$65
Avg Weekly Cost
- Unlimited sessions with a dedicated professional therapist
- All therapists are licensed and experienced
- Therapy sessions by phone, chat, video and messaging
- Mobile App
- HIPAA compliant
The Best Online Therapy Services of 2020 Compared
Choosing the right online counseling service for your needs doesn’t have to be a difficult decision. Though there are over 20 providers offering similar services, and the list keeps growing, the larger, more established therapy companies have continued to improve the features and overall value they offer their customers, distancing themselves from the lesser-known providers. We’ve reviewed the services offered by these providers and highlighted what we believe to be the most important factors in helping you decide which is the best online therapy provider for your needs.
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$65
Avg Weekly Cost
- Specializes in relationship counseling
- Therapy by phone, chat, video and message board
- All therapists are licensed and experienced
$45
Avg Weekly Cost
- Specializing in counseling teens
- All therapists are licensed and experienced
- Therapy by text, phone, chat and video
- HIPAA compliant
$99
Avg Weekly Cost
- All therapists are licensed and background-checked
- Therapy by text, video and audio message
- HIPAA compliant
$99
Avg Weekly Cost
- Video and chat sessions
- Easy to use appointment scheduler
- HIPAA compliant
What is Online Therapy?
Therapy is a resource that has provided people all over the world with support and guidance for generations and is an important part of a solution to people’s emotional suffering. Unfortunately, due to social stigma related to seeking help for mental health issues and inaccessibility due to costs and other logistical barriers, therapy is not always used by the people who need it most. The ability to get to a therapist’s office and then to pay for the treatment they provide can be the biggest obstacle to a person getting the help and support they need. The evolution and advancement of technology, online therapy has made it possible for mental health services to try to battle these barriers in an effort to help more people get mental health treatment. Just like many other businesses and services, technology and access to the internet from virtually anywhere has opened the doors for people to get what they need with just a click of a mouse or a swipe on their phone. You can order groceries online to be delivered, call doctors and get prescriptions, and can even do your entire job from home! Every business is trying to find a way to make their services more accessible to everyone, and mental health businesses are no different. Thanks to the internet, people can now seek out and obtain mental health services from their homes or anywhere else they happen to be.
The goal behind many of the companies providing mental health treatment online is to offer many more people with affordable and accessible services that will help improve their functioning and their lives. Being able to access it from home, often for much less than traditional therapy services, helps those who cannot afford to go to the office of a mental health professional to still obtain support. There are many companies that have begun providing mental health services online, and each of them provides varying features and options for services. Just like finding a traditional, face-to-face therapist, choosing an option may be overwhelming, as it is hard to know what will be the best fit. If you’ve been struggling to figure out where to find the right therapist for you, we’re here to help! We have tried to help you sort through the options to help you come to a decision a little easier; this article will provide you with information about what current therapy sites offer, and information about online therapy (and traditional therapy) as well. Our experts have tested the leading online counseling services based on a range of factors, including support, confidentiality and privacy, counselor qualifications, areas of expertise, usability and pricing. Before we get into the reviews, let’s discuss the ins and outs of therapy and teletherapy to make sure it’s the right choice for you and your needs.
Why People Need Online Therapy
Mental health issues are a major health concern in the United States; researchers have found that mental health illnesses have been the fifth most costly disease group in the US in recent years, and studies show that nearly 50% of American adults suffering from mental illness have not received the mental health treatment they need in the previous year. While online therapy is obviously a very important part of treating diagnosable mental illnesses, it is not just for those with a serious medical condition. Therapy is also a perfect method for helping people manage stress, relationship issues, work-related crises, and personal problems. This is important, especially in this time in American history; Americans of all generations report experiencing chronic stress and feeling constantly overwhelmed. Many believe that the cause of this stress is related to the constant access that we have to the things in our lives that stresses us out. The ability to check work emails at any time of the day and have access to almost anyone at any time seems to have inherently decreased our ability to cope on our own and increased the need for everyone to benefit from support from an experienced therapist.
Studies are finding that people are experiencing more chronic levels of stress and burn out at work as a result of the pressure to work relentlessly and feeling that they can never work enough hours or work hard enough to succeed. In fact, in a recent study, 77% of those surveyed reported experiencing some burn out in their current job. The impact of unresolved work stress can impact a person’s ability to perform in their job, which can impact their immune system and overall health, and it can impact both their work and personal relationships. So, even those who do not meet medical criteria for a mental health disorder may be experiencing symptoms of stress, anxiety, or depression that could be impacting their functioning enough where therapy could help. Learning coping skills from trained professionals who can empathize and help a person perspective take and make healthy choices for themselves is a critical tool in managing today’s inherently stressful world.
