Does Online Therapy Work?

Online therapy has been growing in popularity, even before coronavirus forced us into our homes for self-isolation. But despite having been around for a while, a question I am often asked is.....'does it work?'

There is no denying that while it is good to meet with a therapist face-to-face, not everyone has the kind of job or lifestyle that allows for regular meetings.

It was a work situation that led one of my online clients, Sarah*, to seek an alternative way of accessing therapy for her anxiety and low confidence. Sarah had two children and a successful full-time job in a local bank. She didn't want to do evening therapy sessions, because that was her time with the children and she often felt so tired at the end of the day that she might not get what she needed from the session. Her office was right in the centre of town and traveling through the traffic to see me would involve an extra hour and a half of travel time in addition to the hour for therapy. We therefore settled on doing weekly online sessions and Sarah was able to find a small meeting room where she wouldn't be disturbed. This was a great solution and she was very pleased with the results of her therapy.

In other cases, my clients simply lived outside of the local area, but had decided that they really wanted to work with me, based on a solid recommendation from friends or family. Similarly, significant health issues had meant that for some of my other clients, leaving their home wasn't possible.

Phone, video, text or email?

As a clinical therapist, I had some important decision to make when I first considered offering online sessions. While I’m sure each therapist has their own preferences, I find it extremely important to be able to physically see my client (particularly if they are new) because my eyes and ears are important tools of my trade. Hearing the tone of your voice or seeing how you sit in your seat offer me very important clues about how you are feeling and responding during sessions.

As we all know from communicating by text or email, we can easily miss – or indeed – misconstrue tones and meanings of words. Therefore, when considering what therapy channels to use, I quickly decided against offering text, email or phone sessions, choosing only to offer therapy by video conferencing software – similar to the experience you would have using Skype, Zoom or Face Time. Seeing someone face-to-face, even in the virtual world, allows rapport to develop quickly and trust is a very important element of therapy.

But is online therapy as effective as meeting with a therapist face-to-face? My own experience is that it can be incredibly effective for the right clients, but let’s take a look at what some of the current research says.

Current research outcomes

Certainly Olympian swimmer Michael Phelps has helped to bring people’s attention to the world of online therapy.

As a therapist myself, I know that my own clients have had very successful outcomes for issues such as anxiety, insomnia and phobias. Research has consistently shown that online treatment

can be very effective for many mental health and wellbeing issues.

Here are the results of a few studies:

A 2014 study published in the Journal of Affective Disorders (Maercker, Horn & Wagner) found that online therapy treatment was just as effective as face-to-face treatment for depression. Furthermore, they concluded that:

‘..Internet-based intervention for depression is equally beneficial to regular face-to-face therapy. However, more long term efficacy, indicated by continued symptom reduction three months after treatment, could be only be found for the online group’

A collaborative study published in 2018 in the Journal of Psychological Disorders found that online cognitive behavioural therapy was:

‘Effective, acceptable and practical health care.’

The study found the online therapy was equally as effective as face-to-face therapy treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.

Another 2014 study published in Behaviour Research and Therapy found that online cognitive behavioural therapy was effective in treating anxiety disorders. Treatment was cost-effective and the positive improvements were sustained at the one-year follow-up.

While online therapy is not limited to CBT, the research clearly shows that effective talking therapies can be successfully delivered online; efficacy does not rely on seeing a therapist for face-to-face session. Indeed, studies show online therapy requires 7.8 times less of a therapist's time than face-to-face treatment, meaning therapists can often treat more people online than they can in-person.

The Potential Benefits of Online Sessions

Online therapy isn’t limited to anxiety or the larger problems we might encounter. Sometimes it’s just about having a few sessions with a supportive and knowledgeable person that can help you make a change or achieve a goal. There are many therapists who work in ‘lifestyle’ adjustments, helping clients to loose weight, cut back on alcohol or boost confidence or self esteem.

Let’s take a look at the positives online therapy can offer:

• You are not ‘tied’ to a location for your therapy.

• People who travel a lot with work may be able to access sessions when they are not at home.

• Therapists can treat a wider geographical area.

• People who experience extreme anxiety, such as agoraphobia, or physical disabilities will be able to access a therapist more easily.

• Parents with young children will not need to arrange childcare

• Travel time to sessions, traffic jams and parking will not be a consideration.

• It can be easier for some people to reveal private information when they're sharing it online

• Online therapy can be mixed with attending face-to-face sessions if desired

• Therapists are less likely to need to hire premises, therefore keeping down the cost of the therapy and often allowing the therapist to see more people across the day and evening

The Potential Drawbacks of Online Sessions

Not everyone will want to see an online therapist. For some people, therapy will always be about talking with a person face-to-face in a room away from the realms of their normal life.

• Online therapy won’t be suitable for people with certain issues, such as suicidal intent or psychosis

• Without being able to interact face-to-face, therapists might miss out on body language and other cues that can help them during sessions and when initially establishing a rapport with a client

• Tech issues can occur - Wifi signals can drop and screens can occasionally freeze, interrupting the session.

• Clients must still check that their therapist is qualified and is aware of the need for GDPR and security

• It can be difficult for therapists to intervene in the event of a crisis

• Some clients, particularly seniors, may not be familiar with using the required software

• Parents or guardians should be present for safeguarding of minors in therapy

• Clients will need to establish their own quiet space where they won’t be interrupted.

So if you find yourself feeling stressed, anxious or struggling to cope in this current climate, you may well be able to access help without leaving your home, if you feel online therapy is for you. Remember that you often have a cheaper initial session to try out the software, speak with the therapist online and make sure you are comfortable.

Similarly, if enforced self-isolation has given you time to work on the issue that you’ve been meaning to fix for a while – the time might well be now. Having someone to help with stress or anxiety at the moment might well offer relief in the current situation.

In conclusion - if you are comfortable communicating online, therapy is literally a click away!

If you have any further queries about online therapy you can contact us via our website contact form and we'd be happy to help you.

---

*Name changed to prevent identification