Is Online Therapy Actually Effective? What the Research Says
You’ve probably heard someone say “therapy saved my life”—but can it still work its magic through a screen?
Online therapy has rapidly grown in recent years, but many people are still skeptical about its effectiveness. Let’s dig into what research has to say, the pros and cons, situations where it does and doesn’t work well, and what to expect out of a virtual therapy session.
What the Research Actually Says
A 2021 study by Bulkes et. al reported that in a sample of adults seeking intensive treatment for depression, there were no differences between in-person and telehealth groups in depressive symptom reduction, and significant increases in self-reported quality of life across both groups.
Another study, completed in 2016 by Brown et. al, explored the effectiveness of web-delivered Acceptance and Commitment Therapy, finding that web-based ACT was effective in managing depression, with high adherence and completion rates. Side note: at The Gaia Center, ACT is one of our favorite therapeutic modalities!
While a lot of research for online therapy has focused on depression and anxiety, there are also some studies that show the effectiveness of virtual therapy for other presenting concerns.
A 2023 study by Vijayapriya & Tamarana demonstrated that online DBT skills training led to significant improvements in executive functions among college students with BPD traits.
Online therapy has also been shown to be effective for treating PTSD. A 2018 review of over 40 studies concluded that both online and in-person therapies effectively reduced PTSD symptoms.
The Rise of Online Therapy
Online therapy has been available for several decades, however, its popularity has grown significantly, particularly since 2020. Some of the reasons for this growth include:
The COVID-19 pandemic forced therapists and clients to shift sessions to virtual platforms due to shutdowns and quarantining. For many, even once in-person sessions were a safe option, they opted to stay virtual due to becoming comfortable with the approach and seeing that it was effective for them.
Many therapists also chose to remain only offering virtual sessions due to reduced overhead costs and increased flexibility in scheduling.
In an increasingly virtual world, some folks are more comfortable engaging in a vulnerable experience like therapy from the comfort of their own home vs. having to go to an office.
When Online Therapy Works Well
Online therapy can work well for many clients. Here are a few examples of ideal candidates:
People with busy schedules
For folks with chaotic schedules, it can be challenging not only to carve out the time for therapy, but also the time required to commute to a therapy office. Virtual therapy can allow someone to do therapy on their lunch break at the office, or for remote workers, therapy can easily be done before the start of the work day while still being able to login on time. In addition, many therapists offer a wider variety of session days and times for online therapy sessions than they do for in-person therapy sessions.
Folks in rural or underserved areas
For folks who live in more remote areas, finding a therapist at all can be challenging. There may be no therapists within driving distance, or there may be a few therapists, who also all happen to see people you know. Another factor is that different therapists have different kinds of training and specialties, and if there are only one or two therapists in your area, they may not be specialized in the type of care you need for your healing journey. In Tennessee, there are many rural counties with zero mental healthcare options, and while The Gaia Center is based in Nashville, we have been able to support clients all throughout the state – expanding access to much needed services.
Clients with transportation issues
In many cities, public transportation is either unreliable or non-existent. If someone doesn’t have access to reliable transportation to be able to get to a therapy office, virtual therapy can be an excellent fit for still being able to access support.
Clients managing chronic illness or chronic pain
For clients with chronic illness or chronic pain, leaving their home can either be extremely difficult or, at times, impossible. Online therapy offers the ability to gain the therapeutic support they need to process these health challenges, while also being able to avoid exacerbating their symptoms.
Folks who want to work with a specific therapist but aren’t located close to them
Having the right therapist is imperative for being able to make progress in therapy. Even if there are several therapists in your area, wanting to work with a specific therapist due to their training or ✨vibe✨ is completely valid. Online therapy gives the opportunity for people to work with their ideal therapist, even if they aren’t in driving distance – so long as they are licensed in your state.
Mental healthcare providers who want to avoid working with providers in their own area
It’s no surprise that mental healthcare providers need and deserve their own therapy. However, even in larger cities, most therapists know each other or know of each other, which can make it challenging to find a provider who you feel comfortable working with. It’s not uncommon for a therapist to choose to work with a therapist who is licensed in their state but is in a different area: for example, a Memphis based therapist deciding to work with a Nashville based therapist virtually. This can ensure that it’s less likely for you to run into your therapist at networking events, leading to a greater sense of confidentiality.
Times When In-Person Therapy May Be A Better Fit
While online therapy can be appropriate for many people, there are some circumstances where in-person support is more effective.
Children or teens who get distracted in online sessions
Whether it’s because of distracting technology (texting friends, scrolling social media) or other struggles with inattention, some kids and teens may not be able to appropriately connect with their therapist in a virtual setting.
Severe dissociation
Folks who struggle with high levels of dissociation may not be a good fit for virtual therapy if they struggle to ground themselves while working on challenging issues. In-person sessions can often be more appropriate because a therapist can more actively help the client regulate in a way that isn’t as possible to do in an online format.
Lack of privacy
For folks who live with others, finding a private setting for online therapy can be a challenge. While there are ways to troubleshoot such as scheduling sessions during times where others aren’t around or doing sessions in a parked car, there are some circumstances where in-person therapy is the only way a client will feel safe in therapy. This can be especially true for circumstances where someone is in abusive situation or if teens worry about their parents overhearing what is said in session.
Is It Possible To Take A Hybrid Approach To Therapy?
Many therapists, including our team at The Gaia Center, are open to clients engaging in a mix of virtual and in-person psychotherapy sessions. This can provide the flexibility for clients to do sessions online when it makes sense for their schedule and needs, while also having the ability to do sessions in-person if they want to engage in a modality that is better suited for that format, or if they just want the ability to connect face to face.
What To Expect From Online Therapy Sessions With The Gaia Center
While we offer in-person sessions at our office in West Nashville, all of our therapists also provide virtual therapy sessions for clients throughout the state of Tennessee. You will get a link to sign on for the session in your appointment reminder email, and your therapist will always do virtual sessions from a safe, confidential location. You can join from your computer, tablet, or phone.
How to get the most out of your online sessions
In order to have the best experience for virtual sessions, we recommend that you close out all other tabs both to minimize distractions and to make sure your device doesn’t get laggy. It’s also a good idea to check your internet connection beforehand. Phone sessions are also always an option if your connection gets bad. An important note is that sessions cannot be held from a moving car. While you are welcome to do sessions in a parked car, we cannot hold sessions safely if you are in a moving vehicle.
Your Healing, Your Way
Both research and our anecdotal experiences with our clients show that online therapy can be effective for a wide variety of mental health struggles. We offer both in person and virtual sessions so that our clients can have autonomy to pick what feels best for them in their unique healing journey. We invite you to explore whether online therapy might be right for you – and if you live in Tennessee, we would be honored to support you on your path to healing.