Research shows that a combination of cost and lack of knowledge about how and where to obtain treatment seem to be the main reasons why people are not getting the help that they need. Many more rural places may also not have therapists available in their area or they may have other issues related to access based on their geographical location. In addition to these issues, while mental health treatment is becoming more widely accepted, there is still a societal stigma that causes people to pause and think twice before seeking treatment.
Understanding our Online Therapy Reviews & Rankings
Therapy is not a quick-fix type of service. It typically involves a long-term process of gradually opening up to the therapist and working on oneself to confront emotions, change bad habits and eventually overcome complicated challenges. Naturally, outcomes vary widely, and thus success fluctuates significantly between different individuals. Understanding that when it comes to emotional well-being, the definition of success also varies greatly, our rankings were heavily impacted by overall customer success stories. This information was collected over hundreds of hours of research from thousands of online therapy reviews. In addition to the analysis of our researchers, we collect feedback from professional therapists and technologists that understand both therapeutic and technological aspects of the features provided by each online therapy service we review. This includes the individual benefits of each provider, in addition to the effectiveness and drawbacks. Additionally, these reviews take a deep dive into the various areas of what the service offers including the features, sign-up process, pricing, usability, counselor support, confidentiality/privacy, counselor qualifications, and each service’s areas of strength and weakness. It’s important to note that our reviews and rankings are based on our knowledge and experience of using each service. Success can vary from person to person and thus it’s imperative to find the service that’s tailored to best suit your specific needs.
Best Online Counseling Services Reviewed
- All therapists are licensed and experienced
- Therapy by phone, chat, video and message board
- Mobile App
- HIPAA compliant
Betterhelp has earned the top spot on our list of best online therapy services, and it’s easy to see why. Most services have one standout feature that sets them apart from their competition. Betterhelp has a handful.
From sign up to overall usability, the verdict is in – Betterhelp is in a league of its own. Both their desktop and mobile app platforms are designed to simplify your journey. It’s essentially structured similar to WhatsApp or Skype, enabling easy chat, phone or video communication. Likewise, the questions posed in the initial sign up stage are not overly intrusive, and they allow you to remain anonymous throughout the entire process, including after you’ve signed up for an account and during your therapy sessions.
Moreover, while success varies from person to person, both expert and user reviews regarding counselor effectiveness and customer success rates are overwhelmingly positive. The fact that Betterhelp works with over 3,500 licensed U.S. based therapists, with thousands of hours of hands-on experience covering virtually every area of mental health, certainly plays a role in this feat.
Overall, Betterhelp is one of two to three online therapy services to both impress our experts and remain extremely popular among more than 500,000 individuals who use their service.
Additional features: pricing (low monthly cost), security, confidentiality.
- Specializes in relationship counseling
- Therapy by phone, chat, video and message board
- All therapists are licensed and experienced
Regain is the premiere couples counseling website online. They are one of the only websites to have close to 1,000 licensed psychologists specifically trained to help resolve relationship issues.
What has attracted so many people to couples’ therapy online via Regain is the fact that they don’t push both members of the couple to sign up. Instead, they realize that most people will likely start therapy on their own, and only then have their partner join in on the therapy sessions. Current success rates, according to countless online reviews, are moderately to very high.
Furthermore, many people who require couples counseling are also experiencing some form of mental illness (e.g. depression). The therapists that work with Regain are fully licensed and trained in all of the areas of mental health, making Regain a one stop online therapy solution.
So, while Regain is known for its professional online marriage counseling, it’s also known for providing quality individual online therapy as well.
- Specializing in counseling teens
- All therapists are licensed and experienced
- Therapy by text, phone, chat and video
- HIPAA compliant
Teencounseling.com is a therapy platform specifically designed to cater to teenagers 13-19 years of age. The therapists on the site are all licensed and experienced with helping teens cope with the issues unique to adolescence.
Though parents can choose to be involved in initially discussing their child’s needs with the therapists, and continuously serve as the points of contact in case the teen is believed to be at risk, the sessions between the therapist and the teen are completely confidential.
- All therapists are licensed and background-checked
- Therapy by chat, video and audio message
- HIPAA compliant
- User friendly
Over the past few years, Talkspace is one of two brands that has essentially become synonymous with the words “online therapy”. A primary reason for this is because they have done an incredible job of marketing themselves as one of the go-to therapy services. From online to TV advertisements, no matter where you look for an online therapy solution, Talkspace is seemingly always there, challenging you to sign up and use their service.
However, marketing isn’t their only strength. It also helps that Talkspace has competitive pricing, a user-friendly platform and generally positive reviews from people who use their service.
And, while there are other therapy providers who are ranked higher on this list, Talkspace is the only brand aside from Betterhelp that can boast about providing stellar mental health help to a whopping one million people.
