Whether you’re seeking therapy for stress, relationship difficulties, bereavement, depression, anxiety, or another mental health problem, online therapy may be a practical solution. Here’s what you need to know.
Online therapy can take several forms. Some therapists offer online therapy through their private practices, while others use third-party platforms, such as apps or directories, to connect with patients. Some of these services may limit your contact with a therapist to email, messaging, or live texting, while others include weekly phone calls or live video sessions.
Like traditional, in-person therapy, online therapy can treat many different mental and emotional health problems. Talking to a professional can help you overcome obstacles in your life, gain awareness of the root cause of your problems, manage symptoms, and heal.
But you don’t have to be dealing with a diagnosed mental health problem, such as depression or anxiety, to benefit from therapy. If you’re going through a difficult time in your life, such as a bereavement, divorce, or unemployment, therapy can help. Even if you’re facing everyday concerns like overwhelming stress, low self-esteem, or trouble sleeping, the right therapist can provide expert support and guidance and help you make positive changes.
Online therapy may not be the right choice for everyone. Deciding if it is your best option can depend on a variety of factors, including the mental health condition you’re dealing with, the severity of your symptoms, and the choices available to you.
Decades of evidence-based research point to in-person therapy being an effective way to treat many different mental and emotional health problems. Since online therapy is a far newer form of therapy, there hasn’t been nearly as much research into its effectiveness.
The studies that have been conducted show some encouraging results. However, some mental health experts argue that it is still too early to say whether online therapy is an adequate alternative to (or replacement for) in-person therapy. Still online therapy—and online therapy platforms, in particular— might be a convenient first step, especially if you’re new to therapy or looking to schedule an appointment as soon as possible.
Even today, a lot of us have limited options when seeking mental health care. For many, the choice isn’t between online therapy or in-person therapy, but rather between online therapy or nothing. Any mental health expert would agree that, with very few exceptions, any type of therapy is more beneficial than no therapy.
How effectively online therapy works for you may well depend on the same factors that determine the success of any type of therapy: the kind of problem you’re seeking help for, the ability of your therapist and the level of connection you make with them, how much you’re able to open up, and the work you’re willing to put into the process.
In addition to attending your sessions, you need to apply what you’re learning to real-life situations and make healthy lifestyle changes that can support your mood and emotional health. While no therapist—online or in-person—can do the hard work of healing and growth for you, a good online therapist can use the available technology to help you gain new insights and improve your well-being.
How you choose to have your sessions may also impact therapy’s effectiveness. While being able to call, email, or message your therapist between live sessions can be extremely helpful, many experts feel that it’s most effective when used in addition to face-to-face interaction via video, rather than as a replacement for it. Since connecting via video provides the closest experience to traditional, in-person therapy, it’s most likely to offer the same rewards.
Body language and other nonverbal cues play an important role in how we communicate. Your facial expressions, mannerisms, posture, and tone of voice can convey far more than your words alone. In a therapy setting, the subtleties of nonverbal communication can be crucial in helping the therapist pick up on any inconsistencies between your verbal and nonverbal responses. It can also help them recognize the things you may be unwilling or unable to put into words, and understand the true meaning behind what you’re saying.
In the case of text- and phone-based therapy, if a therapist misses some important clinical information only revealed by your body language, it could impact their assessment and approach to counseling. For instance, they might not see fingernail-chewing or muscle twitches that might come with anxiety.
Interacting face-to-face with a therapist—even on a video screen—can better help you forge a connection with them that’s so important to the success of therapy. It’s much easier to build trust with someone when you can see the emotions and empathy they’re communicating nonverbally—rather than just reading their written messages or listening to a faceless voice.
The potential benefits of online therapy can vary depending on where you live, the options available, the quality of providers you can find, and the mental health issue you’re dealing with. What is a benefit to someone else may not necessarily benefit you.
Some of the possible advantages of online therapy include:
Access. Online therapy has made therapy more accessible for many underserved communities. If you live in a rural area, have mobility issues, or suffer from a condition that makes it difficult to leave your home—such as agoraphobia or social anxiety disorder—seeking care in-person can be challenging. Having access to therapists from a wider geographical area may also increase your chances of finding a therapist who truly understands your needs. For instance, you might want a therapist who specializes in a specific type of therapy or matches your gender or cultural preferences. You may also find that switching between therapists may be easier online than in person.
