More and more people are trying out therapy online. But does it actually work? Let’s look at what clients and therapists are saying, alongside recent studies too…
From video calls to live text chat, online therapy has been booming in popularity since the pandemic. More and more people are finding that hopping onto Skype or Zoom with a therapist fits into their life much better than in-person appointments.
And as we explored in our previous post on the benefits of online therapy, it seems to be a much more inclusive and accessible approach for many. For instance, people with disabilities, the elderly, carers, parents, nursing mothers — as well as individuals dealing with agoraphobia, anxiety or panic attacks — might welcome the chance to access therapy over the internet. And if you work long hours or have a health condition like chronic fatigue syndrome (CFS), online therapy removes practical barriers that could previously have made it difficult to find help.
Plus if you live in a rural area, or your preferred type of therapy isn’t available near you (for instance, niche approaches like EMDR or psychodynamic), then online services widen your choices dramatically. You can take your pick from a range of methods, plus search for a psychotherapist or psychologist who is exactly the right fit for you.
With all this in mind, the burning question is — does online therapy actually work? Can talking to a mental health professional via a screen really compare to being in the same room as them?
Over the past few years, a number of studies have indicated that the answer is ‘yes’. But before exploring those, let’s take a look at what both clients and therapists are saying about the process.
‘Lucy’ began online EMDR after facing fertility issues and found that she liked the flexibility of this approach: ‘(as a) result of the pandemic…my therapy ended up being online. I hadn’t tried this before but actually found it to be useful as it was easier to juggle with my work. In fact, I would probably have struggled to commit to regular face-to-face sessions and liked the flexibility of online therapy. I also think that being online helped me to open up a bit more than I am able to in person. Added to this, I am very introverted and I found it easier to ground myself after online sessions as I didn’t have to be around other people for a while.’
‘Mia’ began online EMDR therapy after developing panic attacks at work. She soon found that the online approach really supported her healing: ‘I thought it might be strange to engage in therapy through a screen but actually, I found being able to do my sessions from the comfort of home really useful. I didn’t have to worry about facing a waiting room full of strangers after an intense hour excavating my most traumatic memories, or cramming onto a packed tube and weeping into someone’s armpit. I could sit and reflect if I wanted, draw if I wanted, do yoga or move my body if I wanted. I could have a cup of tea by myself and feel safe…doing therapy online meant that I could slot my healing into the changing rhythms of life…’
‘Sara’, who started online therapy as a way of managing anxiety, panic attacks and eating issues, shared the following: ‘All our sessions were online which worked out great for me because we were moving around a lot. If I had had a therapist who only did in-person sessions, I would have had to find three different ones in a year.’
‘Jonathan’, who tried online EMDR therapy after the trauma of an attack, said: ‘Initially, I visited my therapist in person but when the pandemic started we moved onto online meetings. And actually this was just as effective — if anything, I felt more at ease being able to do EMDR in the comfort of my own home.’
It seems that this approach is growing in popularity with mental health professionals. For instance, some have found that clients are more relaxed and open when speaking to them from the comfort and familiarity of their own homes. This might partly be due to the ‘online disinhibition effect’, a phenomena where people feel more comfortable opening up over the internet.
Other therapists have mentioned that video sessions give them a better insight into the client’s homelife. For these reasons, even those who were sceptical about online therapy pre-pandemic have begun to see its benefits.
Reflecting on her own experiences of working with clients over video, psychotherapist Sophia Anderson-Lambri, says: ‘At first, I was unsure how EMDR might be adapted to work online but it has exceeded my expectations. People that I work with agree that wearing a headset and being able to see the person you are working with more clearly helps deepen the therapeutic connection. In this way, it can feel more grounding when working with stressful life events but there is also a real sense of teamwork’.
But what does the science say about therapy delivered online? Let’s take a look…
Since around 2013, when online therapy began to become more available, a number of studies have been conducted into its effectiveness.
For instance, 2014 research published in the Journal of Affective Disorders found that therapy carried out online was just as effective at treating depression as face-to-face treatment. And in that same year, a study in the Journal of Behaviour Research and Therapy shared similar findings. This second study compared two groups — one who had gone through a course of online therapy and another who had accessed in-person therapy. It found that both approaches were beneficial and when participants were interviewed again a year later, their psychological gains had been sustained. This indicates that online therapy can have long-term benefits.
Following this, a 2018 study into online Cognitive Behavioural Therapy (CBT) by the Journal of Psychological Disorders found that therapy delivered online was as effective as the in-person approach at treating various conditions. These included major depression, generalised anxiety disorder, social anxiety and panic disorder.
Two years later, research was carried out into the effectiveness of online EMDR (Eye Movement Desensitisation & Reprocessing). EMDR therapy can treat various conditions and is known for being particularly helpful with trauma. In the study, 60% of clients either had PTSD or complex PTSD, while the majority of the rest had depression, anxiety, obsessive compulsive disorder (OCD) or phobias. The results showed that online EMDR can reduce symptoms of PTSD, anxiety and depression. They also showed that missed appointments were reduced with online therapy, which is significant as the number of sessions a client attends is linked to recovery rates.
Over the last couple of years, similar studies into the online delivery of Schema Therapy, Acceptance and Commitment Therapy (ACT), Dialectic Behaviour Therapy (DBT) and Psychodynamic Therapy found that video sessions were effective. Added to this, specialised online CBT for two different groups — couples affected by PTSD and individuals with obsessive compulsive disorder (OCD) — was found to be effective. Online therapy was also found to be a useful approach to treating addictions.
A number of literature reviews have backed up these studies. For instance, a 2020 review of 17 studies indicated that electronically delivered CBT for depression might actually be more effective than in-person. Also, when participants were asked how satisfied they were with their experience, the online therapy groups were just as satisfied as the in-person ones. The following year, a review of 19 separate studies found that online CBT was better than a placebo for treating anxiety.
A further literature review published in the National Library of Medicine in 2021 found that therapy conducted via video calls was no less impactful than in-person therapy. Video therapy’s effectiveness at treating a range of mental health conditions was backed up by two further reviews in 2022, one by Greenwood et al. and the other by Annaleis K. Giovanetti et al.
That said, if you are thinking of trying online therapy, make sure that you do your research before booking an appointment. This is because ‘counsellor’ and ‘psychotherapist’ are not protected titles in the UK, so it’s important to make sure that the person you are speaking to is fully trained and accredited. Our blog post about the different types of mental health professional offers a useful guide. Alternatively, you could book an appointment through a service like My Therapy Assistant, which makes sure that all of our mental health professionals are highly qualified and carefully vetted.
Over the past few years, a growing wealth of evidence has indicated that therapy delivered online is a helpful approach for a variety of issues. This is good news for anyone who might struggle to access in-person appointments near them. What’s more, it empowers any of us who want to be able to choose from a wider range of therapy options.
In light of this, it seems likely that the popularity of online therapy is only going to grow.
Thinking of trying online therapy? Find an MTA psychologist or psychotherapist today for video or live text chat appointments. We also offer in-person sessions.
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