Does Online Counseling Therapy Work?


Sure it’s easy to access and easy to use, but does online counseling work?

That’s the burning question when it comes to online counseling / therapy. Various forms of online therapy have been in existence for over a decade now and the research is coming to the conclusion:

YES, online counseling / therapy can be as effective in helping people reach their goals as in-person therapy. 

Experienced Clinicians & Educators Are Advocating Online Therapy

As a result of the research and their own experience, well known and respected researchers and educators in the field of therapy have become believers in online approaches to therapy. In this 2016 interview Dr. Irvin D. Yalom, professor of psychiatry emeritus at Stanford University and author of many therapy books, best known to me for his work The Theory and Practice of Group Psychotherapy, talks about why he has become a proponent of online therapy.

If I talk to an online counselor is it the same as an in-person therapist?

Online counseling is not “the same” as in-person therapy, just like talking to a loved on on Facetime or Skype is not the same as talking with them in person. A lot of research shows that it is, however, just as effective as in-person counseling. So while it feels different than sitting in the same room with your counselor, it can help you reach your goals for counseling just as well. Clients report that they still feel close and connected to their online counselor, some even report feeling more comfortable because they control the environment they meet their counselor in.

The research on the effectiveness of online counseling therapy speaks for itself.

  • Web-based interventions compared to non-Web-based interventions showed an improvement in outcomes.
    A University of California meta-analysis concluded that Web-based interventions compared to non-Web-based interventions showed an improvement in outcomes in a meta-analysis of 5 studies. The primary focus was self-care and self-management interventions to encourage individual's behavior change in the presence of a chronic illness or condition necessitating knowledge sharing, education, and understanding of the condition. 
    — Journal of Medical Internet Research
  • Online therapy significantly lowered the number of hospital visits among veterans.
    In a four-year Johns Hopkins study that included close to 100,000 veterans, the number of days that patients were hospitalized dropped by 25 percent if they chose online counseling. This is slightly higher than the number of hospital visits experienced by patients who used face-to-face counseling.
    — Psychiatric Services
  • Five hundred patients assigned to either live video counseling or in-person care showed equal rates of recovery.
    A Canadian study shows that online therapy delivers the same satisfaction at slightly less the cost. Patients in Ontario, Canada were assigned to face-to-face or live video counseling and experienced statistically the same clinical outcome and level of patient satisfaction. The only difference was that the cost of providing the online service was 10% less per patient.
    — American Psychiatric Association
  • Internet-based cognitive behavioral therapy helped reduce symptoms of post-traumatic stress disorder with effects that lasted until well after the treatment had ended.
    Online therapy may be an efficient way to provide PTSD treatment to a large group of people. A pilot study compared the effectiveness of online cognitive behavioral therapy and in-person supportive therapy in 45 Defense service members suffering from post traumatic stress disorder (PTSD) after the September 11th attack. After eight weeks those receiving online therapy showed greater improvement. Six months after their first meeting those who had received online therapy continued to show improvement, in direct contrast to the in-person group.
    — American Journal of Psychiatry
  • After six weeks people with symptoms of depression improved significantly who received online counseling. 
    In one randomized controlled trial published in BMJ, 525 people with symptoms of depression were randomly assigned to receive online CBT; to consult a website that offered information about depression but no actual treatment; or to a control group involving weekly phone conversations with trained interviewers about lifestyle factors that could increase the risk of depression. After six weeks, depressive symptoms improved significantly more in people who received online CBT than in those in the control group.
    — BMJ
  • Internet-based therapy shown as effective as traditional face-to-face psychotherapy for depression and anxiety.
    In a large review published in the Medical Journal of Australia, researchers analyzed the results of 26 randomized controlled trials of online CBT for people with depression or anxiety. Two of the eight depression studies, and almost all of the anxiety studies, included some input from a therapist. Online CBT was found to be effective in 23 of these studies, including six of the eight studies that focused on depression. Overall, Internet-based CBT was as effective as traditional face-to-face psychotherapy for depression and anxiety.
    — Medical Journal of Australia
  • In a study published in the British Journal of Psychiatry, researchers compared four randomized controlled trials of online CBT for mild to moderate depression. The results suggested that online CBT can effectively reduce symptoms of depression.
    — British Journal of Psychiatry
  • In a study published in the Journal of Medical Internet Research, researchers compared online CBT to online interpersonal psychotherapy (IPT). IPT is most effective for people whose depression is the result of a stressful life event, such as the death of a loved one. Researchers randomly assigned 1,840 people with depression to receive four weeks of online CBT. Online CBT significantly reduced depressive symptoms.
    — Journal of Medical Internet Research
  • In a study of people with panic disorder published in BMC Psychiatry, researchers randomly assigned 113 individuals to online CBT or in-person group CBT. Those who participated in online CBT received feedback from a therapist after completing each of the 10 weekly modules. Those in the group CBT treatment met with two therapists for two hours once a week for 10 weeks. Both online and group CBT reduced the frequency and severity of panic attacks, with no significant differences between the two treatments.
    — BMC Psychiatry
  • The Huffington Post published an article about research done by the Department of Veteran Affairs entitled 
    Telemedicine No Less Effective Than In-Person Therapy For Vets With PTSD. Peter Kane, a psychologist at the University of Wisconsin in Madison said the study was able to show that, at least in the VA health system, effective PTSD treatments can be successfully delivered in multiple ways. “Patients with PTSD could be treated effectively in the clinic or by using home based telehealth,” Kane said. The findings are especially important given the common barriers that make it harder for those who need these services to access them, he noted. “Studies such as this one may change how mental health services are delivered in general, not just for PTSD or within the VA system,” Kane said. “It may be the case at some point in the future that mental health clinics may offer home based telehealth as an alternative to traditionally clinic-based care.”
    — Huffington Post & Department of Veteran Affairs



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