11 Types of Online Therapy
There are many types of online therapy, and in recent times, our idea of “therapy” has changed… maybe forever.
In regular times, when someone mentioned the word “therapy,” you pictured going to an actual place, right? Walking into a bland but tastefully-decorated room? Sitting on a couch? Looking across at a purposefully abstract painting?
In this age of social distancing, you might instead imagine a screen. Therapists everywhere have moved their practices to Zoom or other video platforms. No matter where you are, you can log into your smartphone, tablet, or computer with a headset and microphone, and interact with a trained professional. In-person therapy has been eclipsed by online therapy in San Francisco and beyond.
But what’s the deal with this new format? How’s it going to benefit you? And most importantly, what types of online therapy are available?
It comes in many forms. In this post, we’ll review several of them.
Mental health counselors have been successfully adapting their methods and techniques so that you can yield the maximum benefit. Learn more about the various types of online therapy and our private therapy options.
Online Couples, Marriage and Relationship Therapy
It’s usually challenging for two busy people to find a convenient time for couples therapy. They’re often coming from two different places, juggling work schedules and other obligations. Online couples therapy eliminates that barrier.
How does it work?
You and your partner sit in front of the same screen, assuming you’re in the same place. Otherwise, Zoom and other video conferencing programs allow for three-way video chats.
Just as you would in person, you’ll first establish goals for couples therapy. In other words, what are you looking to get from it?
Next, the therapist will conduct a thorough assessment as to what’s going on in your relationship. Are there patterns or dynamics that play out repeatedly? Are there issues that lead to perpetual disagreements?
In the “treatment phase,” you’ll be actively addressing those patterns or dynamics.
Is it any different than in person?
Yes and no. In couples therapy, the therapist needs to gauge nonverbal communication - facial expressions, body language, etc. These signal shifts in emotion and in physiological arousal. Although the camera usually captures from just below the neck to the top of the head, a skilled couples therapist will be able to notice and make use of these shifts over video.
Because partners in a couple want their significant other to be looking out for them, noticing how they’re doing, and responding to their needs, the couples therapist can recognize when couples are slipping into old, frustrating patterns, and then coach the pair to initiate new interactions, in real-time.
The fact that it’s from the comfort of the couple’s own living room may be a huge benefit. Why? Because the brain often makes associations based upon setting. When couples therapy happens in your living room, and later disagreements occur in the very same place, it may be easier to recall things you’ve learned, new ways to take care of each other, and new ways to resolve matters.
Online Premarital Counseling
Who says you need problems in your relationship to be able to work on your relationship?
Couples who are quite happy can benefit from online premarital counseling. You’ll identify strengths to build on, as well as potential areas for growth. And it’s so easy over video!
PREPARE-ENRICH is an online assessment tool for both unmarried and married couples. In fact, it’s the leading relationship inventory in the world, empirically validated for over 35 years. I’m trained and certified in administering the PREPARE-ENRICH inventory.
How does online premarital counseling work?
First, you’ll complete the confidential assessment online, which takes about 20 minutes. PREPARE-ENRICH then forwards the facilitator (that’s me!) a comprehensive report. Following my review of the report, together we’ll craft a treatment plan that’s tailored just for you, based upon the results.
It usually takes 6-8 sessions to adequately address the significant areas in the report, but some couples may require additional sessions. In each online premarital counseling session (which takes place over Zoom Healthcare, a HIPAA-compliant video platform), we’ll go through specialized exercises and conversations addressing each area identified in the results. As a result, you’ll learn new skills and tools to:
Improve communication skills.
Help each other manage major life stressors.
Navigate differences in personality.
Learn how to communicate sexual needs.
Discuss financial concerns and management.
Address how you as a couple relate to family and friends.
Work towards forgiveness of past stuff.
Build a more balanced relationship.
If you’re ready to start optimizing your relationship, or have a few questions first, schedule a time to chat with me during a free initial consultation for online premarital counseling.
Online Sex Therapy
Let’s face it… sex is important! A fundamental human need. But so many of us are uncomfortable discussing it. I get it. So many of us grow up learning that sex is a taboo subject, and lack comprehensive sex education.
That is not the case with online sex therapy. You’re dealing with a licensed professional who talks about this stuff all day. And given that it’s taking place over a smartphone or computer, you may feel even more comfortable.