Online therapy could also potentially cut down the time you have to wait for sessions. When relying on local therapists, you might have to endure long wait times due to the disparity between the number of available providers and the number of people who want therapy. Depending on therapist availability, it’s possible to create an account with an online therapy platform and schedule a session within the same week, or even the same day.
Convenience. When you’re wrestling with a mental health problem, having to travel to a therapist’s office—spending time fighting traffic or dealing with public transport, arranging childcare, cutting out of work early—may feel overwhelming, another chore on your list to check off. Talking to a therapist online can offer more flexibility and convenience. It may also allow you to have more frequent contact with your therapist, or may even keep you returning to therapy when you’d otherwise be tempted to quit.
Savings. In some cases, online therapy may be less expensive than traditional therapy. Your insurance co-pays are usually the same for in-person and online therapy, and if you pay out-of-pocket for a private therapist, they usually charge the same whether you see them online or in their office. However, if a therapist works exclusively online, not having office overheads can mean they charge less than in-person providers. Of course, having therapy online can also save you transport, parking, and childcare fees. You may also be able to save if you’re paying out-of-pocket on an online therapy platform. Some offer monthly subscriptions that can make the per-appointment cost lower than many in-person providers.
Comfort and safety. A lot depends on your home environment, how free it is of distractions, and the type and severity of your symptoms. But seeing an online therapist from the comfort and security of your own home could potentially help you feel more relaxed. This sense of ease and comfort can make it easier to open up to your therapist and divulge more than you might be able to in an unfamiliar office.
Messaging between sessions. When you meet with a therapist for just an hour a week, it’s sometimes difficult to recall everything you’ve been through in the preceding week. Being able to email or message your online therapist between live sessions can be extremely helpful. It gives you an opportunity to share your emotions and concerns as they arise. It can also be useful in keeping track of your progress and monitoring any setbacks. While some in-person therapists may also offer such a service, this type of messaging is more likely to be available on an online therapy platform.
Reduced stigma. Many people feel judged when seeking treatment for mental health issues. You may feel more comfortable receiving treatment online rather than visiting a therapist’s office to avoid bumping into someone you know in the parking lot or waiting room, for example. Some people find that online therapy can serve as an entry point to mental health care. Once you overcome the stigma and barriers to care, you may feel able to try traditional in-person therapy.
Online therapy isn’t right for everyone, and there are situations where in-person therapy may be the better option. Some possible downsides of remote therapy include:
May not be appropriate for all conditions or all situations. Online therapy may not be the best option for all patients and all mental health conditions, especially when you’re dealing with a serious mental health disorder, your symptoms are severe, or you’re having suicidal thoughts and feelings. If you don’t have access to a relaxed, secure space for your therapy sessions, you may also want to consider in-person therapy if that is a choice open to you.
Technical issues. With online therapy, you’re reliant on your own (and your therapist’s) comfort with technology, as well as the speed of your internet connection, reliability of your devices, and the quality of any app or other software used by a provider. If you’re unable to stream movies online, it’s unlikely you’ll be able to sustain an uninterrupted video chat with a therapist. Of course, even the best connections, equipment, and apps can experience problems at times, disrupting your therapy session.
Loss of emotional connection and missed nonverbal cues. When you’re not physically sharing the same space as your therapist, you might find it harder to connect emotionally. Even when talking via video, some body language signals can also be lost.
Unqualified providers. As with seeking any service online, there’s always the risk of falling prey to an unqualified or disreputable provider. It’s important to always check a therapist’s credentials or use a reputable third-party service that screens all the counselors on their list.
Lack of regulatory guidelines. Research has highlighted a lack of standardized regulatory guidelines for online therapy as a major ethical issue. While professional organizations such as the American Psychological Association (APA) and the American Association for Marriage and Family Therapy (AAMFT) offer guidelines on best practices for their members operating online, regulations can often vary greatly by state. There is no single agency that regulates online therapy licensing, training, best practices, informed consent, or cross-border practice.
