What Is Online Therapy?

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What Is Online Therapy?

Online therapy, also known as e-therapy, e-counseling, teletherapy, or cyber-counseling, involves providing mental health services and support over the internet. Services can be offered through email, text messaging, video conferencing, online chat, messaging, or internet phone.

Online therapy can occur in real-time, such as in phone conversations and text messaging, or in a time-delayed format, such as through email messages. Though this type of therapy has limitations, it is quickly becoming an important resource for a growing number of people.

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What Is Online Therapy?

Techniques

Primary tools for communicating in online therapy include:

  • Email
  • Mobile device apps
  • Real-time instant messaging
  • Telephone
  • Text-based chats
  • Video conferencing

Such services may be accessed via a desktop computer or laptop, but mobile apps are also becoming an increasingly popular option.

Online Therapists

Just as therapists and counselors in the "real-world" can have a range of qualifications and licenses, online therapists can also differ considerably in their training and credentials. Though some websites promise a quick and easy path to becoming an online therapist, becoming an online therapist takes the same education and training as becoming a traditional in-person therapist.

However, the actual practice of online therapy is very difficult to regulate since therapists can operate from anywhere in the world making it tough to enforce state laws regulating education, training, and scope of practice.

Rules and Ethics of Online Therapy

The American Psychological Association (APA) offers a good ethical framework for the use of technology in mental health. These guidelines suggest the minimum practices and standards required for ethical online therapy:

  • Have a sufficient understanding of technology. This includes how to use the tools required to deliver psychotherapy online and how to ensure that client information remains private and secure.
  • Work within their Scope of Practice. Therapists should only offer services they are trained to provide. So if you reveal an issue to your therapist that they aren't equipped to treat, they should refer you to another therapist instead of trying to tackle it themselves.
  • Seek out training, knowledge, and supervision. In order to provide the best care possible, most states require therapists stay up-to-date with the latest research and best practices. This can involve attending formal (college or university courses) and informal (workshops and conferences) training sessions, and seeking clinical supervision (either face-to-face or online) when needed.
  • Adhere to relevant laws and regulations. Different states have different policies and regulations in place to manage virtual medical services. It's up to your therapist to know and follow the laws and guidelines specified by their geographic location. For example, in the U.S., only individuals who have received specific training and have passed the required licensing process are legally allowed to call themselves psychologists.

What Online Therapy Can Help With

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

Though online therapy can be useful for a variety of conditions and complex situations, it's not the best option if you have a condition that requires close or direct treatment or in-person intervention.

Benefits of Online Therapy

Below are just a few reasons why online therapy has become a first-choice for so many:

  • Accessibility: There can be many physical barriers to getting to therapy. For example, maybe you live in a remote area. Or you don't have access to adequate transportation, meaning you have to rely on friends and family to get around. Thanks to technology, you can benefit from therapy regardless of mobility issues.
  • Affordability: Online therapy eliminates much of the overhead costs associated with a brick-and-mortar location, which allows therapists to offer more affordable treatment options. And don't forget, there is no cost associated with "traveling" to an online therapy session.
  • Convenience: Online therapy makes it possible for you to schedule sessions that fit your life. You can schedule them around your work schedule and family obligations.
  • Privacy: Worried about bumping into your co-worker at a therapist's office? With online therapy, you can enjoy complete privacy. You can schedule your sessions for when you're home alone.

Effectiveness

Research suggests that online therapy is just as effective as traditional face-to-face therapy. In one study, researchers found that when combined with clinical care, online cognitive behavioral therapy (CBT) can effectively treat depression, anxiety, and illness-related emotional distress.

Some evidence even suggests that online therapy may be more effective than in-person therapy. A review of 17 studies found that online CBT was more effective than face-to-face CBT at reducing the severity of depression symptoms.

While online therapy presents some challenges, it has received support from many patients who have utilized online mental health treatments. In a review of studies published in the journal World Journal of Psychiatry, patients receiving mental health treatment through video conferencing reported "high levels of satisfaction."

online therapy
 Verywell / Alison Czinkota 

Things to Consider

Research increasingly suggests that online therapy can be an effective option, but that doesn't mean that it's right for everyone. More serious forms of mental illness, including substance use disorders and psychiatric conditions including severe depression and schizophrenia, require more than online treatment can provide. 

Consider talking to your doctor about whether online therapy works for your situation or if you should only use it as a supplement to more traditional treatment options. If you think that online therapy might be right for you, research some sites and apps that are available to determine which one is right for your needs and budget.

How to Get Started

If you think online therapy may be the right fit for you, consider the following questions:

  • Do you want a subscription service that allows unlimited messaging or would you rather schedule and pay for therapy sessions as you need them?
  • Does your online platform of choice accept your health insurance?
  • Can you choose your own therapist or is a therapist selected for you?
  • How would you like to communicate with your therapist: instant messaging, live video appointments, or phone calls? 
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Article 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.
  1. Joint Task Force for the Development of Telepsychology Guidelines for Psychologists. Guidelines for the practice of telepsychology. Am Psychol. 2013;68(9):791-800. doi:10.1037/a0035001

  2. Kumar V, Sattar Y, Bseiso A, Khan S, Rutkofsky IH. The effectiveness of internet-based cognitive behavioral therapy in treatment of psychiatric disorders. Cureus. 2017;9(8):e1626. doi:10.7759/cureus.1626

  3. Gratzer D, Khalid-Khan F. Internet-delivered cognitive behavioural therapy in the treatment of psychiatric illness. CMAJ. 2016;188(4):263-272. doi:10.1503/cmaj.150007

  4. Luo C, Sanger N, Singhal N, et al. A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. EClinicalMedicine. 2020;24:100442. doi:10.1016/j.eclinm.2020.100442

  5. Chakrabarti S. Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World J Psychiatry. 2015;5(3):286-304. doi:10.5498/wjp.v5.i3.286

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