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A wide range of online therapy options is available for people to try. Online therapy can be convenient but expensive, and health insurance only sometimes covers the cost.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
Ask the tough question: “Are you considering suicide?”
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Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
Stay with the person until professional help arrives.
Try to remove any weapons, medications, or other potentially harmful objects.
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Below, we look at some of the best online therapy options a person can consider.
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Disclaimer: All the services tested below were tried by Medical News Today editors. All opinions are their own. Due to the sensitive nature of the services in this article, the editors chose to write anonymously or used pseudonyms for their reviews.
Some of the advantages and disadvantages of online therapy are as follows:
Pros
Sharing personal information: A person may find sharing personal or difficult details easier online than in person.
Travel: People do not need to account for traveling time or costs.
Illness or injury: Those who cannot leave their homes can still access therapy.
Cost: Online therapy is typically more cost-effective than in-person therapy.
Convenience: A person with a busy schedule can arrange sessions at convenient times.
Cons
State licenses: Some therapists may not have a license to operate outside their home state.
Crisis: Online therapy is not appropriate in a mental health crisis. A person should seek immediate assistance by calling 911 or calling the Suicide and Crisis Lifeline at 988.
Insurance: Many insurers do not cover online therapy. A person should contact their insurance provider to confirm benefits.
Specific psychiatric conditions: Online therapy may not be appropriate for some mental health conditions.
Security and privacy: As with all digital communication, people cannot guarantee the security of private and personal information online.
Communication errors: Online therapy depends on technology, which may sometimes fail.
Online therapy is a type of talk therapy service. A person may use online therapy instead of a face-to-face appointment with a therapist or counselor. Some reasons a person may choose online therapy include:
finding it difficult to leave their home
having a busy schedule
living in a remote area
feeling safer online
Online therapy may be as beneficial as traditional in-person appointments for the treatment of anxiety, depression, and post-traumatic stress disorder (PTSD).
A 2021 study found that online therapy during the COVID-19 pandemic was effective in helping with anxiety and depression. A second 2020 research review also notes that teletherapy can effectively treat mental health conditions such as anxiety, depression, and PTSD.
Online therapy may benefit people with mild to moderate mental health conditions, including anxiety, depression, and panic disorders. It may also be suitable for those interested in relationship counseling.
People may find online therapy convenient as they can have sessions from the comfort of their homes or another location of their choice. However, a person must have a reliable internet connection and a private room where they will not be disturbed during therapy sessions.
People may wish to discuss online therapy with a doctor to determine whether it is appropriate for their needs.
If a person is in crisis or needs immediate or urgent care, they should call 911 or their local emergency number.
Online therapy suits people who are seeking a convenient way to talk with a licensed mental health professional. It suits people who cannot easily access in-person sessions due to location, price, or health conditions that stop them from leaving the house.
People experiencing the following may find online therapy useful:
anxiety
depression
relationship concerns
stress
It is suitable for children, adolescents, and adults, and it can be more affordable than in-person therapy in some cases.
People in a mental health crisis should not use online therapy. They should instead call emergency services or the Suicide and Crisis Lifeline at 988.
Additionally, some people may prefer not to speak with a therapist virtually. They may find it difficult if they do not have a private space to have their session or if they have difficulty connecting to the internet. Additionally, therapists may not respond quickly to messages outside of scheduled appointment times.
People should pick the platform that they feel best suits their needs and their preferred communication style. Messaging may be better than video calls if a person prefers greater anonymity. Video calls are a good option for people who are looking to balance the experience of in-person therapy with the convenience of online therapy.
Online and in-person therapy can be similar in many ways. However, there are certain differences a person should expect if they choose online therapy.
In online therapy, a person may not be able to pick their therapist before their first session. This may not be suitable for people who want to feel comfortable with the therapist before they start working with them.
The first session
The first online therapy session will typically involve conversations about what a person wants to gain from online therapy. The therapist may ask a person about the following:
goals for the sessions
previous experience with therapy
any mental health diagnoses
any medications they are taking
issues currently affecting their mental health
traumas or triggers
The therapist may also review any assessments a person took with the company before their first session.
A person should consider their main reasons for visiting a therapist. They should aim to find a therapist who specializes in the field in which they seek help. People may wish to view the therapist’s qualifications if these are available.
A person should always ensure that their therapist is licensed.
