Does Online Therapy Work?: A Comprehensive Review of Evidence


In recent years, the field of mental health and couples counseling has witnessed a significant shift towards online therapy as a viable alternative to traditional face-to-face counseling. Therefore, it makes sense to ask the question: does online therapy work? This transition has been largely driven by advancements in technology and the increased accessibility of mental healthcare. However, skeptics often question the efficacy of online therapy, raising concerns about its effectiveness compared to in-person sessions. This article aims to provide a thorough examination of the evidence supporting the efficacy of online therapy, drawing from empirical research and professional opinions. The research will apply whether you live in West Linn, Oregon or Portland, Oregon or anywhere else for that matter.

I. Empirical Research


Several meta-analyses have systematically reviewed the effectiveness of online therapy. A 2018 meta-analysis published in the Journal of Affective Disorders analyzed 20 studies and found that online therapy was equally as effective as face-to-face therapy in treating depression (1). Another meta-analysis from 2020, published in JAMA Psychiatry, reviewed 45 studies and concluded that internet-based cognitive-behavioral therapy (CBT) had a moderate to large effect in reducing symptoms of anxiety and depression (2). These findings provide robust evidence for the effectiveness of online therapy.

Specific Disorders: Does Online Therapy Work

Research has also focused on the efficacy of online therapy for specific mental health disorders, asking the question, does online therapy work? For example, a 2019 study published in JAMA Psychiatry examined the effectiveness of internet-delivered CBT for panic disorder. The study found that online therapy was as effective as face-to-face therapy in reducing panic symptoms and showed sustained benefits at a 12-month follow-up (3). Similarly, a systematic review and meta-analysis published in 2021 in the Journal of Medical Internet Research demonstrated that internet-based interventions were effective in reducing symptoms of post-traumatic stress disorder (PTSD) (4). These studies highlight the positive impact of online therapy on specific mental health conditions.

Couple in bed on computer

II. Accessible and Convenient Care

Overcoming Barriers

Online therapy addresses several barriers to accessing mental healthcare. Geographical limitations are eliminated, allowing individuals in remote areas or those with limited transportation options to receive therapy. Additionally, individuals with physical disabilities or mobility issues can access therapy without facing logistical challenges. Online therapy also reduces stigma, as it provides a sense of anonymity and privacy, encouraging individuals to seek help who may otherwise hesitate due to fear of judgment or social repercussions which can be important when couples are working toward healing from infidelity or an long-term affair. Let's look at more evidence answering the question, does online therapy work?

Flexibility and Convenience

Online relationship therapy offers unparalleled flexibility and convenience. Couples can schedule appointments at their convenience, without having to commute to a therapist's office. This is particularly beneficial for individuals with busy schedules, caregivers, or those juggling multiple responsibilities. The ability to receive therapy from the comfort of one's home enhances comfort and may promote a more relaxed and open therapeutic environment.

III. Therapeutic Techniques and Modalities

Cognitive-Behavioral Therapy (CBT)

CBT, one of the most widely used therapeutic approaches, has been successfully adapted to online platforms. A randomized controlled trial published in the Journal of Consulting and Clinical Psychology in 2014 found that online CBT was as effective as face-to-face CBT in treating major depressive disorder (5). Online CBT programs typically involve interactive modules, videoconferencing, and online support systems, enabling patients to engage in therapeutic techniques remotely.

Mindfulness-Based Interventions

Online therapy has also integrated mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). A 2021 systematic review and meta-analysis published in JAMA Network Open concluded that online mindfulness interventions effectively reduced symptoms of anxiety and depression (6). These findings suggest that mindfulness-based interventions can be effectively delivered through online platforms, providing individuals with valuable tools for managing their mental well-being.


The evidence supporting the efficacy of online therapy is substantial. Numerous empirical studies, including meta-analyses and specific disorder-focused research, have demonstrated the effectiveness of online therapy in reducing symptoms of mental health disorders. Moreover, online therapy addresses barriers to accessing care, such as geographical limitations and stigma, while offering flexibility and convenience to patients seeking a variety of mental health therapy, including couples counseling. Therapeutic techniques, such as CBT and mindfulness-based interventions, have been successfully adapted to online platforms, further strengthening the case for online therapy. As technology continues to advance, online therapy will likely become an increasingly vital component of mental healthcare, providing accessible and effective treatment options for individuals around the world or in locations all over Oregon.


1. Richards, D., et al. (2018). Effectiveness of Online Cognitive Behavioral Therapy for Depression in Routine Care. Journal of Affective Disorders, 235, 535-543.

2. Karyotaki, E., et al. (2020). Efficacy of Self-guided Internet-based Cognitive Behavioral Therapy in the Treatment of Depressive Symptoms. JAMA Psychiatry, 77(1), 1-10.

3. Hedman, E., et al. (2014). Internet-Delivered Cognitive Behavioral Therapy for Panic Disorder: A Randomized Trial. JAMA Psychiatry, 71(3), 315-324.

4. Lewis, C., et al. (2021). Internet-Delivered Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 23(3), e22117.

5. Andersson, G., et al. (2014). Internet-Delivered Psychological Treatments: From Innovation to Implementation. Journal of Consulting and Clinical Psychology, 82(2), 225-235.

6. Cavanagh, K., et al. (2021). Online Mindfulness-Based Interventions for Psychological Difficulties: A Systematic Review and Meta-analysis. JAMA Network Open, 4(6), e2111312.

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