Is Video Therapy Really Effective?

How does video therapy compare to traditional in-person psychotherapy?

Online therapy has changed exponentially since the first therapists used the medium in the mid-1990s. Although video therapy has been around for several decades, its popularity grew during the COVID-19 pandemic. Now, millions of people worldwide use online video therapy as an alternative to traditional in-person psychotherapy. For many clients and conditions, video therapy can be as effective as in-person; however, seeing a therapist online may not suit everyone. Here are some of the primary ways video therapy compares to in-person psychotherapy:

• Effectiveness 

Research has consistently shown that video therapy can be as effective as in-person therapy for a wide range of mental health issues, including anxiety, depression, PTSD, and certain types of traumas. Meta-analyses and randomized controlled trials have demonstrated that video therapy can yield comparable treatment outcomes, especially when evidence-based interventions, like cognitive-behavioral therapy (CBT), are used. However, it's important to note that online therapy may be less effective for people requiring more direct and intensive interaction.

• Accessibility and convenience

Video therapy significantly increases access to mental health care for many who would otherwise face barriers to treatment, such as those in rural or underserved areas. In such regions, access to mental health professionals may be limited. Meeting a therapist virtually also provides a lifeline for individuals with physical disabilities, caregivers, and those with busy schedules, making mental health care more accessible and convenient.

• Connection and therapeutic alliance

Research indicates that the therapeutic alliance (the relationship and bond between therapist and client) can be successfully maintained through video therapy. While some clients report feeling more comfortable and open in their own space, others may initially find the virtual medium less personal. One may find it easier to evaluate and vet a potential therapist in person before committing to an extended treatment program.

• Treatment adherence 

Some studies suggest that individuals in video therapy are more likely to stay engaged in the treatment process. This may be largely influenced by online therapy’s enhanced convenience and accessibility. On the other hand, technological issues, such as poor internet connection, can disrupt sessions with the therapist, potentially impacting engagement.

• Comfort and boundaries

Video therapy may offer more convenience than in-person treatment—an attractive feature for those who feel uncomfortable visiting a therapist's office. Being in a familiar environment and avoiding contact with individuals one might ordinarily encounter in an in-person setting, such as office staff or other clients, can make individuals feel more at ease. However, it might present distractions or concerns if others are at home. 

• Affordability

Sometimes, video therapy may be more affordable than traditional methods, particularly for those with insurance plans that accommodate online treatment. Additionally, eliminating the need to commute to and from sessions and overhead costs often associated with in-office treatment can cut costs considerably. Some online therapy companies may accept insurance and a variety of major insurance plans, but some do not, so it can be helpful to reach out to the company directly to learn more about types of insurance accepted as well as other options for affordable care. You may also want to contact your insurance provider to learn more about your specific insurance benefits and out-of-pocket costs.

What are the benefits of video therapy for clients who prefer online counseling over face-to-face counseling?

For clients who prefer online therapy, video therapy offers several unique benefits. It’s often more discreet and comfortable. The ability to attend sessions from home can provide a level of comfort that enhances openness, especially for clients who feel self-conscious or anxious in a therapist’s office. This option can also reduce the stigma some may feel about seeking mental health care.

Video therapy eliminates travel time, making it a bit easier for clients to fit sessions into busy schedules. This convenience can significantly benefit clients with demanding jobs, childcare responsibilities, or other logistical constraints. Online therapy also offers improved accessibility. For example, clients with physical disabilities, chronic health issues, or compromised immune systems benefit from video therapy. Additionally, this flexibility allows people who may otherwise find in-person therapy inaccessible due to location or other variables to engage in regular sessions.

Video therapy enables continuity of care even during life transitions, such as moving to a new area, changes in work schedules, or travel, preventing disruptions in treatment that might occur with in-person sessions. Virtual therapy can reduce anxiety and enhance comfort because it's held in a familiar environment. Some clients, especially those with social anxiety or agoraphobia, feel more at ease in their own space. This can lead to greater openness, allowing them to address complex topics more comfortably.

Because it removes geographical limitations, online therapy allows clients to access specialists who may not be available locally. This can be particularly valuable for those seeking a therapist with specific expertise or cultural understanding. Online platforms may also remove limitations in situations where more than one person participates, such as group or marriage therapy.  

For some clients, video therapy is a low-cost alternative to traditional therapy without in-network insurance coverage. Online therapy may help individuals save on travel costs and reduce missed appointments, possibly lowering costs in the long run. Additionally, video therapy may allow therapists to minimize fees by saving on office space and overhead.

With its relative affordability and availability to anyone with an internet connection, online therapy may help address certain mental health disparities by reducing some barriers that exist for in-person care. For instance, finding a local therapist may be more difficult for those in a very rural area of South Dakota compared to those in an area like West Hartford, Connecticut; but with online therapy, individuals from any location can find great therapists with experience treating people with similar concerns, and then have weekly sessions without having to be in the same room. 

How can therapists ensure that the quality of counseling remains high when delivered through videos?

