Online Therapy Just As Effective As In-Person Sessions

Mental health treatment via telehealth is here to stay, and may even increase in use post-Covid-19.

People are needing therapy more than ever before. There has been a significant increase in anxiety, depression, and suicidal thoughts in the months since the pandemic, according to a Centers for Disease Control study. The greatest increase was found in those aged 18-24.

In addition to anxiety, depression and suicidal thoughts, there has been an increase in substance abuse and domestic violence.

For those who cannot leave their homes or choose not to risk virus exposure by venturing out, counseling via telehealth has provided a much-needed service.

Cognitive-behavioral therapy (CBT) is a talk therapy that is designed to be short-term. “Cognitive distortions,” or destructive self-talk, is discussed, along with challenging those beliefs. “Homework” is frequently assigned in CBT, in order to make the sessions more effective and to extend the therapeutic alliance past the hour-long session.

Several literature reviews have found efficacy and satisfaction with online CBT. A review of 17 studies found that online CBT for depression may be more effective than face-to-face counseling. Participants were equally satisfied with either type of CBT. Online CBT was also found to be more cost-effective for clients than face-to-face therapy.

Another literature review of studies regarding online CBT found that it leads to significant decreases in symptoms of anxiety and depression. Online CBT was also found to be just as effective as face-to-face therapy in treating panic disorder. Online CBT was also significantly effective in treating post-traumatic stress disorder, panic disorder, and specific phobia.

An additional literature review of 14 studies found that online CBT led to a 50% improvement in symptoms of panic disorder, social anxiety disorder, generalized anxiety disorder, depression, obsessive-compulsive disorder, and compulsive gambling disorder. Online CBT was also found to significantly decrease the impact of stress and chronic fatigue. The length of the online CBT sessions was between 8 and 15 weeks, considered a short period of time in therapy.

Yet another review of 19 studies found that online CBT was superior to placebo and being wait-listed, and equal in effectiveness to face-to-face therapy for the treatment of anxiety.

Online therapy is not only beneficial to the client, but also to the therapist. Therapists are no longer having to commute to the office, and in some cases, they are no longer having to rent office space. A more relaxed therapist, as with any worker, means more productivity and an increase in staying in the present moment.

The availability of therapy-specific HIPAA-compliant portals for sessions has increased since the Covid-19 pandemic. Therapists have a variety of services that provide secure video sessions. This means that even those that are wary of the privacy of online sessions can have comfort knowing that the sessions will be private. While therapists should always use a HIPAA-compliant video service, it is up to the client to verify with the therapist that he or she is using such a video service.

Drawbacks to online therapy include ambient noise (especially since many therapists and clients are currently attending sessions from home), technology issues, and missing non-verbal communication. There is also the possible healing factor of seeing a therapist in person, but most clients would agree that not being potentially exposed to Covid-19 is a good tradeoff.