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Considering online therapy? Here’s what therapists want you to know

Read this before your first session.

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You’re not alone: The prospect of starting therapy can feel daunting. Luckily, online therapy can make it easier to work through trauma and tough emotions and help you evolve into a more compassionate, self-aware human. Attending your therapy sessions at home can make this process less intimidating for first-timers and save you travel time, commuting expenses, and possibly some cash on the sessions themselves.

Perhaps you’ve seen ads for large online therapy platforms such as BetterHelp or Talkspace, which offer mental health and wellness services via a monthly membership fee, making them a potentially lower cost option for patients seeking therapy but can’t afford it. Post-pandemic, many local practices also offer virtual live sessions for those who want to invest in better mental health without leaving the comfort of home. We talked to licensed therapists to find out what you need to know before starting online counseling.

What are the benefits of online therapy?

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Making mental health care more accessible is a major benefit of online therapy services.

The biggest benefit of online therapy services is that it makes prioritizing your mental health more accessible. For starters, you may be able to see a therapist who accepts your insurance but isn’t convenient for you to see in-person. Online therapy also opens up your options if you’re looking for a therapist with a certain specialty that you can’t find in your local area, such as gender-affirming care. Not having to go anywhere also makes online therapy a great option for the disabled or immunocompromised, who might find it more challenging to travel to and access a physical office space.

Online therapy can also offer more privacy, as you don’t have to leave your home or worry about who sees you seeking care. It also saves time, as you don’t need to commute to your appointments. Finally, for those who don’t have insurance or whose insurance doesn’t cover therapy, it may be less expensive to use an online platform than to pay a la carte for sessions with a traditional therapist.

Who can benefit from online therapy?

Online therapy is a great option for anyone who feels they’d like to talk to a mental health specialist like a psychologist or social worker. For those who’ve never sought mental health support, an online session may be less intimidating than an in-person visit.

“If it's your first time going to therapy, you don't know what to expect,” says Nirmala Bijraj, LMHC, NCC, a therapist based in New York City. “If you're going in person, you're going to have to figure out how to get to that place, and that can be a lot more overwhelming for people than just just signing into a browser and having a session. So it takes away some barriers in terms of anxiety and access to care."

Anyone who doesn’t enjoy commuting to sessions—especially those who feel safer talking in their own home—may also want to consider online therapy.

What are the disadvantages of online therapy?

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Most sites don’t employ psychiatrists, who can prescribe medication.

Online therapy isn’t the right fit for everybody. For starters, because licensing board rules can vary by state, you may be limited to those geographical borders and therefore may have limited choices of therapists, especially if you’re seeking a less common specialty.

Second, there are the limitations of seeing someone only on a screen. Therapists can’t read full body language as effectively over camera, which could be problematic for patients suffering from physical manifestations of mental illness or self-harm. “When you're in-person, [the therapist] can read body language better,” Bijraj says, though it’s not a total dealbreaker. “But other than that, a person will talk with their hands, [the therapist] will see their hands. [They] can see their faces, [they] can see their facial expressions, [they] can see their eyes.”

Additionally, not everyone is fortunate enough to have a safe space at home to openly discuss their emotions. If you don’t feel comfortable discussing certain matters in your house where others might be able to eavesdrop, or if you just prefer meeting in-person to get a break from family members or roommates, online therapy probably isn’t right for you.

Finally, most of these sites don’t employ psychiatrists, who are medical doctors that can prescribe medication. If you think or know that you might benefit from such a prescription, you should seek an in-person doctor.

How much does online therapy cost?

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Some websites offer package deals for the uninsured.

As with any form of therapy, the cost for each appointment will vary depending on your insurance or lack thereof. But with greater access to therapists covered by your insurance plan, online therapy may cost less, and some sites offer package deals for the uninsured that make the cost more affordable.

Traditional therapy, even when offered online, costs an average of $100 to $200 per session, though could cost up to $500 without insurance. However, larger online platforms like Cerebral use a subscription model that costs $100 to $200 a month for bi-weekly or weekly sessions. You may consider using a Health Savings Account (HSA), which you can open on your own if your employer doesn’t offer one, or Flexible Spending Account (FSA) through your employer’s benefits package to set aside pre-tax funds to cover these costs.

How can I sign up for my first session?

Getting started with online therapy using a site varies, but you’ll often take a quick quiz about why you’re seeking help. From there, the website will match you with a licensed professional that may be a good fit, though you can shop around until you find someone you click with. If you aren’t into the idea of signing up with a site, you may also try a site like Psychology Today’s online directory to target individual therapists who may suit your needs. You can filter by insurance plan, price, type of therapy, language, sexuality, and more to find the right therapist.

How can I find a good therapist online?

Because mental health conditions can often have a substantial impact on your physical health, finding a therapist you feel comfortable opening up to is of the utmost importance. “You shouldn't feel stuck with the first person you go with and you shouldn't feel pressured to continue therapy with a specific therapist,” Bijraj says. “You should feel comfortable to be able to share your feelings.”

Not sure if you’re clicking with the person you decide to open up to? Bijraj recommends giving a new therapist three to four sessions before asking yourself if you feel anxious, guarded, or judged with them.

“Not everybody connects with everyone, and that's perfectly okay,” Bijraj says. “You should find someone that you're able to be honest with. Because if you're honest with them, you're technically being honest with yourself. Similarly, if you're lying to them, you're lying to yourself. And you want to be honest because the space is for you. It's not for the therapist, it's for you.”

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