People seek online sex therapy for:
Decreased desire
Mismatched libido
Feeling sexually bored
Anxiety about performance
Erectile dysfunction
Premature ejaculation
Anorgasmia
Impotence
Sexual dysfunction
But wait, there’s more.
People also seek online sex therapy for a variety of issues, including low libido, pain during intercourse, matters related to kink, out-of-control behavior, porn addition, or the impact of past abuse or trauma.
Whether it’s part of a romantic relationship or otherwise, and regardless of sexual orientation or gender identity, with online sex therapy, you can get things back on track.
Online Cognitive Behavioral Therapy
Cognitive-behavioral therapy has been delivered online for years. This type of treatment lends itself very well to the format. Some studies have even shown it to be more efficient than similar treatment in person.
Most clients seeking online cognitive behavioral therapy are aiming to alleviate symptoms of anxiety or depression.
According to cognitive behavioral therapy, problems develop when people develop automatic negative thoughts (ANTs), which are repetitive words, phrases, or images that drive our emotional responses. These ANTS are derived from beliefs about themselves, the world, and their future. Change happens by modifying those dysfunctional beliefs. The therapist helps the client notice the ANTs, link them to an emotion, identify those core beliefs, and design experiments to test the validity of those beliefs in the real world.
It’s routinized and structured, which translates well over video. The therapist can send worksheets for the client to complete between sessions. A typical example is a thought log.
Online CBT Therapy
Many online CBT options have emerged recently. They can be found on websites and mobile apps, and are usually self-guided. They offer greater anonymity than meeting with a live person and are ideal for those who lack the resources to access a live professional.
However, our thought patterns and our belief systems are unique. It’s often a product of how we were parented, the things we got or didn’t get from our early caregivers, our early temperament, and other factors such as culture, religion, friends, community, etc.
This means that one-size-fits-all programs may not be tailored to you or to what you’re needing. You might derive more significant benefit from in-person therapy, with insights and treatment options that are individualized.
Also, most of these apps lack substantial peer-reviewed research as to their methods and outcomes.
Bottom line: online CBT apps may offer convenience and cost-efficiency, but they’re not for everyone.
EMDR Therapy Online
EMDR therapy is an evidence-based treatment to help you heal from emotional distress or anything disturbing that’s happened to you (aka “trauma”). It’s got tons of research demonstrating its effectiveness.
How do we know if we’ve got stuff that needs to be healed? As described here, when insomnia, excessive anger or guilt, or frequent conflicts are part of our life, it may be due to the things we’ve experienced. This is also true when there are patterns like harsh self-criticism, difficulty trusting others, excessive people-pleasing, or frequent zoning out or detachment to cope.
COVID-19 has led many EMDR therapists to transform their practices, becoming even more creative and inventive with online therapy.
When discussing things you’ve been through (even if it’s a tangential mention), you should feel safe. Being at home may create that feeling of safety, especially when sitting in a comfortable spot. What else promotes that safety? A therapist who “gets you.” Who really understands, and cares.
Besides safety, EMDR and Attachment-Focused EMDR are designed to give you a true, internal sense of strength, self-worth, control, and even nurturance. Things we often didn’t have before. It’s worth the time and effort.
Online Eating Disorder Therapy
Eating disorders are one of the most deadly mental health disorders. Whether it’s for anorexia, bulimia, or binge-eating disorder, you’ll want to consult with someone who specializes in this area.
Treatment often involves cognitive behavioral therapy to target destructive messages that we tell ourselves, such as “I’ll never look good enough,” or “The only thing that matters is how I look.” Also, mindfulness therapy can teach us to stop critical thoughts from taking over, enabling us to live in the present moment.
Ideally, therapy will be combined with the involvement of other professionals, such as a medical doctor, a nutritionist, and a psychiatrist. That way, your treatment program will be integrated and comprehensive. Online support groups may be useful, as well.
With online therapy, you can rebuild your self-confidence and self-esteem, promote a safe recovery, and prevent relapse.
Eating disorders are sometimes related to adverse experiences early in life (aka trauma). It may be wise to consult with a therapist who works with trauma and is certified in EMDR.
Online Mental Health Therapy
We forget to take care of ourselves. Days turn into weeks, weeks turn into months, and stuff just builds up.
When do we finally sense that something’s wrong? It’s usually when we have trouble sleeping. When we’re distracted at work. When we find ourselves feeling kinda irritable, frustrated by little things. Feeling like everything sucks.
