What is Online Therapy: Pros and Cons of E-Counseling

What is online therapy?

Online therapy, also known as e-therapy, e-counseling, teletherapy, or cyber-counseling is defined by Sucula and colleagues (2012) as, ‘ a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. This subbranch of therapy is designed to deal with already well-defined challenges.

Online therapy

E-counselling initially gained popularity simply because it showed the same results as face-to-face therapy, however, at a quarter of the in-person therapy’s price. Furthermore, the only thing needed for this type of therapy or counseling is access to an internet connection and a desktop or mobile phone. According to Whiteford and Groves, online therapy is widely popular due to its ease of use and the anonymity it can provide to the user or the patient, or the client.

With the recent SARS-COV2 pandemic and the whole world being in lockdown mode, online therapy became even more popular since it was the only option available.

It is very important to note that contrary to popular belief, online therapy doesn’t include public forums or chatrooms created to be support groups for those with mental illnesses. In fact, it includes a professional speaking to their client using internet-based communication methods like those mentioned above.

Online therapy sessions are typed into two:

Asynchronous sessions: These sessions include email correspondence between the patient and the mental health care professional, however, this doesn’t happen in real-time.
Synchronous sessions: These sessions are real-time sessions using video chat, phone calls, text messages, and so on.

However, online therapy sessions are usually a combination of the above-mentioned sessions and are generally used for anxiety-related disorders, post-traumatic stress disorder (PTSD), and social and specific phobias, as mentioned by Olthius and colleagues in their research on the topic.

Online therapy also includes a specific subtype, namely internet-delivered cognitive-behavioral therapy which is further subtyped into two; Guided cognitive behavioral therapy which implies the involvement of a healthcare professional or counselor, and unguided cognitive behavioral therapy in which a patient applies self-help CBT without help from a professional.

History of Online Therapy

Although online therapy seems like a new concept, the basic idea of distance communication and therapy has been around for a long time. In fact, Sigmund Freud; the father of psychoanalysis, used to exclusively write letters to his patients for their treatment.

With the popularity and availability of the internet, self-help groups started forming online. They are no longer considered a form of online therapy but they helped pave the way for its development.

Today, many private online therapy clinics exist online for everyone’s use. There are also many websites that offer more information about mental illness and mental health in general, breaking the stigma around the topic.

All of this, starting from support groups to an easily accessible mental health website, has resulted in the founding of the International Society for Mental Health Online, a great step forward in the field of online therapy.

Is online therapy effective?

The widespread use of mobile phones is one of the main reasons for the popularity of online therapy. Another advantage of online therapy is its easy access, especially in rural areas or areas where going to therapy is stigmatized. However, despite these advantages, the question still remains; is it effective? Does it have any benefits over the conventional forms of therapy?

A review study performed by Chakrabarti and published in the World Journal of Psychiatry found that patients who received online therapy found it extremely efficient and effective, reporting high levels of satisfaction.

Most empirical studies performed on the topic of online therapy found that it’s a promising new field, with higher patient satisfaction rates and easier access. The studies do not have a diverse sample size but have produced well-founded results.

Benefits of Online Therapy

Online therapy is a slightly controversial yet efficient method of mental health counseling or therapy and has several benefits, all of which are listed below:

Patients who are immobilized and require great effort to leave the house to go to a mental health care professional’s office can easily access these sessions online, making online therapy an inclusive approach to therapy.
An Online therapy session does not require any commute to the mental health care professionals’ office and hence, does not need to be canceled or postponed due to commute-related issues. Furthermore, travel costs can be completely eliminated in online therapy sessions.
As an online therapy session does not require a commute to the counselor or therapist’s office, it allows for an intense and longer therapy session.
Online therapy provides intense therapy, hence showing progress quicker than conventional forms of therapy.
Easier access to therapists and mental health care professionals, even those not in the same geographical area as the client.
Easier to receive therapy if the person lives in a community where receiving therapy may be seen as a negative thing resulting in the ostracization of the person.
Easier to schedule and reschedule, around one’s own work schedule, and that of the mental health care professionals.

Although online therapy has many advantages over the conventional forms of therapy, it is important to note that it also has many disadvantages that should be considered before ruling e-counseling as the most efficient method of therapy out there.

Disadvantages of Online Therapy

Even though online therapy is considered an all-inclusive branch of mental healthcare, it still is only limited to include those with a stable internet connection and access to a desktop. Furthermore, it requires a certain ability to work a desktop or mobile app, an ability some people may lack.
Boundary issues: Doctors and mental healthcare professionals face this issue since patients can easily access them and may continue to message or call or email them continuously, even out of their appointment time.
Since an online therapy session can be conducted on text or phone call, professionals and the clients cannot read and understand non-verbal cues, leading to many misunderstandings.
Most importantly, online therapy comes with a serious risk of data leakage that can affect the confidentiality of the patients, leading to many problems for the patients and the professionals alike.

Is online therapy cost-effective?

A major perk of online therapy or e-counseling is that it is cost-effective unlike the conventional forms of therapy which are known to be quite detrimental to one’s finances.

But it is important to note that most insurance companies cover the complete cost of conventional forms of therapy or at least reimburse the users a significant amount. However, that is not the case with online therapy. Most insurances will not cover online therapy or if they do, the client will have to pay large amounts of copay meaning that only a small percent of the total price was reimbursed by the insurance company.

This was all prior to the COVID-19 pandemic that forced all businesses to work from home. Since working from home became the only option worldwide, even for medical care, most insurance companies have revised their policies on covering the costs of online therapy.

Most online therapy services mention clearly if they accept insurance or not, and which insurances they accept on their sign-up pages. But the important part is most services are now covered by insurance companies.

Overall, online therapy is a useful tool to receive mental health support, especially in unprecedented times like now. And the advantages of it outweigh the disadvantages, although both should be considered by an individual before starting the process.