People may want to choose a certain type of therapist, depending on their needs. Types of therapists include:
Psychiatrists: Psychiatrists can provide prescription medication to a person if they feel this is necessary. A psychiatrist is both a medical doctor and a psychologist.
Psychologists: Psychologists cannot prescribe medication. They have training in the mind and behavior and the ways these two intertwine. They usually specialize in the treatment of mental health conditions.
Licensed marriage and family therapists: These professionals specialize in relationship and family counseling.
Licensed professional counselors: These counselors have a master’s degree and treat groups or individuals with mental health conditions or substance use concerns.
Licensed clinical social workers: Social workers support people with interpersonal issues and support their well-being. They can refer people to community or government services they may need or help them resolve problems by directing them to relevant resources.
A person should also consider how they would like to communicate with their therapist. Some services offer one form of communication, while others have multiple communication options.
Some services allow a person to provide preferences for their therapist’s gender, age, or religion.
Many online therapy services allow people to change therapists if they wish.
Various therapy services accept insurance. People should look for these services and determine which insurance plans cover them. Some insurance policies may also partially cover the cost.
In addition, there are various resources online that are free to access.
Most online therapy providers have a privacy policy and should offer transparent information on how they store and protect a person’s personal information.
People can ask their intended therapy provider if it complies with rules set out in the Health Insurance Portability and Accountability Act (HIPAA), such as the HIPAA Privacy Rule and the HIPAA Security Rule.
Security and privacy are extremely important, and most companies should have robust protective systems. However, as with any online service, there is always a risk of data theft, computer viruses, and hacking.
As a form of telehealth care, online therapy is regulated in several ways, although regulation can be inconsistent and difficult to understand. Licensed therapists must meet the standards of the state in which they operate and the state in which their clients live. Some healthcare organizations and some states have multistate compacts that simplify the process.
Additionally, reputable online therapy providers must meet federal and state regulations addressing:
privacy, according to HIPAA
breach of privacy notification
the therapist’s duty to warn or protect the public from potentially dangerous clients
Below, we answer some of the most frequently asked online therapy questions.
Costs for online therapy vary by provider, platform, and type of treatment. Online talk therapy typically costs $50–$70 per week and can go up to about $129 per week. Psychiatric care generally costs more, at $109–$299 per session. Free options are available, although these may not offer licensed therapists.
BetterHelp offers more affordable online therapy services than many other companies, and people can access a wide range of platforms to have their sessions. The company also has a positive reputation on trusted review sites such as the BBB and Trustpilot. This may make it a suitable option for many people.
BetterHelp is more affordable than Talkspace. BetterHelp charges $65–$90 per week, while Talkspace charges $69–$109 per week. On Talkspace, initial psychiatry sessions cost $299, and subsequent sessions cost $175 each.
Yes, BetterHelp is a legitimate company that uses licensed healthcare professionals to deliver mental health care online. The BBB accredited BetterHelp in 2015.
Research indicates that online therapy can effectively reduce psychological stress due to depression, anxiety, interpersonal sensitivity, and obsessive-compulsive disorders. However, every person’s experience with therapy, whether in person or online, will be unique.
To have the best chance of a productive and positive experience with therapy, a person should find a therapist who specializes in their condition or concern; understands their culture, identity, or lifestyle; and provides professional and sensitive support.
Talkspace is a popular platform for online therapy with licensed mental health care professionals. But it is a significant investment — people can expect to pay at least $69 per week for therapy services and around $299 for an initial psychiatry appointment.
To make the service worth the cost, Talkspace offers a user-friendly website, personalized matches with therapists, and convenient video and messaging platforms for appointments.
However, online therapy will not suit everyone, and people should check that Talkspace’s healthcare professionals offer the type of therapy they want on a platform that suits them.
At this time, BetterHelp does not have the ability to prescribe any medication, including Xanax.
7 Cups is a legitimate site and has a good customer rating on Trustpilot. However, the free service only allows a person access to forums and chat rooms. The listeners are volunteers, not licensed professionals.
Online therapy may be an effective option for people who prefer not to meet in person with a mental health care professional or are unable to do so.
There are many ways for people to access online therapy. Before using any online therapy service, it is important to clarify the costs and the required level of commitment.
Anyone who is concerned that they may pose a danger to themselves or others should not use online therapy. Instead, they should call 911 or go to the nearest emergency room.
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