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Best Ways on How to Get the Most Out of Online Therapy

Gleb Tsipursky
Top 10 Science-Based Tips for Effective Online Therapy
Telehealth offers a vast improvement in access and convenience to many medical services, and online therapy is one of the most promising case studies for telehealth.

With many online therapy options available, you can choose whatever works best for you. Yet many people are hesitant about trying online therapy. Even if they do, they often don’t know how to use this treatment modality effectively.

Why do so many feel uncertain about online therapy? A major reason stems from its novelty. Humans are creatures of habit, prone to falling for what behavioral scientists like myself call the status quo bias. This mental blind spot refers to a predisposition to stick to traditional practices and behaviors. 

Many reject innovative practices and novel solutions even when these new techniques would be much better for them. Thus, while teletherapy was available long before the pandemic, and might have fit the needs of many potential clients, relatively few took advantage of this option.

Even when we do try new methodologies, we often don’t do so effectively because we use the same approaches we used with the old methodology. Scientists call this behavior functional fixedness. When we learn one way of functioning, we tend to apply that way of functioning to other settings, whereas new ways of functioning might be better for those settings. 

It’s kind of like the saying about the hammer-nail syndrome: “when you have a hammer, everything looks like a nail.” Clients frequently bring their mindset from traditional therapy into teletherapy without sufficient consideration of the differences between the two.

Status quo bias and functional fixedness are two types of dangerous judgment errors known as cognitive biases. These mental blindspots impact decision making in all life areas. Fortunately, recent research has shown effective and pragmatic strategies to defeat these dangerous judgment errors. The tips below will help you make the best decisions about how to get effective online therapy.

Top 10 Science-Based Tips for Effective Online Therapy

Trust the Science About Online Therapy

Extensive research shows that, for most patients, online therapy offers the same benefits as in-person therapy.

For instance, a 2014 study in the Journal of Affective Disorders reported that online treatment proved just as effective as face-to-face treatment for depression. The Journal of Psychological Disorders published a 2018 study, which reported that online cognitive behavioral therapy was just as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.

Additionally, a 2014 study in Behaviour Research and Therapy discovered that online cognitive behavioral therapy proved effective in treating anxiety disorders, and helped lower costs of treatment. 

During the forced teletherapy of COVID, therapists worried that those with serious mental health conditions would be less likely to convert to teletherapy. Yet research published in Counselling Psychology Quarterly in 2020 alleviated that concern. It found that those with schizophrenia, bipolar disorder, severe depression, PTSD, and even suicidality converted to teletherapy at about the same rate as those with less severe mental health challenges.

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Yet teletherapy is not for everyone, according to this research. For example, adolescents had the most varied response to teletherapy, according to a 2020 study in Family Process. Some adapted quickly and easily, while others found it awkward and anxiety-inducing. 

According to a 2020 study in Child Abuse & Neglect, children with trauma respond worse to online therapy. And according to a 2020 study from the Journal of Humanistic Psychology, online therapy may not be as effective for those suffering from loneliness.

Trust the Science About Online Therapy

Leverage the Strengths of Online Therapy

Online therapy is much more accessible than in-person therapy for those with a decent internet connection, webcam, and mike, and sufficient digital skills. You don’t have to commute to your therapist’s office, wasting money and time. 

You can take much less medical leave from work, saving you money and hassle with your boss. If you live in a sparsely populated area, online therapy providers, such as Cerebral and Faithful Counseling, allow you to access many specialized kinds of therapy that you might not be able to access locally.

You can address the long waiting lines for in-person therapy through much quicker access to online options. You also have much more convenient scheduling options.

Online therapy is often cheaper than in-person therapy. Given COVID, many insurance providers cover online therapy.

Online therapy also reduces stigma. It’s easier to conceal from others if you’re worried about negative consequences from being discovered. You also don’t have to wait in the waiting room, worried about running into someone you know.

Many patients may feel more comfortable and open to sharing in the privacy and comfort of their own home.

