Thanks to the digital and technological advancements that have reshaped the 21st century, mental health services are now more available and accessible than ever. From valuable self-help tools (like articles, videos, e-books and guides) to trained mental health professionals, everything is one click away. Did you know that there are web-based platforms where you can book an online therapist? That’s right! You can benefit from quality counseling and therapy services without having to leave the comfort of your home.

What is an Online Therapist?

There’s not much difference between an online therapist and a “traditional” therapist. Both focus on providing mental health services that help you cope with emotional or behavioral issues.

But unlike “traditional” therapists, online therapists deliver their services via online channels. That means you can carry out your sessions through video conferences, audio calls, or even text messages.

Online Therapy

At this moment, online therapy is one of the simplest, most accessible ways to get in contact with a licensed professional who can help you deal with your emotional or behavioral problems.

This new approach to mental health is especially useful for people with disabilities, for whom going to a mental health clinic might be a considerable challenge. It’s also an excellent alternative to “traditional” mental health care for people living in isolated areas.

How Does it Work?

As the name suggests, online therapy takes place via online communication channels; making it easier for you to get in touch with a professional.

Some of the main communication channels used by online therapists are:

  • Video conferencing
  • Instant messaging
  • Real-time online chat
  • E-mail
  • Audio call

Traditional Therapy vs Online Therapy

As mentioned before, the only notable difference between traditional and online therapy is the communication channel through which the therapeutic process takes place.

In terms of quality and efficiency, both approaches seem to be equally valid for a broad range of conditions. In fact, some experts recommend the use of both online and offline counseling services to increase the chances of recovery.

For example, one study published in Psychotherapy and Psychosomatics, suggests that a mix of online self-help and inpatient psychotherapy can lead to significant improvements in depressive disorders.

What Can Online Therapy Help With?

Most experts claim that online therapy is an excellent solution for people who struggle with problems like depression, anxiety, or stress. It has also been suggested that online therapy can help people who suffer from mental health issues like post-traumatic stress disorder. But what do researchers have to say about online therapy services?

Two recent studies, published in JAMA Psychiatry, revealed that web-based cognitive behavioral therapy is an effective intervention for insomnia and suicidal ideation.

Furthermore, one study (published in Behavioral Modification) concluded that web-based acceptance and commitment therapy can work wonders for college students who struggle with alcohol use, eating disorders, or hostility.

Overall, it seems like there’s plenty of evidence supporting the effectiveness of online therapy for behavioral health and mental health as well as assisting those who suffer from mental illness.

Benefits of Online Therapy

To help you understand how online therapy can make a huge difference, let’s look at a 2015 study published in The Journal of Medical Internet Research.

According to this study, online therapy can help people with PTSD who live in war-torn countries and don’t have access to “live” therapy sessions.

This is an excellent example of how an online therapist can provide support to people who don’t have access to inpatient or outpatient mental health clinics. Online therapy can also help you to avoid stigmatization and it creates an ideal opportunity for keeping your life private.

Online Therapist: Training and Qualifications

In broad lines, online therapists are required to complete the same training courses and follow the same qualification procedures as any other types of therapists. They also have to comply with the same practice guidelines.

Fortunately, most online therapy platforms do serious background checks to make sure the therapists listed on their websites are in fact certified professionals.

Ethics of Online Therapy

Ethical and legal issues can raise many questions for people who wish to contact an online therapist. In general, online therapy should be governed by the same ethical and legal standards as “traditional” therapy.

But can we be sure that a platform providing this service doesn’t share our personal information with a third party? What about the counselors and therapists listed there? Are they certified professionals?

First of all, therapists should ALWAYS obtain informed consent from their clients, regardless of the channel through which they provide their services.

Secondly, it’s up to you to gain as much information as possible and to clarify any possible dilemmas, before you decide to work with an online therapist.

For more details, you can visit the National Board for Certified Counselors website.

