ADVICE: Why telling all on webcam works just as well as in-person therapy

Research indicates that virtual therapy can be as effective as in-person therapy, and is more accessible for many patients.

Karen Hawthorne 5 minute read June 17, 2022
Online psychotherapy concept, sad young girl in depression

Virtual therapy can take on a variety of forms, from over-the-phone talks and webcam sessions to email therapy where people work on online programs and workbooks. GETTY

Dear Asking For a Friend,

I’m stressed and feeling overwhelmed with work, life, the aftermath of COVID-19’s ups and downs. I’m considering seeing a psychotherapist for virtual sessions. Is virtual therapy really as effective as in-person therapy?

Signed, Need Some Help Coping


Dear Need Some Help Coping,

No one can argue that the past two-plus years have been a downer. The isolation, not being able to see family and friends, masking, social distancing, and the economic fallout of the pandemic have been tough on our mental health.

First and foremost, you’re not alone if you feel you need a therapist for help and support, and experts say that virtual therapy can be as effective as an in-person visit. In fact, virtual therapy has the potential to be even more valuable because of its accessibility.

The Centre for Addiction and Mental Health (CAMH) found that 22.3 per cent of participants in the centre’s national online survey experienced feelings of depression and 25.1 per cent reported feeling moderate to severe anxiety because of COVID-19. And nearly half are worried about coping with the uncertainty of the pandemic, worried the virus may never go away.

CAMH also reported that one in five adults responding to the survey had received professional help for mental health during the pandemic — even though services had to move to online counselling. And a 2021 survey of psychologists by the American Psychological Association revealed the adoption of digital therapy, and the still-rising increase in demand for treatment of anxiety and depression.

Virtual therapy can be more accessible than in-person therapy

Researchers at the University of Alberta published their review of the science on teletherapy for military members, veterans and public safety personnel, in the journal JMIR mHealth and uHealth which is a peer-reviewed journal on digital health and open science. They confirmed that digital mental health treatment can work just as well as in-person therapy, improving access and also reducing stigma and cost.

Christine Korol, psychologist and director of the Vancouver Anxiety Centre and adjunct professor at the University of British Columbia, has practised virtual therapy for more than 15 years. While the technology has certainly improved over time, the concept of teletherapy is over 30 years old, she says.

Much of the programming originated in Australia because of its geography of remote communities, and Saskatchewan is a leader in Canada with virtual program development out of the University of Regina.

“It’s just as effective and people feel just as connected. So it can be a really good option and it has some great advantages,” says Korol, a strong advocate for telehealth. She also offers training for therapists to safely integrate technology into clinical practice.

About a third of her clients were virtual before the pandemic, and now 99 per cent of the therapy she provides is remote.

“You don’t have to pay for parking. You can save money on gas, getting to the therapist’s office. Or if you have kids, you don’t necessarily need a babysitter if you can time it right. I see a lot of moms with their babies. And if you’re in a rural or remote community, it can be really convenient since there might not be a therapist in your area.”

Korol says that many of her patients switched to online virtual treatment before the pandemic because of the convenience.

“If someone forgot their appointment and I’d give them a call and, and say, ‘well, instead of charging you for not showing up for the appointment, why don’t we do a telephone session and see how you like it?’ Then, uh, at the end of the session, I’d say, how was that? And they’re like, ‘this is actually great. I’m not coming back.’”

“Same rapport, trust, comfort” with virtual therapy

But isn’t it more meaningful to make the connection with a therapist in person for building a relationship?

Korol says her patient progress and feedback supports the scientific research on telehealth as equally valuable. “The research says you’re getting the same rapport, trust, comfort, all those things.”

Interesting to note, virtual therapy can take on a variety of forms, from over-the-phone talks and webcam sessions to email therapy where people work on online programs and workbooks. The act of writing things down for these online programs is another way to process feelings and people tend to remember more of what they’ve learned, which is a key benefit.

“One-time when I was doing email therapy with somebody, they said, ‘I just feel like I have a really smart pen-pal,’” she adds.

There are exceptions, of course, that make in-person intervention necessary. For example, someone who is in severe distress contemplating self-harm, or someone who doesn’t have a private place for therapy, comfort with technology or a secure internet connection.

Do your research before paying for a virtual appointment

If you’re ready to get professional help, what’s the best way to go about finding a therapist? Check out an online directory of regulated professionals, Korol recommends, which offers a level of safety and protection.

The pandemic demand for telehealth services has prompted a huge response by the tech industry, with more than 20,000 mental health apps available for download and a rash of companies that promise mental health counselling or therapy at a fraction of the cost of traditional providers, Korol says.

“It really is buyer-beware, so Google anything that you’re looking at and do your research.”

Some companies are “really playing fast and loose with privacy, and a lot of them have grown very quickly,” she cautions. They may be more interested in profits than effective treatment, with a goal to keep clients engaged and subscription payments going.

“If you see an individual therapist, it is more expensive. The hour or 50 minutes takes time for that one person. One-on-one therapy isn’t cheap, but then you’re also paying for their liability insurance, their computer setup, possibly their office if they need a quiet place to see patients.”


Karen Hawthorne is a Toronto-based writer.

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