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Online Counseling Guide: Effectiveness, Benefits Over Traditional Counseling

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Online counseling (also called e-therapy, cybertherapy, or e-counseling) has bloomed out of the rising need for mental health services and our increasing reliance on technology in our daily lives. By the latest numbers, there are roughly 44 million Americans with a mental health disorder, but approximately 24 million choose not (or were unable) to get appropriate treatment. [1]

The reasons for seeking counseling are many, including many famous faces like Brad Pitt, Selena Gomez, The Duchess of Cambridge, J.K. Rowling, Jay-Z, and countless others. As Actress Kristen Bell so eloquently stated, in an interview for Good Housekeeping, “”You do better in the gym with a trainer; you don’t figure out how to cook without reading a recipe. Therapy is not something to be embarrassed about.” [2]

Yet, there are many reasons preventing people who need help, from accessing it – including stigma, costs, and accessibility. Perhaps because of all these reasons, we, as a country, are turning to find help for our mental health online.

Going Online For Health Information

Health Information Online

Searching online for information on a health issue is by now, a completely normal experience. A few decades ago, seeking medical advice from anyone outside of a doctors office was unheard of – but now it’s entirely normalized today.

After email and shopping, the third most common use of the internet is to find answers for health-related questions. In total, 80 percent of Americans with internet access have at some point used it to look up a health issue. [3]

Today, the internet is the most extensive resource we have for health information, so it makes sense that we are now using it to look up information and available services for our mental health concerns as well.

Naturally, online counseling fills the widening void between inaccessible in-person services and the rising need for those services. Speaking with a counselor online is proven to be as effective as in-person therapy, and it may even break down the barriers between the client and the counselor by using text, phone, and video chat as the means of communication.

What is Online Counseling?

Man Having Online Counseling Session

Online counseling takes everything you’d expect from an in-person session and moves it online. It’s one of the fastest growing trends in psychology, thanks mainly to the increasing number of people seeking help, the ease of accessibility, and the lower costs.

At its core, online counseling is a network of counselors, listed in a database, waiting to be paired with you, the client. Instead of commuting in a face-to-face session, you schedule an online session via text, video call, or phone call. Whatever works best for you and your lifestyle.

Online counselors work with the same mental health concerns as offline therapists, including relationships, depression, anxiety, and personal development. They work with married couples, single people, LGBTQ community, busy entrepreneurs, single-mothers, youth, seniors, and any other demographic you can imagine. If you are a candidate for traditional in-person therapy sessions, you are a candidate for online as well.

What are the Differences Between Online and Offline Counselors?

Woman's Hands in Therapy Session

One of the most common questions about online counseling is that of credentials. You may wonder whether online counselors have the same education and training as their offline peers. Rest assured, the same caliber of counselors work online as off, and many counselors maintain both online and offline practices.

There is no difference between the benefits you’ll reap from an online session as an in-person one, save those of convenience, cost, and means of communication.  Notably, these differences are all in favor of online sessions. Not only is it exponentially more accessible, but it offers far more therapeutic options, and gives you a powerful means to find someone suited to you and your mental health issue.

As a client seeking treatment, online counseling allows you to search through vast databases of potential counselors. Find someone who you connect with by exploring their profile, their approach, and their personality. You need to have a comfortable, working relationship with any counselor, and an online one is no different. But online, it may be much easier (not to mention faster) to find the perfect match.

Moving between counselors in the offline word takes time, logistically wrangling, and significant time scheduling. You may also live in a region with few other options, which makes moving from one to another even that much more challenging. Online, moving to a new therapist can happen with a few mouse clicks, and there is always another option.

Online Counseling Fits Your Schedule

Man Relaxing In Grass

Online sessions are also highly adaptable to your busy schedule. Whether you choose to text with your counselor or connect through a phone call or video chat, you set the time that works best for you — no need to plan around your work or family’s schedule. Online counseling happens anywhere, anytime. As long as you have a data or wifi connection, you have the ability to connect with a counselor.

Seeking help online also helps to break through the shame which unfortunately continues to stigmatize issues of mental health. It’s one of the main reasons why 26 million people with a mental health disorder continue alone, without any professional support.

For some, meeting someone in a face-to-face session may feel like an impossible challenge – too stressful, to shameful or too embarrassing. A call or text conversation may be much more approachable, and not bring with it all the stigma.