- Video and chat sessions
- Easy to use appointment scheduler
- HIPAA compliant
Breakthrough online therapy, which was bought out by a major telehealth company called MDLIVE, has earned a top spot on our list, with real world users agreeing to their prestige.
One of the core benefits of Breakthrough is their on-screen scheduling system, which is rated best in class by both experts and users alike. What’s particularly impressive is its seamless integration via their mobile apps (found on both iOS and Android).
Another reason why more than 30,000 individuals have signed up to Breakthrough is because of their health insurance acceptance. They are the only large online therapy service to accept major insurance plans. Though with Breakthrough, the initial ‘listing’ cost is similar to what in-office therapy costs, which can be up to $300/hour if not higher. Subtract insurance coverage and most people end up paying a fairly affordable rate per session.
And for good measure, Breakthrough requires all therapists operating on their platform to conduct a minimum of 5-15 sessions/month in order to stay up to date on providing therapy online.
- Additional Providers:
- e-Therapy UK
- Better Your Way
- Faithful Counseling
- iCounseling
- iTherapy
- Timewith
- Relationship Hero
- Presto Experts
- Pride Counseling
- MyTherapist
- Livehealth Online
- Online-Therapy.com
- Counseling on Demand
- Thera-Link
- AmWell
- 7 Cups of Tea
- My Therapist Online
- Doctor on Demand
- JustAnswer.com
- TranQool
The Main Benefits of Online Counseling
Many believe that online counseling should not replace in-office counseling. Rather, it should complement your traditional counseling sessions, as online counseling offers a range of benefits to users. Others, however, including thousands of satisfied customers already using online counseling services, boast that that level of connection they are able to make with their therapists online make in-person counseling unnecessary. Some of the most common benefits associated with online counseling are:
- No Boundaries: With online counseling, there is no longer a need to seek out help within your city limits. You have the ability to connect with a psychologist that’s not in your area. Best of all, should you not click with your therapist, you have the option to change therapists.
- Efficiency: If you’re working full-time, chances are you have very little personal time set aside. With online counseling, you can receive help 24/7, or while you are on-the-go.
- Communication Channels: Gone are the days of having to set pre-arranged appointments and then receiving counseling in person. Online counseling enables you to open your counseling app and get help right away. This includes SMS/chat, video, and phone counseling options.
- Stigmas: Oftentimes people don’t set therapy appointments due to the stigma surrounding counseling. In fact, some people who do in fact set appointments won’t show up for their session due to this unfortunate stigmatization. With online counseling, that stigma is gone.
- Privacy/Confidentiality: Using online counseling provides users with complete privacy and confidentiality. For starters, therapists on the platforms are bound by strict local and federal laws, as is the case with their brick and mortar business. Your counseling sessions are protected by HIPAA. Furthermore, your chat sessions are also secured by various bank-grade encryption levels, which only you and your therapist can access. Lastly, should you still not feel comfortable with counseling, even online counseling, you have the ability to sign up using an alias and dummy e-mail account.
- Pricing: Did you know that it generally costs someone roughly $200 for one therapy session? Even if you are covered by premium insurance, the co-pay for each session can be as high as $50. If you’re going into therapy once a week, that’s $200 per month on therapy. On the other hand, some of the best online counseling services provide users with incredible pricing, starting as low as $32 per week ($128 per month). Moreover, some online counseling services even work with major insurance companies, which further reduce your costs.
Diagnoses That Can be Treated Through Online Therapy
There are many different lists of issues that therapy can help, but they are usually categorized in the following areas:
- Mood Disorders: Usually related to depression or bipolar disorder — these disorders usually have symptoms of mood fluctuation, including periods of depression (feeling excessive sadness, worthlessness, and lack of interest in previously enjoyed activities). Bipolar disorder in particular can include periods of depressed symptoms, as mentioned above, but also periods of mania (hyperactivity, lack of sleep, lack of impulse control, risk-taking behaviors, etc.)
- Anxiety disorders: Anxiety takes many forms, but can involve specific fears, phobias, or worries, or generalized anxiety, which means that a person feels excessive worry about a variety of situations and experiences that aren’t tied to one specific thing. Diagnoses like social anxiety disorder (excessive fear of being in social situations and places), obsessive compulsive disorder (having obsessive thoughts that lead to compulsive, repetitive behavior), and others are all categorized as anxiety disorders.
- Personality disorders: While everyone has their own unique personality, there are some people who have a personality pattern that causes themselves or others significant distress or harm. People who are diagnosed with personality disorders often are describes as having long-term, fixed patterns of behavior that are extreme or rigid and inflexible. This inflexibility makes it hard for people to function in their lives and complicates their occupational and social functioning and relationships. Narcissistic personality disorder, obsessive compulsive personality disorder, and others are common diagnoses related to personality disorders.
