How Effective Is Online Therapy for Addiction?
Online therapy, also referred to as telehealth or virtual therapy, can be highly effective for the treatment of substance use disorders. It reduces barriers to treatment and provides an alternative way to engage with therapy than traveling to in-person treatment sessions. Intensive outpatient services for addiction treatment can be effectively provided online via individual and group counseling formats.
A recent study evaluating online therapy services provided during the COVID-19 pandemic found that online therapy can be just as effective, though not more effective, as traditional in-person treatment.[1] People who engaged with online therapy reported equal satisfaction with the overall therapy, the connection they formed with their therapist, and improvements with substance use as people who received in-person treatment.[1]
In a survey of 114 counselors, researchers asked about their experience with delivering online therapy during COVID-19. Counselors said that client preparation for the sessions varied, and it mattered. Some people were disengaged and distracted rather than comfortable and open. The effectiveness of the therapy was closely tied to client preferences and how well they prepared.[8]
In a separate study of 301 people with alcohol use disorder, researchers provided face-to-face therapy to some and virtual therapy to others. They measured success by how much alcohol people consumed. They found that the virtual therapy was no less effective than the in-person version.[9]
Online vs. Traditional Addiction Treatment
Online and traditional therapy both offer important options for accessing mental health care, including addiction treatment services. The same addiction treatment services, such as cognitive behavioral therapy or medication-assisted treatment, can be accessed via both modes of care.
The chart below outlines examples of how online and traditional addiction treatment are both similar and different:[2]
| Online Therapy | Traditional Addiction Treatment |
|---|---|
| Can be accessed from any location | Must be able to attend sessions in person |
| Can address the treatment gap of accessibility of treatment | Limited access due to where a person lives or their ability to travel |
| Can be provided in real-time (live) or delayed (via text or email) | Provided in real time with immediate feedback |
| Effective for reducing substance use | Effective for reducing substance use |
| More cost-effective | Can be expensive for individuals and communities |
| Must have access to a smartphone, tablet, or computer with internet access | No technology required to access services |
Benefits of Online Treatment for Substance Abuse
Online treatment for substance abuse offers many benefits. Access to care and affordability are just two reasons people may opt for online treatment.
While some people are hesitant to try online services, online treatment offers benefits and satisfaction levels that are comparable to traditional treatment. Some of the many benefits of online treatment include the following:[2]
Accessible to Everyone
Offering services via telehealth greatly increases access to all stages of addiction treatment, including screening, assessment, direct treatment, medication management, and ongoing support for recovery. No matter where someone lives, they can access high-quality addiction treatment online.
Convenience
Individuals seeking treatment for substance abuse can connect with trained providers from nearly any setting. As long as they are connected to the online platform, treatment can be provided to people in their homes, in private clinical settings, or anywhere else in the community. The treatment setting can also change from session to session, depending on the client’s location.
Affordability
Online treatment is often more affordable for both individuals and communities. In smaller or more rural communities, for example, it can be difficult to pay for an on-site behavioral healthcare provider. Accessing the same services online greatly reduces organizational costs while still offering treatment services to the community.
Reduced Stigma
Many people delay seeking addiction treatment due to the cultural stigma of accessing mental health care. When accessing treatment from the comfort of their own home, clients maintain a greater sense of privacy while still receiving the care they need.
Potential Drawbacks of Online Treatment
While there are many benefits of online treatment, that are also potential drawbacks. Consider the following challenges of online therapy before signing up:[3]
Technical Problems
Online therapy can only be accessed where there is a stable internet connection. Technological disruptions have been identified as one of the barriers to successful online treatment.
You can improve your internet connection by ensuring your therapy device (like your computer) is the only item connected and online. Then, close all your internet-connected apps and programs on your computer.
Less Emotional Impact
When only meeting via video or phone, it can be difficult to establish an emotional connection with a therapist that typically serves as a strong influencing factor in traditional therapy.
Missed Social Cues
Without meeting in person, it can be challenging for therapists to pick up on essential behavioral and emotional cues that can greatly inform therapy.
Lack of Online Training
As a relatively new concept, many therapists have not received explicit training in how to conduct effective online therapy.
Despite the potential drawbacks of online treatment, studies have found that in-person therapy and online therapy result in roughly equivalent outcomes.[1] As therapists become more versed in providing online treatment, they will be increasingly more equipped to meet the growing demand for online care.
Types of Online Therapy for Addiction
Online therapy involves meeting with a qualified professional without being in the same room. Your online therapist will help you understand what program you’ll use to connect. It might involve Zoom, FaceTime, Skype, Vsee, or something else altogether. You should know what type of program you’ll use before the treatment begins.
