Online therapy vs. in-person therapy: Cost, confidentiality, accessibility and more

Are online therapy services like BetterHelp or Talkspace just as good as seeing a therapist IRL?

If you’ve been considering getting help for mental illness but haven’t done it yet, you’re not alone. Nearly 60% of American adults with a mental illness didn’t receive mental health services in the previous year, according to the Substance Abuse and Mental Health Services Administration. The reasons why — stigma, cost, accessibility — vary, but services like Talkspace and BetterHelp that offer online therapy is helping to bridge that gap.

“Online counseling can bring people to therapy who would otherwise not go,” says Mark Pines, a licensed marriage and family therapist in California and the CEO and founder of OpenCounseling, a website that helps connect people to free and affordable counseling. But he says, “There are times when it should definitely not be used.”

So when is online therapy appropriate and how does it differ from in-person sessions? We asked mental health experts with experience administering both to evaluate both along five main points of consideration: services, efficacy, accessibility, cost and confidentiality.

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