- Psychotic disorders: Psychotic disorders are severe mental health conditions that are characterized by abnormal and odd thoughts and perceptions. Reality is often distorted for those who are in a psychotic state, and they often experience hallucinations (seeing or hearing things that are not really there) and delusions (false beliefs, often of a paranoid nature). Schizophrenia, delusional disorder, schizoaffective disorder, and others are common diagnoses related to psychotic disorders.
- Trauma-related disorders: Trauma-related disorders present themselves when a person experiences an event that causes them to feel excessive fear, often involving fear that they will die as a result of the experience. While these diagnoses were initially studied relating solely to combat experiences, research has expanded to include many other facets of trauma into the disorder, including situations of chronic abuse, rape, incest, neglect, car accidents, medical traumas, and many others.
- Substance abuse disorders: Substance use is an issue that has been present for decades and only continues to be more and more problematic in our lives with the increased use of opioids (strong pain killers) leading to addiction and ultimately causing overdoses and death. Alcohol and drug dependence are specific mental health and medical conditions that have specific treatments that have been shown to be effective in helping a patient reach sobriety, and ultimately saving their lives.
Diagnoses Most Effectively Treated via Online Therapy
Online therapy is currently used in a variety of settings and ways, from speech and occupational therapies to mental health treatment. It can be used for individual, family sessions, or even groups! Online counseling sites and apps have specific criteria for the types of issues they feel comfortable treating. Most of the online therapy companies mentioned in our review are meant to treat non-severe conditions, such as minor symptoms of depression, anxiety, stress, and mood regulation. Most of these online therapy outlets report that this format is not designed for more serious issues involving suicidal or homicidal ideation, risk-taking behavior often related to mania and bipolar disorder, psychosis or other major thought-distorting diagnoses, or any symptoms that require more intense observation and treatment. Online therapy is best for people who are experiencing minor struggles in their functioning who do not need intense services and support.
Betterhelp.com reports that their site’s goal is to help people with the following conditions: stress, anxiety, relationship issues, parenting, depression, addictions, eating, sleeping, trauma, anger, family conflict, LGBTQ+ concerns, grief, religion, self-esteem, and more. This seems to be the common theme for most sites dedicated to helping via online therapy. It is not recommended for those experiencing a mental health crisis or emergency, for those diagnosed with or experiencing severe mental illness in need of psychiatric care, or someone who is involved in a forensic capacity and mandated to participate as a result of a legal case. It is important to note that many private practice therapists also conduct therapy working outside of these traditional teletherapy businesses and may offer different expertise, training, and willingness to see people with a different set of symptoms and circumstances than these sites. If you do not meet the criteria for seeing someone via an online counseling platform but still want to obtain teletherapy services, searching for individually licensed clinicians who provide those services may help you find the right fit for your needs.
Therapy: Does it Really Work?
If you’ve gotten this far, you’ve read a bunch of statistics about all the people who are seeking out (or NOT seeking out) online mental health services to help them improve their lives. There is a lot of data out there about the benefits of therapy and treatment, both in person and online, but does it really work to reduce a person’s stress and significantly improve their functioning? The science suggests that it does! To answer questions related to the success rate of therapy and subsequently teletherapy, it will be important to discuss the theories of therapy, the specific models of therapy, and the rates of success that these different treatment approaches boast. And even when discussing the different treatment approaches, there is a lot to consider that could impact the ability for there to be a success in treatment. Let’s discuss the theories of therapy first and then how they measure up in terms of effectiveness.
As is the case with any service or product, there have been people who question the effectiveness of online counseling. Such concerns include:
- The absence of verbal cues
- Effectiveness in treating clinical disorders
- Technological complications
- Regulatory concerns
Though many of these concerns are valid, they vary on a case to case basis. Some have suggested that human/face to face contact is the only way a therapist can truly identify the feelings and behavior of their client. This may be true in some instances over chat therapy, however video therapy eliminates this issue, which in turn eliminates many of the ‘limits of effectiveness’ claim as well. Moreover, people living in rural areas may have spotty Internet connection. There are also some who point to transmission and server problems, an issue we found very little evidence of in our research.
Overall, the best measure of effectiveness is hearing from the thousands of existing customers already using these services. Most of them post testimonials and reviews on their websites. While some leave negative reviews, the fact that so many have had positive experiences is very telling. It means that at least to some extent, this is working. It’s just a matter of trying it out oneself to make an individual determination.
Therapeutic Theories
These are the main theories that therapists will use that influence the styles of therapy that they use to help their patients.
