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Like the name suggests, online therapy is a term used to describe mental health counseling that you can receive from the comfort of your own home in front of your PC or right at your fingertips on your smartphone.
Often referred to as “e-therapy” or “internet therapy,” online therapy isn’t meant for people who are in the midst of a mental health emergency or who need urgent medical care. Instead, it’s a way for people to get easy, convenient, and reliable counseling that tends to be much cheaper than in-person therapy. In addition, it can also be a real help for people who have mobility issues or simply live too far away from a licensed therapist for it to be convenient.
One of the biggest benefits to online therapy is its ability to reach people who otherwise couldn’t make it to a therapist’s office in person. David Kaplan, the chief professional officer of the American Counseling Association, told The Atlantic, “Online counseling can be especially useful with individuals in rural America, as a great many rural counties do not have a single licensed mental-health professional.” The magazine also mentions patients with agoraphobia, or those whose anxiety limits their mobility, as other potential benefactors of online therapy.
The web may just be catching on to this phenomenon, but the US military is no stranger to the benefits of distance therapy. For more than 20 years, the military has been using a form of teletherapy to help soldiers work through anxiety and PTSD.
A recent study published in Behaviour Research and Therapy compared the effects of remote therapy compared and traditional face-to-face counseling. Researchers chose 132 military veterans with PTSD and provided each with 10-12 prolonged exposure therapy sessions. Half of the veterans were given face-to-face counseling at a VA center while the other half’s sessions were conducted by video conference from the comfort of the patients’ homes.
“Our effects with PTSD were just as good in person vs. home based telehealth,” psychologist Ron Acierno, who led the study, told the Huffington Post. While those who were given at-home treatments were less prone to completing the program than those who visited the VA center, Acierno and his colleagues were surprised and inspired by the lack of success between the two modes of therapy.
There’s been less pushback than you might expect from the psychology community, given that online therapy services could pose a real threat to traditionalists in the field. The American Psychological Association (APA) has covered the topic extensively, offering a hopeful, yet cautious endorsement of what it sees as a new avenue to helping those who need it find support.
“With some caveats, the Internet continues to be extremely useful for disseminating health and mental health information,” the APA said back in 2001. A more recent APA article, titled “A Growing Wave of Online Therapy,” celebrated online therapy’s potential and stated that “the onus is on psychologists to make sure they comply with federal and state laws.”
Most online therapy companies offer 3 main types of counseling: real-time chat, video chat, and phone chat.
Email and text message counseling is popular with people who want to be able to think out their questions and write them out before asking. These tend to not be free-flowing conversations like with phone or video chats, but being able to write out what you want to say can be preferable. Typically these chats are done through your personal email to a special, secure email provided through the site, which can help safeguard your anonymity.
Video chat will require a reliable internet connection and will allow you to speak with a counselor face-to-face, if not in the same room. It’s intimate, personal, and allows you to establish a rapport that can be more difficult with the written word.
Real time chat puts you into a secure line and allows you to chat back and forth with a counselor in real time. Think of it like having your own personal, private chat room with a counselor who’s there to listen to what ails you.
When you sign up for an online therapy service, you’ll typically be asked to take a short quiz to determine which sorts of issues you’re dealing with, which can be used to help the service match you with a counselor who may specialize in your concerns. If you’re seeking out online counseling for your child, the quiz will ask you a lot of questions about what you think the child needs help with, before sending the child an invitation on your behalf.
The prices vary by company, but typically online therapy services charge a monthly fee to use the service, and don't charge by minute or hour or text. For instance, BetterHelp , one of the bigger names in the industry, charges a flat fee of between $40-$70 per week, including all messaging, chats, phone, and video sessions.
These memberships tend to be quite flexible, and allow you to quit at any time.
Most online counseling is not covered by insurance, so while it’s cheaper than in-person therapists, you will typically have to pay out of pocket.
There are several important things to ask your therapist when you are first introduced to each other. Some of these questions might include:
So what should you do if you get matched with a therapist that you don't like? If you don’t feel connected to your therapist, most sites give you the option to request a new one. While you shouldn’t necessarily play switcharoo each time you dislike or disagree with your counselor’s input, you should make sure you are working with someone you trust — and who you can relate to. It shouldn’t take too long to be comfortable, but it does take some time to build a working, reliable and dependable relationship with your therapist.
However, therapy takes work and commitment, so remember that it is your counselors’ job to challenge you sometimes and hold you accountable to yourself. The process can be uncomfortable, and that oftentimes means you are making progress. Be sure to distinguish the difference between someone who is inspiring you to confront what you need to work on while holding you accountable with someone who you are unable to connect with.
Before you sign up for an online therapy service, do a little research. Take a look at how the company screens its counselors and if their certification checks out. You can also look at online testimonials by customers to get an idea about the quality of service.
You’ll want to decide which types of counseling you want—chat, video, or email—and if they’re available through the service. If you’re interested in using the service on your smartphone, see if the company has an app and if you’re allowed to have sessions with your counselor by chat on your phone.
In addition, check what type of security they provide and if your chats will be encrypted, and if you’ll have the ability to remain anonymous to your counselor.
Look at the price also, and see if it fits your budget. In addition, see if you can quit the membership at any time, or if its binding.