Text therapy allows a person to contact a mental health provider through online messages. Although it is convenient, requires no appointment, and is a more affordable option, it has some drawbacks.

Text therapy, also known as online therapy or e-therapy, is an innovative form of mental health support that has now gained significant traction.

By leveraging the power of modern technology, text therapy offers individuals a confidential and convenient way to access therapy services without the constraints of traditional in-person sessions.

Through secure digital platforms and real-time communication, people can engage with licensed mental health professionals, receive emotional support, and explore their thoughts and feelings in a safe virtual space. However, there may be delays between messages, and it lacks a professional, therapeutic relationship.

There is a global increasing awareness of the role mental health plays in society, and many forms of treatment, including text therapy, are beginning to become available for all.

This article explores the nuances of text therapy, delving into its structure, effectiveness, and the benefits it brings to those seeking support.

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Text therapy is a newer form of mental health counseling that employs digital communication to connect individuals with licensed therapists. It uses secure and encrypted messaging platforms, enabling people to converse with a therapist from the comfort of their home or other environment.

An individual can discuss their emotional struggles, personal challenges, and mental health concerns with a qualified professional through written exchanges.

Evidence suggests it is potentially valuable, with one 2022 study finding it may reduce suicidal thoughts and another study published in 2020 suggesting it may be as effective in reducing post-traumatic stress disorder (PTSD) symptoms as more traditional therapy.

Furthermore, 2020 research found that those with anxiety or depression experienced reduced symptoms after text therapy.

Text therapy encompasses various formats, such as real-time chat sessions or asynchronous messaging, where the person sends a message, and the therapist answers during a specific window. It allows individuals the flexibility to communicate at their preferred pace.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • 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.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Learn more about types of therapy.

Text therapy operates on virtual platforms. Generally, a person answers questions to enable a match with a suitable text therapy provider and ensure their suitability for this mode of therapy.

Once matched with a licensed therapist specializing in their specific needs, the person can begin their therapeutic journey.

During sessions

During text therapy sessions, individuals articulate their thoughts, emotions, and experiences through writing while the therapist responds with thoughtful insights, reflections, and guidance.

Many of these services offer unlimited text messaging, and some also provide audio and video chat, although this may have an additional cost.

A person can text their therapist anytime but may not receive a reply immediately, as some platforms only offer a reply window, such as within a day. However, some offer live sessions where the person exchanges texts with their therapist in real time.

When considering text therapy as an option, individuals should evaluate the following:

  • Communication style: Some people may not feel able to express themselves in writing or without direct support to articulate how they feel.
  • Flexibility and convenience: Text therapy offers unparalleled convenience, especially for those with busy schedules or limited mobility.
  • Anonymity and privacy: The written format allows individuals to maintain distance from their emotions while still engaging in therapeutic progress. Chats with therapists over text are secure and will not reveal any details that may identify the person.
  • Therapeutic goals: A person should discuss their goals with a therapist to ensure this modality suits their specific needs.
  • Cost considerations: Text therapy can vary in cost, and individuals should review their budget to choose an option that fits their finances.

The text-based nature of this therapy allows for more deliberate and introspective expression, enabling individuals to explore their feelings in-depth before formulating responses. It also has some other potential benefits, including reducing overall anxiety:

  • Accessibility: Text therapy transcends geographical barriers, making it accessible to individuals regardless of location.
  • Convenience: Its asynchronous nature allows for flexible scheduling, enabling people to engage in therapy conveniently.
  • Anonymity: The written format offers a sense of anonymity, empowering individuals to discuss sensitive topics without fear of judgment or stigma and encouraging open and honest communication.
  • Continuous support: Asynchronous messaging permits ongoing support between sessions, enabling individuals to share real-time experiences and receive guidance during challenging moments.
  • Affordability: Text therapy can be a cost-effective alternative to traditional therapy, providing high quality mental health support at potentially lower rates.

Text therapy also has some downsides to consider, such as:

  • Limited nonverbal cues: The absence of nonverbal cues, such as tone of voice and facial expressions, can limit the therapist’s ability to understand and interpret a person’s emotions and responses fully.
  • Real-time interaction: Asynchronous messaging may result in delayed responses, which might be less suitable for individuals in immediate distress or seeking real-time feedback.
  • Misinterpretation of messages: Written communication can sometimes be ambiguous or subject to misinterpretation, potentially leading to misunderstandings.
  • Emergencies: Text therapy is not suitable for those in crisis.
  • Technology and connectivity issues: Technical problems or internet connectivity issues could disrupt therapy sessions, affecting the continuity and quality of communication.
  • Security: Even well-protected platforms could potentially face security breaches or data leaks.

The following platforms offer text therapy:

Text therapy costs vary depending on the provider and the additional services included. However, it typically costs far less than in-person therapy.

For example, BetterHelp costs $60–$90 each week, while Talkspace is up to $109 weekly, depending on the plan.

If text therapy is not the right fit, there are other options besides traditional in-person therapy, including:

  • Video counseling: Meeting a counselor via video conferencing allows for a face-to-face experience in real time.
  • Group counseling: Therapy groups are typically small groups of people sharing the same experiences, such as substance misuse or eating disorders, led by a licensed therapist.
  • Support groups: Similar to group counseling, but led by a trained peer instead of a clinician.
  • Emergency services: A significant drawback of text therapy is its limited use in emergencies. If a person requires immediate mental health support, they can reach out to the Crisis Text Line and National Suicide Prevention Hotline for free, on-demand services no matter where they are.

Text therapy can help people navigate challenges in life and offers convenient, accessible support. However, while text therapy is affordable and boasts other benefits, individuals should also consider its limitations, such as the absence of nonverbal cues and potential misinterpretation of messages.

A person considering text therapy should evaluate the positives and negatives and discuss their thoughts with a therapist to see if it is the right option.