- Psychodynamic Therapy (Psychoanalytic): Therapists who use psychodynamic or psychoanalytic therapy strategies often work to help their patients gain insight into the unconscious ways we have processed things that have happened in the past, and how this is playing a part in how they are currently behaving in the present. They work to help a patient begin to understand how their past may be causing them to recreate patterns in their lives that cause them stress and pain and help them to learn how to undo these patterns and develop more healthy and sustainable ones.
- Behavior Therapy: Derived from the early work of Ivan Pavlov who was famous for his work with dogs, behavior therapists usually help patients overcome fears, phobias, or anxieties by desensitizing them to whatever they are worried about. They do this through gradual exposure to stressful experiences, events, or things, and help them to use coping skills to get through an exposure exercise, ultimately showing a person that they can change their perceptions of these things and situations and change their behavior in the process.
- Cognitive Therapy: Often coupled with behavior therapy, cognitive therapists focus on helping a patient become able to notice their thoughts and how these thoughts affect their feelings and ultimately their behavior. Therapists who utilize cognitive therapy will help their patients recognize that challenging their thoughts and using coping skills to tolerate them if they cannot be changed can ultimately change how they feel about whatever is causing them stress.
- Cognitive Behavioral Therapy (CBT): CBT is a variation of cognitive therapy and behavior therapy and blends the two to help people recognize how their thoughts are contributing to their distress, but also challenges them to use coping skills and to practice challenging their thoughts in situations where they are exposed to stressful situations. This helps them to practice the skills enough to use them in real times of stress, thus helping them improve their ability to handle whatever comes their way outside of therapy.
- Humanistic Therapy: Humanistic therapists believe that a person should work toward becoming the person they want to be, and that this self-actualization ultimately helps a person heal. The way that they help a patient work toward self-actualization involves helping them make choices that are in their best self-interest in combination with support and consideration/respect for others to help them achieve their goals. The search for meaning is often discussed in humanistic therapy, and therapists work to help patients come to conclusions for their own purpose and meaning.
- Integrative or Holistic Therapy: Many therapists will say they utilize an integrative or holistic approach, and this generally means that they work with different approaches depending on patient need and their personal expertise and training.
Types of Therapy
As mentioned above, therapists generally conceptualize their treatment using one of the above-mentioned models. From those conceptualizations, psychologists have worked to develop different strategies for using these frameworks to help people manage their specific symptoms. What was born from this was a list of therapies that are used to help a person manage their personal struggles by working through set steps that have been shown to be helpful in overcoming negative emotional patterns. Here is a list of common therapy types that are used to help treat a variety of conditions both online and in-person:
- Cognitive Behavioral Therapy (CBT): Mentioned above, CBT is an approach that is well researched and is used to help people overcome a variety of conditions, from depression and anxiety to trauma. There have been many iterations of CBT that have been developed to help specific symptoms, such as CBT-Insomnia, Trauma-Focused CBT (TF-CBT), and many more.
- Dialectical Behavior Therapy (DBT): DBT is a model that uses a CBT theoretical approach and teaches patients skills to manage and regulate their emotions and to decrease conflict and toxicity in their relationships. DBT uses four main areas to teach skills that help their patients learn new ways of emotion regulation and communication with others: mindfulness (helping them become more “present-minded” and focused on the here-and-now rather than the past or the future), distress tolerance (developing skills to increase their ability to tolerate negative feelings and emotions), emotion regulation (being able to manage and regulate emotions after tolerating them), and interpersonal effectiveness (helping people communicate in a healthy and assertive way to get their needs met appropriately).
- Family Therapy: There are various techniques used to help treat a whole family who is experiencing conflict, but usually family therapists work to help families learn how to communicate in effective and healthy ways and help them to heal relationships that have been torn apart by conflict. Family therapists tend to work from a systemic perspective, meaning that even if one person is considered the “problem” in a family, the therapist will work to see the family as a system that is reinforcing whatever negative behaviors are happening with that one individual. This framework helps them to get inside the system to help everyone in the family make small changes that will ultimately help decrease the problematic behaviors in the individual over time.
- Group Therapy: Often also called a “support group”, group therapy is a helpful strategy to help others find supportive peers who have experienced similar struggles of difficulties in order to help a person feel less alone in their feelings. Group therapy is a technique that is shown to be helpful in many areas, including managing grief, processing, and healing from traumatic experiences, and helping in changing behaviors like addictive behaviors or substance abuse. Having a supportive network of people who have experienced similar situations can help others to normalize their experience to decrease their judgment of it. It can also help a person become more accountable to change their behavior with a group of people there to check-in and provide assistance when needed.
- Interpersonal Therapy (IPT): IPT is used to help patients who struggle with mood disorders or fluctuations. Therapists who use this strategy in helping their patients work to help them identify that a large cause of their mood struggles may be related to their interpersonal relationships and how they are functioning socially. They use the following four techniques to help them improve these areas, therefore improving their mood: addressing interpersonal deficits (helping them to identify struggles they are having socially or any social withdrawal they may be engaged in which is impacting their mood), manage unresolved grief, handling transitionary periods in life (graduation, retirement, getting married, having children, etc.), and helping them learn how to handle conflict in interpersonal relationships in a healthy way.
