Is Online Therapy really effective?

Ishita Ahuja

Cognitive Behavioural Therapy (CBT) refers to a type of psychotherapy focused on alleviating psychological symptoms by causing changes in the underlying cognition and behaviour of a person. CBT focuses on changing unpleasant and distorted patterns of thoughts and behaviours by attempting to improve emotional regulation as well as developing personal coping strategies. The main premise underlying CBT is that an individual’s thoughts, behaviours, and emotions interact together to contribute to various mental disorders. Focusing on the present rather than causes from the past, CBT uses behavioural goals to improve a person’s condition. The goal of this therapy is to convert an individual’s maladaptive thoughts into adaptive thoughts -- cognitive restructuring. The aim of CBT is not only to target maladaptive thoughts but also to improve maladaptive behaviour patterns. Engaging in maladaptive behaviour reinforces the validity of the maladaptive thoughts that are counterproductive and continues to perpetuate the mental illness. In an attempt to break the cycle of maladaptive thoughts and their subsequent maladaptive behaviours, the therapist and client work together to develop healthy habits and even engage in exposure therapy for certain anxiety disorders. 

Internet-based CBT – therapy provided through a computer or a mobile phone – has become increasingly popular as it tends to be more cost-effective and comparatively brief as it requires around 12 to 16 weekly sessions. Traditional therapy is expensive and faces a huge drawback of a lack of follow up from patients of the younger generation or from a lower socio-economic class. In this regard, internet-based therapy is more effective.  As the therapy primarily focuses on present causes, it can be widely used and adapted to suit the needs of patients across a wide variety of places. It has also gained popularity as it is easily accessible to individuals, even those that cannot get in-person therapy or cannot afford it. There have been concerns raised as to the security of online therapy, but the benefits outweigh the threat posed by the lack of confidentiality that is not offered via online therapy. Although a therapist is bound by ethics to the confidentiality of all information divulged during a therapy session, the software and technologies used for online therapy may save records of conversations and chats. In spite of this major drawback, online therapy has been found to be significantly beneficial. 

There have been several studies that have been conducted that suggest that online therapy or internet-based cognitive behaviour therapy is truly beneficial. In a study conducted by the Canadian Medical Association Journal, that reviewed studies of online CBT showed that it could effectively reduce depressive symptoms and help alleviate symptoms of other mental health issues. It had been reported that in certain cases, online CBT had been more effective than the traditional in-person therapy. Although a huge drawback of online therapy is that the human connection is lost, there is significant evidence in support of it thereby making it an increasingly popular form of therapy. Another study published in JAMA Psychiatry followed the effects of online therapy on the well-being of young doctors who often work long hours including nights and weekends and the stress incurred due to this could potentially lead to mental health issues such as depression and an increase in suicidal thoughts. The effects were studied and it was seen that doctors that received a few sessions of online therapy before they began their residency had fewer suicidal thoughts.

The results of another study conducted to assess the effectiveness of online CBT It was seen that this form of therapy may be as effective as traditional, routine, in-person therapy. An article reviewing the potential of online CBT and its involvement in the management of various psychiatric disorders have shown that it is effective in the management of symptoms and in the treatment of psychiatric disorders such as depression, GAD, social anxiety, panic disorders, phobias, addiction, substance use disorders, bipolar disorder and OCD amongst others. In certain diseases, online CBT has been effective in managing comorbid symptoms of mental health conditions due to the disease as well.

As internet access and usage gains popularity, traditional forms of in-person therapy are not the preferred option anymore. People are gravitating towards using internet-based cognitive behaviour therapy due to its effectiveness in terms of the number of sessions needed as well as it being of a lower cost.

References: 

Ruwaard J, Lange A, Schrieken B, Dolan CV, Emmelkamp P (2012) The Effectiveness of Online Cognitive Behavioral Treatment in Routine Clinical Practice. PLOS ONE 7(7): e40089. https://doi.org/10.1371/journal.pone.0040089

Kumar, V., Sattar, Y., Bseiso, A., Khan, S., & Rutkofsky, I. H. (2017). The Effectiveness of Internet-Based Cognitive Behavioral Therapy in Treatment of Psychiatric Disorders. Cureus, 9(8), e1626. doi:10.7759/cureus.1626