How Does Online Counseling Work?

There are four basic steps to set up your first online therapy session:

  • Sign up to a service
  • Complete a brief survey
  • Select the perfect counselor
  • Schedule the first session

Generally speaking, you’ll access an online counselor through a platform. Look for platforms which protect your privacy, and which offer access to a large database of professionals.

Sign up should take no time at all, and unlike some daunting intake forms for in-person therapy, should require minimal personal information. After all, merely signing up shouldn’t have to mean disclosing your inner-most thoughts. Save those for the counseling sessions!

Once you’ve signed up, take five minutes to complete a short survey. This survey is designed to match you with an appropriate counselor who has the experience, training, and approach suitable for your goals.

Again, the survey only requires surface-level information. For example, what is your primary goal for online counseling (to improve relationships, personal growth, etc.)? Also, you’ll want to identify the ways through which you wish to connect to a therapist (phone, video, text).

Once the platform has a better idea of your goals and preferences, it’s time to choose a counselor. The best way to envision how a platform like Chat Owl does this is to imagine a counselor matchmaking service, entirely focused on pairing you with the perfect counselor suited to your needs and goals. Browse through the listings to find a match.

The final step is finding a time to chat. There is always the option of 24/7 support through text messaging, while more in-depth sessions, scheduled on a weekly, biweekly, or individual basis, are designed to work with your schedule.

Meeting with a therapist in their office generally means working their office hours into your schedule. In the online counseling world, the tables are reversed. You can schedule early morning, late night, and on the weekends. It’s your availability which matters.

Is Online Counseling Effective?

Happy & Confident Woman

More people are seeking professional help for their mental health concerns than before, and many are finding support online. It’s one of the fastest growing forms of therapy these days.

Did you know that remote counseling, in one form or another, has been around for decades? This included early versions of telephone therapy and prototype internet chat rooms. Years ago there was even mail-based therapy sessions. Slow, but effective.

Remote therapy, or teletherapy, was originally designed as a way for employers, schools, and other organizations to ensure access to mental health services for their members, despite rising demand for those services.

As more and more people accessed these non-conventional counseling sessions, experts began questioning their effectiveness. Could a therapist do the same work online, as they did in-person?

What Does the Research Say About Online Therapy?

Today, early analysis continues to support the effectiveness of online counseling. As far back as 1999, research has found comparable scores when comparing the success of offline versus online counseling for the treatment of anxiety. A study done in 2009 discovered similar levels of client satisfaction no matter the method of communication.  This more recent study also found comparable levels of treatment success. [4]

It’s worth noting, that a few studies found outliers in the data; respondents who felt uncomfortable with online communication. However, their dislike of an online counseling format may have to do with the demographic.

Millennials are much more at ease working and communicating online; it’s a pivotal part of their daily lives. Those over the age of 65 may have less familiarity or comfort with online technologies, especially when it comes to mental health treatment. Some may have issues adjusting to the novel new online experience and prefer methods of communication which are much more familiar.

Despite the few who didn’t take to an online format, the literature strongly supports online counseling as a much less stressful interaction than a face to face session. Its something researchers have dubbed the “online calming effect.”

In a massive review of 92 studies of cyber therapy, which included over 9,000 patients, researchers found virtually no differences in effectiveness. The noted, “A comparison between face-to-face and Internet intervention as reported on in 14 of the studies revealed no differences in effectiveness.” The evidence is mounting behind the usefulness for online modes of counseling. [5]

Online Counseling As Good, or Better than in-Person

According to a review of the literature from 2013, people generally rate their relationship with their online therapist as “strong as—and sometimes stronger” than those with a more traditional face-to-face experience. Importantly, people also rated the impact of their sessions as just as important (or more so) than those who only worked with a therapist in-person.

For most of us, whose reliance on technology for knowledge and communication is daily,  online counseling is proving just as effective as conventional therapy sessions. For both results and client satisfaction, there are no measurable differences between types of service. A recent review on the subject, “Psychology at a Distance” concluded, “The client participants gave overwhelmingly positive assessments of online therapy.”

There is also an argument to be made that online counseling may be more effective, simply because it is more accessible. Access to therapy is clearly more beneficial than no access at all.  From people living in remote areas with little mental health services to those who are too busy to fit in a face to face session – it’s easier than ever to find and work with a trained counselor through text, video, and phone.