- Play Therapy: Used with children, play therapists generally use free play as a way to assess a child’s thoughts and feelings that come up in the play and to help support, validate, and help them work through any struggles they appear to be experiencing. Children often struggle to directly communicate their emotional difficulties, but they will often reenact it or express it through play. A play therapist will observe these things and then use techniques to help the child feel supported, but also to help them shift perspective through play as well.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR comes from the theoretical framework started with behavior therapists and is used primarily for symptoms of posttraumatic stress disorder (PTSD). EMDR uses the exposure approach mentioned earlier when discussing behavior therapy to help a person become gradually exposed to traumatic memories or images and uses their eye movement or other physical movements to help them focus on external stimulation. EMDR therapists believe that associating the traumatic experiences with a safe and possibly soothing external stimulus can help a person to decrease their reactivity to the triggers they experience as a result of their trauma and can help them work toward healing.
- Biofeedback Therapy: Biofeedback is a technique that is used to help people manage a lot of different emotional and physical ailments, from depression and trauma to chronic pain and migraines. Biofeedback therapists will attach electrodes to their patient’s skin that help to identify their internal body state (heart rate, breathing rate, blood pressure, temperature, sweat levels, muscle activity, etc.). A therapist will use this information to help a person practice relaxation exercises and other coping skills and help them see the impact these tools can have on their internal states. This visual representation of the coping skills working can often help a person see their value and help them to do them in times of real distress.
Efficacy of Therapy Styles
Therapy, and the various types of therapy available, have been widely studied and have been accepted to be effective in treating mental health symptoms. Studies have shown that psychotherapy treats many different conditions, from intermittent stress to symptoms that are associated with severe and chronic mental illness. While there are overall information and consensus that suggests that therapy is effective, most studies have been conducted to confirm its effectiveness for treatment of mental health diagnoses, and thus the research behind which is most effective may not be the best representation of what will actually work for you, especially if you do not meet criteria for a major mental health condition. Overall, studies continue to find that cognitive behavioral therapy (CBT) is the most effective therapeutic style for the treatment of depression and anxiety symptoms as well as stress and other issues related to everyday functioning, thus it is often noted as the most effective type of treatment.
CBT has earned its place as an “evidence-based therapy” (EBT) via thousands and thousands of research studies showing its effectiveness in treating many different disorders. The psychological community has moved toward recommending EBTs as standard treatment approaches due to the fact that there have been so many research studies confirming its usefulness with managing mental health symptoms. Thus, EBTs are considered the gold standard because mental health professionals want to ensure that they are only participating in treatments that the scientific community knows are proven to be effective. There is a long list of other evidence-based programs, all of which have been molded from the earlier-mentioned theoretical models of treatment, particularly cognitive, behavioral, and psychodynamic therapies.
While EBTs are great and effective approaches, a specific EBT may not be the right option for everyone, even if it is noted as an effective treatment for the symptoms that the person presents with. CBT, for example, is great for someone who needs a fundamental understanding of how thoughts affect feelings and behavior and how to challenge their thoughts to change their ways of responding. If a person obtains this information and still finds themselves getting stuck in patterns of behavior that negatively impact their life, they may need additional support from a therapist from a different approach, like psychodynamic therapy, for example, to help them try to uncover possible reasons for these difficulties and how to help them undo some of their learned patterns of behavior by looking more critically at the past. Working with experienced mental health professionals is a great way to tease out what could help you personally and how the many treatment options available to you can work for you.
Types of Treatment Used in Online Therapy
Aside from play therapy and biofeedback, most of the above-mentioned types of therapy can be used just as effectively online as they are used in person. The type of therapy used will depend on the training, experience, and theoretical orientation of the therapist you are paired up with and the specific needs you are trying to address. Now that you have some knowledge about the types of therapies available and the frameworks that therapists use in their treatment, this can help you seek out the right person for you, whether you decide to see them online or in-person! Through the various online portals using online therapy, a patient is often matched with a therapist through the system. When matched, the goal of the introductory session will be for a therapist to begin to establish a relationship with you and to determine whether or not they are the right person to help you with what you want to work on. This is a great time to ask about the therapist’s theoretical orientation, style of therapy, and types of therapy they frequently use. If you do not think that the therapist’s particular style is right for you, you can absolutely ask to be paired with someone else!
