Online therapy is increasingly popular, especially as the world continues to cope with the COVID-19 pandemic. Even before COVID-19, Americans sought counseling or mental health treatment in numbers that increased by 48% from 2002 to 2019.
With many Americans now turning to online therapy sessions out of necessity and then discovering the benefits and convenience, many predict that its growth will extend far beyond the pandemic. Online therapy is likely a permanent fixture in mental health care.
At Innerbody Research, our readers have sent us many questions about online therapy. We decided to compile and answer the most common questions, drawing from the experience of a professional who has counseled online extensively (via Betterhelp) as well as from our own testing of online therapy platforms. If you have a question that you feel we’ve missed, please email your question to: contact [at] innerbody.com.
Understanding online therapy
What does online therapy treat?
What is the best online therapy company?
How much does online therapy cost (and is it worth the money)?
Will my insurance company cover online therapy?
Will my privacy be protected, with everything remaining confidential (or even anonymous)?
How hard is it to cancel or pause sessions with my online therapist?
How long is online therapy?
How can I tell if the therapy is working (or if I should try something else)?\
Therapy definitions and types
What degrees or qualifications will my therapist have?
What do all those letters after a therapist’s name mean?
Can an online therapist prescribe psychiatric medication?
Is there any free online therapy?
Can online therapy work effectively for couples, too?
Can my child participate in online therapy?\
In-person vs. online therapy
Can online therapy be just as effective as traditional, in-person therapy?
Why should I choose online therapy over traditional, in-personal therapy?
Are there downsides to online therapy or situations when it isn’t appropriate?\
Preparing for online therapy
How best can I prepare for my first online therapy session?
How do I choose the best therapist after I sign up?
What questions should I ask my new therapist to ensure they are right for me?
What types of questions can I expect therapists to ask me?
Can I switch therapists if I don’t like the one assigned to me?
Don’t see your question here?
Online therapy can be an effective treatment for many different mental health issues, including:
- Anxiety disorders
- Relationship problems
- Grief and loss
- Work or school issues
Keep in mind that you don’t need a specific reason to seek help. Many clients benefit from processing their feelings with a safe and trusted professional. Therapeutic support can be invaluable in helping you feel validated and understood.
We consider BetterHelp to be the overall best online therapy company right now for several reasons, including:
- Commitment to facilitating live video sessions
- Flexibility in how you’re matched to a therapist
However, what’s best for one person might not be best for another. For more information about how major platforms compare, please visit our full guide to the best online therapy.
The cost of online therapy varies depending on the therapist, platform, and how you intend to pay for treatment. For instance, some therapists provide direct online therapy. These therapists often charge the same fees for traditional, in-person therapy (anywhere from $100-$250).
Here are the current costs for the most popular platforms:
- BetterHelp: $60-$80 per week
- Regain: $60-$80 per week
- Pride Counseling: $60-$80 per week
- Amwell: Starts at $99 per session
- Doctor on Demand: starts at $49 per session
- Talkspace: Ranges from $260-$396 per month with a la carte services available
Most people find that therapy is worth the investment. However, therapy isn’t just a passive process. You need to actively dedicate yourself to the work. Many therapists assign homework between sessions, and you need to practice the skills you learn.
You probably don’t like to hear this answer but also don’t find it surprising: it depends.
Some insurance companies contract with specific, in-network therapists to subsidize costs. At this time, most insurance companies do not reimburse for online therapy services provided through the major platforms. To determine potential coverage, contact your insurance’s membership services before starting your treatment.
In many situations, online therapy is cheaper than using insurance for traditional, in-person therapy.
Yes, all reputable online therapy is HIPAA-compliant. That means your privacy and confidentiality are legally protected. That said, it’s important that you also take the necessary precautions to ensure privacy within your home and with your specific electronic devices.
Depending on the specific platform, you can remain anonymous. Some online therapy platforms allow you to choose a nickname for your treatment. This is not always the case, so you will need to check with each provider.
Clients always have a right to cancel or pause their sessions. Most platforms make it easy to make this request. You can also talk to your therapist directly.
There isn’t a one-size-fits-all answer for this one. In fact, the question may refer to two separate things:
- The length of a live online therapy session
- The duration of therapy
When it comes to live sessions, experiences vary somewhat from platform to platform as well as from therapist to therapist within certain platforms. Let’s consider our top recommendation, BetterHelp, as an example. BetterHelp gives you and your therapist the freedom to determine the best frequency of live sessions, expecting that you’ll have one per week at a minimum. When you and your therapist opt for more frequent live sessions, these will very likely be shorter in duration than a single, longer weekly session. A single weekly video session generally lasts about an hour.
When the question is about how long a person continues to access online therapy, it depends on your circumstances and goals. Some clients benefit from solution-focused, short-term work. Others may need longer support. Talk to your therapist about their intentions for your treatment length.
Therapy can be subjective, but it’s crucial that you feel like you’re progressing and growing throughout the process. Here are some common ways to tell if therapy is working:
- You feel comfortable talking about your feelings with your therapist.
- Your therapist maintains appropriate boundaries with you (they don’t try to be your friend or tell you what to do).
- You know your goals, and you believe you’re making some positive movement towards achieving them.
- You feel like your therapist really listens to your concerns.
- You generally feel like you are functioning better in life.
- Your self-esteem is improving.
At a minimum, therapists must be licensed in their state. To become licensed, therapists need to complete graduate school, accrue several clinical hours, and pass all required board exams. They also must maintain eligibility through continuing education units.
