Is Online Therapy Legit?

You’ve probably heard about online therapy, or e-therapy. It’s often more accessible to those who need it, but is it effective and safe? Here’s what you need to know.

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Therapy can be useful for anyone, whether you’re struggling with mental health issues or not. Sadly, though, it’s not always attainable for those who need it: Therapy can be expensive and difficult to access, especially if you live in a rural area. Online therapy, also known as e-therapy, can make mental healthcare a little more accessible for those who need it. If you struggle to find transportation to a therapist, or if you can’t find a local therapist you like, online therapy could be the answer. Jana Scrivani, PsyD, a licensed psychologist and online therapy expert, says that flexibility is a huge appeal of online therapy. “Online therapy sessions can be held wherever you have an internet connection! Additionally, online therapy makes it possible for people who are unable to get childcare or those with mobility limitations to have more choice and better access to care,” she says.   “We live in a fast-paced society, and for some people, making an appointment and sticking to it is difficult,” says Sal Raichbach, PsyD, LCSW of Ambrosia Treatment Center. Ambrosia’s Family Wellness program offers free therapy sessions via webcam for addicts and alcoholics as well as their loved ones. “Additionally, mental health issues can pop up anytime, and the option of having a licensed therapist to talk to anytime is a tremendous asset to the mental health community,” Raichbach adds. “Those who are handicapped, live in remote areas, or are immobile can also enjoy the accessibility of e-therapy from the comfort of their home.” If you’re considering online therapy, here’s what you need to know.

What is online therapy?

“Online therapy” is a broad term. It could refer to occasionally using video chat to talk to your therapist if you’re traveling or moving to a new city, or it could refer to using portals like BetterHelp or Talkspace to find and talk to a therapist. There are dozens of online therapy portals, each with their own guidelines, drawbacks, and advantages. Online therapy could also refer to using artificial intelligence and chatbots for therapeutic purposes. For example, Woebot is a free-to-use automated conversational agent, or chatbot, designed by scientists at Stanford University. Woebot tracks the user’s mood, helps the user to find potentially harmful patterns in their behavior, and offers tools and strategies to help the user improve their mood and work through their struggles. In a trial, it was found that Woebot reduced depression and anxiety in users. Another example of a therapy chatbot is Wysa, which is also free. Most online therapy—whether it involves talking to a real therapist or a chatbot—relies on talk therapy and cognitive-behavioral therapy (CBT) techniques. This involves discussing your thoughts, feelings, and actions, and processing them. It also involves noticing and breaking potentially harmful patterns of thought and behavior. It aims to make you more aware of your moods, and it’s one of the most widely-used and studied forms of therapy for mood disorders.

Does online therapy actually work?

Online therapy might sound good, but is it an effective alternative to in-person therapy? Both Scrivani and Raichbach note that online therapy can be just as beneficial as face-to-face therapy. Studies have suggested that online therapy is an effective form of treatment for depression and anxiety as well as post-traumatic stress disorder. One 2013 study suggested that online therapy was just as good as face-to-face therapy. Of course, there are some limitations to online therapy, Raichbach says. Communication is an essential element of therapy, and if that communication is compromised, it will influence the effectiveness of your treatment. “When it comes to chat therapy, where a therapist and client are joined by text or instant-message chat, there can be some things that get lost in translation,” he explains. “If you think about how often context is misunderstood when you are texting a friend or family member, you can understand why this isn’t ideal for a long-term therapeutic relationship.” Additionally, online therapy can be difficult if the client doesn’t have regular access to a stable internet connection. However, Raichbach adds, online therapy can still be a more accessible alternative to face-to-face therapy—and some therapy is better than no therapy. “For someone who is nervous about therapy or doesn’t have a lot of time on their hands, it can be a great way to get their feet wet,” he adds. Some clients may be more comfortable seeking in-person therapy after they’ve experienced online therapy, so it can be a useful first step.

Will my privacy be protected in online therapy?

Many of us are increasingly aware of our online privacy—or lack thereof—especially when it comes to social media. Understandably, when it comes to e-therapy, many of us have privacy concerns too. After all, you’re telling someone your most intimate thoughts. However, there are certain laws that protect your privacy when you speak to your therapist online. “Online communications between a client and therapist should be held to the standards outlined in the Health Insurance Portability and Accountability Act, or HIPAA, which is a law governing the privacy and security of electronic health information,” Scrivani says. HIPAA applies to all healthcare providers in the United States. “There are platforms that are encrypted and meet HIPAA standards for privacy protection, and these are the platforms which should be used for tele-mental health.” Scrivani adds that apps like Skype and Facetime are not HIPAA compliant. “In the event that there are questions about the use of unsecure platforms like email, your therapist should review the risks to your privacy with you prior to your agreement to use them,” she says. Before you sign up with an online therapy platform, take a look at their privacy policy. Is the platform HIPAA compliant? If it’s not a platform based in the U.S., what laws are there to protect your privacy? Any therapist or platform providing online therapy should be willing to explain how they address issues of privacy and safety.

How do I choose an online therapist?

There are many ways to start online therapy. You might see a therapist in person, and they might suggest you use an online platform to continue therapy if you’re traveling or if you move away. You might also start looking for an online therapist through different platforms—but what exactly should you look for? If you’re deciding between different therapy platforms, make sure they comply with HIPAA or whatever privacy laws are relevant in the country where they’re based. It is also important to make sure therapists have been adequately screened. “Potential clients should look for an online therapy platform that diligently screens their therapists. This is not only a safety concern, but will ensure that the therapist is qualified and capable of doing their job,” Raichbach says. It could also be beneficial to seek a specialized therapist. “When choosing an online therapist, it’s important to make sure that individual is qualified to give the type of treatment you require,” Raichbach says. “For instance, if you are having relationship issues, it would be wise to find a marriage or family counselor or someone who has experience in that subfield, rather than one that has a generalized psychology degree.” Some online therapy platforms will give you a quick questionnaire and match you to a therapist who’s best suited to your needs. Remember that once you find a therapist, it’s not set in stone; you can always look for a different one later if you decide they’re not a good fit. Many online therapy platforms allow you to look for another therapist quickly and easily if you don’t like the one originally assigned to you. Before you pursue therapy of any kind, Raichbach suggests thinking about your goals and reasons for pursuing professional help. Ask yourself, What do I need help with? Which issues do I want to discuss? What do I want to get out of seeing a therapist? To see the benefits of therapy, online or off, both sides must put in some work. It’s very effective in improving mental health, Raichbach says, “but the person seeking help must be willing to work towards those goals with the help of their therapist.”

Digital Tools for Mental Health Beyond E-Therapy

In addition to e-therapy and CBT chatbots, technological improvements mean there are a number of other apps that can be used to support our mental health. Examples include:

  • Meditation apps like Headspace, which is available for both iOS and Android
  • Apps that help you make or break habits, like The Fabulous, also available for iOS and Android
  • Apps like Happify, available on iOS and Android, which help you break negative patterns with exercises that improve your mental wellness
  • Productivity apps that can help people who struggle with executive dysfunction and concentration; try Tide for iOS and Android, or Todoist for iOS and Android

These aren’t alternatives to therapy, and they won’t fulfill the role of a licensed mental healthcare provider, but they can support your mental health. Online therapy is revolutionizing mental healthcare, making therapy more accessible to those who need it. Despite its limitations, many people are benefiting from having mental health support at their fingertips. In what ways do you embrace modern technology to support your own mental wellness? Check out Senior Editor Maggie’s piece on apps that she turns to for a pick-me-up and our guide to making the most of a digital detox.

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