What Is Online Therapy?

A Look at the Ins and Outs of Online Psychotherapy

A woman trying online therapy
Online therapy can take place online via e-mail, video conferencing, online chat, or Internet phone. Martin Holtkamp / Taxi Japan / Getty Images

Online therapy, also known as e-therapy, e-counseling, teletherapy or cyber-counseling, is a relatively new development in mental health in which a therapist or counselor provides psychological advice and support over the Internet. This can occur through e-mail, video conferencing, online chat, or Internet phone. Online therapy can occur in real-time, such as in phone conversations and online chat rooms, or in a time-delayed format, such as through e-mail messages.

It is important to note that online therapy cannot be considered psychotherapy and will never replace traditional therapy. In many ways, e-therapy shares some similarities with life-coaching. While online therapists cannot diagnose or treat mental illness online, they can offer guidance and advice to people experiencing problems in relationships, work, or life.

E-therapy has limitations, but it is quickly becoming an important resource for a growing number of consumers. Despite a lack of research on the effectiveness of online treatment, e-therapy offers mental health professionals another way of providing services to clients.

How Does Online Therapy Work?

Primary tools for communicating in online therapy include:

  1. E-mail
  2. Instant Messaging (IM)
  3. Real-Time Chat
  4. Internet Phone
  5. Videoconferencing

The History of Online Therapy

Distance communication between a therapist and client is not a new concept. Sigmund Freud utilized letters extensively to communicate with his clients.

Self-help groups began emerging on the Internet as early as 1982. Today, there are numerous sites offering mental health information as well as private e-therapy clinics such as Find-a-Therapist.com and HelpHorizons.com.

The growth in online counseling and mental health services has led to the foundation of the International Society for Mental Health Online.

This dramatic rise in the availability of online health care has led to a need for information and guidelines for customers interested in receiving mental health services via the Internet.

Online Therapy Today

While online therapy is viewed with skepticism by a large number of mental health professionals, it has received support from many patients who have utilized online mental health treatments. In a study published in the journal Psychiatric Services, patients receiving mental health treatment through video conferencing reported "high levels of satisfaction."

Online therapy is not appropriate for everyone, but it has shown effectiveness in some situations. One Newsweek article, for example, reported that recovering addicts might benefit from online therapy, especially for those who feel uncomfortable attending traditional face-to-face support groups.

Dr. John M. Grohol of PsychCentral notes that while many psychologists are willing to try e-therapy, there is a notable lack of consumer demand.

"People are so used to getting services for free online, the idea of having to pay for professional therapy online is still not something most are willing to do," he explains. "If it's going to cost pretty much the same as it would for face-to-face services, many are going to opt for the face-to-face services."

Online psychotherapy services have some advantages and disadvantages that should be carefully considered. Convenience is often cited as one of the greatest benefits while unreliable technology and lack of insurance coverage are potential downsides.

Before you consider online therapy, you should think about issues such as confidentiality, ethical and legal issues as well as the qualifications of online therapists.

Next: Concerns About Privacy and Confidentiality in Online Therapy


Frueh BC, Deitsch SE, Santos AB, et al. (2000) Procedural and methodological issues in telepsychiatry research and program development. Psychiatric Services, 51:1522-1527.

Grohol, J. M. (2011). Wait, There's Online Therapy? PsychCentral. Retrieved from http://psychcentral.com/blog/archives/2011/07/14/telehealth-wait-theres-online-therapy/

Kanani, K., & Regehr, C. (2003). Clinical, ethical, and legal issues in e-therapy. Families in Society, 84, 155-162

Ehrenfeld, Temma. (2006) Virtual Therapy. Newsweek.

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