What Conditions Does Online Therapy Treat?

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Online therapy sites like Talkspace and Betterhelp have helped make online therapy more visible and approachable. This ability to access mental health services from home is appealing—one of the big advantages of this medium is that it helps make mental health services more accessible, particularly in rural and underserved areas.

You might be left wondering, however, just how effective such services are for various mental disorders. Is online therapy the same as traditional therapy and what kind of conditions can be treated online?

While there’s still a lot we don’t know about the use and effectiveness of online therapy, researchers have found that online therapy can be used to treat many of the same mental health conditions that are treated in a regular, face-to-face office setting.

Conditions Online Therapy Treats

Research on online therapy is still ongoing and continues to emerge and evolve as the technology used to deliver these services changes. Researchers have looked at the effectiveness of therapy for a number of different conditions and learned more about what works and what might not be as useful.

Some of the conditions that can be effectively treated with online therapy include the following.

Depression

Major depression is one of the most common types of mental disorders in the United States, affecting an estimated 17.3 million adults each year. This number represents 7.1% of all adults in the U.S. Unfortunately, the National Institute of Mental Health suggests that approximately 35% of people who experience depression do not receive treatment.

Research has shown that online therapy can be just as effective as face-to-face therapy in the treatment of depression. Such findings are promising since online delivery would be a useful way to expand treatment services to people who might otherwise not receive it.

One study published in the Journal of Affective Disorders compared the two treatment modalities and found that internet-based depression treatment was just as beneficial as traditional, in-person therapy for treating depression. Interestingly, only participants in the online group continued to show reductions in symptoms three months after treatment.

Panic Disorder

Online therapy can also be an effective treatment for panic disorder, an anxiety disorder that affects an estimated 2.7% of U.S. adults each year. A study published in BMC Psychiatry compared internet-based cognitive behavior therapy (ICBT) to group-administered CBT for the treatment of panic disorder.

The results indicated that not only was internet CBT as effective as the more traditional group CBT for reducing symptoms of panic and agoraphobia, it was also more cost-effective. Group CBT required much more of the therapist's time than the internet-based CBT did.

Online therapy might be an effective way to treat people at a lower cost than traditional face-to-face therapy.

Social Anxiety Disorder

Social anxiety disorder (previously known as social phobia) involves the persistent fear of social situations. It affects about 7.1% of all U.S. adults and can have a serious impact on a person's ability to function academically, socially, and occupationally. Research suggests that online therapy may be an effective treatment option for people with this condition.

A study published in the Journal of Psychological Disorders concluded that internet-delivered cognitive behavioral therapy (ICBT) was equally effective as face-to-face CBT in the treatment of a number of conditions including social anxiety disorder. The authors of the study describe ICBT as "effective, acceptable, and practical health care."

While those in online therapy showed only moderate adherence to their treatment, they gave online therapy high marks in terms of satisfaction and acceptability.

The nature of online therapy may be particularly appealing to people with social anxiety disorder—traditional treatment may trigger feelings of anxiety, but online therapy allows people with SAD to access treatment in a way that feels safer and less anxiety-provoking.

Generalized Anxiety Disorder

Studies have shown that ICBT is as effective as face-to-face therapy in the treatment of generalized anxiety disorder. One study compared online therapy led by a therapist to online therapy led by a technician and found that both produced results comparable to traditional therapy.

Such results are promising—technician led online treatments could potentially help increase the capacity and availability of mental health services.

Stress and Anxiety

Online therapy can also be a useful tool for helping people cope with stress and anxiety. One study looked at the potential effectiveness of a mobile-based program to manage mild-to-moderate stress, anxiety, and depression.

The program lasted for a period of six weeks, during which time the participants had access to a program that included online CBT-based modules, real-time self-monitoring, and message prompts.

Those who took part in the program showed improvements in their symptoms of stress, anxiety, and depression. Overall psychological distress decreased and many also showed improvements in self-efficacy.