Privacy, confidentiality, and security concerns. Other potential drawbacks to online therapy are issues relating to security and privacy. Unsecured websites, unencrypted communication tools, compromised data security, and possible breaches of confidentiality are concerns for many of us when using online therapy. To learn how to protect yourself, see the section below on the privacy of your health and data information.
Financial gain being prioritized over patient care. With online therapy becoming so popular, more and more companies are moving into the space to offer services or different ways to connect you with an online therapist. There is always the danger that some of these companies are motivated far more by financial gain than the best interests of the people they serve.
If you require immediate, in-person support during a mental health crisis, an online therapist may be limited in the responses they can offer. Similarly, if you experience a crisis during a session, it may be harder for an online therapist to ensure you get quick and direct help, especially if your location hasn’t been verified or your online connection is interrupted.
When you sign up for an online therapy platform, you’ll likely be screened for crisis intervention. If you’re experiencing suicidal ideations or self-harming thoughts, most platforms will refer you to more appropriate sources of help, such as crisis helplines or emergency services. While at least one platform we’ve tested does offer a specialized crisis care program aimed at suicide prevention, it requires a referral from a mental health provider.
If you’re set on exploring online therapy but are currently suffering from a severe mental health problem or have a history of experiencing crises, you may want to look for a private therapist who offers online counseling—ideally one who is familiar with crisis intervention.
In the United States, your health records and the interactions between you and a health care provider are protected under the Health Information Portability and Accountability Act (HIPAA). This means that everything you say to a therapist—whether it’s in-person or online—stays between you, with the exception of a few specific situations, such as you being an immediate danger to yourself or others. In all other circumstances, the thoughts, feelings, and beliefs you express to your therapist cannot be revealed to anyone else. Other countries have similar protections.
However, online therapy platforms may still be able to collect data on you for marketing or research purposes. This data could include email and IP addresses. Some may even share anonymized questionnaire information or medical data, such as your therapy notes.
Before signing up for an online therapy platform or website, or choosing a therapist from a directory or other source, there are steps you can take to protect your sensitive information. Organizations such as the U.S. Department of Health and Human Services (HSS) and the nonprofit Mozilla Foundation recommend you:
In the United States, mental health professionals who provide therapy or counseling services online are usually required to be licensed in the state where they practice. While online therapy can offer you access to therapists who are not in your local area, state licensing requirements vary greatly.
No federal law allows providers to practice online therapy across state lines. However, some states allow telehealth registration for out-of-state providers, and some states have signed agreements (such as PSYPACT for psychologists) that allow professionals to practice across state boundaries without the need for additional licenses.
The designation or types of licenses can also vary by state, and each has different requirements in terms of education, qualifications, and scope of practice. When searching for an online therapist, the most common designations you’re likely to come across are:
Psychologist (PhD or PsyD). A psychologist holds a doctoral degree (a doctorate in philosophy, a Ph.D., or a doctorate in psychology, a Psy.D.). They are trained to assess and diagnose mental health conditions, and are licensed to provide individual and group therapy. A psychologist undergoes between 1,500 and 6,000 hours of supervised clinical practice, depending on the state, and may be more likely to treat severe mental illnesses. Broadly speaking, a PsyD spends more time than a PhD studying clinical techniques and less time conducting research.
Licensed Professional Counselor (LPC) and Licensed Mental Health Counselor (LMHC). An LPC or LMHC holds a master’s degree and tends to be less focused on assessment and more on individual talk therapy to help address immediate mental health and life challenges. Therapy from these counselors tends to be shorter term, more goal-oriented, and aimed at individuals.
Licensed Marriage and Family Therapist (LMFT). Like an LPC or LMHC, a therapist with an LMFT license is a health care professional educated to a master’s degree level. But since their training is more focused on relationship dynamics, they specialize in relationship, couples, marriage, and family counseling, rather than individual therapy.
Licensed Clinical Social Worker (LCSW). A LCSW is another master’s-level professional. In addition to training in case management, advocacy, and how law, policy, and other social influences can impact mental health, clinical social workers are also trained to use talk therapy to treat mental and emotional health issues.
