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Online Therapy
What You Need To Know

What is Online Therapy?

Online therapy is the delivery of mental health counseling via the Internet. People also know it as e-therapy, distance therapy, Internet therapy and web therapy. Therapists and online therapy networks use a variety of mediums such as apps for texting, video chatting, voice messaging and audio messaging.

Studies have proven the efficacy of therapy via the internet to the point where it has become a viable alternative and supplement to in-office therapy. There are even people who can afford and make time for in-office therapy but choose online therapy.

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Here are some common reasons why people prefer online therapy:

(or use it as an alternative or supplement to in-office therapy)

  • In-office therapy is expensive
    (average $75-150 per session) — e-therapy gets as low as $65 a week, depending on the service and plan you choose
  • The commute can be inconvenient or impossible
  • Some e-therapy providers do not require insurance
  • People worry about the stigma of in-office therapy
  • Clients are concerned people they know will see them enter or leave a therapist’s office
  • Clients are more comfortable and open while at home
  • Text or message-based therapy allows clients more time to structure their thoughts
  • It is easier for clients to cancel, reschedule or change their therapist within a network of online therapists
  • Clients who want shorter sessions prefer it
  • Some clients feel therapy via the Internet provides greater confidentiality
  • Clients don’t have to cancel if they get sick
  • Extra benefits for clients who will encounter less “triggers” if they stay home
  • It benefits people who cannot drive to a therapist’s office
  • It is a convenient option for people with disabilities
  • People in abusive relationship who want to receive therapy without their partner knowing

There are unique benefits for therapists as well:

  • More time to respond to clients and form better answers
  • Easy to instantly send resources via links
  • Therapists can travel more often

The Difference Between Video Chats and Texting Therapy

When people hear about therapy via the Internet, they first think of video chats facilitating the same therapy they would receive in an office. Nonetheless, e-therapy also includes text-based psychotherapy: clients and therapists exchanging an unlimited amount of text messages via the phone, an online therapy network or an app. There are no sessions. Instead, therapists or the online therapy network they work with usually charge a weekly, monthly or yearly rate.

Millions of people choose text-based therapy because it removes even more barriers that often prevent potential clients from committing to therapy.

Barrier #1: Sessions

Even when patients don’t have to commute, it can be hard to schedule sessions. People are sometimes not able to section off an hour of their day due to other commitments that can pop up at any time. The texting approach means no canceling, rescheduling or missing sessions, which saves therapists and clients time, stress and money.

Barrier #2: Privacy

When clients video chat, they need to find a place where no one can hear them. This can be difficult, and there’s the risk of thinking no one can eavesdrop when they actually can.

Barrier #3: Stigma from Face-to-Face Interactions

Revealing your darkest secrets and fears can be scary enough without having to look a therapist in the eyes while you do it. Not having the face-to-face interaction of video chatting allows many clients to open up and make progress more quickly.

Barrier #4: Price Can Still Be an Issue

Using video chatting to receive the same therapy often means going through the same obstacles and paying comparable prices.

Why Clients and Therapists Often Prefer Text-Based Psychotherapy

Shattering more barriers isn’t the only reason people choose texting therapy. In the same way video chatting works best for many clients and therapists, people prefer texting therapy for the following reasons:

  • Some people express themselves better by writing rather than talking.
  • It is easy to look at previous messages and progress. Clients and therapists do not need to take notes.
  • They already enjoy texting, spend a lot of time doing it and feel texting therapy fits that lifestyle.
  • Texting therapy is similar to journaling or keeping a diary.
  • Therapists and clients can take more time to respond to difficult questions or issues.

Does Text-Based Therapy Work?

There are several studies that prove the efficacy of texting used in psychotherapy. Here are a few we have curated:

Therapist-delivered Internet psychotherapy for depression in primary care: a randomized controlled trial
The Lancet

Prevention of Eating Disorders in At-risk College Women
National Library of Medicine

A Preliminary Study of Talkspace’s Text-Based Psychotherapy
Columbia University

Finding the Right Network of Online Therapists

Finding a therapist without a network is possible but frustratingly difficult without a referral from a friend or family member. You have to search for in-office therapists via in-office therapy networks or Google searches and check page-by-page to see which ones offer their services online. But there are dozens of networks, so you’ll need to keep some tips in mind while you search and choose the best fit:

  • There is a difference between therapy and coaching, counseling, consulting, etc. Ensure the network you choose only offers licensed therapists. If their certifications are not displayed, you can ask the network to provide them.
  • Think about your price range and whether you want to bother with health insurance. Some sites do not require health insurance and are more cost-effective without using it.
  • Does it comply with the the Health Insurance Portability and Accountability Act of 1996 [HIPAA]? You can ask site administrators to provide evidence if it is not listed on the site. This is relevant even if the site does not require health insurance.
  • Do you prefer only texting/messaging, only video chatting or being able to switch between both?
  • Do you want the option of being confidential?
  • Do you want a matching agent to help you or would you rather stick with a search engine?