Therapists can maintain high-quality care in video therapy by adopting specific strategies and adjustments tailored to the virtual environment. For example, a secure, HIPAA-compliant video platform in a quiet, safe space allows counselors to provide higher-quality services. 

Therapists should ask clients if they are comfortable with the technology and address any concerns. If technical issues do arise, having a backup plan, such as switching to a phone call if video fails, can prevent disruptions. Additionally, high-quality audio and video can make the interaction feel more natural, as can a well-lit, uncluttered background.

Establishing expectations around etiquette issues like conducting sessions in a quiet, non-distracting environment (e.g., turning off the TV and finding a safe space) and refraining from multitasking during therapy (e.g., not checking emails or doing household chores) can help. Therapists should also pay extra attention to how they read and deliver nonverbal cues such as eye contact (looking into the camera), using clear facial expressions, and maintaining a warm, empathetic tone.

What challenges might arise in online therapy, and how can both therapists and clients overcome them?

Video therapy offers many advantages, but it also brings unique challenges. Here are some of the most common issues and how therapists and clients can work together to address them:

• Technical issues

Poor internet connections, software glitches, or device issues can disrupt live sessions, making it harder to maintain a natural flow. To minimize such problems, therapists and clients can test their tech setup before sessions, checking internet speed, audio, and video quality. Both parties should have a backup plan, such as switching to a phone call if the video connection fails.

• Limited non-verbal communication

Subtle non-verbal cues like body language, posture, or small gestures are more challenging to perceive on video, potentially limiting emotional attunement and understanding. Therapists can make an extra effort to observe facial expressions and tone, encouraging clients to express their feelings verbally. Therapists might also occasionally “check in” to ensure that they accurately perceive clients’ emotions and reactions.

• Environmental distractions

Clients and therapists may face distractions at home, such as household noises, pets, or interruptions by others, which can detract from the focus of therapy. To combat distractions, clients are encouraged to find a quiet, safe space and minimize potential interruptions, ideally using headphones to help block out noise. Setting session boundaries—like keeping doors closed or informing others of the session time—can also help.

• Boundary concerns

Some clients might feel uncomfortable discussing sensitive topics if they lack boundaries at home or worry about others overhearing them. Therapists can work with clients to find strategies for safe space, like using headphones or scheduling sessions when others aren't home. To ensure a safe environment, they can also explore creating a safe space in less traditional areas (such as a parked car).

• Severe or crisis situations

Some clients experiencing extreme distress or crises may require the in-person presence of a therapist for adequate support, which can be more difficult when operating virtually. Therapists can develop a crisis plan with clients, ensuring that emergency contacts and local resources are available. Therapists may arrange shorter, more frequent check-ins for clients in high distress to maintain support. 

• Barriers to affordability

In some cases, insurance covers online therapy—but in many cases, it doesn't—even if an individual's plan includes mental health services. Although online therapy may be less expensive than traditional treatment, cost may present a barrier to treatment. In such cases, online mental health professionals might offer a sliding-scale fee dependent on the individual's income. 

How does the convenience of online therapy through videos impact client engagement and therapeutic outcomes?

Studies indicate that online therapy can significantly impact client engagement and, in turn, therapeutic outcomes. For example, participants in a 2021 focus group attended sessions with a Talkspace therapist and then completed a survey about their treatment experience. The survey findings reveal that the clients’ decision to continue or discontinue therapy was largely impacted by the quality of their therapeutic relationship. External factors like social support, financial costs, and platform usability also significantly influenced engagement patterns. 

However, some individuals find online therapy much more effective and experience better treatment outcomes than others. For example, the flexibility of video therapy allows clients to attend sessions without the added burden of travel time, which can be especially valuable for those with demanding schedules or logistical constraints. Studies have found that clients are more likely to stick with therapy consistently, resulting in fewer missed sessions and lower dropout rates, which is critical for effective treatment outcomes.

Because online therapy removes some barriers to access, such as commuting and time away from work or family, clients are often more likely to commit to the therapeutic approach, frequently leading to faster or more sustained progress. Further, video therapy provides essential access that may not otherwise be available for individuals with disabilities, chronic health conditions, or those living in rural or underserved areas. 

Many clients feel more at ease in their own environment, leading to a greater willingness to share personal or difficult information. This comfort level can lead to deeper self-exploration and more effective therapy sessions, enhancing therapeutic outcomes. Additionally, clients who feel stigmatized by attending therapy in person may prefer the convenience and discretion offered by online sessions. This can encourage people who may otherwise hesitate to seek help to engage in therapy, broadening access and fostering a sense of acceptance toward treatment

Can therapy make you better?

Therapy can be a lot of work, but this approach is effective in terms of mental health improvement. Seeing a therapist provides benefits like treating mental health concerns, improving relationships, and developing coping skills. In addition, therapy can also improve communication skills and change negative thought patterns.

However, some people may also need other forms of mental health treatment beyond therapy, such as psychiatry services like a psychiatry plan and medication management services, depending on their needs. 