These days people seek online therapy to work on things like:
Worry about COVID-19;
The stress of sheltering in place;
Tons of arguments in their relationship;
Anxiety;
Work stress;
Depression;
Lack of motivation to do anything;
A breakup, a job loss, or some other big change in their life.
If any of this sounds familiar, online therapy may be the right choice.
What is online therapy like?
Before your first session, your therapist will let you know what platform they use for teletherapy. It might be Zoom, Doxy.me, VSee, or something else. They’ll tell you how to begin the call. If you’re using a tablet, laptop, or desktop computer, you’ll need a decent WiFi connection. Otherwise, go with your mobile phone.
At first, it may feel a little different than traditional therapy. Some might find it rather impersonal, or may not take it as seriously.
But therapists experienced in online therapy, with specialized training, have adapted their approach to the new format. Many have learned how to convey the same “feel” as you’d get from in-person therapy. It should feel comfortable and interactive.
Some video platforms (like Zoom) have shared whiteboards, making it possible to review therapy documents together. Pretty cool!
Online Therapy for Agoraphobia
Agoraphobia is an anxiety disorder involving fear of enclosed spaces or public spaces, usually after we’ve experienced at least one panic attack. Specifically, it’s fear of having another panic attack, feeling humiliated or embarrassed, being trapped without an easy exit. This fear usually leads us to isolate ourselves at home (or close to home).
Understandably, if we have agoraphobia symptoms and have been sheltering in place because of COVID-19, online therapy may feel more comfortable than in-person treatment. It’s appropriate for those who are getting their basic needs met and aren’t a danger to themselves or anyone else.
CBT is commonly used for agoraphobia and is evidence-based. It targets the automatic negative thoughts that guide our behavior. Treatment includes learning how to view physical symptoms (like the perception of racing heartbeat) as the body’s normal fight-or-flight response, and not dangerous. Treatment may also involve gradually and safely exposing yourself to situations in real life that generally lead to fear, a process called graduated exposure. Eventually, the conditions that once caused a sense of panic will no longer seem like a big deal.
Online Therapy for Hoarding
Hoarding Disorder is a mental health disorder in which we excessively acquire items or objects, regardless of actual need. It becomes a problem when we can’t use a room for its intended use, or when we feel so emotionally attached to objects that the thought of parting with them causes anxiety.
For those who feel shame or embarrassment over hoarding behavior, the idea of someone seeing inside your home (in this case, a therapist) may be concerning. You’ll want a therapist who conveys warmth and non-judgment.
And here’s an idea… Zoom now has a “virtual background” feature that allows you to change what appears behind you. You might consider asking your therapist if this is okay.
Online CBT therapy is helpful, along with mindfulness therapy and motivational interviewing. One crucial step is making us aware of dysfunctional thoughts and beliefs about acquiring or saving things. These thoughts often center around viewing an item as useful, feeling emotionally attached to it, feeling concerned about wasting it, and hoping to remember it. Another step is learning how to recognize an urge and challenge our thinking, which leads to positive change.
Online Child Therapy
Kids and teens are already glued to their devices, so why not catch them where they’re most comfortable?
Therapy can take place through video calls, phone calls, texts, or even email. If your child has ever used any of these, chances are they already know what it’ll be like.
The home setting offers some additional perks:
It’ll feel way less stuffy and formal than going to an office;
Your child will be learning skills in the same setting that you’d like to see those skills employed (meaning that it’ll be generalizable to everyday life);
The therapist can facilitate more positive parent-child interactions in a setting that approximates normal life.
Parents can use materials the child is already familiar with (toys, art, etc.) to advance the child’s goals.
Speaking of which, the video format is perfect for therapeutic tools such as games, puppets, YouTube videos, and worksheets.
Online therapy can help kids and teens learn coping skills for dealing with anxiety, stress, trauma, anger, low self-esteem, difficulty socializing, family conflicts, bullying, eating disorders, and more.
When children or adolescents have active thoughts of hurting themselves or someone else or are in an urgent crisis, online therapy is not recommended.
Interested in a free 15-minute phone consultation? Reach out today!
As you can see, online therapy is legit and can help you improve your life in so many ways.
I’m a TBHI-Certified Telebehavioral Health Practitioner and offer online therapy over Zoom Healthcare, a HIPAA-compliant platform. If you’ve got general questions about treatment with me, click here.
Otherwise, what are you waiting for? Let’s get started!