Talk to a Therapist Online…Seriously? Exploring the Validity of E-counseling

Validity of E-counseling

As the world shifts more and more toward functioning in a virtual reality of internet based communication, the impact is also felt in the area of the helping professions. While the idea of therapeutic advice and support online has been around since the advent of the Internet, progress in terms of technological efficiency and advances as well as the comfort of the average person in conducting as many aspects of their lives as possible on line the, notion of talking to a therapist online is increasingly gaining traction. Whether you call it e-counseling, online therapy, e-therapy or online counseling there is an explosion of services offering you the opportunity to talk to a therapist online.

But what is the efficacy of online therapy relative to face-to-face therapy? Is a talk with your online therapist going to yield the results you need?  Let’s start by defining online therapy as the delivery of mental health services via the Internet through e-mail or chat, real-time face-to-face remote interactions and/or video-conferencing (Mallen, Michael J.; Vogel, Rochlen and Day 2005). The most striking difference between therapy online and traditional talk therapy is the presence or absence of face-to-face contact and the geographical proximity of the therapist to the service provider. Clearly then the population suited for online talk therapy does not include clients that would require direct physical containment and support and access to local medical and/or public service resources and facilities (e.g. patients in crisis, suicidal patients, patients with severe psychiatric disorders, clients in abusive relationships).

Online counseling is generally viewed as more suitable for moderate to higher functioning individuals (Stofle, 2001). Within this population, there are differing opinions as to whether online therapy should be seen as a form of counseling and coaching, an adjunct to face-to-face therapy or whether indeed it is an actual substitute for psychotherapy. Many online therapy services ( see talking to an online therapist as a useful service for less complex issues.

While E-counseling is a relatively new field there is a small but growing body of literature supporting the efficacy of online therapy. Many of these studies have design and methodological issues that need to be taken into consideration in evaluating their findings. A number of studies have pointed to online counseling as being at least as efficacious in terms of client satisfaction and treatment outcomes as face-to-face therapy (Mallen et al, 2005 and Murphy, L., Parnass, P., Mitchell, D., Hallett, R., Cayley, P., & Seagram, S. , 2009).

For instance in a study of 62 patients primarily presenting with mild depression and employing cognitive behavior therapy there was a decrease in symptoms of depression for 53 percent of those using an online therapist, in comparison to 50 percent who had face-to-face counseling. In a follow-up three months after completing treatment, 57 percent of patients with an online therapist reported being symptom free versus 42 percent of those who undertook conventional therapy (Maercker, 2013).    Godleski, Darkins and Peters (2012) in a study spanning four years and involving almost  100 000 military veterans over a four year time period found that participating in remote clinical videoconferencing over six months decreased psychiatric hospital admissions by on average of 24.2% and lowered the number of days hospitalized by on average of 26.6%.

So clearly while online counseling is a relatively new avenue for offering therapeutic serves there is evidence to suggest that talking to an online therapist can certainly be s beneficial as conventional therapy.   Increased client compliance and consistent attendance may contribute to the success of online therapy.  The possibility of more honest, expressive and open communication with a therapist online especially for individuals who feel uncomfortable in face-to-face communication has also been suggested (Perle, Langsam and Nierenberg, 2011).  The increased versatility, convenience and accessibility to therapists that online counselling offers have also been touted as a significant benefit (Perle et al, 2011). Perhaps talking to a therapist online is something seriously worth considering.


Linda Godleski, M.D., Adam Darkins, M.D., M.P.H., and John Peters, M.S.  Veterans Affairs Patients Enrolled in Telemental Health Services, 2006–2010

Published online: April 01, 2012  |

Maercker, A.   Psychotherapy via internet as good as if not better than face-to-face consultations.  Published online:  July 30, 2013

Mallen, Michael J.; Vogel, Rochlen and Day (November 2005). Online Counseling Reviewing the Literature From a Counseling Psychology Framework . The Counseling Psychologist. 33 (6): 819–871. (

Murphy, L., Parnass, P., Mitchell, D., Hallett, R., Cayley, P., & Seagram, S. (2009). Client Satisfaction and outcome comparisons of online and face-to-face counselling methods. British Journal of Social Work, 39(4), 627–640

Perle JG, Langsam LC and Nierenberg B.  Controversy clarified: An updated review of clinical psychology and tele-health.  Clinical Psychology Review 2011; 31:1247–1258.

Stofle, G. S. (2001). Choosing an online therapist. Harrisburg, PA: White Hat Communications.