Finding the Best Online Therapy

It is important that you search for the best online therapy suited to your particular situation. Do your research and learn from others.

We have studied online therapy platforms to make your search easier.

What is the best online therapy platform?

Our top pick is BetterHelp 

BetterHelp is the largest e-counseling platform worldwide.  Their mission is: “Making professional counseling accessible, affordable, convenient – so anyone who struggles with life’s challenges can get help, anytime, anywhere.”

 Pros and Cons of the BetterHelp Platform

PROS:

  • Flexible: Users have a wide range of multi-modal options including messaging, phone calls, live chat, and video chat to access the services
  • Reasonably priced: At $65 a month, which is comparable to other online therapies like TalkSpace at $ 65-$99, and ReGain at $40 to $70 
  • Backed by clinical results: BetterHelp has been found to be comparable to face-to-face counseling(details below)
  • Personalized: Profile match of clients to therapists are managed based on the therapists skills sets and the clients’ problem area

CONS:

  • They do not have a suicide or self-harm hotline

 How does BetterHelp vet their therapists?

BetterHelp has a database of 3000 licensed and accredited psychologists, psychologists (PhD / PsyD), marriage and family therapists (LMFT), clinical social workers (LCSW / LMSW), and licensed professional counselors (LPC). The advantage that BetterHelp has over sites like TalkSpace is that the profiles of the therapists are available for the clients to view.

The induction requirements are strict to ensure only experienced and thoroughly qualified therapists are made available through their platform: 

  •       Each of them must necessarily possess a Masters Degree or Doctorate
  •       They must have a minimum of 3 years and 2,000 hours of in-clinic work
  •       The screening includes:
    • Correct licensure documentation
    • Proof of identity
    • Medical references from licensed therapists
    • Verified licensure information from the state licensing board.
    • Completed case study exam by a licensed clinician
    • Evaluation by a video interview

Induction requirements at BetterHelp: https://www.betterhelp.com/faq/

What do BetterHelp therapists specialize in?

BetterHelp offers its services within a defined range of mental health issues: including: 

  • Stress, 
  • Anxiety, 
  • Relationships, 
  • Parenting, 
  • Depression, 
  • Addictions, 
  • Eating, 
  • Sleeping, 
  • Trauma, 
  • Anger, 
  • Family conflicts, 
  • LGBT matters, 
  • Grief, 
  • Religion, 
  • Self-esteem and more.

They state clearly that they are not the right platform for cases involving:

Minors, self-harm or suicidal issues, emergency, severe mental illness, psychiatric care, court ordered therapy and such.

What type of clients are BetterHelp therapists best for? 

The BetterHelp services are geared towards individual therapies, couples counseling, as well as teen counseling (they offer added assistance for teen counseling through their sister site TeenCounseling.com).

How does BetterHelp work?

Since it’s an online service, the process starts with a series of questions that you need to fill online. The questions cover vital aspects of the issue you need help with, your medical history, as well as certain basic demographics like gender, age, and marital status. The counselor to client match is made within 24 hours, based on the profile you described, your specific issues as listed, and your wellness goals.

Once the therapist match is done, you are allotted a secure chat room where you can share your thoughts and concerns via messaging at any time. BetterHelp online services are available in four modes: You may use any platform that suits your mood, accessibility, or need of the moment. You could select the messaging or chat options for a more anonymous interaction, or use phone and video calling options for a more personalized experience.

The online services are available through these mediums: phone, tablet, or computer.

  •     Chat room messaging:
    • You can log-in and post your queries, thoughts, concerns at any time, without waiting for an appointment.
    • Once active, you are assigned a dedicated chat window where you can message your assigned therapist.
  •     Live chat:
    • This is a scheduled live interaction, using a dedicated chat window
    • You have a defined period of time where you may connect with your therapist in real time
  •     Phone:
    • As with the live chat, you will need to log in to the chat room at a pre-scheduled time
    • The system will ask for your number and call you at the scheduled time (please note, your number is never shared with the therapist)
  •     Video conferencing:
    • The video chat is the most personal, live interaction option available
    • You may log into your chat room at the scheduled time

How much does BetterHelp cost?

