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Free Online Therapy: Is it Really Free? Paid vs. Free Online Therapy

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Americans are relying on the internet in more ways than ever before for their health and wellness. Right behind email use, and product research – looking up information about health issues is one of the top three reasons people use the internet these days. Some of the top health-related searches include look up symptoms of disease and illness, and topics like depression, anxiety or stress. [1][2]

With so much free health advice online, it’s no surprise that increasingly people are searching for “Free online therapy.” Since 2004, the number of people searching for this topic, on a monthly basis, has doubled according to Google Trends. Accordingly, there is a rise in free online mental health support from all over the world, but is free online therapy worth all this buzz? 

We are going to dig to the real (and critical) differences between paid counseling and free online counseling. And spoiler alert, if it sounds too good to be true – it likely is too good to be true.

What is Online Counseling in the First Place?

Online counseling is essentially the same service as in-person counseling – so long as it’s with a licensed counselor or therapist. Whether you are sitting on a chaise lounge or skyping from your bedroom – the counseling session will feel very much the same. Just like their offline peers, online counselors work with the same approaches, tools, and techniques, only over the internet or by phone.

By accessing therapy online, you benefit from the ease of scheduling, lower costs, and for certain people, less stress from a face-to-face meeting. Online therapy usually happens via text message, by phone, or video chat. Finding a suitable counselor online is also much easier than finding one locally. There are seemingly endless choices online, where you may only have a few licensed options locally.

Is Online or Offline Therapy More Effective?

As the appeal of online counseling has grown over the last few decades, many have questioned the effectiveness of the approach. They wonder if high-tech forms of therapeutic communications give the client the connection and support they need to overcome mental health concerns. 

Thankfully, researchers are exploring the success rates of online versus offline therapy. Despite the assumptions you might have held about counseling via the internet, all the data points to equal if not better results.  Not only are clients as satisfied, or more, with their online counselor, they may see better longer-term improvements.

A study from Germany, published in the Journal of Affective Disorders, compared results for online counseling versus in person for the treatment of depression. Immediately after the sessions, the group receiving online counseling experienced a 50 percent drop in rates of depression, versus 53 in the offline group. In a follow up a few months later, the online group’s rate of depression dropped 57 percent, perhaps because these clients re-read the communications with the therapist and gained new insights.[3]

Other studies have demonstrated similar results. People accessing therapy through online-sources tend to rate their experiences on par (or better) than people who choose the more conventional on-the-couch route. 

As one literature review concluded, “Overall, the outcome literature appears to support the feasibility of online therapy. Teletherapy appears to produce therapeutic changes in a client in a similar manner to traditional therapy. This occurs in spite of the obvious differences in the medium of transmission and communication (i.e. speaking directly to a person in the same room versus digitally facilitated communication over a distance).”[4]

The Difference Between Paid vs. Free Online Therapy

Here is where we get into the nitty-gritty details about online “therapy.” There are significant differences between therapy performed by licensed and certified professionals online, and other forms of free support or advice provided online. What is often the case when you Google “free online therapy,” the search sends you to a for-profit organization, offering one of three options: support chats, monitored forums, and trial sessions.

As you’ll see below, while these options are free, they tend to fall more into an online support role than certified counseling role. For anyone looking for quick advice or a place to connect with others, these might make perfect options. But if you are looking for real, therapist supported long-term solutions – the paid versions are a safer bet.

A quick caveat here – some places offer free therapy for those who cannot afford it. These services are often in short support and provided locally. Commonly it’s offered to communities in need (women, LGBTQ, minorities, etc.). Usually, there are services offered via your health insurance, your university, or a local charity. 

Unlike the “free online therapy” options described above, these free sessions are with a certified counselor. Call your local community services networks, employee assistance program or your school’s student office to find out what options are available locally.

What Really Goes on in Free Online Therapy?

In a recent piece for Elle Magazine, writer Laura Barcella compared notes from her experiences with three free online therapy providers. In each case, they were a for-profit company, with free services on the side. [5]

According to Barcella, she has personally relied on in-person talk therapy for decades. So her experiences with free online therapy paint a real-life picture of what you can expect for free, and their value in comparison to counseling performed by a licensed professional.

