"When I was diagnosed with postpartum anxiety during the pandemic, traditional in-person therapy wasn’t an option. But even if it had been, between my severe symptoms and my newborn, I doubt I would have made it out of my house to go. Instead, I was able to meet with a therapist via video conference, thus joining the growing number of Americans who are participating in online therapy.
I’m not alone. Mental health issues are on the rise, with nearly a third of Americans reporting symptoms of depression and anxiety—three times as many as in 2019. At the same time, access to care is on the decline. Close to 160 million Americans—nearly half the population—live in areas where there is a shortage of mental health professionals.
The growing prevalence of online therapy is helping to close this gap, but how do you know if it’s the right option for you? Here are some of the various online therapy pros and cons to consider when making your ultimate decision.
What is online therapy?
Unlike traditional therapy where the therapist and client meet face-to-face, online therapy is virtual and can happen through a range of mediums: video calls, messaging services, email, and phone calls. It can happen anywhere at any time. Often the communication between the therapist and client happens in real time, such as a video conference. But it can also be asynchronous, similar to sending text messages or emails to friends or colleagues where you might have to wait for a reply.
Telehealth services, in general, expanded during the pandemic, particularly in the mental health space. But even as the world has gotten back to “normal,” virtual delivery of mental health services has remained high.
Does online therapy work?
While some may cast doubt on the effectiveness of online therapy, research shows it can be just as effective as the traditional face-to-face model. In the case of depression, particularly, a review of 17 studies found that, in some cases, online therapy may even be more effective. Even text message-based therapy, which has its fair share of skeptics, has been shown to be effective.
How do I know if online therapy is right for me?
While everyone’s individual case is different, here are a few key factors to consider.
Cost
While online therapy platforms can be less expensive than traditional therapy, often it’s not by much. There are now many virtual therapy platforms that are accessible via apps and websites, and the lower-cost plans on these platforms usually fall between $40-60 per week. This is generally cheaper than traditional therapy, especially if you’re paying out of pocket. However, once you add on video or phone sessions, the cost goes up to more like $90-125 per week, a price that’s much closer to that of in-person therapy.
Health insurance is also a big factor in many people’s decisions about which kind of therapy to pursue. As online therapy grows in popularity, more insurance companies may start covering it, but currently, this isn’t widespread. And even if insurance does begin to cover it, sometimes copays may be almost the same as what you’d pay out of pocket anyway. Check with your insurance provider to confirm your options.
Privacy
While the stigma around some mental health conditions, such as depression and anxiety, is fading, many people are still uncomfortable discussing sensitive topics like substance abuse or sexual abuse. Some clients might feel more comfortable sharing from behind a screen or over the phone or may even prefer to remain unidentified. Online therapy allows for a level of anonymity that traditional therapy can’t match.
Other important privacy considerations include whether you have consistent access to a private location in which to conduct your sessions and whether your phone and messaging accounts are secure if you plan on using text message or email therapy. If not, then traditional therapy might be a better choice.
Access
Many people live in “therapy deserts” where their access to in-person therapy is low or non-existent. Or they may live in a small community where they don’t want to be seen going to therapy. These are great reasons to consider online therapy. I have one friend who is a therapist and thus knows all the other mental health practitioners in her community. For her, online therapy has been a great option to maintain her privacy.
Alternatively, if you don’t have regular, consistent access to a computer or phone with internet or cellular service, participating in online therapy could be a challenge.
Convenience
We all lead busy lives, and sometimes trying to shoehorn one more thing into our schedules is more stressful than therapeutic, particularly if you add on the time it takes to commute to in-person therapy and back. Having the flexibility to log on to talk to someone from the privacy of your own home or to exchange messages throughout the day can feel more realistic for some. This is especially true for anyone suffering from depression or other conditions that can make getting motivated to leave the house feel like an impossible task.
Your specific mental health challenge
While individual therapy for depression and anxiety conducted via video or the phone has been shown to be as effective as in-person therapy, this may not be true for serious mental illnesses and psychiatric conditions, which may benefit more from in-person therapy.
How do I get started with online therapy?
First, talk to your primary care provider. They may be able to provide a recommendation for an online therapy provider. These days many therapists who do in-person therapy also offer virtual sessions, and some of them may take insurance.
If you’re planning to pay out of pocket, talk to your doctor about trying out one of the many virtual therapy platforms that have come online in recent years. And if it feels overwhelming to decide which one is right for you, unbiased review sites like CNET and Consumer Reports offer good breakdowns of the different features and costs of many of the major platforms.
Most importantly, if you’re struggling with your mental health, know that you’re not alone. Help and support exist, and seeking it out is the first step toward feeling healthier, both for yourself and for the people you love.
