Man speaking with a therapist online from his homeTherapy is just one of the numerous goods and services now regularly accessed digitally, though experienced therapists may have some doubts about this approach to treatment. After all, face-to-face therapy provides valuable opportunities to hear a client’s tone of voice and note their body language and facial expressions. Many long-time practitioners may consider online therapy an inferior approach that limits the development of the therapeutic relationship. 

Research suggests as many as 80 percent of Americans turn to the internet when seeking information about mental health concerns. As we stride farther into the 21st century, more and more people are also turning to the internet for online therapy, or telemental health services, instead of seeking traditional therapy that takes place in a clinic or private practice office.  

What’s behind the rapidly increasing popularity of telemental health? How will online therapy shape the future of mental health treatment? We offer some points to consider below. 

Telemental Health Statistics and Facts

A note: Here, we use the term telemental health to describe therapy offered by a trained, licensed mental health professional through secure video, online chat, or email. While therapy bots or apps may help some people get through brief challenges or tough periods, they shouldn’t serve as a substitute for ongoing therapy with one provider. A true therapeutic relationship is an essential aspect of therapy, and it may be tough to address serious or persistent mental health concerns without this bond. 

Telemental health improves access to therapy services, which increases its appeal to many people. The number of people able to easily access mental health services is far lower than the number of people in need of those services. 

According to the Psychiatry & Behavioral Health Learning Network, clients seeking therapy continue to express their faith in telemental health as a helpful approach to treatment, and research continues to support the benefits of online therapy. 

A 2013 review article published in Telemedicine Journal and e-Health looked at 70 studies published over the previous 10 years and found that telemental health benefits a range of populations: children, young adults, and older adults, including those with diverse multicultural backgrounds. Telemental health addresses symptoms of a wide range of mental health concerns, the study suggests, and seems to be as effective as in-person therapy.

A 2017 review article published in Acta Informatica Medica supports these findings; telemental health can help improve delivery of therapy services worldwide. The review, which looked at 25 articles published in English-language journals over a period of 17 years, found evidence to suggest telemental health offers benefits comparable to in-person therapy. The authors also emphasize that the inexpensiveness of telemental health makes it even more beneficial to people living in rural or difficult-to-access areas.

To support the effectiveness of telemental health, one 2012 study looked at nearly 100,000 veterans who sought therapy between 2006 and 2010. Among the veterans who received telemental health services, hospitalization and number of days spend in a hospital decreased by approximately 25 percent, respectively. 

These findings help explain why many practitioners in a range of mental health fields—social work, psychiatry, counseling, and addiction treatment—have begun including telemental health in their services offered. 

Who Is Searching for Online Therapy? 

Anyone who prefers to avoid in-person counseling might find online therapy helpful. Research points out some women who have been raped or otherwise abused by men might feel more comfortable with video counseling than a face-to-face approach if there are no female providers available.  

People living with agoraphobia or other phobias or anxiety issues that make it difficult to leave home may also prefer online therapy. 

Research suggests many veterans living with posttraumatic stress (PTSD) prefer video counseling to working with a therapist in person. 

Telemental health may also have benefit for children and adolescents who lack adequate access to therapy. According to 2016 research, online therapy delivered in schools helped supplement in-person therapy when insurance, transportation, family difficulties, or other issues blocked access to care. 

Other populations who may seek online therapy include:

  • People with limited mobility
  • People who lack reliable transportation
  • Residents of rural areas or secluded communities
  • People who live in areas with bad traffic
  • Adults caring for small children or older adults

Why Do People Look for Therapy Online? 

Online therapy makes it possible for any person with access to the internet and a secure, private room to access mental health services. This allows many people who might not otherwise seek care to get the support they need. 

But online therapy doesn’t just increase accessibility for people living in areas that lack mental health providers. It also helps break down other barriers, like cost of therapy and stigma associated with seeking therapy. 

Many people who would like to go to therapy simply can’t afford it. Telemental health care offers an option that’s more feasible for many people in need of care. 

Online therapy costs still vary from provider to provider, based on type of therapy offered and other factors. Still, many therapists offer discounted rates to clients they work with online. Some therapists who only offer online counseling may choose to offer rates much lower than standard in-person session rates. 

Finally, it’s important to consider that a number of people may prefer the privacy of online therapy because they feel ashamed of needing help. No one should ever feel ashamed of experiencing mental health concerns or needing support to work through them. But the fact remains: many people do have these feelings. Working with a compassionate counselor can help relieve shame and distress, but without the option of online care, a significant number of people may avoid reaching out at all. 

Disadvantages of Telemental Health

Telemental health care is still an emerging approach, so it’s not perfect. 

Some possible disadvantages to consider include:

  • Inadequate training among providers
  • Possible technical issues that disrupt therapy
  • The need to purchase or subscribe to HIPAA-compliant, secure video software (Skype is not a viable option)
  • Difficulty interpreting body language or nonverbal communication
  • Licensing or insurance requirements to navigate

Telemental health care may seem to invite less connection than a traditional face-to-face therapy session, and it may be awkward at first. But there’s no evidence to suggest telemental health offered by trained and compassionate counselors negatively impacts clients. In fact, the opposite appears to be true. For many people in need, the benefits seem to significantly outweigh the potential downsides. 

Change often presents new challenges to consider, and mental health professionals thinking about incorporating online therapy delivery into their practice should take these challenges into account. However, it cannot be emphasized enough that online therapy, all potential disadvantages aside, increases access to care—which is, in the end, what’s most important.

If you are a mental health professional who provides online therapy, consider becoming a GoodTherapy member to boost your referrals and help people searching for therapy online find you.

References:

  1. Coyle, S. (2018). The continued growth of telemental health. Social Work Today, 18(2), 18. Retrieved from https://www.socialworktoday.com/archive/MA18p18.shtml
  2. Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine Journal and e-Health: The Official Journal of the American Telemedicine Association, 19(6), 444–454. doi: 10.1089/tmj.2013.0075
  3. Kelley, T. (2017, April 13). ‘Telemental’ health is becoming the norm. Managed Care. Retrieved from https://www.managedcaremag.com/linkout/2017/4/26
  4. Langarizadeh, M., Tabatabaei, M. S., Tavakol, K., Naghipour, M., Rostami, A., & Moghbeli, F. (2017). Telemental health care, an effective alternative to conventional mental care: A systematic review. Acta Informatica Medica: Journal of the Society for Medical Informatics of Bosnia & Herzegovina, 25(4), 240-246. doi: 10.5455/aim.2017.25.240-246
  5. Quashie, R. Y. (2015, September 24). Telemental health is booming. Behavioral Healthcare Executive. Retrieved from https://www.psychcongress.com/article/telemental-health-booming
  6. Stephan, S., Lever, N., Bernstein, L., Edwards, S., & Pruitt, D. (2016). Telemental health in schools. Journal of Child and Adolescent Psychopharmacology, 26(3), 266-272. doi: 10.1089/cap.2015.0019