Does Online Therapy Actually Work? Here's What the Research Says

Does Online Therapy Actually Work? Here's What the Research Says

If you've been considering therapy but aren't sure about doing it over video, you're not alone. A lot of people wonder whether it's "as real" as sitting in a room with someone. Whether the connection is actually there. Whether you can have a hard conversation through a screen.

The short answer: yes. And the research backs that up.

What the evidence actually shows

Studies comparing in-person therapy with video-based therapy consistently find that outcomes are similar across a wide range of conditions - anxiety, depression, trauma, relationship difficulties, and more. A 2022 review published in the Journal of Affective Disorders found that internet-delivered cognitive behavioural therapy (CBT) produced results comparable to face-to-face delivery for depression and anxiety disorders. The therapeutic relationship - which is one of the strongest predictors of whether therapy helps - forms just as strongly online as it does in person.

That doesn't mean online therapy is for everyone. There are situations where in-person care is more appropriate - particularly for people with complex presentations, severe mental illness, or who need crisis support. But for the broad range of concerns that bring most people to therapy, virtual sessions work well.

Why Canadians are choosing virtual therapy

Canada has a geography problem when it comes to mental health care. A lot of us live in cities, but even urban Canadians face months-long waitlists for in-person services. For people in smaller communities, the problem is worse - there might be one or two therapists within a reasonable drive, and both of them might be full.

Virtual therapy dissolves that problem. When your session is a video call, you're not limited to whoever practices within 20 minutes of your house. You can access a therapist in Calgary while living in Red Deer. You can see a BC-registered clinical counsellor from a smaller community on Vancouver Island. You can book an evening appointment from your living room without fighting traffic.

Privacy is another factor. For some people, walking into a therapy office in a small community where everyone knows everyone is a real barrier. Virtual therapy removes that.

What a typical virtual therapy session looks like

At GoodTherapist, sessions happen over a secure, encrypted video platform - not consumer apps like Zoom or FaceTime. Before your first appointment, you'll fill out a short intake form so your clinician knows a bit about what you're bringing in. Sessions are 50 minutes, and you can attend from wherever you feel comfortable: your home, your car, a private office at work.

Your clinician will set the agenda with you. The first session is usually about understanding what's going on and what you're hoping to get out of therapy. From there, you build a plan together.

What virtual therapy is not good for

It's worth being honest here. Virtual therapy has real limits.

It's not a substitute for emergency or crisis care. If you're in crisis, please contact 988 (Canada's Suicide and Crisis Helpline) or go to your nearest emergency room. It may also not be the right fit if you don't have a private, quiet space to attend sessions, or if you find video calls significantly more stressful than meeting in person. If that's the case, talk to a clinician - the right setup matters, and a good therapist will work with you on it.

How to get started

You don't need a referral from your doctor to see a therapist at GoodTherapist. You book a Good Fit Call - a short, no-pressure conversation where we learn a bit about what you're looking for and match you with a clinician who's a good fit.

From there, your first appointment is typically within a week.

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