woman provides therapy through online video chat

Considering Text, Video, and In-Person Therapy

Updated April 2021

Recently, New York Magazine’s cover story called app-based therapy a “fantasy” and the cover image slammed the idea of text-based therapy. This provocative story has understandably caused many important discussions in the mental health community and beyond.

Although LifeStance Health does not offer text-based or app-based therapy at this time, we feel strongly that it is our duty to stand beside other organizations in this space. We are different companies, yes. But all mental health organizations share a common goal: to improve people’s lives.

In this country and around the world, we are dealing with a severe shortage of mental health care providers, including qualified therapists. This shortage makes it hard for many people to access care, especially people who live in rural areas. While we all take different approaches to this problem, companies like LifeStance Health and others are working hard to find solutions every day.

Ultimately, the best choice for therapy is the one that works for the individual. Some people only feel comfortable with a face-to-face conversation. Others may only want to text their therapist. Some split the difference and use live online video therapy.

All therapy is valid. