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Does online therapy work?

Updated: Apr 28, 2023



Are you considering online therapy? For most people this option can be as effective as in-person therapy and is now widely offered in Private Practice as well as the NHS. Here is an overview of the research into this area to help you decide whether it's right for you.


Anxiety

A number of studies (for example here and here) show that Cognitive Behaviour Therapy (CBT) carried out online is equally effective for Health Anxiety, Panic and Generalised Anxiety.


Obsessive Compulsive Disorder (OCD)

The research into OCD suggests that mild to moderate OCD can be supported effectively online but that severe presentations benefit from being seen in person.


Depression

Research suggests that CBT for Depression can improve Quality of Life (improving negative thinking patterns and social interactions), although outcomes are better for those with less severe difficulties. This research echoed this finding, although specified that brief therapy was ineffective for Depression, only extended CBT was successful in reducing difficulties.


Post Traumatic Stress (PTSD)

A 2016 meta-analysis (a study that looks at the results of smaller studies combined) into the effectiveness of online and in-person Trauma-Focused CBT showed that the outcomes for both were equivalent.


Similarly a small study during the pandemic (when online therapy really took off) into online EMDR therapy showed meaningful reductions on measures of anxiety, depression and trauma. The topic of online EMDR has a few open studies currently so expect more data on this soon.


Chronic Health Difficulties

Two types of CBT therapies that are already shown to be effective in this area are Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT). This study showed that both of these approaches were equally effective online and that the positive shifts were maintained at the follow ups (carried out 3 and 6 months later).


Factors that make online therapy effective

The therapeutic relationship has consistently been shown to be the most important component in getting positive outcomes from therapy, regardless of the approach.


What this means is that, if you have a strong relationship with your therapist (one where you can feel safe enough to explore and do things that put you outside of your comfort zone in order to grow) then you will see benefits. So this research (carried out in 2020) which showed no difference in the therapeutic relationship whether therapy was carried out in-person or by phone is important, highlighting that you can still have this important piece of the jigsaw, even when you're not in the same room as your therapist.


Another important consideration is whether a client believes that the therapy will work or not, when you trust the process you throw yourself into it fully and are more likely to see improvements more quickly. With this in mind this review during the pandemic of client and therapist experiences of online EMDR therapy showed some factors that can help with trusting the process. For example some benefits of being online included the client feeling more comfortable in their own home and therefore less inhibited about disclosing difficulties than in a therapy room; some people also experienced their therapy as more immersive when they were online.


Summary

The research above generally shows that online therapy is a reliable option except when you have a severe presentation, and that a key consideration when deciding between in-person or online is that you have good relationship with your online therapist. The next step then is to have an initial assessment to determine the severity of your issues and see if you and your therapist have a good fit.


This is good news if you have practical or physical reasons that make attending in-person therapy tricky, or if you have found a therapist who has the specific specialism you need but isn't local to you.


Next step

Contact a member of our team to book an assessment.






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