“Associate” prefix. If an online therapist has “Associate” as a prefix—Associate Professional Clinical Counselor (APCC) or Associate Clinical Social Worker, for example—that essentially means they are a therapist in training. They have completed the education portion of their license and are now undertaking supervised clinical experience in order to obtain a full license.
A therapist, such as a psychologist, licensed counselor, or clinical social worker, treats mental health issues using psychotherapy. While there are “prescribing psychologists” in some states, generally, therapists are NOT able to prescribe medication.
A psychiatrist is a medical doctor (MD or DO) specializing in mental health who can prescribe medication. Consider consulting an online psychiatrist if you have a severe mental health condition that requires medication as well as therapy, or if you have a medical issue accompanying your mental health problem. In most cases, a psychiatrist will provide only medication management, and not therapy.
Whether practicing online or in-person, a therapist must be licensed by their state board. Before starting online therapy, you can check whether a therapist is licensed by searching the state licensing board.
In most cases, checking your state’s licensing board will not only confirm whether a therapist is currently licensed, but also if they have a record of disciplinary or ethical violations or license suspensions.
The key to any type of therapy—online or in-person—is to find the right therapist for you. Qualifications, experience, and philosophy can be important, but it’s the relationship you build with the therapist that will often define the success of your therapy.
Finding the right online therapist can take some time and effort, so don’t be afraid to ask questions, read reviews, and take advantage of any free introductory sessions. An online therapist will become your partner in healing, recovery, and growth. So, it’s essential to choose someone who makes you feel understood, supported, and cared about. You need to trust this person enough to talk comfortably about intimate and often difficult subjects and to be honest about what you’re thinking and feeling.
Compare private therapists, platforms, and directories. All may offer different services, but give preference to online therapists who provide weekly live video sessions. These live sessions allow you to connect face-to-face in real time, rather than just text and messaging therapy services.
Do your research. It can sometimes feel overwhelming to scan a long list of available online providers. Understanding a little about the different types of therapy and therapists can make it easier to make a selection. For example, you might decide that you want to try out a certain type of therapy, such as dialectical behavior therapy (DBT), which focuses on mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. Although there are many different approaches to therapy, cognitive behavioral therapy (CBT) is often the most widely used in online therapy, perhaps because it translates most readily to the virtual format.
Be open to change. Once you’ve chosen a therapist, be open to making a change if it doesn’t feel right. Trust your instincts. An advantage of selecting an online counselor from a third-party service is that it may be easier to keep changing therapists until you find one that’s a good fit for you.
Understand what you want to achieve. The clearer you are about your goals for starting therapy, the easier it will be to measure your progress and ensure you’re getting the most out of the process. You may want to address a specific mental health problem, for example, or cope with a particular aspect of your life that’s not working. Whatever your reasons, make sure you communicate them to your therapist and ensure they’re being addressed during your time together.
Be open and honest with your therapist. It’s common for uncomfortable or even painful emotions to arise during therapy. Open up and share your feelings with your therapist. If something is too difficult to talk about, let them know. The more open and honest you are, the better your therapist will be able to help you.
Be prepared to put in the work. Online therapy requires more than just logging on to talk once a week. A counselor may give you homework to do between sessions or ask you to try out techniques in real-world situations. To get the most from the experience, be prepared to put in the time and effort. And if you find yourself frequently skipping therapy sessions, ask yourself why—and discuss it with your therapist.
Limit distractions at home. Talking to a professional from the comfort of your own home is extremely convenient—but you’re not going to get as much from therapy if your sessions are disrupted by kids, other family members, noisy neighbors, phone calls, or other interruptions. Choose a time for therapy when your home is at its quietest, ask other family members not to disturb you, turn off your phone, and mute any other apps.
Ensure you have a fast and reliable internet connection. If your sessions are frequently interrupted by connection or computer problems, you might feel frustrated or discouraged. Address any technical issues you experience, whether that’s by upgrading your internet speed or updating the software or app you’re using.
There are multiple options out there when it comes to finding an online therapist.
BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.
