Is Online Therapy Effective?

Does it work?

If you’re in a remote area, are extremely shy, agoraphobic, or have no access to a therapist; this may be your best option. However, if you do plan on using a psychologist who employs email, or internet therapy, you should consider this:

  • Many e-therapists charge $40-50 a question, $70-125 an hour per chat, or perhaps $90 an email. A regular therapist charges by the hour and doesn’t limit the questions you can ask.
  • It is not a replacement for traditional therapy. A therapist relies on body language, tone of voice, appearance, hygiene, etc. to accurately gauge how you are.
  • Unencrypted email is not secure. It can potentially be viewed by loved ones, or worse– forwarded by anyone who has the password to your email address.
  • There is a code of ethics on how email therapy should be conducted, but they are not enforced and often disregarded. This is also possible with legal codes.
  • Most insurers will not cover online therapy.
  • Because online psychologists using email therapy may have a turn-around time of one or two days, or even more, they cannot respond to crisis situations.
  • Online therapy is not appropriate for those with a serious psychiatric illness. If you’re taking medication for such a condition, or need them, you will need a psychiatrist to evaluate you and determine if you need your medication adjusted, changed or prescribed.

In a 2009 article from, Thomas Nagy, a psychologist who does both traditional and online therapy through videoconferencing when possible, notes that “essentially email therapy is an oxymoron.”

In short, if you don’t have access to a psychologist, and online therapy is your only option if you seek mental health assistance;  you should consider finding one that does videoconferencing. If someone offers to treat you via email and you’re going to be charged by the question, not only will this be ineffective, it will be costly and self-defeating if what you really need is psychiatric care or an actual dialogue.

Suggested reading on email therapy ethics: