Is Online Therapy Effective? What the Research (and Our Clients) Say!

If you've ever wondered whether online therapy works, you're not alone. As a trauma therapist offering virtual therapy for adults across Cincinnati and PSYPACT states, I hear this question a lot. And it makes a ton of sense!

We’re all trying to make informed choices about our mental health. For many of my clients, especially those healing from trauma, PTSD, or Borderline Personality Disorder (BPD), the idea of showing up in a traditional therapy office feels overwhelming. Online therapy offers a quieter, more private path forward. But is it actually effective? Absolutely.

What Is Online Therapy?

Online therapy (also called teletherapy, virtual therapy, or telehealth) involves meeting with a licensed therapist over a secure video platform rather than in person. For many of my clients, this means they can attend sessions from the safety of their own home, office, or any private space without dealing with traffic, logistics, or the stress of being in a new environment.

It’s flexible, accessible, and can be just as powerful, sometimes even more powerful, than in-person therapy, especially for trauma survivors.

So, Is Online Therapy Actually Effective?

Short answer: Yes.

Long answer: There’s a growing body of research showing that virtual therapy is just as effective as in-person therapy for a wide range of mental health concerns, including trauma-related disorders.

Here are some really encouraging findings from the research:

• A 2021 meta-analysis published in Clinical Psychology Review found that online CBT (Cognitive Behavioral Therapy) is equally effective as face-to-face CBT for treating anxiety, depression, and PTSD.

• A 2020 study published in JMIR Mental Health concluded that telehealth for PTSD is not only effective but sometimes leads to better engagement and attendance than in-person sessions.

• The American Psychological Association (APA) supports the use of telepsychology and affirms that many modalities, including EMDR, ACT, CPT, and DBT, can be adapted to a virtual format without losing effectiveness.

How Online Therapy Supports Trauma Recovery

In my own experience with evidence-based trauma modalities like EMDR (Eye Movement Desensitization and Reprocessing), Prolonged Exposure Therapy, CPT (Cognitive Processing Therapy), and DBT, I’ve found that many trauma survivors feel safer opening up from their own space.

Here’s how online therapy can help trauma clients in particular:

1. You’re in your space

Being in your own environment, whether that’s a bedroom, car, porch, or tucked-away corner of the house, can be regulating in itself. You can control the lights, the scents, the sounds around you, etc. Most people find being in some control of their environments to be very grounding. Being in your home, car, office, or other personal space also ensures you are completely private.

Being able to complete therapy from the place of your choosing is also a huge advantage for people who live in remote areas, have difficulty finding childcare but need treatment, or have physical limitations that prevent them from seeking therapy in person.

2. Better emotional regulation

When you’re working through intense emotions, having access to your own grounding tools (like a weighted blanket or soothing music) can help you stay present. Additionally, I find that my clients enjoy being able to practice coping skills together using their own materials, and that this often helps them be able to put the skill into use when they experience intense emotions in between sessions.

3. More consistent access

Because there’s no commute involved, many clients find it easier to stick with regular sessions, and we know that consistency is key to making progress in treatment. In addition, due to our ability to carry out therapy to 42 states (and counting), our clients are able to see us even if they have to travel throughout the United States.

What Modalities Work Well Online?

In our virtual practice, we regularly use these therapies and more:

• CBT (Cognitive Behavioral Therapy) – Helps reframe negative thinking patterns. Because it’s highly structured, it translates really well to online delivery. Expect lots of collaborating with your therapist on thought challenging.

• EMDR Therapy – Yes, EMDR can be done virtually! With secure platforms and tools like bilateral tapping, bilateral audio tones, or eye movement via video, it’s just as effective.

• Prolonged Exposure (PE) – Helps clients gradually process and desensitize traumatic memories. You and your therapist work together to find out what you’ve been avoiding since the trauma, or in other words, how trauma might have shrunk your world. We also expose you to the traumatic memory in a way that helps put it into context and give it meaning.

• CPT (Cognitive Processing Therapy) – Similar to CBT, you and your therapist work collaboratively to challenge thoughts and process the trauma in a healthier way. If you prefer a more structured approach with worksheets to help you solidify new beliefs, this is a great fit that works seamlessly over telehealth.

• ACT (Acceptance and Commitment Therapy) – In ACT, the focus is on living in the present and aligned with your values. The exercises and coping skills we use in ACT help us to relate differently to our emotions in the present so they don’t control our actions. They are easily taught and practiced together over telehealth.

• DBT (Dialectical Behavior Therapy) – Especially helpful for emotion regulation, often used with clients who have BPD. The research is especially encouraging in suggesting that clients who are engaged in DBT therapy online often stick with their treatment programs more consistently, leading to larger improvements over time.

All of these can be tailored to a secure and engaging online format.

But What About the Connection? Can You Still Feel Safe and Seen?

Yes. And we truly believe this part matters the most.

We know from both research and experience that the therapeutic relationship, not the platform, is what creates real change. The warmth, trust, and safety that we co-create in session doesn’t depend on being in the same room. We build the same deep, warm, and real relationship together over time as we work together. In fact, many of my clients have told me they prefer telehealth therapy, especially early on in treatment, as they begin to redefine their relationships with themselves, other people, and the world.

Are There Any Cons to Online Therapy?

While online therapy is effective and accessible for many, it’s not perfect, and it may not be the right fit for everyone. We believe in being transparent about both the benefits and the limitations, so you can decide what’s best for your healing.

Here are a few potential cons of online therapy, especially to consider if you're navigating trauma, PTSD, or BPD:

Technology challenges

Not everyone has reliable internet, a private space, or comfort with using video platforms. Glitches and dropped calls can disrupt momentum during emotionally sensitive moments. While we always have a backup plan (like switching to phone or another secure video platform), it can still be frustrating. We do our best to minimize interruptions when these challenges happen and get back on track as quickly as possible.

Less physical presence

For some people, being in the same physical space as a therapist feels more comforting during moments of emotional release. Online therapy can feel more removed for those who rely heavily on nonverbal connection or body language.

Limited crisis support

If you're in active crisis or need intensive, in-person stabilization, online therapy may not be the right level of care. While I provide support and referrals, virtual sessions aren’t designed for emergency or inpatient needs. When this is the case, we work collaboratively with providers in those settings to ensure a smooth transition in and out of more intensive levels of care.

Privacy concerns at home

For clients who share space with others, it can be hard to find a truly private moment. This is especially true in emotionally or physically unsafe environments. In those cases, therapy may feel more constrained. We do our best to help clients troubleshoot these barriers and enhance safety, recognizing that there may be limits to how much we can help in these situations.

Ready to Begin?

If you’re considering virtual therapy and want a space that’s safe, skilled, and flexible, we’d love to work with you.

We offer secure, HIPAA-compliant virtual sessions for adults across Cincinnati and over 40 states through PSYPACT.

Schedule a free consultation to create a space where you are and healing can begin.