How to Get the Most From Online Therapy

Happy Woman During Counseling Chat

As with any form of therapy, you are an integral influence over its success. Your active participation and openness with your counselor are going to have an impact on how easily and quickly you achieve the goals you’ve laid out.

Before heading into any counseling session, whether online or off, get the most out of your experience by doing a little preparation beforehand.

  • Connection: Make sure you have a reliable wifi or data connection for the duration of the session. Without the means of communication, both you and your chosen counselor will struggle to make a meaningful connection.
  • Distraction Free: With online counseling, you can choose a time and place which works best for you. No need to schedule solely within Monday to Friday office hours, you and your counselor are open to schedule as works best for your busy schedule.

It’s easy to be distraction free in a private counseling session, behind closed doors – but sometimes challenging when you are video chatting from home.  As such, find a time with no distraction. When you can close the door, turn down the chaos around you, and commit to a session without interruption.

  • Prepare in Advance: For your first session it’s valuable to have a list of issues you would like to cover. A written record can come in handy, as sometimes during therapy you can get distracted, overwhelmed, or nervous.
  • Goals: Why are you seeking help? Maybe you are working through a complicated relationship, trying to cope with depression or anxiety, or any number of other challenging mental health issues.

Speaking with your counselor about why you’ve chosen to seek treatment, and the end goal of that treatment is beneficial for both parties. Goals may change throughout your treatment, but in the beginning, a goal can help set the direction.

What are the Benefits of Counseling?

Adult Man Lying Down On Psychiatrist Couch

Therapy, in any form, has benefits. Whether you seek it online or in person, seeking the assistance of a licensed professional can help you overcome personal trauma, mental illness, and more.

The possible outcomes of counseling, are as varied as the reasons for seeking counseling in the first place. Counselors provide advice, support, and tools for you to get through difficult situations. Counseling is a long term solution.

Some of the most frequently cited benefits of counseling are as follows:

Communication Skill

Counselors can offer tools and advice on how to manage difficult relationships, whether they are romantic, familial, or professional. Learn how to approach situations from different angles, how to process painful experiences, and communicate better overall.

Dealing with Trauma

Trauma can often lead to depression, anxiety and other mental health disorders like PTSD. Counselors are trained to work with clients to process trauma in a healthy way which reduces stress, relationship issues, and reduces the risk of depression and anxiety.

Managing Depression

One of the most effective ways to treat depression is with cognitive behavioral therapy. The research shows it is equally as effective as medication – but is also often used in tandem. [5]

Overcoming Anxiety

There are many different types of anxiety, but they share a common irrational fear-based pattern of thought. Counseling helps you address these negative thoughts and learn to change them. Therapy also gives you the tools to cope with stress, including breathing exercises and mindfulness activities, to reduce anxiety as it occurs in the real world.

Personal Growth

Talk therapy helps you address mental blocks on your road to success. If you feel frustrated with your career, relationship, or academic life, it’s a very lonely road. Working with a therapist focused on helping you achieve your personal goals, can help improve your satisfaction and sense of achievement.

Strengthening Relationships

Counseling isn’t just helpful for you as an individual; it’s also beneficial for relationships. Couples counseling helps spouses work through tough subjects, improve positive communication, and deepen intimacy.

And Now, the Benefits of Online Counseling

Frustrated Man Stares at Computer

There are, of course, many other reasons behind why people seek out professional advice for mental health, relationships, and personal growth. Whatever the underlying cause behind why you choose to seek help, there is no difference in the type of advice you’ll receive from an online counselor versus sitting across from one on their office.

When it comes to the benefits of therapy, both online and offline are valuable resources for overcoming challenging periods. But, online counseling has some benefits which the offline version doesn’t have; some you may not have considered. Online counseling is explicitly beneficial in the following ways

Accessibility

As many have already discovered, there is a shortage of mental health workers across the country. Especially in rural areas, there is little to no available licensed therapists. If there are, they may not offer the services you need, you may not feel a connection with them, or they could have years-long waiting lists.   Waiting lists are standard even in larger urban areas.

Online counseling immediately dissolves this issue of accessibility. There are no waiting lists and no barriers to entry based on physical location. Even if you live on a deserted island, so long as you have an internet connection or a cell phone, you have access to a world of licensed practitioners eager to help.

