I have been working online for the past few years. The last couple of years, due to Covid lockdowns, this has increased, and at times, this was the only way I could assist my clients.

Prior to that, I conducted therapy in a traditional, in person face-to-face format. I wondered the same things many of us do when considering trying something new: How does this work? What can I expect? Is this vastly different than what I’m used to? What are the possible pros and cons?

Many people have found relief by accessing a qualified therapist from the comfort of their own homes, others raised concerns about whether online therapy might be difficult or risky.

One of the biggest concerns about online therapy is that therapists don’t have an opportunity to observe their clients, something that is usually integral to our work. Tone of voice, body language, and overall demeanour provide insight into an individual’s well-being.

A major component to effective therapy involves the relationship between the therapist and the client. Online therapy can be somewhat more impersonal, so some people have raised concerns about whether digital therapy can provide skills, tools, and healing power to individuals staring at a screen.

Despite the concerns, research consistently shows that online treatment can be very effective for many issues. Here are the results of a few studies:

A 2014 study published in the Journal of Affective Disorders found that online treatment was just as effective as face-to-face treatment for depression.

A 2018 study published in the Journal of Psychological Disorders found that online cognitive behavioural therapy is “effective, acceptable and practical health care.” The study found the online therapy was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalised anxiety disorder.

A 2014 study published in Behaviour Research and Therapy found that online cognitive behavioural therapy was effective in treating anxiety disorders. Treatment was cost-effective and the positive improvements were sustained at the one-year follow-up.

The Potential Benefits of Online Therapy

Online therapy offers benefits over traditional face-to-face treatment:

• People in rural areas or those with transportation difficulties may have easier access.
• Saving travel time and difficulties to park in bigger cities.
• Scheduling is more convenient for many people.
• Therapists can often offer timeslots before or after regular business hours.
• Clients don’t have to worry about seeing people they might know in the waiting room.
• It can be easier for some people to reveal private information when they are sharing it online, some project more authentic versions of themselves from the comfort of their own homes, enhancing vulnerability and disclosure.
• The integrity of the therapeutic relationship is not diluted in any way because we are connecting through a screen.
• Individuals with anxiety, especially social anxiety, are more likely to reach out to an online therapist.

The Potential Drawbacks

Online therapy isn’t for everyone. Here are some potential risks and drawbacks:   

• Online therapy is not appropriate with certain problems or conditions.
• Difficulty to ensure client’s private and confidential setting and environment (flatmates, family members, thin walls).
• Without being able to interact face-to-face, therapists miss out on body language and other cues that can help them.
• Client’s lack of technical skills or knowledge of applications.
• Technological issues can become a barrier. Dropped calls, frozen videos, and trouble with audio are not conducive to good therapy.
• Sites that are not reputable may not keep client information safe.
• It can be difficult to form a therapeutic alliance with someone when meetings aren’t face-to-face.

As you can see, online therapy, like traditional therapy, is imperfect. Is it better or worse than face-to-face therapy? I’d say that depends on perception. Does it have limitations? Sure. But it does appear to be effective for most of my clients.

The experience of online therapy is apparently a reinforcing one; otherwise, it wouldn’t be a rapidly expanding means of providing and receiving therapy. But I leave it to you to decide if teletherapy is the right fit for you.