Online therapy

Online therapy offers the same kinds of support as traditional therapy, but sessions take place over the internet or by phone instead of in an office. You talk with a psychologist, psychotherapist, counselor or other licensed mental health professional from home or another private space.

Common formats include:

• Video sessions, which feel closest to meeting face to face
• Phone sessions, which some people find easier for talking openly
• Secure messaging or chat, sometimes used between sessions or as a main format
• Guided digital programs, such as internet-delivered cognitive behavioral therapy (CBT), with support from a clinician

Online counselling (the common UK spelling) can be used for individual therapy, couples therapy, family sessions and some group programs. Many therapists offer a mix of online and in-person sessions, so you can switch depending on your needs.

Online therapy is not a lesser form of care. The quality depends mainly on the therapist's training and the relationship you build, just as with in-person therapy.

Benefits of online therapy include:

• Convenience: no travel, and sessions can fit around work or family life
• Access: helpful if you live far from services or have limited mobility
• Wider choice: you may be able to find a specialist who isn't available locally, where licensing rules allow
• Comfort: some people feel more relaxed talking from home
• Continuity: you can keep seeing your therapist if you travel or move within the same jurisdiction

It's particularly useful for people with agoraphobia, social anxiety, chronic illness, caregiving responsibilities or busy schedules.

There are also limitations:

• You need a private space and a reliable internet connection
• Some people miss the in-person connection
• Technical problems can interrupt sessions
• Online therapy may not be appropriate in a crisis, for some severe mental health conditions or when physical examinations are needed

If you're in crisis, contact emergency services or a crisis line rather than waiting for an online session.

Research on online therapy, particularly video-based therapy and internet-delivered CBT, has grown considerably. Studies suggest that, for many people, online therapy can be as effective as face-to-face therapy for conditions such as depression, anxiety disorders, insomnia and PTSD.

Evidence-based approaches, including CBT, acceptance and commitment therapy (ACT), interpersonal therapy and EMDR, can be delivered online, sometimes with some adaptations. Couples and family therapy can also work well remotely.

As with any therapy, results depend on several factors:

• The therapist's qualifications and experience with your concern
• The quality of your relationship with the therapist
• How well the approach fits your needs and goals
• Your engagement between sessions, such as practicing skills

Online therapy may be less suitable for people at high risk of harm, those experiencing severe psychosis or eating disorders that need close medical monitoring, or young children. A professional can help you decide whether online, in-person or a combination is best.

When searching for "therapy near me" or wondering how to find a therapist, consider these steps:

• Check credentials: look for a licensed professional, such as a licensed psychologist, licensed clinical social worker, licensed counselor or psychiatrist, depending on your needs
• Confirm they are licensed to practice where you live, as therapists are usually regulated by state, province or country
• Look for experience with your specific concern, such as anxiety, trauma, relationships or ADHD
• Consider their approach, for example CBT, EMDR or family therapy
• Think about practical factors like availability, language, cost and session format
• Ask about privacy and how sessions and records are protected
• Book an initial consultation to see whether you feel comfortable

Finding the right fit can take time. It's okay to try more than one therapist before deciding. A professional directory that lets you filter by specialty, location and online availability can make the search easier.

Affordable therapy is a common concern. Costs for online therapy vary widely depending on the professional's qualifications, location, session length and format.

Does insurance cover therapy? It depends on your country, plan and provider. In the US, many health insurance plans include some mental health coverage, and some cover telehealth sessions, but rules about in-network providers, copays and session limits vary. In other countries, public health services may offer free or low-cost psychological therapy, sometimes with waiting lists, alongside private options.

Ways to make therapy more affordable can include:

• Checking your insurance or public health coverage for mental health services
• Asking therapists whether they offer sliding-scale fees based on income
• Looking into employer-sponsored assistance programs, which may offer a few free sessions
• Exploring university training clinics, where supervised trainees offer lower-cost therapy
• Considering group therapy, which is often less expensive

It's always worth asking about fees and cancellation policies before your first session.

Your first online therapy session is usually an opportunity to get to know each other. The therapist will ask what brings you to therapy, your current difficulties, history, goals and any safety concerns. You can ask about their experience, approach and what therapy will involve.

To prepare:

• Find a quiet, private space where you won't be overheard
• Test your internet connection, camera and audio in advance
• Use headphones for extra privacy
• Have water and tissues nearby
• Write down any questions or points you want to cover

The therapist will also discuss confidentiality, what happens if you lose connection and how to get help in an emergency. It's normal to feel nervous at first. Many people find online sessions feel comfortable surprisingly quickly.

If you are in crisis, don't wait for a session: call 911 in the US or your local emergency number, call or text 988 in the US, or call Samaritans on 116 123 in the UK and Ireland.