A Closer Look at E-Therapy

More and more people are turning to the Internet for help with something that used to be confined to a doctor's office: psychotherapy.

Generally, E-therapy is defined as a treatment based in dialogue -- talking about what's bothering you with a professional who is supportive, neutral, and nonjudgmental.

E-therapy may be a solution if you can't afford a traditional therapist, you feel uncomfortable discussing these things in person, or you can't find qualified help you in your area.

How It Works

A quick online search can show a long list of sites offering services -- for a variety of fees -- to help you work out whatever you're facing. There are specific therapists for each issue, and different ways to pay.

Counselors can reach people in different ways:

Phone calls: Counseling over the phone is hardly a new idea. Many therapists have reported positive results for their clients using this growing option.

Some of the pluses include:

  • Lower costs
  • More convenience
  • Anonymity
  • A better sense of control for the person seeking help.

Video conferencing: This may be especially valuable for people who live in rural areas, where travel is difficult, or where there may not be many counselors with the needed skills. Usually people using this method have more sessions than they would in-person.

Text-based communication: Whether it's e-mail, chat rooms, or direct messages, texts make it easy for people to reach out to a therapist. They can also support more direct counseling. Research on this newer trend is ongoing. Generally, it's found to be effective and helpful. Still, there's some evidence that a chat feature is more effective than e-mail alone.

Who It Works Best For

For some, even admitting they need help can be tough. They could feel shame or embarrassment. They could be resistant to it or afraid that family members or friends will find out. Either way, that first step can be hard. Reaching out anonymously can break the ice and make it easier to tackle any challenges.

While there's still a great deal of research to be done, there is evidence that under-served populations -- either because of where they live or their reasons for not coming in person -- have benefited from E-therapy. Costs for this can be half of face-to-face sessions. You don't have to travel, either, which makes online therapy a good choice for some people with disabilities, too.


Things to Watch Out For

As E-therapy gains momentum, there's a move to make it more regulated, encouraging online counselors to work to protect their clients' data and learn international laws.

Some online therapists aren't licensed but work around that by calling themselves “life coaches” instead. It's important to make sure the website you are using requires that therapists be credentialed or you have a trusted referral. In addition, E-therapy is not ideal not for people with psychotic symptoms or suicidal thoughts, which may not be easily assessed over a phone or screen.

Several issues face the industry, including more demand for services. Sometimes, therapists with more traditional in-person practices aren't eager to include these new methods.

A lack of confidentiality -- something that's always looming in online interactions -- is a growing concern, as well.

If you're thinking about E-therapy, there are some commonsense things to consider before logging on to a website. As with any activity online, to keep your information secure:

  • Think carefully about your password.
  • Make sure you have a strong firewall program.
  • Consider using document encryption software, to keep others from being able to read your emails.


WebMD Medical Reference Reviewed by Smitha Bhandari, MD on September 03, 2019



Substance Abuse and Mental Health Services Administration: “Considerations for the Provision of E-Therapy,” “Using Technology-Based Therapeutic Tools in Behavioral Health Services.”

American Psychological Association: “Understanding Psychotherapy.”

National Public Radio: “Online Psychotherapy Gains Fans and Raises Privacy Concerns.”

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