Free Support Chat Rooms

Support chat rooms are a 24 hour, seven days a week service offering a connection to others in the same space as you. Users connect anonymously, either in a therapist monitored or user-monitored room to discuss their issues and provide support to one another. It’s a place to commiserate, and share experiences, but there is usually no one-on-one communication with a counselor.

In Barcella’s experience using one free chat service, she was confronted with a warned before signing on, “Venting to a stranger can be incredibly dangerous if you are at a very mentally sensitive state. By entering the chat, you understand that [omitted]is not liable for any advice given.” For her, this warning spoke volumes about the pitfalls of the service. It’s very clearly not a replacement for real online counseling sessions.

Free Therapist Monitored Forums

She also tried out a number of therapist-monitored forums. These forums explore topics like depression, anxiety, and other common mental health concerns. These spaces allow users to post questions and experiences; to receive follow up advice from counselors. In some cases, Barcella received immediate responses, while in others she troublingly never received any feedback whatsoever. 

As she put it after her interaction with a counselor on a forum about depression “…as our back-and-forth winds down, I feel totally underwhelmed. [….] it’s not in-depth enough to provide any real insight.”

Free-Trial Sessions

There are also pay-for online counseling websites which offer trial sessions for new customers. Of course, this is an excellent way to test out a counselor or see if you feel comfortable with the format – but one session rarely solves a mental health concern.

On average, you’ll need eight sessions to see significant improvements. This number varies significantly depending on the person, therapeutic approach, and goals, but it should give you a good idea that one session won’t cut it for long term solutions.[6]

Barcella perhaps put it best when she sums up her free online therapy experiences, “Overall, my experiences on the sites were intriguing but not mind-blowing—none of the free forums felt equipped to help me dive into real issues. They felt more like social outlets than mental health resources.”

How Much Does Face-to-Face Counseling Cost?

As with all private services, traditional in-person counseling costs vary depending on the region of the world, local competition/regulation, health insurance coverage and the credentials of the counselor. In most areas of the US, you can expect to see an invoice between $75 to $100 per session. Although, some therapists charge upwards of $200.[7]

Check with your health insurance for coverage, as they often cover a predetermined number of visits a year, or a percentage of each visit to a yearly maximum. Some counselors also offer sliding scale services, where the more you can afford, the more you pay. If neither of these is an option, ask local community resources (women’s centers, student organizations) if there are local free counseling services in your area.

How Much Does Online Counseling Cost?

You’ve got a world of options out there for licensed online support. Costs vary, depending on the frequency of sessions (weekly, bi-weekly, one-off), and the type of access (24/7 text messaging versus scheduled meetings). As an example, Chat Owl offers sessions for under $50, and text message support for under $40. The one consistent aspect of online counseling from certified therapists is its affordability compared to traditional in-person sessions.[8]

You’ll quickly see that full-session online costs a fraction of the same session offline. It’s why so many people have sought online counseling as a much more feasible option for their budget and lifestyle.

Free Online Therapy: Is it Worth it?

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If you are looking for online advice or a support network, the many forms of free pseudo-therapy online are all suitable options. There are more chat rooms, forums, and support networks out there than ever before. So if you need a friendly person to talk to, you may want to give one of these options a try.

However, finding a licensed, experience online counselor is a much better option for long term support. If you have serious concerns about your mental health, including trauma, a diagnosis, or problems in a relationship,  you’ll want to speak with someone specialized in that field. Speaking with someone trained in that area can have positive impacts for the rest of your life, not just a short term solution.

[1]http://www.nbcnews.com/id/3077086/t/more-people-search-health-online/#.XHg7jJNKjOQ

[2]https://trends.google.com/trends/explore?date=all&geo=US&q=Free%20online%20therapy

[3]https://www.sciencedaily.com/releases/2013/07/130730091255.htm

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

[5] https://www.elle.com/beauty/health-fitness/advice/a12683/free-internet-therapy-websites/

[6]http://psychologyinfo.com/consumers/treatment-sessions.html

[7]https://www.lifehack.org/572084/how-much-does-therapy-cost-and-how-choose-well

[8]https://www.lifehack.org/572084/how-much-does-therapy-cost-and-how-choose-well