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How Does Online Therapy Work?

Jennifer Fritz
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How Does Online Therapy Work?
The advent of online therapy is a viable alternative to seeing someone face to face for a multitude of reasons. Whether it is affordability, distance, the lack of social stigma or inability to find an adequate face-to-face therapist, millions of people worldwide are choosing to access their therapy this way.

Often referred to as telehealth or e-counseling, these services allow for direct access to compassionate, licensed counselors, minus the obstacles that have historically kept many away. It has become an increasingly more viable, convenient alternative to those who choose not to seek in-person counseling. 

It is easily accessible, private, and the providers are licensed psychologists, social workers and counselors with experience in the field. There are many excellent motivations for why one should explore the online therapy options, so sit back and read on.

Why Online Therapy?

Online therapy is easy and can be done from a phone, tablet or computer.  Most sites offer chat, phone and video sessions and — in between sessions — you can message your therapist via your private portal anytime you like.  Most sites have easy to navigate apps for your phone or device, which helps when you are on-the-run or unable to make it to your computer.  

Most sites allow you to schedule your own appointments from your therapist’s available time slots, and on some of the more sophisticated sites you can have weekly standing appointments. Some platforms allow you to mix and match sessions, depending on how your schedule changes weekly or monthly. It’s true flexibility at its best. As for writing on the platform, there is no designated time frame for that: You can write whenever you wish, day, night or anytime in between!  

How Much Does It Cost?

Typically, you can have four 30- to 50-minute sessions per month, depending on the package you choose. Prices range from about $35-$70 a week, while some have monthly bundles that offer lower rates. Online therapy is cheaper than face-to-face counseling and much easier to arrange.  

Though it is true that most (but not all) online therapy is not covered by insurance, by the time you pay your copay and meet your deductibles, online therapy often ends up being more affordable. This is especially true because of the frequent access you have to your therapist. With many of the sites you can be in contact with your therapist each day, even if it is just for a brief check-in between your live sessions. This consistency is beneficial, especially if it helps maintain your focus on your therapeutic development.  

What Site Is Most Suitable for Me?

There are plenty of top online therapy sites available, so before choosing one, take the time to explore the one that feels like a good fit. For example, some focus on a certain type of therapy like CBT (onlinetherapy.com) or those that are psychology theory heavy (myonlinetherapy.com), while others focus more generally and your therapist decides which method or therapeutic approach to take. 

Additionally, there are platforms designed to target different groups of people, such as teens, Christians and the LGBTQ+ community. There are many outstanding choices of sites and therapists available, and most describe how they work so you can make an informed decision about what feels right for you.  

Before choosing a site, you should look at how many therapists they have, the different reviews of the site itself and of the therapists, the cancellation policy and absolutely read the Q&A page for items you might not have thought of yourself.   

Taking the step to therapy is so empowering and it can feel great to have the choice of which platform is best for you.  It is not one-stop shopping, so explore and see what your options are!  

How Does Online Therapy Work?

For most sites, the process begins once you join and are assigned to a therapist. In order to get the most out of the therapy process, you need to be active and engaged from the beginning.  While a great number of people seek online therapy because they are anxious, depressed or have a relationship issue, many are looking for support for other mental health disorders. You can choose a therapist based on their area of expertise, and, if that is not an option, it is alright to at least make sure they are qualified in the areas that you want to address.  

After you have been connected it is time to establish a relationship and let your therapist know why you are there. Be honest about who you are, what you are struggling with and what you expect from the therapeutic process. It really helps if you start to think about some goals or things you want to accomplish while in therapy. Some might be shorter-term goals, while some might be overarching longer-term life changes you are hoping to make as you focus and learn more about yourself.  

Your therapist will ask you questions, so be true to yourself because that is the way you will start to see and feel the positive changes. Remember that these online sites are totally private and confidential, so no one else will see or hear what you say. You can confirm that they are HIPPA compliant, but it would be rare that any of them wouldn’t abide by all privacy guidelines regarding your personal healthcare information as well as being confidential.  

Some people decide to begin live sessions right away, while others like the writing process for a while first. There is no right or wrong way to navigate the online therapy process.  It depends on what your desire is, what your comfort level is and even your reason for choosing this route in the first place. Many of the sites have worksheets that your therapist can give you, which is like homework you can work on in between sessions.  

Choosing Your Therapist

There are several important things to ask your therapist when you are first introduced to each other. Some of these questions might include: 

  • When and how often do you typically respond?
  • Do you work evenings and weekends?
  • What is your therapeutic approach?
  • What are your areas of expertise?

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. 

It is also a therapist’s responsibility to refer you to someone else if necessary. Among other things, this would apply if a therapist doesn’t feel equipped to handle a certain issue, isn’t fluent in a client’s language or is in a time zone that is difficult to work with a client’s schedule. 

In Closing: Some Fine Print

There are some things that you should know before you decide if online therapy is for you. Just like traditional therapy, all therapists are bound by their code of ethics that have certain safety mandates. 

If a client is suicidal or reports that they intend to harm themselves or others, the therapist has a “duty to warn” and must report this. There is also a “duty to report” any child or elder abuse that a therapist becomes aware of, just as one would in face to face therapy.  

Most clinicians will give you this information up front when having you sign a consent form or while explaining how things will work, or at least in some sort of the introduction to the site.  

Even so, if a person is in crisis or is experiencing suicidal thoughts or feelings, online therapy is not a good option. When this is the case, call 911 or go to the nearest emergency room for immediate care. This is critical and should always be remembered.  

While online therapy might not be for everyone, it is an excellent option for many. It’s no longer just an alternative for those without transportation, worried about stigma or those who are too busy to make it to an in-person session. It is a meaningful, logical option for affordable, accessible and quality therapy. Making time to take care of yourself should be a priority, and online therapy is an outstanding way to begin in the route to self-care!

Jennifer Fritz
Jennifer Fritz writes for top10.com and is a Licensed Social Worker. She received her MSW and PhD from the University of Michigan in Ann Arbor and has been an online therapist for several years. She specializes in areas such as depression, anxiety, relationship issues, anger, self-esteem and abuse.

The author of this article has been paid by Natural Intelligence to write this article. Neither the author nor Natural Intelligence provide medical advice, diagnosis, or treatment. If you think you may have a medical emergency, call your doctor or your local emergency number immediately.