Each online therapy platform has different standards for the therapists in its network, but you can always ask potential therapists about their education and career background.
This is one of the more common questions we receive. The various abbreviations, titles, and terms in the world of therapy can become very confusing, so much so that people feel intimidated and discouraged.
In many situations – including finding the best online therapist for yourself – it’s beneficial to have a bit of familiarity or a cheat sheet of common therapy abbreviations, titles, and general terminology. For that reason, we created this helpful guide on the topic.
No, only a psychiatrist can prescribe psychiatric medication. This limitation doesn’t just apply to online therapy; traditional, in-person therapists cannot prescribe medication either.
Some online platforms like Amwell, Doctor on Demand, and Talkspace offer psychiatric services. You can receive an assessment and then pick up a prescribed medication at your local pharmacy.
Some websites, like 7 Cups, offer free peer-to-peer support. However, online therapy typically isn’t free. If you’re looking for free or low-cost therapy, you may want to consider:
- Asking local therapists if they offer any sliding-scale services
- Seeking services through local nonprofit centers
- Trying counseling at a local university or college
Some platforms also offer free trial memberships. With this option, you can meet with a therapist for 1-2 sessions to determine if it’s a good fit. You can also consult our comprehensive guide to free online therapy.
Yes, many couples benefit from online therapy. Regain is an online therapy platform that focuses exclusively on couples’ work.
Yes, many online therapists work with children and teenagers. Each state has different rules regarding parental consent.
Yes, online therapy can be just as beneficial and effective as traditional, in-person therapy. Since online treatment is relatively new, there isn’t substantial research validating its worth. That said, some studies indicate promising results.
For example, a 2020 study supported that online therapy was just as effective as traditional therapy in treating anxiety. With more and more people seeking online therapy every year, it is very likely more research will continue to emerge.
Online therapy has numerous advantages. For one, it’s convenient. Online therapy fits right into your schedule, and you don’t have to worry about commuting to an office or sitting in a waiting room. It’s accessible for people lacking transportation or living in more rural areas. Many clients prefer the discreet nature of logging in for sessions wherever they want.
Finally, the increasing healthcare treatment costs continue to be a concerning barrier for most Americans. Online platforms offer cheaper therapy than private therapists offering traditional, in-person therapy.
Some clients prefer the intimate feel of a traditional therapy setting. Additionally, therapists may have a more challenging time intuiting body language over a screen. In some cases, this discrepancy may affect the therapeutic relationship.
With online therapy, you are also responsible for ensuring you have a quiet and confidential space for your sessions. If you live with family or other roommates, you must let them know so they can avoid interrupting you.
Online therapy isn’t suitable for people in acute psychiatric or medical emergencies. It’s not typically appropriate for clients with severe substance use disorders or eating disorders. Furthermore, if you feel suicidal or psychotic or are seriously self-harming, you may need a referral for a higher level of care.
You need an internet-connected electronic device like a computer, phone, or tablet with a microphone and video access to meet with your therapist. Some clients also prefer using headphones during their sessions.
Beyond technical equipment, it’s crucial to find a space free from distractions, where you’ll be fully comfortable opening up about personal and challenging subjects in a live therapy session.
Yes, most platforms allow you to leave messages for your therapist whenever you need to talk. Additionally, these platforms offer various communication methods for corresponding with your therapist. Typically, you may choose between:
- Live video conferencing
- Messaging (similar to instant messaging or text messaging)
- Phone sessions
Most online therapy is fairly intuitive and straightforward. However, you need some basic understanding of using the Internet, connecting to WiFi, and downloading apps (if using a tablet or cell phone). Live video sessions are a lot like Facetime, Zoom, Google Meet, and similar video chatting interfaces. Most providers offer support if you need technological assistance.
Think about what you want to gain from therapy. Are you hoping to improve your self-esteem? Do you want to improve the quality of your relationships? Do you want skills to manage your depression or anxiety? It’s okay if you don’t know how to prioritize your concerns, but it’s important to have a general idea of what you’d like to address. Many clients find it beneficial to write down their goals ahead of time.
For more information on getting the most from your online therapy, visit our full guide with our top 8 insider tips.
When getting started, most online therapy companies have a questionnaire and process for matching you to a therapist. In this mode, your success in matching to a therapist depends largely on how thoroughly you answer the questions as well as the qualities of the platform itself (the sophistication of its questionnaire and/or algorithm, the abundance of participating therapists in this network, and other factors).
However, you can choose your own online therapist if you’d prefer (and if you know how). For more information about this, visit our guide with 7 insider tips for finding the best online therapist (in this case, on our top choice – BetterHelp).
Keep in mind that you can ask your therapist anything you want. They may not answer every question, but most therapists want to ensure that you feel comfortable and supported during your work. Some questions to consider include:
- How often will we meet?
- What issues do you specialize in treating?
- What experience do you have treating my particular issue?
- What kind of outcomes can I expect in my work with you?
- How will I know if I’m progressing?
- How long do you typically work with clients?
- How will we collaborate on my treatment goals?
Every therapist is different, and the questions depend on your individual therapy goals.
Most therapists will ask questions about your thoughts and feelings. They will also ask you about the critical parts of your life: your relationships, school, work, and health. If therapists are unsure about your goals from therapy, they’ll likely ask questions to gain clarity.
Yes, all platforms allow you to switch therapists. Most of the time, you can make this switch instantly. You are never obligated to continue working with a provider.
If you feel that your therapist isn’t the right fit, we encourage you to switch without hesitation.
If you have a question we didn’t address about online therapy, please email us at: contact [at] innerbody.com.