Online Counseling: Help at Your Fingertips

Does America need a greater focus on mental health? Recent studies suggest that the answer may be yes.

A 2016 study by Mental Health America revealed that 18.5 percent of American adults (43.7 million) were experiencing some form of mental health issue. And that’s just the adults: approximately 10 percent of young (12-17) Americans reported at least one major episode of depression in 2016, with 64 percent receiving no treatment.

The good news is that the numbers are slightly down from 2015, but the fact remains that many Americans suffer from personal, social, or psychological problems and receive little or no help. Is there a solution?

Counseling can provide a lifeline for those experiencing depression, anxiety, insomnia, or other mental health problems that often accompany a chronic pain condition. So why are so many people going untreated? The barriers to getting help seem to be threefold: cost, accessibility, and the perceived stigma often attached to those who seek counseling.

Any or all of these barriers can prove nearly insurmountable, but increasingly, the word is getting out about the availability and efficacy of affordable, discreet online counseling. Being able to message or talk to a qualified services provider anyplace at any time via computer, tablet, or phone is now a reality.

Online Mental Health Services: A Brief History

Almost from day one, the Internet and mental health services have been linked. In 1972, a mere three years after the first-ever instant message was sent via computer, a simulated psychology session between linked computers at Stanford and UCLA was demonstrated during the International Conference on Computer Communication.

At first “online counseling” consisted mainly of informational and educational resources, but at some point, the potential for providing services previously available only in face-to-face sessions started to be widely recognized. Almost as soon as computers became more readily accessible, an increasingly plugged-in population began to seek help anonymously, first on the computer bulletin board systems of the 1970s and later in online self-help support groups.

By the mid-1990s, various types of both free and fee-based online mental health services — whether of a generalized “Dear Abby” nature or in a form more closely resembling today’s one-on-one e-counseling — had become available to the public. Today, cellular phones give many of us a hand-held computer that provides services that we can access no matter where we are. For many, this means that counseling in a convenient, affordable, and private manner is now only a click away.

Getting Started With Online Counseling

There are a number of online mental health providers to choose from. Three of the most prevalent are BetterHelpPresto Experts, and Talkspace.

Once you’ve chosen a provider, getting started may involve filling out an online questionnaire or simply clicking on a box to start talking with a counselor. Provider websites should offer cost and payment options up front so there are no unpleasant surprises later on. Be advised that although insurance won’t cover your treatment, online counseling costs only a fraction of what you’d pay for face-to-face sessions, so in most cases, you should be able to find a treatment option that fits your budget.

With the “formalities” out of the way, you’ll be matched with a counselor. Your sessions can be conducted anywhere, at any time, on your computer or on mobile devices, and reputable providers are meticulous about security, using encryption, scrambling, and secure storage to maintain the privacy of your information.

What Can (and Can’t) Online Counseling Do?

Dr. Sonya Bruner, Ph.D. is the head of clinical development for BetterHelp and a licensed clinical psychologist in California. Before joining BetterHelp, she was in private practice, working with adults with a variety of presenting problems, including anxiety, depression, and trauma, in addition to relational and family issues.

Dr. Bruner recently gave us some inside information on how online counseling works:

PP: What types of counseling/therapy services does BetterHelp provide?

SB: BetterHelp provides counseling services for individuals over the age of 18 who are struggling with a variety of presenting problems. The most common reasons people seek out support are self-reported symptoms of depression and anxiety. BetterHelp does not provide diagnostic services and cannot be used to fulfill court-ordered treatment requests. All BetterHelp counselors are licensed by their respective state regulatory boards and hold at least a Master’s degree.

PP: What do you see as some of the advantages of online versus in-person counseling/therapy?

SB: One of the main advantages of online therapy is the accessibility it provides to professional counseling for individuals who might not otherwise be able to avail themselves of treatment due to a variety of reasons. Individuals with chronic pain or illness, the elderly, and people in rural areas can all benefit from being able to access a counselor online. Another advantage for clients is that they can message their counselor anytime, instead of waiting to share a distressing event in their weekly session. It is also possible for the client to review previous, written communication with their counselor, which can help reinforce the progress that has been made.

PP: Have you helped any clients manage the stress of dealing with chronic pain?

SB: We have assisted clients with chronic pain, and the typical treatment strategy for this population involves a combination of cognitive behavioral strategies as well as mindfulness strategies to help individuals cope with their day-to-day life.

PP: Are there some instances in which you would advise a client to seek face-to-face rather than online counseling/therapy?

SB: Definitely. Clients who are struggling with active suicidal or homicidal ideation are not appropriate for online counseling and are referred to more appropriate offline resources. In addition, individuals with certain diagnoses that affect reality testing (schizophrenia, psychosis) are not typically going to be appropriately served by online counseling.

PP: What is the application process for therapists like?

SB: Therapists go through an extensive application process which includes completion of a case study reviewed by our internal clinical team. Counselors who are invited to participate with BetterHelp complete a video interview with a member of our team.

PP: Do your therapists ever meet their clients in person?

SB: BetterHelp is an online counseling service, and so counselors do not meet their clients in person as part of the service. However, there are counselors who have transitioned to seeing members in person if they thought this was more clinically appropriate.

PP: What steps does BetterHelp take to ensure confidentiality?

SB: We understand that confidentiality is very important to our members, and we make it a top priority. Client information is kept confidential and encrypted. In addition, we follow the guidelines provided by HIPAA:

  • All messages between client and counselor are secured and encrypted
  • Our servers are hosted in an “A Grade” facility, ensuring the best-in-class security and protection.
  • Our databases are encrypted and scrambled so they essentially become useless in the very unlikely event that they are being stolen or inappropriately used.

Life is stressful for most people, and pain, loneliness, fear can wear away at both mind and body. But help is no longer something reserved for only the wealthy, or the well placed: and the therapist’s couch has been supplemented by the keyboard, putting help within reach of more people than ever before.

If you’ve ever used online counseling, share your experience in the comments below.

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