Take Assessment HelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site. Learn moreWhen looking at online therapy platforms, here are some considerations to keep in mind:
Does the service fit your needs? You can narrow down your choices by considering your therapy goals and needs. For example, a platform such as BetterHelp focuses mostly on individual therapy, while Regain, its sister site, focuses on couples counseling. If your needs include medication, check to see if the providers in the network include psychiatrists who can write prescriptions.
How quickly will therapy start? Many of the most popular online therapy platforms aim to match you with a therapist within two days. Of course, match time depends on the availability of suitable therapists, so your stated preferences and needs—as well as where you’re located—may play a role here. In some cases, you might even be matched in just a few hours.
How easy is it to switch therapists? Some services match you with multiple therapists, and then you get to choose one. You can typically choose to switch to a different therapist if you decide your initial match isn’t right for you, which happens a lot in any type of therapy. Check the service’s policy on switching providers and whether that will affect the timing of your sessions.
Can you search for therapists who match your preferences? Finding a therapist who understands your sexual orientation, cultural background, or how mental health is viewed in your community can be important to establishing a rewarding connection. Some services specifically enable you to search for LGBTQ+ providers, therapists of color, or counselors with the same cultural background, among other criteria.
There are a number of online services and directories that cater exclusively to certain groups. For example:
The cost of online therapy can vary considerably according to where you live in the world, the health benefits you have, and the type of services being offered.
In the United States, health insurance plans often cover online therapy, but this may vary based on your plan and the therapist or therapy platform you use. Private practice therapists often list the insurance plans they accept, while some of the platforms that accept insurance allow you to submit your details and check if you’re covered. You can also reach out directly to your insurance company to find which therapists or services are in-network.
If you don’t have insurance or if your plan doesn’t cover the online services you want, you might still have options. Here are some opportunities to consider:
When you’re searching for private practice therapists or browsing a directory of providers, you may be able to filter results by the type of insurance accepted.
When it comes to therapist-matching platforms, some may accept insurance from popular insurers, as well as Medicare or Medicaid.
Whatever country you live in, you also have the option of paying for online therapy out-of-pocket, either directly with a private practice therapist or through an online therapy platform.
Many third-party services offer monthly or yearly subscriptions that may help to reduce the cost, or packages that allow you to purchase multiple sessions at a discounted rate. Before signing up for a subscription-based service, though, you may want to inquire about the following:
How long does the subscription cycle last, and when will you be billed? It’s important to understand how much you’re paying per week and how often you’re billed. Some services list their weekly prices, but you may actually be billed on a monthly basis. Also, check to see if you’ll be charged before a therapist match is made.
What’s included in the subscription, and how flexible is it? An online therapy subscription will probably cover a specific number of live sessions each month. But are other services, such as group therapy sessions and messaging also included?
If the service has multiple subscription levels, you’ll also want to know if it’s possible to switch to a different plan. Ask how changes in your sessions may affect your next billing statement. Will missing a session result in a refund? How much will additional sessions cost?
It’s also a good idea to research the cancellation policy in the event you want to switch services or simply decide that online therapy isn’t right for you.
If you’re living in the UK, you may have access to free counseling through the Talking Therapies program run by the National Health Service (NHS). You can either seek a referral from your GP or self-refer.
You might have to wait several weeks for someone from the service to reach out for an assessment of your symptoms. If you’re approved, NHS says that waiting times for the first session will vary. Data from the NHS shows that most people who receive a referral for the Talking Therapies program receive their first appointment within six weeks .
Depending on the recommended course of treatment, you may only be offered a limited number of sessions.
Online private therapy options—including BetterHelp, Online-Therapy.com, and Talkspace—can serve as faster alternatives to the NHS program. You may also get more flexibility when it comes to switching counsellors, choosing a therapy approach, and booking appointments.
In Canada, you’ll find that mental health services may be free in government-funded clinics and hospitals or covered by provincial health plans. But, similar to the UK, the wait times can be long.
According to the Canadian Institute for Health Information, half of Canadians end up waiting roughly a month for ongoing counseling services. You may find yourself waiting nearly five months. Part of this is because there’s a limited number of mental health professionals compared to the population in need.
Again, private therapist-matching services like BetterHelp, Talkspace, and Online-Therapy.com are also available to you in Canada.
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