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The Pros and Cons of On-line Therapy

On-line therapy (also known as e-therapy, telehealth, or video counseling) is becoming more widespread and more popular these days.  There are some big organizations that are dedicated to providing therapy on-line (Talkspace, Bare One’s Soul, BetterHelp, and others) and they typically operate nationwide and sometimes internationally.  Also, more individual therapists and therapy practices are also providing on-line therapy as a treatment option.  Some therapists have changed their practice to where they are only providing e-therapy.  I provide the option of on-line therapy in my practice and I have found that people are somewhat intrigued by it but also skeptical.  Initially, I was concerned about the emotional connection that would be possible with e-therapy as it is so important to building trust.  I am finding that over time it is becoming more and more comfortable and natural, not just for me but, I believe, for my clients as well.

Of course, the benefits to on-line therapy is that it is convenient and makes therapy much more accessible to people in rural areas, people with transportation or mobility issues, and for those who just have difficulty finding the time to attend in-person therapy sessions.  If the therapist that specializes in your unique issue has their practice 100 miles from where you live it no longer has to be a problem The only requirements of on-line therapy are that you have an internet connection and a computer or iphone. (Current licensing requirements of therapists stipulate that therapists can only counsel people in the state they hold their license. If you live in Florida and find a therapist you like in North Carolina that therapist may not be able to work with you if they do not also hold a license in Florida.)

Sometimes, due to the stigma of mental health, people don’t want to be seen going to therapy or fear running into someone they know in the therapist’s waiting room.  On-line therapy eliminates this problem. I have also heard client’s say that on-line therapy provides a little bit more anonymity to therapy since you are viewing someone on a computer screen versus face-to-face.  And this is useful for some clients who feel embarrassed or ashamed to talk about their problems.  Client’s with agoraphobia or social anxiety might be more likely to participate in e-therapy versus the more traditional therapy.

Confidentiality has been a concern with on-therapy and if you live in a home with lots of people milling around it might be more of a challenge to find a private area.  Also, the platform a therapist uses to conduct the therapy should also be HIPPA compliant.  I use a platform called that I find is really easy to use for both me and my clients. It is my understanding that a platform such as provides more confidentiality than using facetime or skype.

E-therapy does make it harder for the therapist to read a client’s body language and reading body language can aid in the therapy process. However, this can be overcome by the therapist just recognizing that this information is not available to them. I find that I will sometimes ask more questions and seek more clarification to reduce any chance of misunderstanding.