Your treatment team might use one of the following counseling types during your session:[7]
- Motivational interviewing, which helps you strengthen your resolve to be sober
- Cognitive behavioral therapy, which helps you identify your triggers and learn to deal with them
- Contingency management, which provides rewards for small tasks you take toward sobriety
- Supportive psychotherapy, which helps you form a connection with your counselor and learn more about yourself
Researchers say that all of these types of therapy can be provided online, but some (like contingency management) are harder to deliver via this format.[7]
How to Engage With Online Therapy for Addiction
Your treatment team will tell you how your therapy will work. You might meet with your therapist weekly, monthly, or on some other set schedule. You should understand how much it might cost, how frequently you’ll be billed, and how the therapy will work.
Every online program has different technological requirements. In general, it’s best to conduct these meetings on a computer (so the screen is bigger) with a fast connection (so the talk won’t hitch) and a lot of memory (so the picture is clear).
Follow these steps to prepare for your session:[6]
- Test the software before the session starts.
- Find a private, quiet place to log into your session.
- Consider using headphones for better sound quality.
- Ensure that your computer is on a stable surface (so the screen doesn’t jiggle).
- Turn off all email and phone notifications that might distract you.
- Close other programs that could slow your computer’s processing speed.
How to Find Online Therapy for Addiction Treatment
Finding an online addiction treatment program can begin with a simple online search or by contacting your insurance provider if you have insurance. An insurance representative should be able to tell you which programs are covered by your insurance plan as well as information on specific therapists you could work with. Visit the therapists’ websites or phone them to inquire about possible telehealth services.
The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers a free online search platform to locate appropriate mental health and addiction treatment services.[4] You can filter your search for telemedicine and substance use services. Your searches remain confidential and anonymous, and it is up to you to contact treatment providers you may be interested in.
What to Look for Before Choosing an Online Therapist
Before choosing an online therapist, there are many points to consider. Not every therapist is a good fit for everyone, so take your time to learn about a few potential therapists and consider if you think you will do well working with them. Ask family members or friends to help you with this process.
The American Psychological Association (APA), recommends considering the following points before selecting a therapist:[5]
- Is the therapist licensed to provide therapy by the state you live in?
- How much of the costs of working with this therapist will your insurance cover?
- When is the therapist available for treatment?
- Which treatment platforms does the therapist use, such as online, video, or phone?
- What type of therapy does the therapist provide for addiction treatment?
- Ask the therapist about their experience with addiction treatment and how they may be able to work with your situation.
- Don’t hesitate to contact multiple therapists to find one that is a good fit. Therapy is a highly personal matter, and you won’t connect equally with every therapist you speak to.
High-quality online therapists can be found via many avenues, such as national and state psychological systems, online search platforms, or just by talking to others you know who may have previous experience with online therapy. If you are interested in online therapy for addiction, effective and accessible care is available.
Reach out to us here at Boca Recovery Center to learn more about our online treatment options.
Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More
- Addiction treatment and telehealth: review of efficacy and provider insights during the COVID-19 pandemic. Mark, L., Treiman, K., Padwa, H., Henretty, K., Tzeng, J., and Gilbert, M. Psychiatric Services. 2022;73(5):484-491.
- Telehealth for the treatment of serious mental illness and substance use disorders. Substance Abuse and Mental Health Services Administration. Published 2021. Accessed January 17, 2024.
- Qualitative investigation into therapists’ experiences of online therapy: implications for working clients. Kotera, Y., Kaluzeviciute, G., Lloyd, C., Edwards, A., and Ozaki, A. International Journal of Environmental Research and Public Health. 2021;18(19).
- Search for treatment. Substance Abuse and Mental Health Services Administration. Accessed January 17, 2024.
- How do I find a good therapist? American Psychological Association. Published 2017. Accessed January 17, 2024.
- How to transition to seeing your therapist online. Gillihan S. Psychology Today. Published March 19, 2020. Accessed April 23, 2024.
- Addiction psychotherapeutic care. Yue H, Pena E. StatPearls. Published November 11, 2022. Accessed April 23, 2024.
- Online therapy: Lessons learned from the health crisis. Barker G, Barker E. British Journal of Guidance and Counseling. 2020;50:66-81.
- Internet-based therapy versus face-to-face therapy for alcohol use disorder, a randomized controlled non-inferiority trial. Johansson M, Sinadinovic K, Gajecki M, et al. Addiction. 2020;116(5):1088-1100.
