12 Things You Should Know Before Starting Online Mental Health Counseling


I’ve always had a rocky relationship with counseling. For years I found myself in and out of therapy, trying out a number of counselors but never really finding the right fit. A handful of unpleasant and unhelpful experiences left me feeling pretty discouraged about the counseling process, basically giving up on it all together. But this fall, I decided to give it one more chance, this time in a less traditional fashion. Not really knowing what to expect, I decided to give online counseling a try.

I’ll admit, in the beginning I was skeptical. I wasn’t sure how it could be effective — could an online therapist really help me address what I needed to? Would I actually be able to get something out of it? But since I hadn’t ever had great experiences with in-person therapy, I decided to give it a shot. What did I have to lose? As it turns out, the 10 weeks I spent working with an online counselor turned out to be the most effective and positive counseling experience I have ever had.

If you’re curious about online counseling, or you think that it might be something you want to try, here are some things to consider:

1. Online counseling is not a substitute for in-person therapy in all cases.

Online counseling can certainly have limitations, and may not be suitable for everyone. The following are a few situations where online therapy would not be appropriate:
If you are in immediate crisis or are feeling suicidal.

If you are looking for an official diagnosis.

If you are looking to be prescribed medication.

If you are under the age of 18.

2. But, it can still have similar, extraordinary benefits.

The counselors working for the two counseling platforms I researched (BetterHelp and Talkspace) are all licensed, practicing mental health professionals. The counselor I worked with had almost 10 years of experience. She was knowledgeable, patient and insightful, and was able to help me process everything that I was feeling and thinking. In many ways, online counseling provided me with the same benefits I had always hoped to experience with in-person therapy.

3. It can also have additional advantages.

One of the things I loved about online counseling was that I was able to scroll back through previous messages whenever I wanted to recall something my counselor had suggested. While you are subscribed to the online counseling service, all of your messages are saved so that you can access them at any time. I thought this was incredibly useful! I also used my counseling room as a journal of sorts, to document what I was thinking and feeling throughout each day.

Additionally, I felt that because I had a constant, ongoing dialogue with my counselor, I was more committed to online counseling than I ever was to in-person therapy. My counselor would message me at least twice a day, six or seven days out of the week. This felt much different than spending 45 minutes with an in-person therapist every week or every other week. Because I was constantly engaged in the therapeutic process, I was always focused on ways to work toward feeling better. I felt like this aided and even accelerated my treatment process.

4. Your experience may be dependent on your individual counselor

As I mentioned before, the counselor I worked with was phenomenal. She was very insightful, easy to communicate with, and was able to articulate her thoughts very clearly in written form. But from reviews I’ve read, this isn’t always the case. Just like with in-person counseling, the first counselor you connect with may not be the right fit. BetterHelp and Talkspace both have options to switch counselors if you feel this is the case. Finding the right counselor can make all the difference!

5. There can stigma associated to it.

Although there isn’t much, I did experience some stigma when I told people I was giving online counseling a try. Some expressed to me that they felt it wasn’t real counseling, that it could never be nearly as effective as in-person therapy. There were times when I felt that somehow pursuing online counseling was a cop-out, a sign of weakness because I couldn’t handle traditional therapy. I processed this with my counselor, and ultimately came to the realization that as long as I felt like the counseling was working, that was all that mattered.

6. Online counseling is generally pretty affordable.

Because my insurance plan would have required me to pay out-of-pocket for in-person therapy sessions (at least $75 a session), online counseling was a much more affordable option for me. Typical subscription plans range from $35 to $45 a week, which is comparable to most co-pays.

7. You have 24/7 access to your counseling room.

You can message your counselor at any time, from any device. Sometimes I would think of something I wanted to say that I forgot in an earlier message, and I could just send another quick message from my phone. There is no limit to how many messages you can send. Typically my counselor replied to me at least twice a day, but in times where I wasn’t doing as well, she would check in more frequently.

8. Many platforms offer a variety of ways to communicate with your counselor.

In addition to sending text messages back and forth with my counselor, the platform I used also allowed me to schedule real-time chat, phone and video sessions. I used the real-time chat option about once a week. This allowed me to get more in-depth, individualized attention from my counselor. Unlike the normal, daily messaging, the response time in these chat sessions was instant. I could see everything my counselor wrote as she was typing, and she could see everything I was typing as well. It felt very much like having a conversation in person, and I always felt so good after the sessions were over. Typically, these sessions would last between 45 minutes to an hour — similar in length to an in-person counseling session.

Some platforms charge extra for these additional services, but the platform I used included all of the options I described in their basic subscription plan.

9. Online counseling is super convenient.

Online counseling allowed me to engage in counseling on my own time, in a way that fit with my busy schedule. Using the platform’s mobile app, I was able to message my counselor at any time, from virtually anywhere.

10. Self-motivation is key.

I found that much of my counseling experience was self-directed. Part of why I felt that my experience was so successful was because I was extremely motivated and engaged in the process. In addition to our conversations, my counselor also provided me with worksheets, articles and self-help books to supplement our interaction. I would almost always share my thoughts on the readings with her, and I felt this added a lot to my experience. I never had a problem motivating myself to do the work. This may not be the case for everyone though — and it’s definitely something to consider before starting online counseling.

11. Ending or taking a break from online counseling is relatively painless.

When I did feel like I was ready to move on (after approximately 10 weeks), I found that ending my subscription was a relatively painless process. I was worried that once I stopped counseling, it would be difficult to reconnect with the same counselor if I ever decided I wanted to return. However, with the platform I used, I found out that it is incredibly easy to re-subscribe and request to work with the same counselor once again. Knowing that this option existed was extremely reassuring.

12. Ultimately, it has a different feel than in-person counseling.

For me — and my situation at the time — online counseling was the perfect fit. But that may not be the case for everyone. Some people may prefer the face-to-face interaction that in-person therapy offers. Additionally, some may feel they can’t express themselves as effectively through written communication as they could verbally. Others may feel that online counseling is less demanding, and they need the greater intensity of in-person therapy. For me, I found my online sessions to be just as intense, if not more intense than any of my previous in-person therapy experiences. I very much preferred the feel of online counseling, and found that I made a greater amount of progress — in a shorter amount of time — than I have ever made before. I was able to articulate my thoughts clearly in a written format, and I felt that I was able to build a pretty strong relationship with my counselor, despite never actually talking in person. Overall, my online counseling experience was extremely positive and successful.

If you are on the fence about online counseling, especially if you have not had much luck with in-person therapy in the past, I highly recommend giving it a shot. Choosing to connect with an online counselor turned out to be one of the best decisions I have ever made.

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