Accessibility of online counseling is also beneficial for people with physical disabilities. Statistics say that a physical disability increases the risk of depression, and yet a physical disability can prevent you from seeking treatment for mental health. [7]

If you are differently-abled, it may be much easier to chat with someone via Skype than it is to commute across the city for an in-person visit. On top of that, many offices are not accessible for wheelchairs and other mobility devices, making the search for a qualified and accessible therapist even more restricted. Clearly, the ability to stay in your own home and work with a counselor removes these frustrating barriers.

Discretion

The stigma around mental health and the treatment of mental health disorders is rapidly decreasing. Still, stigma is a significant reason why many people avoid seeking out professional advice. People may feel concerned about what others may think, or in some cases, prefer to keep their therapy sessions private. It’s why the anonymous nature of online therapy is attractive.

Having the ability to work with a counselor from the discretion of your own home, removes this real (but unfortunate) stressor from the process. You are anonymous in a certain way. While there is nothing to be ashamed about in regards to counseling, shame still poses a genuine mental barrier to treatment. Having the ability to seek help, without leaving work, or rescheduling familial obligations can make the first step that much easier.

The Disinhibition Effect

One of the most surprising benefits of online counseling, versus the offline version, is an effect called disinhibition. Technology seems to have an ability to lower inhibitions between a client and their counselor, which allows for better communication.

Discussing your innermost thoughts and deeply personal issues in person may bring with it feelings of embarrassment, discouragement or shame. But these negative emotional limitations are less of a problem when you use text, video or a phone call as the method of communication.

This effect is reported time and time again in the literature on online therapy, and for most people seems to improve their overall satisfaction with the experience. According to one report, “by using the Internet as a communications modality, people feel less inhibited, which may encourage more personal, emotional expression, and self-reflection.” [8]

Costs

A conventional face-to-face meeting with a licensed counselor can cost well over $150 for a one-hour session. Without insurance coverage, this means the price of therapy is just too high for most people to afford. It’s another reason why so many don’t seek treatment for their mental health.

Online counseling opens up access to treatment, by offering the same services at a reduced cost. Because counselors and therapist don’t need to support an entire office, they also don’t need to pass those costs along to their clients.

The price of an online therapy session does vary depending on the provider, but they are almost always are offered at a fraction of the cost as a conventional one. Some of the online options  range between $70 to $80 per week (Better Help & Talk Space). But there are also more affordable options out there, like Chat Owl. For as low as $39 per week for unlimited text support, or $49 per talk session. It also gives you the ability to seek a one-time session, something which isn’t usually open for a brick-and-mortar practice.

Online Counseling: Lowering Barriers to Access

Choosing to be Happy!

While online counseling may still feel like a relatively new, and unproven trend in therapy, it is surprisingly well established. Since its initial launch, by letter mail, to its evolution to text, video, and mobile phones, online counseling is proving itself time and time again by its effectiveness. On top of which, it’s often also preferred.

Online counseling opens up doors to people who have always wanted to speak with a mental health professional, but who have faced one or more limitations to access.

Whether you had accessibility issues, couldn’t afford the astronomical costs of conventional therapy, or felt too much stigma, online counseling helps to overcome all of these obstacles.

Online counseling flips the idea that you have to work with someone else’s schedule and instead fits counseling into your schedule. Connecting people to counselors in a direct and meaningful way means nobody has to wait to find the treatment they deserve.

[1] http://www.mentalhealthamerica.net/issues/mental-health-america-adult-data

[2]https://www.goodhousekeeping.com/life/relationships/a32083/kristen-bell-dax-shepard-marriage-works/

[3] http://www.nbcnews.com/id/3077086/t/more-people-search-health-online/#.XHVsL5NKjOQ

[4] https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?article=1343&context=honorstheses

[5]https://www.tandfonline.com/doi/abs/10.1080/15228830802094429

[6]http://dare.ubvu.vu.nl/bitstream/handle/1871/48057/2013%20Cuijpers,%20Meta%20CBT,%20Can%20J%20Psychiatry.pdf?sequence=1

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130183/

[8]https://www.researchgate.net/publication/254378109_Current_and_Future_Trends_in_Internet-Supported_Mental_Health_Interventions