Finding a therapist is a lot like finding a romantic partner; you want to make sure it’s the right fit for your personal needs, and that you feel confident that the relationship with the therapist will help you to grow. Therapists are trained to understand that the connection that they have with their patients is the most important part of helping them, and they should always be accepting and understanding of letting you find the person who will be right for you. An experienced online therapist will work within the first couple of sessions to help you make the decision whether or not they are the person for you. During this time, it is more than acceptable to “shop around” to find the person who you connect with most. The research shows time and again that the single most important thing that leads to therapy success is the relationship that the patient has with their therapist. If you have a trusting, loving, and supportive relationship, you’re more likely to meet your goals and alleviate your distress, so finding that perfect match is one of the most important parts of your online therapy journey.
The Statistics
Here are some statistics related to mental health treatment in the United States from the 2018 National Survey on Drug Use and Health. This data did not specify between in-person or teletherapy treatment but appear to be an estimation of both forms of treatment.
Statistics about Therapy in General
- In 2018, an estimated 37.1 million adults received mental health services during the past 12 months of being surveyed. This is equal to about 15% of adults, or about 1 in 7.
- Approximately 12% received prescription medication for a mental health concern. This percentage was greater than in 2002-2008 but similar to percentages in 2010-2017.
- About 7.9% obtained outpatient mental health services. This percentage was greater than in 2003-2016 but similar to the percentages in 2017.
- 1% obtained inpatient mental health services. This was higher than the percentages in the years 2002-2014 but similar to 2015-2017.
- About half of the adults who did not receive treatment explained that they wanted to obtain services, but costs were a barrier to obtaining treatment. Other reasons included: not knowing where to obtain treatment and believing they could handle their symptoms without treatment.
Statistics on Therapy Based on Ethnicity
A 2015 study, Racial/Ethnic Differences in Mental Health Service Use among Adults found the following information regarding the differences between ethnicities seeking therapy services from 2008-2012:
- Adults of the following ethnicities were reported to have similar utilization of mental health services as they have in previous research:
- White adults (16.6%)
- American Indian or Alaska Native adults (15.6%)
- Adults who identified as two or more races (17.1%)
- The following were ethnicities of adults who are estimated to have sought out and obtained therapy more than had been previously reported throughout the years:
- Black adults (8.6%)
- Hispanic adults (7.3%)
- Asian adults (4.9%)
Statistics about Therapy Based on Ethnicity and Gender
A 2015 study, Racial/Ethnic Differences in Mental Health Service Use among Adults found the following information regarding the differences between ethnicities seeking therapy services from 2008-2012:
- Adults of the following ethnicities were reported to have similar utilization of mental health services as they have in previous research:
- White adults (16.6%)
- American Indian or Alaska Native adults (15.6%)
- Adults who identified as two or more races (17.1%)
- The following were ethnicities of adults who are estimated to have sought out and obtained therapy more than had been previously reported throughout the years:
- Black adults (8.6%)
- Hispanic adults (7.3%)
- Asian adults (4.9%)
Therapy Statistics Based on Socioeconomic Status
A 2015 study, Racial/Ethnic Differences in Mental Health Service Use among Adults found the following information regarding the differences between ethnicities seeking therapy services from 2008-2012:
- Adults of the following ethnicities were reported to have similar utilization of mental health services as they have in previous research:
- White adults (16.6%)
- American Indian or Alaska Native adults (15.6%)
- Adults who identified as two or more races (17.1%)
- The following were ethnicities of adults who are estimated to have sought out and obtained therapy more than had been previously reported throughout the years:
- Black adults (8.6%)
- Hispanic adults (7.3%)
- Asian adults (4.9%)
Statistics about Online Therapy
There is little data, research, or statistical information about teletherapy and the people who are frequent users of this platform of support. While there is limited available data regarding the types of people who are seeking treatment via teletherapy, there is some information about telemedicine, in general. Telemedicine involves anyone using the internet to connect with a health provider, so while this could include medical doctors and other formats of seeking help with a person’s health, it also includes the use of teletherapy as well. Here are some statistics that were found regarding teletherapy and telemedicine in general:
- Almost ¼ of US consumers have had an online health appointment with a clinician.
- Globally, the number of people using online therapy services went from 0.35 million in 2013 to about 7 million in 2018.
- In 2017, the Employment Benefit Research Institute conducted a survey of 3,500 insured adults throughout the United States and found that millennials (those born sometime between 1981 and late 2000s) were far more likely to express interest in the idea of telemedicine than those in the baby boomer and Generation X generations.
- Another study showed that 9 in 10 Americans aged 40 or over reported being comfortable using telemedicine- which is about the same as those 18-39 years old, however, Americans age 51-60 submitted the most insurance claims for telemedicine in 2017.
- 83% of health care organizations planned to invest in telemedicine in the next year and only 1% of organizations reported having no plans to do so at any point in the future.
