Sources checked November 9, 2026 · Peer-reviewed research and U.S. telehealth guidance
I’m glad you’re here. If getting across town for an appointment feels like one more thing to squeeze into your week, a video visit might make therapy easier to start. It’s reasonable to wonder whether meeting on a screen changes what you’ll get out of it.
There are two questions worth asking. Can the kind of therapy you need work remotely? And can you make the appointment work in your life, with enough privacy, a clear price, and time to talk?
If you’re also looking for small ways to care for yourself between appointments, our everyday self-care ideas are a place to start.
Online therapy can be effective. For the conditions studied in a 2024 review, therapist-guided cognitive behavioral therapy (CBT) delivered remotely and in person produced similar measured outcomes.
If you’re considering online care, ask the provider what approach they’d use for your concerns and how they’d deliver it remotely. That gives you a more useful answer than a general promise about a platform.
What Does the Research Say About Online Therapy vs. In-Person Care?
A 2024 systematic review in CMAJ compared therapist-guided remote CBT with in-person CBT across several conditions, including anxiety-related disorders and depressive symptoms. The main comparison drew on 51 randomized trials. The authors found moderate-certainty evidence of little to no difference in the outcomes the trials measured.
That finding is about CBT delivered with a therapist’s guidance. When a service uses the term “online therapy,” ask what it actually offers. A scheduled video or phone appointment gives you time to talk with a provider in real time.
A portal might also let you send messages between visits, so it’s worth finding out when someone will read them and what kind of reply you can expect. A self-guided app is a different service, even if it offers exercises based on CBT.
When Might Online Therapy Fit Your Life?
An online appointment can save you the trip to an office. That may be helpful if you live far from a practice, have difficulty traveling, or need an appointment that fits around work or caregiving. Some people also find it easier to talk from a familiar room. Think about the time and space you’d actually have on an ordinary week.
For example, a lunchtime appointment might look easy on the calendar. If your only place to take the call is a shared break room, you may spend the session wondering who can hear you. You could ask about a different time or an in-person option. A useful test is whether you can make the appointment consistently and feel able to speak freely when you get there.
Technology and personal preference matter, too. If your internet drops often, ask whether the practice offers phone appointments and whether that format suits the care you’re seeking. If you feel more at ease talking face to face, ask whether the provider offers office visits or a mix of formats.
What Should You Check Before Booking Online Therapy?
You can ask these questions by phone or email before you commit to an appointment. A few clear answers can make it easier to compare providers.
1. Can you see me where I’ll be during the appointment?
Ask for the provider’s name and professional credentials. In the U.S., confirm they’re licensed or legally permitted to see you in the state where you’ll physically be. Check again if you’ll be traveling for a session. The HHS guide to behavioral health licensure explains why the location matters.
2. How would sessions work for the concern I want help with?
Ask about the provider’s experience, the approach they’d consider, and whether you’d meet by video or phone. If the service includes messages, ask how they’re used and when to expect a response.
3. What would I pay for the first appointment and later sessions?
Ask the practice for its fees and check your coverage with your insurer. If the service charges a subscription, confirm what it includes and what costs extra.
4. How will my privacy be handled?
Ask which platform you’ll use, who can access appointment messages, and what the practice shares about confidentiality. Think about privacy on your side of the call as well. The HHS telehealth privacy guide has practical steps for protecting your information.
Does Insurance Cover Online Therapy?
Some plans cover online therapy. What you pay depends on the plan, the provider, and the visit. Ask your insurer whether it covers this provider for the appointment format you’ll use, whether the provider is in network, and what you’d owe, including any copay, coinsurance, or deductible that applies.
Ask the practice to confirm the fee for the first visit and whether it differs from follow-up sessions. If you’re paying yourself, ask for the full price before booking. HHS explains how to check telehealth costs and coverage.
How Can You Prepare for Your First Online Therapy Session?
Find the appointment link or confirm which number will be used. Choose a place where you can speak without being overheard, and test your camera and microphone if you’ll be on video.
Agree on who will call whom if the connection drops. If you need captions, an interpreter, or help using the platform, tell the practice before the visit so you know what arrangements are available.
You can also jot down one thing you want help with and one question for the therapist. If you feel awkward starting on video, it’s fine to say so. You might begin with, “This is my first time meeting online. Could you tell me how today’s session will go?”
Final Thoughts
If online therapy sounds like a possibility, start with one question that would help you decide. Maybe you need the actual first-visit cost. Maybe you want to know whether you can try video and switch formats later. Once you have that answer, it may be easier to see what fits.
I hope your first conversation gives you room to ask what’s on your mind.
Take gentle care of yourself,
Anna
Safety Notes
This guide offers general information for U.S. adults. A qualified clinician can help you decide what kind of care and appointment format fit your needs. For immediate crisis support in the U.S., call or text 988, or chat with the 988 Lifeline. In a life-threatening emergency, call 911.
Helpful Resources
- NIMH guide to getting mental health support virtually — what to consider when choosing a provider and where to look for help.
- HHS guide to preparing for a telehealth visit — practical steps for setting up your space and using the technology.
