Is Therapy By Video Really Effective?

Medically reviewed by Paige Henry, LMSW, J.D.
Updated April 17, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Seeking the support of a therapist or another mental health professional can make a significant difference in a person’s life, whether they’re facing challenges related to a mental health condition like depression or anxiety or a situation like relationship conflict, grief, or low self-esteem. For some people, however, attending traditional in-person therapy sessions is not feasible. Some are unable to regularly travel to and from in-office appointments, while others simply feel more comfortable engaging with mental health professionals virtually from home. Either type of counseling may be an effective way to seek mental health services.

Video therapy in particular is a form of online counseling that many people find more convenient than traditional, in-person formats. It involves clients speaking with a therapist via virtual sessions using a smartphone, tablet, computer, or laptop. That way, the client and the online therapist can still see each other face to face and form a strong therapeutic relationship, but the client never has to leave their home if they don’t want to or aren’t able to. Read on to learn more about how online counseling sessions work and what the research says about their efficacy.

Getty/Vadym Pastukh
Various benefits are associated with virtual therapy

Efficacy of online therapy services

In face-to-face talk therapy, clients and licensed therapists, clinical social workers, family therapists, or other licensed mental health professionals will engage in a conversation that aims to address the individual’s needs. Depending on the particular therapy modality being practiced, the client will usually be invited to discuss their thoughts and feelings and will then be guided toward a deeper understanding of their challenges and improved thinking patterns over time by the therapist. During each counseling session, the client may receive mental health support regarding any challenges they’re experiencing.

Virtual counseling works in just the same way in general, except that the therapist and the client are in separate locations and connecting through an internet-based app, website, or online counseling platform. Just as with in-person counseling, virtual therapists are required by law to be licensed to practice. Online therapy platforms may have a wide range of professionals available, such as online therapists, licensed clinical social workers, marriage and family therapists, and more.

Online counseling uses

Just like in-person therapy, online counseling may be used to allow mental health professionals to help individuals with a variety of mental health conditions and challenges, from diagnosable illnesses to other obstacles and difficulties that may arise in life.

Some examples of conditions or situations that can typically be addressed through online therapy can include but are not limited to: 

  • Depression
  • Anxiety disorders
  • Eating disorders
  • Substance use disorders
  • Grief
  • Significant life changes (birth, death, divorce, moving, job loss)
  • Relationship troubles
  • Past trauma and post-traumatic stress disorder

Note, however, that online therapy is not appropriate in every case. For example, some individuals with moderate to severe eating disorders or substance use disorders may require inpatient care. Any mental health emergency should also be treated in person, and you may also need to see a provider in person for them to prescribe medication or help with medication management in some cases. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

It’s also valid for a person to simply prefer to meet with a provider face to face, regardless of the challenge that they may be facing. Online therapy simply represents an alternative option for those who are interested in it and who do not require inpatient or in-person care. Note also that any online modality isn’t recommended for emergency care, as an online therapy provider may not have the necessary resources to help with emergencies.


Benefits of online counseling

Of course, not having to commute to and from each appointment is one key element of convenience that comes with virtual therapy. In general, you can log on to virtual sessions from home, work, or elsewhere as long as you have a smart device, an internet connection, and some quiet. That means people in certain situations may find it easier to consistently attend these appointments, such as those who:

  • Have a busy schedule
  • Don’t have reliable transportation
  • Have a physical illness or disability that makes travel difficult or impossible
  • Are experiencing symptoms of mental health diagnoses like depression or social anxiety that makes leaving home difficult
  • Live in a rural area without mental health care providers nearby
  • Prefer to control their own surroundings during therapy
  • Feel intimidated at the thought of speaking with a therapist in face-to-face therapy

Save time

Online counseling sessions can also save time, since you don’t have to get dressed up and drive or take public transportation to attend appointments, which could add as much as an hour or two to the process in some cases. In general, online counseling services tend to offer a higher level of convenience and availability.


It’s also worth noting that online counseling like virtual sessions is often more cost-effective than traditional in-person sessions as well. This is because providers who do video therapy don’t necessarily need to have a brick-and-mortar office space, so they can save significantly on overhead costs and pass those savings along to clients through reduced rates. With online therapy services like BetterHelp, for example, session costs are comparable to that of most insurance co-pays. However, online therapy providers do not always accept health insurance, and your insurance may not cover online therapy, which can affect the overall online therapy cost. Still, the best online therapy platforms typically have lower costs per session than in-person therapy, even when insurance doesn’t cover online therapy.

Effectiveness of virtual therapy 

You may be wondering, “Is online therapy effective?” Since the advent of online counseling in recent years, researchers have conducted a variety of studies to examine its effectiveness. In general, they have found that it may be as effective as in-person sessions in many cases and for many conditions and challenges. For example, consider a 2021 study on the topic that suggests that video is “an effective modality for counseling delivery” and that it’s “no less efficacious” than in-person methods. This can make the best online services comparable to in-person services.

Consider also research from 2019 that reports that virtual therapy for couples counseling in particular may be a viable alternative to in-office sessions as well. It indicates that participants in the study who engaged in video-based couples therapy reported feeling “less intimidated” and “less judged” than in in-person sessions, a factor that may help clients and providers form strong, healthy relationships for better therapeutic outcomes, which can be vital for effective mental health service in therapy.

Getty/Vadym Pastukh
Various benefits are associated with virtual therapy

Seeking online counseling

If you’re interested in virtual therapy, you might consider a platform like BetterHelp for individuals or ReGain for couples. With either, you can get matched with a licensed therapist according to your preferences as indicated in a brief questionnaire. Then, you can meet with them via video or phone, depending on which is more comfortable or convenient for you. You can also contact them via in-app messaging between appointments and receive a response at their earliest convenience. Again, research suggests that online therapy via video or audio can be as effective as in-person sessions in many cases, so it may be worth exploring if you're interested in this format. Either way, the best online or in-person therapy option is usually the one you’re most comfortable with.


There are a variety of reasons someone might seek therapy, from a mental health condition like depression to another life challenge like grief or past trauma. In many cases, you can receive care of equal quality and effectiveness through online therapy if this option is more convenient or comfortable for you. Research suggests that online and in-person therapy can offer similar benefits in many cases, so you can typically choose the one that works best for you.
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