- Telemedicine is projected to grow at a compound annual growth rate of 16.8% from 2017-2023.
The History of Online Therapy
Online therapy has been used since the dawn of the internet in various capacities but is believed to have originated in 1972 at the International Conference on Computers by UCLA and Stanford staff who discussed the idea of conducting psychotherapy sessions online. Since then, a variety of different options have been available via the internet for support with mental health issues, from Q&A style blogs and eventually actual therapy sessions that began at $15 a session! While it has been around for a long time, it has not been near as accepted or recognized as it has in the last 5-10 years. During this time, several companies have begun providing affordable treatment via the internet that has taken the world by storm. Prior to these kinds of services, teletherapy services may have been offered by providers, but privacy and HIPAA-related concerns had always made it more of a hassle for professionals than it was worth. As technology has continued to improve, these concerns have been addressed and teletherapy businesses have been able to provide private and confidential treatment to its users without violating federal regulations. Since then, the ethical boards for therapists and medical professionals, in general, have provided guidelines for use of teletherapy services and have begun to develop a streamlined, safe, and effective way for people to get the care that they need. Healthcare services, in general, have begun to trend online with a goal of offering services to everyone, no matter their geographical location, which was often a struggle for those living in rural areas without immediate access to health professionals.
The Research on Online Therapy
The research on online counseling has reported positive benefits for the patients, as it can save time (both in securing an appointment and the travel time to get to and from), is often more cost-effective, and can meet the needs just as well as an in-person appointment can. Studies have shown via surveys that 80% of Americans use the internet to obtain information about mental health information and have begun to use it to seek out support and treatment as well. Because this is a relatively new phenomenon, there are not a lot of statistics about how many people are utilizing online services versus regular services, but online therapy companies like Talkspace and Betterhelp report having provided supportive services to millions of users who have completed millions of therapy sessions, though this is not indicative of how many people have obtained fully completed treatment through these sites. In addition to sites like these, mental health therapists in private practice have also begun to create online businesses where they see a majority of their patients online as well. These people often charge a bit more for their services, but often offer specific expertise and training that can be effective for people looking for specific kinds of treatment and support.
Since about 2004, there have been multiple studies that have reported that online therapy services do obtain results similar to, or better than, traditional therapy models. It is also suggested that beginning treatment via online counseling can help reduce the stigma and can help attract patients to seek and obtain face-to-face treatment if they have a positive experience on the app. More time and research will ultimately tell whether or not the online platform is a preferable and more efficacious model for people to use to obtain treatment, but as of now, it is an option that is helping many more patients get through the virtual door that can help them begin to make changes in their lives for the better.
Which Online Therapy Service Should I Choose?
While we have ranked the best online therapy services, it’s important to understand that these rankings are very general and thus may not be best suited for you. As we’ve noted above, outcomes and people’s needs vary. Every online therapy service caters to a certain individual and thus it’s important to understand and consider what type of issues you are dealing with:
General Mental Health Issues
The majority of people looking for online therapy are dealing with general mental health issues such as depression, anxiety, bi-polar, grief, etc.
Relationships
The next most common type of therapy people look for is online marriage counseling. Though many of these people are also dealing with general mental health issues, their primary reason for looking into online therapy is to help heal their relationship.
Religion
Religion is a major part of many people’s lives. If you are religious and are specifically looking for online therapy with religion playing an integral role in your therapy sessions, you will need to take this into account when choosing a service.
LGBTQ
Being part of the LGBTQ community has its perks. One of them is the ability to receive online therapy specifically catered toward the LGBTQ community.
Conclusions on Online Counseling
Online therapy provides a wealth of benefits, including convenience, privacy, the elimination of stigmas, low cost, and many other positives. Because of this, it’s no surprise to see millions of people currently using online therapy as their go-to source of therapy. If you’re looking to make the switch to online therapy from in-office appointments, make sure your needs are clearly defined so you can make the best possible decision for yourself.
Therapy is a resource for anyone, young and old, to use when they are feeling stuck. They could be feeling stuck regarding work issues, relationship problems, past life experiences, or for many other reasons, and they don’t know what to do to turn their life around. Online Therapy can often lead a person to answers these questions! Having a trusted relationship with someone outside of your day to day life can help you have a place to vent and express your innermost thoughts and struggles, and this person can help you arrive at the answers for how to make your life better. It can be so hard to deal with the stress of life without support, and even when we do have the support of our loved ones, we can feel misunderstood and alone. Therapy can help a person feel understood and accepted in a way that others may not be able to provide. Online therapy has provided an easy and cost-effective way for people to give therapy a try and see if it works for them! No matter which way you get in the therapy door, whether physically or virtually, it is a great option to try when you are looking for a little support and guidance on how to navigate life’s greatest challenges.