By Martha McLaughlin

The digital age has vastly altered the way that people access information and entertainment. It’s affected the way that people interact socially and is beginning to change the healthcare industry. In the mental health arena, online tools are being used, but much is yet to be determined about how they compare to traditional in-person therapy.

Types of Online Mental Health Treatment

Young woman texting on smartphoneThere are multiple types of online mental health treatment. The type most like traditional therapy is when a therapist and patient with an existing in-person relationship hold some of their counseling sessions online, generally using video technology. This is common in substance abuse aftercare, when a patient who has traveled to attend a residential rehab program returns home. By keeping in touch online, therapists and patients are able to navigate the challenges of transitioning back to everyday life.

Sometimes patients receive online treatment from providers they never meet in person. The patients or counselors may have physical limitations that make traveling to an office difficult. Other times, resources in a geographical area are limited and an online relationship may help a patient access a therapist whose office is too far away for easy travel.

Many online therapy offerings utilize video, but there are also options that are entirely text-based. Patients and counselors communicate solely in writing. These text conversations can be either in real time or delayed, with counselors responding to messages at their discretion.

The Pros and Cons of Online Mental Health Treatment

As with all modes and types of treatment, there are pros and cons to online therapy, and circumstances in which it makes more sense than in others. It’s obviously beneficial for people who have no good in-person options. Text-only therapy is also generally less expensive, which may be important for people with limited insurance coverage or other financial challenges.

Although online therapy can produce results, there are ways in which in-person treatment can offer patients a more complete and beneficial experience. When meeting in person, a counselor is able to pick up on more nonverbal cues and therefore has more information to use in steering the conversation. In a video chat, generally only the face is seen, making it impossible to read body language, such as crossed arms and legs or tapping feet. One counselor notes that it’s more difficult, when meeting online, to notice subtle indications of emotion, such as a quiet sigh or dilated pupils, and that it’s impossible to smell alcohol on someone’s breath.1

Sometimes, the act of going to an office to access therapy is helpful in and of itself. One psychologist notes that she finds her clients to be more committed to the therapy process when they make the effort to meet in person.2 Traveling to the office also provides a greater degree of social interaction, which may be helpful for people who are depressed or isolated.

The technology used in online therapy can present problems that in-person treatment doesn’t encounter. Technical issues can disrupt the flow of a session and cause unnecessary distraction. Confidentiality is a greater concern with online therapy, because of the vulnerability of online platforms to data breach.

Emergency situations are also a greater concern. Sometimes, especially in text-based programs, a client will stop communicating, leaving the counselor unsure of whether or not the patient is in trouble, or just busy or distracted. Text-based programs also sometimes give counselors limited information about their clients, leaving them not knowing who to contact when an emergency arises.

Digital Tools to Help Manage Mental Health

Although they aren’t a substitute for seeing a therapist in person, there are a number of digital tools, including both web-based programs and smartphone apps, which can help people maintain good mental health. Some are simply digital versions of long-used non-digital practices. These include online journals or programs that help guide meditation.

Other programs help people organize and correlate data. They may help users keep track of when to take medication, for example. There are also programs that ask users to enter information, such as their moods at given times, what they ate, how much they slept and events that caused them stress. The programs put the information in graphic form that makes patterns easier to discover. These tools can be useful additions to therapy.

Research demonstrates that the best treatment results come from the strongest therapeutic alliances between patients and their counselors.3 Rolling Hills Hospital can help you find the therapist that is best for you and begin to build the alliance that will help you meet your goals. To take the next step and speak with one of our admissions coordinators, give us a call at 855-686-0532. Your future is waiting.


1 Reidbord, Steven. “Online Psychotherapy: The pros and cons of therapy via Skype or FaceTime.” PsychologyToday.com, July 31, 2013.

2 Gould, Wendy Rose. “The Pros and Cons of Online Therapy.” Everup.com, January 12, 2017.

3 Cabaniss, Deborah L. “The Therapeutic Alliance: The Essential Ingredient for Psychotherapy.” HuffingtonPost.com, July 31, 2012.