How do I know if I need therapy?

Seeking help from a trained therapist does not require a specific situation. However, seeing a therapist is recommended if you are experiencing symptoms of mental health issues that are already affecting your day-to-day functioning. A therapist can also be helpful if you are facing stressful or challenging life events.

What are 4 types of therapy? 

There are many types of therapy rooted in different theoretical concepts. Here are four common types of treatment, each with unique approaches and applications:

• Cognitive behavioral therapy (CBT)

CBT is a goal-oriented, structured form of therapy that focuses on identifying and changing negative thought patterns and behaviors. CBT is widely used for conditions like anxiety, depression, PTSD, and phobias. CBT helps clients develop skills to manage their thoughts and actions more effectively, often through homework assignments and skill-building exercises. CBT is suitable for many treatment modalities, including marriage and family therapy.

• Eye movement desensitization therapy (EMDR)

Foldable outdoor EMDR is primarily used to treat trauma and post-traumatic stress disorder (PTSD). It integrates cognitive-behavioral therapy (CBT) elements with rhythmic eye movements or other forms of bilateral stimulation, such as tapping or audio tones. During EMDR sessions, individuals recall distressing memories while focusing on these movements, which is believed to reduce the emotional intensity of the memories and help reprocess them more healthily. 

• Humanistic Therapy

This client-centered approach, developed by Carl Rogers, emphasizes self-exploration, personal growth, and self-acceptance. Humanistic therapy, which includes Gestalt therapy and existential therapy, focuses on helping clients achieve their fullest potential by understanding their values and goals. It’s often applied to clients dealing with self-esteem issues, life transitions, or a desire for personal development.

• Dialectical Behavior Therapy (DBT)

Originally developed to treat borderline personality disorder, DBT combines cognitive-behavioral techniques with mindfulness practices. It focuses on four primary skills: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT is used to help individuals with intense emotions, self-harm tendencies, and relationship challenges, and it has also been adapted for other conditions, such as depression and eating disorders. 

Other types and forms of therapy can include group therapy, couples therapy, trauma therapy, acceptance and commitment therapy, and many others. Some therapists may also draw from a preferred theoretical framework in their sessions, such as critical race theory, depending on a client’s experience. Different approaches may work best depending on your specific concerns and why you’re seeking care, whether it’s for depression, anxiety, gender identity, generational trauma, family issues, or something else. In your first session of individual therapy, you can talk with your therapist about their approach as well as your individual needs, and they can develop a therapy plan tailored to your specific concerns. 

What's virtual therapy?

Virtual therapy, also known as online or teletherapy, is a form of mental health counseling conducted via the Internet or other digital communication platforms. It allows individuals to connect with licensed therapists through various methods, such as video calls, audio calls, text-based therapy, or chat-based systems. This approach provides accessibility to mental health care, especially for people who face barriers to in-person therapy, such as geographic distance, physical disabilities, or time constraints. 

Virtual therapy offers many benefits for mental health professionals who use an online platform—such as BetterHelp, ReGain, and Talkspace therapists. For example, online therapists may enjoy more flexible scheduling options and a broader clientele base. Additionally, therapists licensed in different states might appreciate the broader reach. Like their clients, one therapist may have better outcomes with online platforms, while another prefers in-person interactions. 

Various online therapy platforms may also offer different features or focuses that resonate with different people. For instance, some parents of teens might consider a platform like TeenCounseling, which focuses on teen therapy. Or, some people might appreciate having unlimited messaging while others might prefer having in-depth therapy sessions at regular, scheduled appointment times through weekly video sessions. Other considerations might involve the cost of sessions or subscription plans, the strengths and clinical work experience of providers in the therapist directory, and the ease of switching to a new provider to find the best therapist for you. For therapy “newbies” or those trying therapy for the first time, the convenience and availability of virtual therapy may make starting therapy feel a little easier.

Do therapists cry in therapy? 

Many therapists do cry in therapy; in fact, several surveys indicate more than half of therapists cry at some point during sessions throughout their careers.

What are therapy videos?

Therapy videos may refer to clinical psychology training tools for mental health professionals or informational and educational materials for individuals interested in learning more about types of therapeutic modality. For psychology students, therapy videos may give them a firsthand look at case studies for different types of mental health conditions. 

What is the most successful type of therapy?

Currently, cognitive behavioral therapy (CBT) is considered the gold standard in psychotherapy and is often the first-line treatment for many mental health disorders such as depression, anxiety, phobias, and obsessive-compulsive disorder (OCD). CBT is evidence-based and is supported by a considerable amount of scientific data. Many therapies, such as dialectical behavior therapy (DBT) and mindfulness-based cognitive therapy (MBCT), are modified versions of CBT used in different circumstances. CBT can also be modified for relationship therapy. However, other types of treatment might be more effective for different people and situations. For example, humanistic therapies, such as gestalt and person-centered, focus more on individual experiences and challenges. These therapies might be a good fit for individuals who prefer exploring emotions and identifying goals over more structured and directive methods.