As a psychotherapist, I've spent the majority of my career offering traditional therapy in an office setting. And while the thought of providing online therapy has occurred to me, I'd never thought to test online therapy services for myself.

So when Verywell, a health information website, asked me to conduct a special project for them (as a paid, contracted writer) that involved testing various online therapy websites, I jumped at the opportunity. My mission was to sign up for various online therapy services as a client and then document my findings in a series of articles.

How Online Therapy Works

Reputable online therapy sites allow you to access mental health treatment with a licensed therapist in your state. They usually treat the same conditions you can get treated for in a traditional office setting, such as depression, PTSD, and anxiety.

Some of them even offer online couples counseling.

Most online therapy sites offer several methods of communication. Some allow for unlimited messaging, meaning you can send a message to your therapist any time of day or night. Messaging usually occurs through a secure app, and it's similar to the way you might message someone on social media.

Of course, just because you can leave a message any time of day or night doesn't mean your therapist will reply right away. Therapists often reply to messages once a day.

Some online therapy sites even allow you to leave audio or video messages, which can be a great alternative if you aren't into typing out a long message.

Some sites only offer live appointments. You can schedule a live video chat with a therapist from your smartphone or computer.

Other sites allow you to schedule live chat sessions, so if you aren't comfortable being on camera, you can still have a conversation in real-time.

And a few offer phone sessions. This can be especially helpful for those with slower internet speeds or for someone who wants to talk to someone (but isn't comfortable being seen).

Benefits of Online Therapy

I found that online therapy definitely offered some major advantages over traditional therapy:

  • Online therapy is usually cheaper. Online therapy appointments are usually much less expensive than in-person sessions. Many sites allow you to purchase a subscription, so you pay by the week or the month for services, as opposed to paying for each appointment.
  • Communication options are more convenient. They can also be more convenient in terms of scheduling. Many therapists offer live appointments during weeknights and weekends. And messaging can be done anytime from anywhere.
  • You can usually remain anonymous. Most therapy sites allow you to communicate with a therapist by using a nickname. That means your therapist might never know who you are, which can be extremely important to some people.

The Downsides to Online Therapy

Online therapy does have some downsides as compared to traditional face-to-face treatment. Here are some of the potential problems with online treatment:

  • It's impersonal. Sending messages back and forth certainly feels much different than sitting down and talking to someone face to face. Most therapists couldn't keep my information straight, and it's no wonder why. I was a nameless, faceless person they were communicating with online. And that's concerning to me, because the relationship between a therapist and a client is important to the treatment outcome.
  • The therapist might miss the big picture. Most of the online therapists didn't ask any background information. Or if they did, it was a quick couple of questions. It would likely be easy to miss the bigger picture issues--like a traumatic past, depression, or an anxiety disorder.
  • The therapist can't observe the client. Therapists learn a lot of information on someone based on their observations of that person's body language, how they speak, and how they interact. But many forms of online communication don't allow the therapist to observe clients in real time. The therapist can't see if that someone constantly fidgets (which may be a sign of anxiety) or that someone speaks slowly due to depression.

Online Therapy Is Likely Quite Effective for Some People

My thoughts about online therapy are mixed. At times, I saw how messaging a therapist throughout the day could be helpful. But at other times, I felt like I was talking to a robot. Some therapists replied to my messages with generic information or they asked me to complete worksheets without any discussion about my answers or explanation about why I should complete them. 

Overall, I think online therapy can be quite effective for some people. An individual with social anxiety who is afraid to see a therapist in person, for example, might benefit greatly from online therapy.

Or someone who needs a little extra support during a time of transition--someone going through a divorce or dealing with a job change--may find it to be quite helpful.

High-functioning individuals who are just looking for a little professional advice might also find it to be useful. The ability to text someone when you're stressed out or to ask a professional how to deal with everyday issues, like trouble sleeping or disagreements with a coworker, might prove quite useful.

But online therapy likely isn't for everyone. I fear that someone who doesn't recognize that they're anxious or depressed might have trouble communicating their struggles effectively online. And some of their symptoms may go unnoticed or overlooked.