Why consider online therapy? [Part I of III]

While it might not feel strange to check your bank account online or FaceTime with a friend, the idea of online therapy can challenge our ideas of what feels comfortable to do online. Most of us have an idea of what counseling looks like, and it usually involves a couch of some sort and maybe some questions about your mom. Never fear: With online therapy, you can still have the couch (and the questions about your mom), but it just might be your couch instead of a stranger’s.

Why consider online therapy? Brittany N. Murphy, PhD, LPC, NCC, BC-TMH, www.drbrittanymurphy.com

Over the course of this series, I’m going to cover why to consider online therapy, how to prepare for an online therapy session, and what to expect during an online therapy session.

Why consider Online therapy (also known as telehealth or video counseling)?

Some people object to the idea of online therapy because “it’s not the same as being in a room with somebody.” You know what? They’re not wrong! Communicating with somebody online is not the same as communicating with them face-to-face, but just because it’s different doesn’t mean that it doesn’t work. The technology is there, and we take advantage of it every time we use Zoom to conduct a business meeting or FaceTime to chat with Grandma (both arguably important conversations). It’s time to consider using it for another type of conversation - a counseling one.

As part of a court case in the 1990s, the question arose as to whether or not a forensic interview that was conducted via video means could be considered valid. Could a video interview really be considered the same as an in-person one? Apparently yes! It was determined that the fact that the interview was conducted via video “did not increase the risk of an erroneous result”, meaning the fact that the conversation was conducted using video technology did not invalidate whatever was discussed or determined.

What does a court case have to do with counseling? In my mind, both of those types of conversations have pretty high stakes for the people involved, so if a court of law can trust the utility of video interviewing, then maybe we counselors can too.

Now as I sit and update this blog post in 2024, our exposure to online work has increased exponentially, thanks in large part to the shifts needed to keep the world running during the pandemic. It’s okay if you’re feeling Zoom fatigue and feeling averse to trying online therapy. It could be that you’re somebody that will just always prefer meeting in-person. There is nothing wrong with that. That being said, I’d encourage you to consider how nice it could be to have at least one online meeting in your week where you don’t have to be “on” in the same way. You show up for work meetings, but with online therapy, your therapist shows up for you.

There is a lot of good that happens in counseling when the counselor and the client are in the same room, but it’s not the only way that the good stuff happens.


What do we know about online therapy?

Because so much of the success of counseling is based on the therapeutic relationship or alliance, the setting (video or in-person) itself does not determine the success of treatment. Researchers have found that video services are comparable to in-person services and that they show positive outcomes. This means that counseling services can be delivered effectively and meaningfully online to the clients who want them.

Online or telehealth services also address many of the barriers to clients accessing mental health services at all including lack of access to providers, travel costs and time, long waits for appointments, and poor mobility. For these reasons, video counseling is associated with increased client satisfaction.

These comparable experiences, positive outcomes, and increased client satisfaction don’t just happen though. In order to competently provide online therapy services, clinicians have a lot of work to do in terms of preparing their clients on what to expect and how to use online therapy services effectively. In the next part of this series, I’ll take you through how to prepare for online therapy session.

What other objections come to mind when you think about online therapy? Comment below!

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