an important determinant of therapy outcomes. Interestingly, participants in one study felt that online delivery via video actually enhanced this therapeutic rapport. Potential Drawbacks While there are many benefits associated with online couples couple therapy, it’s important to acknowledge some of the potential drawbacks, as well. Those might include the following: It’s harder to read body language: "With a virtual session, there’s a limited understanding of body language and interaction specific to in-person behaviors in online sessions," says Hafeez. While some body language can still be read through a screen, some important cues might be missed by your therapist. Interruptions might occur: Children, knocks on the door, pets, internet connectivity issues, and other interruptions are more likely with online therapy. Hafeez also points out that you might speak more quietly or with more hesitation if you live with others or have children for fear of being overheard. All these factors can impact the flow of your session. Sessions might feel less intimate: Since you’re communicating with a therapist through a screen, sessions can feel less personal, which might make it harder to open up and be vulnerable. Sessions are trickier to control: Though not always the case, Battistin says it can be difficult to keep more volatile couples calm without having the physical presence of the therapist. Generally speaking, in situations where there have been physical altercations, it is best to schedule an in-person, one-on-one therapy session versus an online or virtual session. Additionally, Battistin says that one-on-one sessions (virtual or in-person) are ideal if one person is struggling with deep depression or a mental disorder. Press Play for Advice On Online Therapy Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares the pros and cons of online therapy. Click below to listen now. Subscribe Now: Apple Podcasts / Spotify / Google Podcasts Finding a Therapist Several studies have suggested that online therapy can be as effective as in-person therapy, permitting you’re speaking to a skilled therapist. "I recommend seeking a private practice therapist who primarily has specialized in couples therapy in-office, yet offers online when the need arises. It’s also best to seek a therapist who has completed additional training in couples therapy," says Battistin. "You might be surprised to learn most therapists have had only two to three classes in conducting couples therapy while pursuing their master's or doctoral degree." Dr. Hafeez adds that it’s also important to look for the following credentials: LMFT (licensed marriage and family therapist), LMHC (licensed mental health counselor), LCPC (licensed clinical professional counselor), or MFT (marriage and family therapist). "Additionally," she says, "a social worker with training in couples therapy could be a good fit. And always, the persons with the greatest training in any type of counseling are those with doctorates (PsyD or PhD)." The following directories can help point you in the right direction: Gottman Couples Therapists Imago Couples Therapists Emotional Focused Couples Therapists Navigating the 4 Stages of a Relationship Online Platforms There are several online platforms that have emerged as alternatives to private practice therapists. Some platforms are better suited than others to provide couples therapy. There are differences in how you can choose or change your therapist, and video chat may not be available on every platform. As the field of online therapy continues to develop, however, it's likely that these platforms will expand and refine their offerings to suit more specific needs, including couples therapy. If affordability is a concern, there are options to explore. How Much Does Online Couples Therapy Cost? Therapy costs can vary depending on a variety of different factors. For traditional in-office therapy, rates are often somewhere between $75 and $200 per hour. Online rates can vary depending on the provider, platform, and options you select. Some providers offer weekly rates that start around $40 a week. Live video therapy sessions often cost more and can be around $200 to $250 per session. Check rates with your provider before you begin. Some online providers may accept your insurance, but you should also check whether the services are covered. In some cases, therapists may also offer discounted pricing for cash-paying clients or a sliding-scale option in which your rate is based on what you can afford to pay. A Word From Verywell The advent of online couples’ counseling has provided more flexibility to couples across the globe who desire to navigate their relationship with the help of an expert. In cases where virtual is the only option—while traveling, in a long-distance relationship, or in situations when commuting simply isn’t a possibility—virtual sessions may prove an excellent alternative to in-person sessions. All couples have their own needs, so it’s important to weigh the pros and cons of online couples therapy to determine if it’s the right move for your relationship. Best Online Couples Therapy 4 Sources 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. Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894. Summary of Evidence. Canadian Agency for Drugs and Technologies in Health; 2014. Kysely A, Bishop B, Kane R, Cheng M, De Palma M, Rooney R. Expectations and experiences of couples receiving therapy through videoconferencing: A qualitative study. Front Psychol. 2020;10:2992. doi:10.3389/fpsyg.2019.02992 DeAngelis T. Better relationships with patients lead to better outcomes. Monitor on Psychology. American Psychological Association. 2019;50(10):38. Barak A, Hen L, Boniel-Nissim M, Shapira N. A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. J Technol Hum Serv. 2008;26(2-4):109-160. doi:10.1080/15228830802094429 By Wendy Rose Gould Wendy Rose Gould is a lifestyle reporter with over a decade of experience covering health and wellness topics. 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