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  • Esraa Chaddad

Is online therapy effective?

Psychological treatment has been changing over the years, and many technological tools are being introduced as a means to enhance therapy and make it more accessible for clients. Nowadays, one of the biggest shifts to traditional therapy is doing therapy online. But how effective is it really?


In this blog post I'd like to share with you some pros and cons to online therapy and its effectiveness, as well as my own personal experience using it as a therapist. I hope you can get the information you need here to decide if you'd like to give this form of therapy a try.



The pros of online therapy


The biggest pro hands down to online therapy is convenience. Online therapy takes therapy to you, instead of you needing to go to an office. That means saving on time and money traveling. Also, you can theoretically have treatment anywhere you'd like, if the setting and time are good. Most online therapy practices also provide you with flexible scheduling, and since you don't have to travel, scheduling becomes easier.


The second pro is that it has made treatment accessible to all who have an internet connection. Being able to do therapy online has been a big plus during the pandemic, since you can stay safe at home and still have treatment remain accessible. Also, if you find it difficult to access treatment in your area, you can still have access to treatment from other areas or even other countries. As an expat, I find this aspect very important. Sometimes expat clients want a therapist that speaks their language or has a relatable background to their own, and it is often easier to find that therapist online than to have direct access to them in their area.


Another benefit is the ability to do almost anything with online therapy. Most therapeutic methods don't involve touch or needing to be in the physical presence of your therapist. You can also use the tools that video conferencing software provides to share your screen with your clients or work on the same document together without needing to both be in the same room. If the online setup is done in a way where the client is in a comfortable, private, safe space, there is very little that can hinder your progress in therapy. You can therefore get effective treatment in a convenient way.


Finally, clients are not the only ones who benefit from doing therapy online. Online therapy saves time for therapists as well, making them able to provide treatment for more people than if they were meeting face to face. So, all-in-all, it's a win-win situation for both client and therapist.


The cons of online therapy


Of course, nothing is perfect, and sometimes online therapy doesn't work the way we'd want it to. Here are some drawbacks to online therapy both clients and therapists need to be aware of.


One drawback of online therapy is the fact that it doesn't work for everyone's setting. Even though it enhances accessibility to therapy and is very convenient, sometimes people need to be somewhere away from home to do therapy. For example, now that people are working from home more and more, they may be constantly surrounded by family members or roommates, so they may not feel like they have enough privacy to talk. Also, their setting might be too noisy, or their internet connection shaky, making online therapy difficult to do.


Another drawback is that some forms of therapy are difficult to do online. For example, if your therapist uses EMDR to treat trauma, you may not have an option to do it online because it requires that you and the therapist be face-to-face. In that case, you may either need to see your therapist at their office or ask them to adapt their approach, which may not always be possible.


Finally, and this is more of a difficulty for your therapist than it could be for you, online therapy makes it difficult to see the client fully, which in turn makes therapists unable to read your body language properly. Usually when people do online therapy, you can see their face and their shoulders, and not much else. Rarely are therapists able to see the person's full body and be able to capitalize on that to enhance the therapeutic discussion. This can be made up for, however, when the therapist has experience doing therapy online and gets better at detecting emotional facial expressions and upper body movements. Also, because body language can be difficult to read completely, the therapist will often ask the client to share how they feel more than they usually would, which can enhance the client's self-understanding. So it's not all bad.


How effective is it then?


In terms of effectiveness, studies have been done to show how effective online therapy is for different approaches and different problems clients face. For example, a 2018 study published in the Journal of Anxiety Disorders studied the efficacy of online cognitive-behavioral treatment for depression and anxiety disorders and found that it was as effective as face-to-face therapy. Another study published in 2016 in the Clinical Psychology Review shows that mindfulness-based approaches practiced online with clients were just as effective as face-to-face practices.


These are the most common and effective forms of therapy currently practiced, so the studies mentioned above are important to take into account when thinking about the effectiveness of online therapy. Also, since online therapy has become the safest form of psychological treatment during the pandemic, it is the focus of more and more studies. You can therefore expect that we'll be learning more about its strengths and weaknesses, and that more therapists will learn to adapt to it and improve it to suit their own and their clients' needs.


My personal experience as an online therapist


At Culture Therapy, I use a variety of psychological techniques that are derived from cognitive-behavioral therapy and mindfulness-based interventions to treat psychological issues through an integrative approach. Since these forms of therapy have been shown to be just as effective online as they are face to face, it has been possible for me to do online therapy as a main form of therapy throughout my career.


When it comes to personal experience, I have yet to meet someone who doesn't benefit from online therapy when their setting allows for it. Clients enjoy the convenience of not having to travel and being able to schedule sessions when they are available throughout the day. They also benefit from being able to maintain treatment even when they (or I) travel.


Some drawbacks that I have observed are mainly due to the setting of the videocall. Online therapy becomes very difficult when the client is not in the right setting. Some clients have found it difficult to speak openly due to the presence of another person at earshot. Others did not have a solid enough internet connection, which results in frequent disruption and does not allow for a good flow for the session. Since these situations are out of their hands, we had to adapt and sometimes it was very difficult for both of us to do so. Luckily, these situations were very rare.


All in all, I would say that I consider myself lucky to be able to work at a time when people can access effective care remotely. It has made my work with my clients generally smooth and efficient, and I hope more and more therapists use online therapy so we can develop it and enhance the experience for the benefit of our clients.



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