The benefits of online therapy vs face-to-face

July 17th, 2019

The benefits of online therapy vs face-to-face

By Elina Broholm

  • Efficacy
  • Therapy

As technology evolves and becomes increasingly sophisticated, so have it’s uses.

Unsurprisingly, many of us approach these advances with caution, questioning the range of tasks that machines may be able to perform that were previously only within the human realm of capability.

Today, we can even use technology to facilitate the one job we may presume would never be taken over by ‘robots’ - therapy. It is becoming increasingly common for people to actively seek out therapy online - either via chat, video call, or both.

But can online therapy really measure up to traditional face-to-face therapy? And more importantly, is it as effective?

Some people may have reservations about entering into a therapeutic relationship that is entirely conducted online. They may worry that they won’t be able to connect in the same way that they would with a person who’s not in front of them - this is something that researchers have been investigating in depth over the past couple of years.

For example, Etzelmuller and colleagues (2018) wanted to see if online self-help cognitive behavioural therapy (CBT) combined with online video CBT therapy could prove as effective as online self-help therapy combined with face-to-face CBT.

They found that participants predominantly rated their experience as effective, and identified advantages to traditional therapy such as location convenience and accessibility. Participants also predominantly rated it as equally as effective as face-to-face treatment.

Further, Berger (2015) conducted a review of studies assessing the therapeutic relationship in internet interventions. He found that participants rated the therapeutic alliance as highly as participants using face-to-face therapy.

Another group of researchers (Carlbringer et al, 2017) reviewed 20 studies which compared the efficacy of CBT delivered online compared to face-to-face interventions. They found that online interventions produced an equivalent overall effect when compared to face-to-face therapy.

It is worth noting, however, that not all the studies included in the sample made use of video calling, these enhanced visual and auditory components arguably add a more human touch to any therapeutic interaction, in that it allows both therapist and member to communicate with each other using body language and tone, although additional research is required in this area.

Importantly, one of the advantages of conducting therapy online is arguably increased accessibility. As therapy conducted online often means that you can partake in it from the comfort of your own home, whilst in the office, or if you live remotely with limited access to mental health care for instance. On this note, researchers in the United States (Lindsay et al, 2015) looked at the efficacy of delivering psychological interventions using videolink to people experiencing PTSD across different sites in order to increase accessibility. They found that sites who offered therapy over videolink had 3.2x as many participating clients compared to sites who did not, and that the interventions delivered were rated as equally as effective as in-person interventions.

Online therapy may also provide a platform for those who do not wish to access therapy services locally either due to an anticipated stigma or lack of availability of specialised therapists. When choosing and connecting with a new therapist, it is tremendously important that the person you start seeing is right for you, and fits your needs - that is unfortunately not always readily available locally or in an area that you can visit in-clinic.

Of course, factors such as video resolution and overall quality of a video call can affect the interaction between therapist and client. It is always a good idea to ask whoever is providing your therapy for guidance on how to prepare for your session.

For some, the idea of opening up to someone who they haven’t met “in real life” can be daunting. However, many appreciate the possibilities that online therapy can bring, such as accessing support from the comfort of your home or receiving specialist treatment without having to travel far. As long as you have access to good WiFi and a device, the relationship you build with your therapist can be as good - or even better - than the one you could build with someone sitting in a chair in front of you.

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