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Online therapy: Benefits and challenges

Reviewed by Susan Radzilowski, MSW, LMSW, ACSW

A young man sits on his couch wearing headphones and taking a video call on his tablet

What is online therapy?

Online therapy, also called teletherapy, refers to counseling sessions that take place remotely (via video or phone call) instead of in a therapist’s physical office.

Therapy was first conducted remotely in the 1960s, but teletherapy didn’t become popular until the 1990s, when the growth of the internet made it more accessible.1 Remote therapy has continued to become more common as phone and video connections have improved. Its popularity skyrocketed starting in 2020 during the COVID-19 pandemic.2

How does online therapy work?

Teletherapy can take place via a video or phone call. Most clients and therapists prefer video, because it allows you and your provider to see each other’s facial expressions and other body language. But therapy by phone is also a valid and effective method, especially if you don’t have access to the internet or a camera.

Video therapy

Every therapist does video therapy a little differently. Sessions can be conducted over a telehealth-specific platform, such as Doxy.me, SimplePractice, or TheraNest, or over other platforms, provided they’re HIPAA-compliant and offer enough security to protect your privacy.3

Certain platforms require you to download an app, while others work in an internet browser. Almost all platforms ask you to create an account before you start using them. Your therapist will likely tell you before your first appointment which platform they use, how to create a new account, and how to start or join a video call.

You can use a smartphone, tablet, laptop, or desktop computer for video therapy. Any device you use must have a working camera and microphone, as well as a strong internet connection. Be sure to check your equipment before your appointment. Your voice will be audible in your own environment, but you can use headphones if you want to prevent others from overhearing your therapist’s side of the conversation.

Ask your therapist how they accept payment for video therapy. Because your session is online, your therapist can likely process your payment online as well.

Is your information protected when you use online therapy?

Each therapy practice has its own approach to privacy and security. Ask your therapist what steps they take to protect client data, including session notes. They may use a virtual private network (VPN) or a secure telehealth platform.

They should also be conducting their sessions in a quiet, private place—you shouldn’t see partners, housemates, or children wandering in and out of the therapist’s location while you’re in session. If you have any concerns about privacy, express them to your therapist.

Phone therapy

In practice, phone therapy is similar to a regular phone call. You’ll just want to take a few extra steps to protect your privacy.

Be sure to take the call in a quiet, private place. If you’re using a cell phone, choose a place where you have strong reception, and confirm that your phone is charged.

Note that in order to protect your privacy, your therapist is unlikely to text you or leave you voicemail (unless you’re using a platform that specifically offers text communication with your therapist).

Ask your therapist how they accept payment for phone sessions. If you don’t have reliable internet access, you may have to provide payment information over the phone or send a physical check to their office.

Benefits of online therapy

Even with COVID-19 restrictions mostly lifted, experts predict that teletherapy is here to stay.4 That’s because it offers many benefits traditional therapy doesn’t:

  • Convenience: Going to a physical office takes time as you sit in traffic or in a waiting room. Beyond your therapist’s fee, traditional therapy sessions also cost you money in gas, vehicle maintenance, public transportation fees, and time off work. With online counseling, you can schedule your appointment when it’s most convenient for you and have your session without leaving your home.
  • Safety: Teletherapy offered safe access to mental health services during the pandemic, but its safety benefits extend beyond avoiding infectious diseases. With remote therapy, you also sidestep the risk of transportation accidents due to bad weather, heavy traffic, or impaired drivers.
  • Accessibility: Teletherapy can be an accessible option if you have a disability or severe mental health condition that makes travel challenging, such as social anxiety or agoraphobia. Remote counseling also makes it simpler to receive mental health services if you don’t have a car. Online accessibility services, such as screen readers or closed captioning, can make receiving online care easier for people with visual or hearing concerns.
  • Variety of choice: Online counseling opens up your options for choosing a therapist. Instead of being limited to a local provider, you can consider a wider range of therapists licensed to work in your state.

Challenges of online therapy

Teletherapy also presents several challenges, including:

  • Technology barriers: Video therapy requires resources like a computer, video camera, phone, and internet connection. It also requires the ability to use those resources effectively. For some people, these requirements are barriers to treatment.
  • Lack of privacy: It may be difficult to find a quiet, private place for therapy where you live, especially if you share a home with others. You’ll also want to make sure your therapist is using a secure online video platform.
  • Emotional disconnection: Asking for help is a brave and vulnerable act, and seeking therapy is no exception. That’s why it’s important for you to feel safe and connected with your therapist. Beyond possibly losing internet access during a session, you may also find it difficult to connect emotionally with your therapist if you haven’t met them in person. In addition, some younger children who rely on play therapy may find an online setting challenging.

How to prepare for an online therapy session

Take these steps to prepare for your teletherapy session:

  • Find a quiet space: Pick a spot in your home where you won’t be disturbed. If that isn’t possible, consider sitting in your parked car or another quiet space.
  • Speak with family/housemates: Before your appointment, speak with your family or housemates about any privacy concerns you may have. Set clear boundaries by letting them know that you’re not to be interrupted during a session. Also state directly that eavesdropping is a breach of trust.
  • Test your devices: Confirm that your smartphone, tablet, or laptop is fully charged before your appointment. Test your internet connection, camera, and microphone to make sure all three are working.

How to find an online therapist

Finding the right therapist can take time. Follow these steps to get started:

  • Check your insurance plan: Contact your health insurance provider to see if therapy and teletherapy are covered by your plan. If you have mental health coverage, choose a therapist who offers online sessions and accepts your insurance. If you don’t have health insurance, or your insurance doesn’t cover teletherapy, ask your preferred therapist if they offer discounted fees or flexible payment options.
  • Find a provider who’s licensed in your state: No matter where your therapist lives, they must be licensed in your state to offer their services to you legally. As long as your therapist is licensed to practice in your state, they’re also allowed to offer their services remotely. They don’t have to live in a state to be licensed there.
  • Contact potential therapists: If you find a therapist you like, reach out and ask questions to decide if they’ll be a good fit. For example, you may want to ask if they have experience with your particular mental health concern, or if they offer appointments outside traditional business hours.
  • Set up your first appointment: Browse our directory to set up a teletherapy appointment today.

Get help now

If you’re in crisis, you’re not alone. These resources can provide immediate help:

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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