Concerns often arise in relation to the effective of virtual therapy vs. in-person
Changes in the delivery of mental health services throughout the COVID-19 pandemic have resulted in increased availability and utilization of online therapy treatment options. However, when considering whether online therapy is worth exploring, concerns often arise in relation to the effectiveness of online therapy when compared to in-person therapy. Many prospective clients feel that they would not be able to open up to a therapist online, or that they would be wasting their time and money by choosing a form of treatment that doesn’t involve any in-person contact with a therapist.
Virtual therapy comprises “any type of professional therapeutic interaction that makes use of the Internet to connect qualified mental health professionals and their clients” (Dowling & Rickwood, 2013, p.3, as cited in Chipps et al., 2022). This connection can be achieved through synchronous forms of communication, such as instant messaging or videoconferencing; asynchronous forms of communication, such as emailing; or some combination thereof. Seeing as these methods of communication can be initiated from any location with internet access, a clear benefit associated with virtual therapy is that there is no need to travel to and from appointments. This is particularly useful for clients who have difficulty accessing transportation due to financial or time constraints.
Clients seeking treatment through online therapy might also benefit from a phenomenon known as disinhibition. Disinhibition refers to the role of the virtual platform in encouraging disclosure among certain individuals (Suler, 2004). It has been theorized that some clients are able to share with greater depth and frequency in a virtual setting because they perceive a sense of apartness that makes them feel safe (Simpson & Reid, 2014, as cited in Barker & Barker, 2022). Relatedly, virtual therapy is thought to facilitate the process of initiating treatment, as well as subsequent engagement with the treatment process, for clients whose feelings of fear, self-consciousness or shame might otherwise pose a barrier (Barker & Barker, 2022).
Another facet of virtual therapy is telepresence, “the feeling of being in the presence of someone without sharing physical space” (Fink, 1999, as cited in Rathenau et al., 2021, p. 3). Research posits that telepresence mediates the ways in which therapists and clients relate to one another in an online setting (Rathenau et al., 2021). Specifically, telepresence is thought to play a role in the formation of the therapeutic relationship (Bouchard et al., 2007, as cited in Rathenau et al., 2021).
In terms of the results of virtual therapy, cognitive behavioural therapy conducted online was found to be effective in reducing the symptoms of various anxiety disorders, including phobias, panic disorder, post-traumatic stress disorder and obsessive-compulsive disorder (Cuijper et al., 2009, as cited in Barker & Barker, 2022). Moreover, no significant differences in client outcomes were noted when compared to those of equivalent in-person interventions (Cuijper et al., 2009, as cited in Barker & Barker, 2022).
Virtual therapy, in the focus of online rehab, was also demonstrated to be effective in reducing alcohol, tobacco and opioid use, with no significant difference in outcomes relative to equivalent in-person interventions (Carlson et al., 2012; King et al., 2014; Staton-Tindall et al., 2014, as cited in Lin et al., 2019). Notably, there was greater client retention in virtual therapy for alcohol use than in its in-person counterpart (Tarp, Bojesen, et al., 2017, as cited in Lin et al., 2019).
In addition to virtual therapy and online rehab, there are many online peer support groups (if therapy doesn’t seem like what you need). This is a way to ease into reconnecting socially to others without having to meet new people in person after isolating for the last 2 years.
Virtual therapy offers the ability for the employer to reduce the time, travel costs and absenteeism rates that travelling to in-person therapy appointments may incur and decreases some barriers to initiating or engaging in therapy in the first place. Virtual addiction treatment is generally accessible at a reduced cost compared to inpatient treatment and can provide less barriers to accessing treatment.
Many therapists, including those part of company Employee Assistance Programs, offer virtual therapy. If you have been thinking of having a therapy session, a virtual therapy session may be a less intimidating and less overwhelming way to get started.
Barker, G. G., & Barker, E. E. (2021). Online therapy: lessons learned from the COVID-19 health crisis. British Journal of Guidance & Counselling, 50(1), 66-81. doi:10.1080/03069885.2021.1889462
Chipps, W., Petzold, A., Adams, C., & Jackson, K. (2022). Online therapeutic methods: A systematic review. Current Psychology 41, 2835-2847. doi:10.1007/s12144-020-00791-4
Lin, L. A., Casteel, D., Shigekawa, E., Weyrich, M. S., Roby, D. H., & McMenamin, S. B. (2019). Telemedicine-delivered treatment interventions for substance use disorders: a systematic review. Journal of substance abuse treatment, 101, 38-49. doi:10.1016/j.jsat.2019.03.007
Rathenau, S., Sousa, D., Vaz, A., & Geller, S. (2021). The effect of attitudes toward online therapy and the difficulties perceived in online therapeutic presence. Journal of Psychotherapy Integration. Advance online publication. doi:10.1037/int0000266
Suler, J. (2004). The online disinhibition effect. Cyberpsychology & behavior, 7(3), 321-326. doi:10.1089/109431041291295
Authors: Kinga Burjan, MA, RP, Clinical Director – Virtual Integrated Programming at Trafalgar Addiction Treatment Centres, and Dylan Magner, Year 3 BScN Student, Daphne Cockwell School of Nursing, Toronto Metropolitan University.