Is Online Psychiatry Effective?

By: Nadia Khan

Updated February 12, 2021

Medically Reviewed By: Rachael Lee

It is no secret that technology has had an immense effect on virtually every industry, but what about in the mental health sphere? Online psychiatry has made its appearance, and internet therapy may soon be pushing more traditional brick-and-mortar practices to the sidelines.

What is Online Therapy?

Online therapy is known by a few different names, including e-therapy, e-counseling, teletherapy, and cyber-counseling. It is a relatively new development in the mental health world. Essentially, it means that a mental health provider provides psychological advice and support over the internet. This can occur in a number of different ways: via email, video conferencing, phone calls, online chats, or messaging. These methods can be divided into two categories: in real-time (video conferencing, phone calls, and online chat), or with a time delay (emails and text messages)

The History of Online Therapy

Online therapy seems like a new concept, right? Actually, the essence of it has been around for a long time. Remember Sigmund Freud, the neurologist and founder of psychoanalysis who practiced psychotherapy between 1886 and 1938? He wrote letters to his patients frequently, and he encouraged them to write as well. Fundamentally, that is the equivalent of today’s emails.

When it comes to the actual internet, self-help groups began emerging online in as early as 1982 in the form of group chats and forums. Today there are numerous online support communities, chat rooms, bulletin boards, and electronic mailing lists that provide convenient, round-the-clock access to peer support.

In fact, there are so many different online counseling and mental health services today that in 1997, the International Society for Mental Health Online (ISMHO) was founded to explore and support mental health services in the digital age. The mission of the ISMHA is to promote the understanding, use, and development of online communication, information, and technology for the international mental health community.

Benefits of Online Therapy

Online counseling offers a number of potential advantages, reduced cost not being the least of them. One benefit of internet therapy is that the provider does not need to rent office space or employ a receptionist, which results in lower overhead costs.

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Secondly, internet therapy is more efficient than face-to-face therapy. Travel time to sessions is eliminated, and with some platforms, including BetterHelp, quick messages may be exchanged as the need arises. This results in the added advantage of clients having greater access to therapy more of the time. In fact, research has shown that because online therapy requires 7.8 times less of a therapist's time than in-person treatment, therapists can treat significantly more people online than they can in person.

Internet therapy breaks down barriers to accessing therapy in other ways too. Perhaps you live in a small town that doesn't have many in-person therapists, or even in a location with no therapists accessible. Internet therapy enables access to a variety of mental health professionals that you would otherwise not be able to use because of location. Even for those who live in large cities, because geography is not a limit, the number of possible therapists is much greater. Moreover, availability is less likely to be an issue, and it is easier to find the right match in terms of specialty, expertise, and personality.

Another advantage of online therapy is that it reduces the discomforts that come with sitting with a therapist in person. The “you can't see me” effect that happens with a phone call or text chat can help clients feel more comfortable opening up about themselves and sharing embarrassing or painful information. In addition, there are fewer concerns about privacy, including no risk of running into friends or colleagues as in an in-person waiting room.

Finally, online therapy holds benefits for clients whose first language isn't English. Not having to worry about whether you and your therapist will understand each other is an advantage to using online chats, text messaging, or email options.

Most importantly, an electronic therapist is not a chatbot or other form of AI. Online therapy is simply the application of technology to facilitate the connection of clients with the best possible licensed counselors.

The Effectiveness of Online Psychiatry

Online psychiatry has received support from a variety of sources, including those who have been on the receiving end of its services. In a review of studies published by the World Journal of Psychiatry, patients who received psychiatric treatment through video conferencing reported high levels of satisfaction. The review concluded that "videoconferencing-based telepsychiatric assessments are reliable, and clinical outcomes of telepsychiatric interventions are comparable to conventional treatment among diverse patient populations, ages and diagnostic groups, and on a wide range of measures.”

Comparison of Online and In-Person Counseling

As it turns out, research comparing the outcomes of internet therapy to in-person therapy is encouraging. While communicating in writing obscures paralinguistic features, and voice-only communication does not allow for visual cues, these are less critical than one might think. And teletherapy, including video, is a popular option as well. It would certainly seem that online therapy is here to stay, whether as a stand-alone form of treatment or one to be used in conjunction with face-to-face therapy.

Opportunities and Limitations of Internet Counseling

Individuals living in rural areas, prisons, or other inaccessible locations can now receive quality counseling at many times of day or night. Patients can also call upon a much wider range of expertise than a small community of therapists can offer, with specialists in anything from addiction to gender identity counseling who work under the same umbrella organization.

People who might not feel comfortable attending traditional face-to-face support groups also have the opportunity to receive online services.

While online therapy can be beneficial to a large number of people, it is not appropriate for everyone. Although it has shown to be effective in many areas, the treatment of serious mental illness may not be appropriate for online therapy. Online therapy is also not recommended for individuals that are in crisis or unable to commit to staying safe.

There are, however, certain things that electronic therapists just can't do. Making a firm diagnosis for, say, a court order is just not possible, nor is prescribing any form of medication. Effective regulation of these online services, including where confidentiality concerns arise, is also still an open issue. However, it's clear that this new horizon in treating mental health issues is here to stay, and we would be well advised to look for ways to improve it rather than simply dismissing online psychiatry as "an internet thing."

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The Effectiveness of Online Psychiatry

Studies have found video-based online psychiatry (or telepsychiatry) to be empowering to and highly rated by patients, as well as to promote equal access to psychiatric services. Researchers have remarked upon both the clinical and nonclinical applications of telepsychiatry, concluding that the range of such services are “theoretically limitless.” There is significant evidence that video-based psychiatric assessments are reliable and that clinical outcomes are comparable to those of face-to-face psychiatry.

The Benefits of Online Therapy

As discussed above, telepsychiatry is an excellent way for those with mental disorders to manage their psychiatric care from home. And online therapy can be just as helpful to those with psychiatric symptoms. You can access BetterHelp’s platform from the comfort and privacy of your own home. In addition, online therapy offers lower pricing than in-person therapy because online therapists don’t have to pay for costs like renting an office. BetterHelp’s licensed therapists have helped people with a variety of mental disorders. Read below for some reviews of BetterHelp therapists from people experiencing similar issues.

Counselor Reviews

“Samuel is an extremely smart man and makes me feel like he actually cares about me and my mental health. He goes the extra mile in finding me local groups and clinics and refers me books to read. I still have a long way to go but I’m glad it’s with him. Thank you, Sam”

“Julie is by far more than just a therapist. She is a god sent angel. She knows and understands mental health inside and out. She also has a great ability to keep the session focused and hone me back in if needed. She shows the most amount of empathy and understand I have had the pleasure in having of a therapist. She gives homework appropriately and has so many tricks up her sleeves. I am honored to have her in my life.”