What are the benefits of therapy

Advantages and Disadvantages of Online Therapy

Online therapy (page 3/8)

Improving care or a risky experiment?

Online therapy options are still comparatively new and have therefore not yet been scientifically researched to a similar extent with regard to their effectiveness and possible risk potentials as the classic structure of psychotherapy with exclusively personal face-to-face therapy sessions.

Possible advantages and uses of online therapy offers

Online therapy offers can help to improve psychotherapeutic care: In this way, more people affected could receive psychological support and thus the waiting times for a therapy place could be shortened. Therapists need to spend less time with online therapy than with face-to-face therapy to achieve the same improvements.

For example, the therapist gives the patient feedback by email once a week. As a result, a therapist can look after more patients at the same time, which benefits the patient's care and can shorten waiting times for a therapy place. Ultimately, this can contribute to cost savings in the health system.

Access for patients who cannot or would not otherwise undergo therapy

Patients who otherwise cannot or would not otherwise be able to take part in psychotherapy can also be reached via the Internet. These can be patients for whom the journey to a therapy practice is very long or who cannot come to the practice themselves due to physical limitations. It can also be patients who are unable to come to a psychotherapeutic practice at the moment because of their psychological complaints (e.g. severe anxiety or obsessive-compulsive symptoms).

It can also be people seeking help who, out of shame and fear of stigmatization, do not want to go into psychotherapy. Therapy via the Internet can also take place anonymously. In addition, online therapy offers can appeal to new target groups, for example adolescents and young adults, who are often very interested in digital media.

Finally, online therapy can be a first step in which the person seeking help can gain experience with psychotherapy. As a result, some patients may decide to continue working in face-to-face psychotherapy.

Specific offers that would otherwise not be available

Because online therapy can also take place over great distances, it gives patients the opportunity to use very specific offers that are not available in their immediate vicinity. In this way, patients with a different cultural background can use culturally sensitive offers or find offers in their mother tongue that do not exist in their immediate vicinity.

Diversity and flexibility of the offers

Theoretically, there are endless possibilities of what online therapy offers can look like and how they can be combined with conventional psychotherapy.

In this way, the type and extent of therapeutic support can be individually tailored to the symptoms and needs of the patient. For example, more appointments can be offered in the therapist's office if the patient needs more support. If he is better and needs less support, a transition to more online therapy can take place.

At the same time, internet-based approaches offer many opportunities for a patient to work intensively on changing their problems between therapy sessions. Each patient can decide for themselves how often and how intensively they work on their problems.

He is also flexible and can work on the tasks when the time suits him best. If the communication between therapist and patient takes place in writing (for example by e-mail), this has the advantage that both can calmly reflect on the statements of their counterpart and what they would like to write themselves. In this way a patient can possibly describe his problems, his current state, his feelings etc. better than if he had to do this spontaneously in the therapy session.

Sense of self-determination

Because patients are more self-determined in online therapy than in conventional psychotherapy, they have a stronger feeling that they have achieved their successes themselves and not with the help of a therapist. This can be very motivating to keep working on overcoming your problems.

Possible disadvantages and risks of online therapy

A disadvantage of online therapies is the lack of non-verbal communication, as the therapist and patient are not sitting face to face. Without physical presence, there are no non-verbal signals of communication, such as facial expressions, gestures, tone of voice and posture. This can lead to misunderstandings more easily. These features are also important for making an accurate diagnosis and assessing the current state of the patient.

This is more likely to be the case with video calls. However, the impression of the interlocutor is limited to the camera section, and the therapist does not see, for example, how the patient moves, how he enters the room, etc. The transmission of full-body views at least promises to improve the use of video calls on the part of the therapist by positioning a webcam accordingly.

In the case of purely written communication, there is also no direct exchange, which means that the conversation partner can react immediately to what has been said or the behavior of his counterpart. In written communication, for example, it is more difficult to give immediate consolation or to immediately show an understanding, empathetic reaction.

Possible solutions

The Federal Chamber of Psychotherapists (BPtK) demands that the diagnosis of the mental illness should in any case take place in direct contact between the psychotherapist and the patient. The patient should also be informed about the approach to therapy and possible risks, as well as his consent should take place in direct contact. In this way, the patient can be informed verbally and open questions can be answered directly.

If an online offer does not include this procedure, those seeking help should first have their problems clarified in the consultation hour of a psychotherapist before starting therapy or a self-help program on the Internet.

If online therapy is only carried out in writing, it is important for the therapists to express themselves clearly and clearly in order to avoid misunderstandings.

Dealing with crises

Another problem with online therapies can be providing adequate support when the patient is in crisis. On the one hand, the therapist is more difficult to recognize if the patient is endangering himself or intending to kill himself if communication takes place exclusively via the Internet. On the other hand, even with online therapy, a patient must know where to turn in the event of a crisis. In addition, a contact person must also be available here promptly.

Possible solutions

It is therefore important that the therapist continuously monitors the symptoms and the condition of the patient, even during online therapy, in order to identify crises and prevent self-harm or suicide. Furthermore, it should be clarified at the beginning of the therapy where the patient can turn and what he can do if he gets into a crisis. In any case, he should know how to contact his therapist in an emergency or who else to turn to (for example a psychotherapist, a crisis counseling center or a psychiatric clinic in his area).


An important aspect of therapy over the Internet is data protection. Sensitive data from psychotherapy should be specially protected and not be accessible to third parties. In addition, the patient should be able to determine the use of his data himself.

Possible solutions

To ensure this, it is important that all components of online therapies (such as e-mails, video calls, questionnaires that are filled out online or health apps) are encrypted to a high technical standard. In addition, patients should be informed about which data is collected and stored, who has access to it and how they can have the data deleted. After all, every participant in online therapy should know that on the Internet in general - including therapy via the Internet - 100% data protection cannot be guaranteed.

Quality of the offers and qualification of the providers

One problem with online therapy offers so far is that the qualifications of the contact persons who are available for the programs are very different. While some offerings involve psychotherapists or specialists, other programs only use assistant staff who may have only received brief training.

The level of support from a therapist can also vary greatly with online therapies. With some programs, the support only consists of motivating the participants to continue participating in the program and possibly also answering questions.

If the participants in online therapy feel insufficiently supported, overwhelmed with the tasks or poorly advised, they may discontinue the program. In addition, they may develop a negative attitude towards psychotherapy and are then no longer willing to use other therapy offers (possibly also psychotherapy with direct contact).

Possible solutions

One possible solution is to define clear quality criteria for online therapies and to mark offers that meet these criteria with a seal of approval. An essential quality criterion is that the therapies are carried out or supervised by specialists, i.e. by psychotherapists or specialists in the field of psychotherapy. In addition, it should be clearly stated how adequate patient support can be guaranteed.