Understanding the Pros and Cons of Online Counseling

It’s easy to feel that nearly everything in our lives has gone online. Employment, education, socializing, raising money, buying groceries—even medical care can progress virtually. The most isolating months of the COVID-19 lockdowns saw many mental health care providers offering counseling services online, and that adjusted approach has lasted even as on-site, in-person therapy has become safely viable again.

Why is that? What’s so appealing about counseling online that someone would seek it out or offer it if it weren’t absolutely necessary? As it turns out, online therapy offers benefits for the provider and client alike. This post will explore several of the pros and cons of online counseling.

Much like on-site counseling, online counseling provides mental health services via internet media: video conferences, mobile apps, text messages, email, and any other platform through which people can hold conversation virtually.¹ While it’s known by a number of other names, including telepsychology, web therapy, phone therapy, text therapy and online therapy, the common thread through all of them is this: If you’re using web-based technology to interact with a counselor—or, as a counselor, to interact with a client—you’re taking part in online counseling.²

Years of studies have found that online counseling is effective in many situations. They include:

• 2014: The Journal of Affective Disorders published a study finding that online counseling is as effective as on-site counseling for treating depression³
• 2014: Behaviour Research and Therapy published findings that online cognitive behavioral therapy (CBT), in which people learn to change their negative emotions by adjusting how they think about problems, fears, and experiences, is effective in treating anxiety disorders^4,5
• 2018: The Journal of Psychological Disorders published a study finding online CBT as effective as on-site treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder⁶
• 2020: The Journal of American College Health published a study finding that online Solution-Focused Brief Therapy, which centers on setting goals and finding solutions to one’s problems, is as effective as on-site therapy in reducing anxiety⁷

 
There are, however, exceptions to the efficacy of online counseling. A 2024 Forbes Health article quoted psychotherapist Lee Phillips, Ed.D., who noted that some mental health conditions, such as schizophrenia and bipolar disorder, need closer monitoring than online counseling can readily allow. When a client is in crisis, and especially when there’s a need for immediate intervention and/or physical help, online counseling presents some clear limits.⁸

It’s important to note that not all insurance companies in all parts of the country will cover online therapy sessions. This doesn’t have to negate the possibility of seeking or offering online care, but it means that the client and the counselor would have to agree on a viable form of payment. Further, as companies and individuals all over the world continue to cope with breaches of internet security, it’s worthwhile for both parties to evaluate how comfortable they are with sharing personal information in a not-necessarily-private forum.

Founded in 1909, Mental Health America (MHA) is this country’s “leading community-based nonprofit dedicated to addressing the needs of those living with mental illness” and to promoting overall mental health. On its website, MHA describes a few other key challenges that are inherent to online counseling:9

As a therapist or counselor, you have control over the space in which you conduct sessions. You can design your office to be calm, peaceful, appealing and, above all, private. When therapy goes online, however, it becomes your client’s job to locate and/or create a suitable counseling environment—one that’s free from noise and other intrusion from work, school, family members or roommates, and one that’s private enough to let the client speak freely about difficult, often intimate matters.

When you and your conversation partner are in the same room, you have the benefit of many subtle forms of communication. You can take in what is conveyed through facial expressions, body language, vocal inflections, speed and length of breath, and so on, in addition to what a person says in words. With each layer of physical distance introduced to the conversation, some means of communication are lost. Video calls typically only show a person from about the chest up, so communication through body language can be diminished. Voice calls further eliminate facial expression, while text and email leave only words, which are easily misinterpreted and misunderstood.

As people around the world experienced during the lockdowns of the COVID-19 pandemic, technology can provide lifelines when we need to communicate and stay connected to others. Even before then, though, tech users knew that it’s not always a reliable tool. Prior to scheduling online counseling sessions, ask yourself:

• How is your internet connection?
• How is your client’s internet connection?
• Are any storms expected when you plan to have an appointment?
• Will there be work done on utility lines in your area or your client’s during that time?
• How adept are you at solving technological problems?
• What alternate plans do you have in place so that your counseling session can go on as needed if technology fails you?

Though it may seem counterintuitive, it’s often easier to have private conversations at a bit of a distance, rather than in the enclosed intimacy of a shared room. One of the benefits of online counseling is that, depending on personal preferences and needs, it can provide enough of a buffer that clients can be comfortable in discussing emotions and other sensitive issues.

Online counseling liberates counselors and clients from working in a set location. They can participate from the comfort of home, from out-of-town locations—from any place that meets their technological and privacy-related needs. The online modality also lets them avoid the commuting, traffic delays, and parking concerns that can be part of the on-site appointment experience. Depending on where the participants live and work, this can significantly reduce the time and stress involved in seeking and/or providing counseling. Beyond a local commute, online counseling makes therapy available to people who live impractically far from on-site counseling locations. It expands the counselor’s reach and ability to help people who need it.

Further, the release from geographical limits means that established counseling relationships can continue even when one of the participants relocates. When a student goes away to college, a family moves or a counselor goes into practice in a new location, the deeply personal relationship between care provider and client can be protected and sustained.

When counseling appointments can take place at any time that’s viable for both participants—without adhering to an office building’s business hours or the schedules of other members in a practice, for example—this creates possibilities. Neither person in the conversation has to work around anyone else, and counseling can truly become a dialogue between counselor and client alone.

What if an individual who’s seeking counseling works 60-80 hours a week? What if a counselor just isn’t a morning person but is alert and energetic well into the evening? What if one or both of them strive(s) to fit counseling into the unpredictable life of raising small children? Standard business hours in an on-site office model could keep these clients from getting the help they need, and could lessen the practitioners’ ability to build strong practices.

The flexibility of online counseling, however, means that therapy sessions can take place outside of regular business hours, and can be scheduled at varied times from one appointment to another. It makes counseling available based on the participants’ needs, rather than binding them to a structure that may not serve their needs at all.

Psychotherapist Lee Phillips, Ed.D., who was quoted in the Forbes Health article, has multiple clients living with chronic illness and pain. “Accessing therapy from the comfort of their own home has been an advantage in treatment,” he said. “Some have reported less stress and pain because they do not have to travel.”⁸

As brick-and-mortar retail stores have found in the age of internet commerce, the costs of maintaining a physical space can become prohibitive. David Tzall, Psy.D., who practices in New York City, pointed out to Forbes Health that online counseling can be more affordable for clients than on-site counseling because the counselors have less overhead to pay.⁸

Whether you work with clients in a shared space or through video screens, you can make a transformative difference for them. Your clients may be in school, working professionals, active-duty or veteran members of the military, anyone at all—and they need you. With the right education and credentials, you can help them live happier, healthier lives.

Your career and your clients deserve the many strengths of William & Mary’s Online M.Ed. in Counseling program. With concentrations in Clinical Mental Health Counseling (CMHC) and School Counseling and the option to specialize in Military and Veterans Counseling, the CACREP-accredited online counseling programs will help you serve and care for people looking to thrive beyond the challenges they currently face. Led by world-class faculty who teach a robust curriculum, each flexible online program will develop your ability to guide the mental, emotional and physical development of clients of all ages and needs.

Don’t wait to start. Schedule a call with an admissions outreach advisor today.