It's a common 21st century conundrum: You have emotional and mental stuff you need to work out in therapy, but you don't have the time or cash to do it. You've heard about online therapy apps and sites that connect you to mental health experts at your convenience, and in theory, it sounds like the perfect fix. (A podcast I listen to is sponsored by a chicly marketed therapy app, and every time they play the ad for it, it sounds so appealing.)
But can therapy in the palm of your hand be as good as it sounds? To find out, we asked a group of trusted, practicing therapists from a variety of backgrounds to share their thoughts. Unsurprisingly, there's no simple answer to our question—mostly because online therapy hasn't been around long enough to provide one. "Initial research supports the effectiveness of teletherapy when using cognitive behavioral therapy and other directive therapy modalities," says Crystal I. Lee, PsyD, a licensed psychologist and the owner of L.A. Concierge Psychologist. Still, not all therapists are so sure.
Keep scrolling to discover the pros and cons of online therapy (and to decide whether or not it could be right for you).
Many therapists and counselors agree that online therapy is "ultimately a good thing." According to licensed clinical social worker Sepideh Saremi, the trend "is a response to the way people actually live their lives, meets patients where they are, and makes therapy more accessible for people that might not otherwise engage in the process." Being able to access therapy virtually makes mental health counseling available in otherwise impossible circumstances, like moving to a country where you don't speak the language. As Saremi says, online therapy can benefit "anyone who has barriers to going to an office to see a therapist, has financial constraints … or lives in an area in which there are not many therapists available."
Some psychologists say that by engaging with your therapist via phone or video conference, you don't even lose any benefits. "Studies demonstrate that online therapy is just as effective as brick and mortar therapy," says Jennifer Gentile, PsyD, a psychologist who treats patients via telehealth app, LiveHealth Online. As Gentile says, the added conveniences can actually keep people in treatment longer. "With the shortage of available therapist appointments, the inconvenience of going to a brick-and-mortar setting, taking time off work, and the immediate availability of high-quality therapists, it makes every sense in the world that someone would want to see a therapist of their choosing from the location of their choosing and at the time of their choosing," she says.
Not all therapists are on board with replacing in-person therapy with an app, however. "If a client is trying to use an app to meet all of their mental health needs, that's probably not going to be very helpful, [especially] if the client has a serious issue," Lee says. "Using an app to help them practice mindfulness … is entirely different than someone with depression or anxiety."
Saremi agrees that texting, phoning, and Skyping your therapist is "not necessarily appropriate for people who have severe mental illness or would be considered high risk (such as patients who have a history of suicide attempts or other serious instability)."
Then, of course, there are certain psychologists who don't support virtual therapy at all. "Personal contact is imperative for me to have a successful encounter," says clinical psychologist Bart Rossi, PhD. "Psychotherapy is dynamic. Personal interaction requires direct communication." Direct meaning face-to-face, not face-to-screen.
The Bottom Line:
Psychologist Mark Derian puts it like this: "Therapy apps are like Rosetta Stone—probably not that helpful on its own but when used in conjunction with studying flash cards and practicing with native speakers, it can be a useful supplement." According to Derian, if you've been to traditional therapy in the past (or are currently in therapy) and have a pretty good handle on your issues, then therapy apps can be "used as a check-in." Additionally, if you have a more severe condition but are intimidated by in-person therapy, an app "could be a kick in the butt … to begin thinking in a different way."
As for which specific sites and apps to use, Saremi strongly suggests you look for ones that allow you to interact with your therapist via video chat in real time. "I believe it's much more effective and helps the therapist to get to know you better if they can see your face to assess what's really going on," she says. In addition, psychologists agree that therapy apps are only as good as the therapists on them. "Whichever app people choose, they should vet that person just as they would someone they'd be meeting in person. This means looking up their credentials, asking them about their experience, and so forth," says Saremi. It's also important to make sure the app is HIPAA compliant, which guarantees that the sessions are 100% confidential. "Finally, people should also think about the kind of experience they want from therapy, and what kind of app would support that," says Saremi. "Good therapy is more than just advice or guidance—it's a healing relationship. For that, I believe most people need to feel the presence of their therapist beyond just words on a screen."