For many who need help with their mental health, seeking it out is the biggest problem. Having anxiety in and of itself can mean it’s scary to visit a therapist, whilst those with depression may not believe that their issues warrant a trip.
This is where online therapy made a massive difference. During the pandemic, healthcare services began to transition online. Local GP surgeries in the UK began asking for initial phone call appointments before any physical meeting is made, whilst cancer patients around the world began having online meetings to talk over their treatment and progress.
Initially, this migration towards telehealth was to stop the spread of Covid-19, but it became clear that it was a benefit to patients who lived in rural areas or were very busy, whilst it also maximized the number of appointments that medical professionals could make in a given day. We’ve also seen extreme accounts of surgeons performing surgery from the other side of the world using remote technology.
Online therapy is no different. There are barriers in the way for both the therapist and the patient when it comes to physical meetings, and online services are taking off because of that.
The pandemic isn’t actually playing the largest role in the online therapy industry, but it’s a good timeframe to refer to. Pre-pandemic, online therapy existed, but it was mostly from telehealth companies like Amwell who perform a variety of telemedicine. Essentially, they’re very much a traditional healthcare company but in the online world. Online therapy 2022 is a very different landscape than 10 years prior.
The real growth came from the tech firms - as it often does. The likes of BetterHelp and Talkspace, founded in that ~2012 golden era of tech firms (think Wise, Zoom), realized that they could refine the art of delivering therapy down to a more concise, direct vehicle - mobile apps. Comparing the 2 leading online therapy sitescan be useful in seeing what the industry has to offer, and how little it differs from traditional therapy.
What separates them from the older telehealth firms was that they weren’t just leveraging technology, but also modern marketing methods. Influencer marketing became a big tool, such as Ariana Grande’s partnership with BetterHelp, in which she gave away $2m in free therapy sessions, whilst Talkspace has used Michael Phelps and Demi Lovato to promote the app. Because of this odd monetization of mental health, it leads to the question, is online therapy good for us?
There is already a stigma around therapy, unfortunately, and this is further confused by the notion that we should speak to a professional, not seek online answers. However, this is precisely why online therapy has been so powerful: it combines the first bit of advice (speaking to professionals), with the latter human desire for convenience and privacy (online answers).
But, is online therapy good? Is online therapy effective - or as effective - as traditional, face-to-face therapy?
The short answer to that is yes, but there are a couple of caveats to be aware of.
The most important finding that has resulted from various studies is that the medium of communication for therapy isn’t very importantin its effective results. In other words, therapy is therapy, whether you’re face to face or on a phone call. Some studies have shown the exact same levels of effectiveness between the old and new, whilst others are deemed close.
This is good news for those who would rather be at home and speak to their therapist over text message or phone call. However, it’s important to make a distinction in what kind of therapy we are looking for.
Online therapy is highly suitable to the mental health conditions of anxiety, depression, and other common causes of seeking out a therapist. What it is less suited to, however, is very niche forms of therapy and also severe mental health disorders, like Bi-Polar and psychosis.
The reason for that is partly because the likes of Betterhelp and Talkspace use therapists, not psychiatrists, meaning they’re not allowed to legally prescribe medication - and this is a primary form of treatment for severe mental health disorders.
Of course, more broad telehealth companies like Amwell do have online psychiatrists. These may be helpful for ongoing assessments and checking in, but they’re not optimal for diagnosis and intensive therapy. Firstly, with such conditions, reading body language closely becomes more important, and certain psychological assessments may need to be undertaken.
Here are some key benefits to consider with online therapy.
- In most circumstances, it is as effective as traditional therapy
- Cheaper than traditional therapy
- More accessible than traditional therapy (those with disabilities, limited time, live in rural areas)
- More approachable for the younger, tech-focused demographic
- Greater choice of therapists
- More choice over your preferred communication (i.e. texting, phone call, voice notes, video call)
- Treatment on-demand (sessions/conversations can sometimes be improvised whenever)
- Insurance companies can cover it
Here are some key disadvantages to consider with online therapy.
- Less likely to be covered by insurance than traditional therapists
- Often the therapist needs to be licensed in both their state and your state
- Potential data and privacy risk if there’s a breach
- Not appropriate for more serious psychiatric illnesses
- Influencers partnered with the companies are profiting from mental health issues
Online therapy may not be as covered as traditional therapy through insurance, but it’s growing. Blue Cross Blue Shield, for example, covers Amwell and others, whilst Cigna is partnered closely with Talkspace. Kaiser, Anthem, Aetna, and many other insurers have some sort of coverage for telehealth and are on their way to being very comprehensive.
Since the pandemic, Medicare and Medicaid have also stepped up efforts to cover telehealth, including online therapy. Talkspace is not covered by either, but Amwell is, along with various other therapy providers. It’s easier to get a straight answer from Medicare, being federal, than from Medicaid, which will depend on the state.
Online therapy has offered a new, mobile-centered experience of therapy. This is ideal for those struggling with the idea of heading down to a perceived sterile therapist's office downtown, and research shows that treatment over the phone can be just as effective as traditional therapy. So, you don’t need to worry about online therapy vs live therapy - they can work in harmony.
If more intensive treatment or diagnosis were to be recommended, online platforms remain to be a good stepping stone - a smaller, more manageable first step on the way to getting help. It’s cheaper, more convenient, fully licensed, but it’s worth being aware of its limitations.