The entire range of online therapy services can be accessed at a subscription of $65 per month. This entitles the client to unlimited messaging and chatting, 24/7.

BetterHelp online services have been proven to be as effective as face to face counseling for most situations by the independent Berkeley Wellness Institute study, except for specific issues concerning self-harm, extreme mental illness, etc. They do have an offline alternative where one can visit the office for a face to face consultation, for an approximate fee of $150 per session. 

While some clients use the services for a certain period of time and pause when they start feeling the positive effects of the therapy, many go on to making BetterHelp a part of their regular lives.

Why we like BetterHelp?

BetterHelp is our top pick counseling platform for a few reasons:

  • An independent Berkeley Wellness Institute study has found BetterHelp to be an effective alternative to face-to-face therapy* 
  • 98% of BetterHelp clients made significant progress 
  • 94% actually prefer BetterHelp over face to face therapy for reasons like BetterHelp’s quality of therapy, anonymity, affordability, and ease of access anytime
  • 70% of the clients showed reduced depression symptoms with the use of the platform’s services
  • The most progress was exhibited by clients who used BetterHelp’s services without having tried any face to face therapy previously
  • BetterHelp has the largest database of therapists 
  • BetterHelp therapists are screened through a stringent process which only 15% of applicants pass
  • The complete licensing information of each therapist is disclosed to the client for transparency and comfort in the assigned counselor. BetterHelp makes it easy for the client to switch counsellors at any point.

*The results are based on a validated Patient Health Questionnaire (PHQ) that is a self-reporting measure frequently used in clinical studies to monitor depression symptoms and anxiety. There is a series of questions around 10 benchmarks that assess how the patients have been feeling over the past two weeks. The PHQ was filled in by the respondents at the beginning of the study and then again after 90 to 104 days of online counseling. Both results were plotted against each other to understand the improvement in the mental health of the patient. 

Questions to Ask a Potential Therapist

Here’s a couple of questions you can ask your potential future online therapist:

  • How does online therapy work?
  • For how long have you been practicing online therapy?
  • What happens if the platform/communication channel goes down?

References:

  1. R. Zwerenz, J. Becker, R. J. Knickenberg, M. Siepmann, K. Hagen and M. E. Beutel, “Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach,” Psychotherapy and Psychosomatics, vol. 86, pp. 341-350, 2017.
  2. L. M. Ritterband, F. P. Thorndike and K. S. Ingersoll, “Effect of a Web-Based Cognitive Behavior Therapy for Insomnia Intervention With 1-Year Follow-up,” JAMA Psychiatry, vol. 74, no. 1, pp. 68-75, 2017.
  3. C. Guille, Z. Zhao and J. Krystal, “Web-Based Cognitive Behavioral Therapy Intervention for the Prevention of Suicidal Ideation in Medical Interns,” JAMA Psychiatry, vol. 72, no. 12, pp. 1192-1198, 2015.
  4. M. E. Levin, J. A. Haeger and B. G. Pierce, “Web-Based Acceptance and Commitment Therapy for Mental Health Problems in College Students: A Randomized Controlled Trial,” Behavior Modification, vol. 41, no. 1, 2016.
  5. C. Knaevelsrud, J. Brand, A. Lange, J. Ruwaard and B. Wagner, “Web-Based Psychotherapy for Posttraumatic Stress Disorder in War-Traumatized Arab Patients: Randomized Controlled Trial,” Journal of Medical Internet Research, vol. 17, no. 3, 2015.
  6. K. Cherry, “Ethical and Legal Issues in Online Therapy,” Verywell Mind, 01 November 2018. [Online]. Available: https://www.verywellmind.com/online-therapy-ethics-2795227.
author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings

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