You can use a variety of communication tools suited to your needs at any given time. Video can be used to start a relationship with a therapist and have more intense and nuanced discussions, but can be draining, especially for those with social anxiety. 

Voice-only may work well for less intense discussions. Email offers a useful option for long-form asynchronous, well-thought-out messages. Texting is useful for quick, in-the-moment questions, answers, and reinforcement.

Address the Weaknesses of Online Therapy

One area for improvement is the requirement for appropriate technology and skills to use this tech. Another is the difficulty of forming a close therapeutic relationship with your therapist. You won’t be able to communicate non-verbals as fully and the therapist will not be able to read you as well, requiring you to be more deliberate in self-expression and self-analysis. 

The neutral space of a therapist’s office might be helpful to some in sharing personal challenges. You have to do more research on the service offering therapy to make sure it’s reputable, uses only licensed therapists, and has a clear and transparent pay structure. Finally, some mental health treatments need in-person interactions, such as EMDR (Eye Movement Desensitization and Reprocessing).

Be Intentional About Being Your Own Advocate

Figure out what kind of goals you want to achieve. Consider how, within the context of your goals, you can leverage the benefits of online therapy while addressing the weaknesses. Write down and commit to achieving your goals. 

Remember, you need to be your own advocate, especially in the less regulated space of online therapy, so focus on being proactive in achieving your goals.

Be Intentional About Being Your Own Advocate

Figure Out Who's Your Ideal Mentor

Every online therapy journey involves a mentor figure who guides the treatment-seeker. So who’s your ideal mentor? Write out their top 10 characteristics, from most to least important. 

For example, you might want someone who is: 

  • Empathetic

  • Caring

  • Good listener

  • Logical

  • Direct

  • Questioning

  • Non-judgmental

  • Organized

  • Curious

  • Flexible

That’s my list, but depending on what challenge you’re facing and your personality and preferences, you should make your own. Then, when you are matched with a therapist, evaluate how well they fit your ideal list.

Fail Fast

When you first match with a therapist, try to fail fast. That means, instead of focusing on getting treatment, focus on figuring out if the therapist is a good match for you. That will enable you to move on quickly if they’re not, and it’s very worth figuring that out early. 

Tell them your goals, story, and vision of your ideal mentor. Ask them whether they think they are a match and what kind of treatment plan they would suggest based on the information you provided. And observe them yourself in your initial interactions, focusing on whether they’re a good match. 

Often, you’ll find that your initial vision of your ideal mentor is incomplete, and you’ll learn through doing therapy what kind of a therapist is the best fit for you.

Choose a Meaningful Small Subgoal to Work on First

This small subgoal should be sufficient to be meaningful and impactful for improving your mental health, but not a big stretch for you to achieve. This subgoal should be a tool for you to use to evaluate whether the therapist is indeed a good fit for you. It will also help you evaluate whether the treatment plan makes sense, or whether it needs to be revised.

Choose a Meaningful Small Subgoal to Work on First

Stay Organized

Too many people let the therapist manage the treatment plan. Especially in online therapy, you need to be on top of things. Take notes on your progress, and re-evaluate how you’re doing every month with your therapist.

Know When to Wrap Up

As you approach the end of your planned work and you see you’re reaching your goals, talk to the therapist about how to wrap up rather than letting things drag on for too long. You don’t want to become dependent on therapy: it’s meant to be a temporary intervention

Some less scrupulous therapists will insist that therapy should never end and that we should all stay in treatment forever, and you want to avoid falling for this line. When you reach your goals, end your therapy unless you discover a serious new reason to continue it. Still, it may be wise to set up occasional check-ins once every three to six months to make sure you’re staying on the right track.

Gleb Tsipursky
Dr. Gleb Tsipursky is a scholar of behavioral economics and neuroscience and former professor at Ohio State University. Aside from writing for Top10.com, Gleb empowers business owners to avoid disasters as a consultant, coach, speaker, and CEO of Disaster Avoidance Experts. He's also the best-selling author of several books, and was featured in over 750 titles in CBS News, Time, Scientific American, Psychology Today, Inc. Magazine, and CNBC.

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.