Is Your Online Therapist Ethical?

In-office and online therapists follow a code of ethics set by large psychological organizations and the
bodies that licensed them. For those who don’t want to read the documents,
which can be lengthy, here are some general rules these codes cover:

In-office and online therapists follow a code of ethics set by large psychological organizations and the bodies that licensed them. For those who don’t want to read the documents, which can be lengthy, here are some general rules these codes cover:


An online therapist must protect your confidentiality and records of your sessions


An online therapist can only interact with you in a therapeutic relationship, not in a personal or sexual one


An online therapist cannot misrepresent his or her credentials, services or fees


An online therapist cannot make false or misleading claims about what therapy provides

And here are some of these codes:

Ethical Principles of Psychologists and Code of Conduct
American Psychological Association


Code of Ethics
American Counseling Association


Code of Ethics
National Association of Social Workers


Code of Ethics
American Association for Marriage and Family Therapy


Ethics Policies and Procedures
National Board of Certified Counselors



Keeping Your Online Therapy Safe and Secure


Joining a therapy network with advanced security technology is likely to keep the content of your sessions safe and be HIPAA compliant. You can also insist on using certain tools and services to securely connect with online therapists who work outside of a network.

There are also safety measures you can take:


  • Always log out of your account if you use a computer at work or at the library
  • Use a personal computer if possible
  • Make sure payment forms are secure
  • Have passcodes for your device
  • Protect your password and consider making a new password only for therapy rather than reusing an old one
  • Don’t leave your computer out and open to others
  • Ensure you are in a sound-proof environment when doing video chat sessions and use earbuds or headphones

Frequently Asked Questions About Therapy Online


1-green_2x   Does therapy via the internet work? Does it work as well as in-office therapy?

In-office therapy works better for some people, but online therapy is an equally viable treatment and works for the vast majority of clients.

Here are two studies you may find interesting:

2-green_2x   Are online therapists licensed?

All online therapists are licensed, but not all people who call themselves “online therapists” are licensed (same goes with in-office therapists). Exercise caution when seeking help from sites that offer “free online therapy.”Here are some ways you can verify their authenticity:

  • Most online therapy networks display the therapist’s license number or will provide it to you upon request.
  • Websites such as Psychology Today, Good Therapy and Psych Central provide credibility for licensed therapists. Most online therapists or therapists who take in-person and online patients will have a listing on one of these sites even if they don’t mention online options.
  • You can ask your therapist to help you understand what their license means and how to verify it. Don’t worry, they won’t be offended. Therapists understand the need to protect yourself as a consumer.
3-green_2x   Can I communicate in-office and online with the same therapist?

Yes. There are many therapists who see their clients both in-person and online. They often start by only meeting with the client in their office but then move to a hybrid approach that makes therapy more convenient and flexible.

Therapist Stephanie Moir told Talkspace most of her online clients began as in-office clients. Problems with traffic, weather, tight work schedules and commuting to pick up their children, Moir said, are common reasons why clients supplement their therapy with online sessions.

On the other hand, therapist Tanairy Fernandez said she has a mix of clients who began online and only use that medium, clients who only meet in-office and clients who do both. Some of her online clients found her through a therapy network while others connected by searching independently.


4-green_2x   Is therapy secure on the Internet? Will my privacy be protected?

You will receive greater security assurance if you sign up with an online therapist via a network. Individual online therapists will keep your information confidential, but they might need to rely on services with less security. After all, it’s easier for a company to afford a high-tech online security system with industry-standard encryption and authentication measures along with extra layers of passcode protection.

Ethical rules for licensed therapists require they protect your privacy. With the exception of several rare situations (such as clients being at risk of harming themselves or others), they will not reveal the content of your conversations to others.


5-green_2x   Who should not use e-therapy?

Like in-office therapy, people who are an immediate threat to themselves or others should call a suicide hotline or seek psychiatric treatment before committing to therapy.

There are age limitations depending on the therapist or therapy network you consult. Many therapists accept clients under 18 with or without parental consent. Most therapy networks require the person be 18 or older.

Therapy for How We Live Today

Online therapy is a way for more people to receive a valuable service in a different way, one that better suits their needs and preferences. It’s the natural outcome of advancing technology to provide what we want.

One in five Americans struggle with mental illness but only one third of this population seeks treatment, according to the National Alliance on Mental Illness. Then there are the people who could benefit from therapy but don’t think they need it because they don’t live with mental illness. Online therapy is about helping these people, so it’s time we learned the facts.

Ready to try online therapy?

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