Research suggests that online-based interventions have the potential to improve psychological health and overall well-being.

Types of Online Therapy

Not all forms of online therapy are the same and the treatment approach you choose might depend on a variety of factors including the nature of your condition and your therapeutic goals. Some forms such as cognitive-behavioral therapy (CBT) are more popular in online formats, while others such as eye movement desensitization and reprocessing (EMDR) may be more difficult or even impossible to do online.

Some of the types of online therapy you might encounter include:

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy is a form of treatment that has been well-studied and shown to be effective for a number of mental health conditions. The basic premise of this form of treatment is that by identifying and changing negative thoughts and behaviors, people can find relief from their symptoms and find new ways of coping.

Research has shown that internet-based cognitive-behavioral therapy (ICBT) is effective in the treatment of psychiatric conditions and offers a cost-effective solution that can increase the accessibility of mental health services, particularly in rural areas.

Psychodynamic Therapy

CBT is often viewed as the "gold standard" in terms of treatment, but research has also shown that other types of psychotherapy are often just as effective. Psychodynamic therapy focuses on exploring unconscious processes that influence behavior. By gaining insight, people are able to increase their self-awareness and better understand how past experiences influence current behavior.

There has been debate over the feasibility of delivering psychodynamic therapy over the internet—the process tends to focus heavily on interpersonal relationships. In a process known as transference, characteristic patterns of responses to other people often emerge over the course of therapy in relation to the therapist—a phenomenon that may be difficult to produce in an online modality.

However, some studies have shown that online psychodynamic therapy can be beneficial both on its own and as an adjunct to traditional therapy.

One study comparing internet-based psychodynamic therapy to ICBT for the treatment of depression found that symptoms were reduced equally in both groups while participants were receiving therapy. However, those who received ICBT showed better improvement in terms of quality of life and significantly long-term recovery.

Person-Centered Therapy

Person-centered therapy, also known as client-centered therapy, is a nondirective approach that involves people playing a primary role in their treatment. Research suggests that PCT can be effective for some mental health conditions including depression and anxiety.

The effectiveness of this approach in online treatments is not clear, but research suggests that this approach is most effective for helping people deal with mild to moderate symptoms of anxiety, depression, and situational stresss.

When Online Therapy Shouldn’t Be Used

Online therapy isn’t right for everyone and may not be an appropriate choice for certain situations.

Online therapy is not recommended when a person has a severe mental condition or is experiencing thoughts of suicide or self-harm. People with serious addictions or more severe symptoms of a psychological condition likely need more intensive treatment than online options can provide. 

However, online and text therapy may sometimes be a useful supplement to traditional therapy. Some conditions such as bipolar disorder, addictions, PTSD, and schizophrenia may not be appropriate for online-only treatment, but they may benefit from online services that supplement traditional treatments. For example, research suggests that therapy delivered via text may help people with schizophrenia adhere to their medication plan.

Evidence also suggests that using online therapy may increase the likelihood that a person will seek out face-to-face therapy if they need extra help. For example, one study found that college students who needed a higher level of treatment than online therapy could provide were more likely to get help if they had already participated in an online program and worked with a therapist online.

While online therapy may not always be appropriate as the sole treatment for every condition, it may be a useful first step toward a more intensive form of treatment.

A Word From Verywell

Online therapy can be a great alternative to traditional therapy. For some people, talking to a therapist online might actually be preferable—a person with social anxiety disorder, for example, may feel more comfortable sharing their feelings online.

But that doesn't mean that it is right for everyone. If you struggle to understand your own emotional responses, you might have trouble communicating your feelings to your therapist. If you aren't able to accurately describe and share your struggles with your therapist, they may not be able to give you the advice, support, and help that you really need.

Whether or not online therapy may be appropriate for you depends on your individual needs and the severity of your symptoms. If you think online therapy might be a good choice, research some different online services or talk to your current therapist to see if they might consider switching to online therapy. 

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