Is Online Therapy as Good as Face-to-Face?

In the digital world, a computer screen doesn't inhibit psychotherapy.

• A study found digital therapy to be as effective as in-person therapy.

• It can also cut costs and reduce waiting times.

• Many people value the convenience of online therapy.

A massive study, involving more than 27,500 people here in the U.K., has found that talking to your therapist online is just as helpful as seeing someone face-to-face. Not only that, but it also cuts costs and reduces waiting lists.

The study, which was mainly an economic evaluation of service provision, also looked at waiting times and the clinical effectiveness of therapy for patients presenting mainly with anxiety and depression. The data was taken from the NHS Talking Therapies (NHS TT) program, which was formerly known as Improving Access to Psychological Therapies (IAPT). 1

The study found that online therapy (either therapist-delivered or via modules) also brought down costs and decreased waiting times for patients.

“The actual cost of mental health care doesn’t come from treating these conditions but from not treating them,” said study co-author Ana Catarino, director of clinical science at ieso Digital Health.

Catarino and her team compared ieso’s internet-delivered CBT (which has a therapist working one-to-one with patients via text chat) with therapy offered by the NHS (which involved a variety of therapeutic modalities and delivery methods).

The study found that online therapy was more cost-effective than other forms of care because the patients that were offered the therapist-delivered CBT programme got treatment faster. This meant that their quality of life improved faster too. “The longer patients wait, the more likely they are to see their problems become more severe and to have a poorer response as a result of that wait,” said Catarino.

The study itself does not surprise me at all, as the results are the same for private therapists as it is for the NHS and other platforms.

I’ve been offering online therapy as an option (both for rational emotive behavior therapy, or REBT, and hypnotherapy) since the early days of Skype. I went totally online during the pandemic and now, three years later, my practice is roughly 50% face-to-face and 50% online. I’ve even found that people who say they would prefer to see me face-to-face often very quickly revert to virtual, as they favor the convenience of it.

But convenience isn’t the only factor in people’s decisions to see their therapist digitally. Ease of use with and confidence in video calling via smartphones and tablets has also influenced people’s decisions, as has saved money (i.e., no travel costs are involved).

Also, many of my clients often find that it is easier to fit a video call into their work/life schedule than it is to make a trip to my actual clinic.

Most other therapists I know offer both face-to-face and online therapy as a regular part of their practice and several are pointedly online only (as this also fits better with their own work/life balancing acts).

Seeing a private therapist online means you get to see the person you are talking to (as opposed to text and chat box or module-delivered therapy) plus, as the client, you are not restricted by your area, your region, or even your country. This gives you even greater choice in finding the best-fit therapist (in terms of both rapport and modality) than ever before.

With technologies such as Zoom and Skype, the world (and the therapists within it) is indeed the mollusc of your choice.

I have seen (and continue to see) people not only nationwide, but also across Europe and, occasionally, (where time zones allow) in South Africa, North America, and Australia.

“Virtual care won’t be right for every person,” said Catarino. But its effectiveness, accessibility, and convenience cannot be ignored.

COVID revolutionized the way people accessed mental health support. I also see people online as part of my work for The Priory Hospital. It wasn’t an option before the pandemic, but now it’s a service the brand actively promotes. Not only is digital therapy the right choice for a growing number of people, but it is also here to stay.

Daniel Fryer M.Sc., MBSCH - website - media

References

1: https://www.nature.com/articles/s44220-023-00106-z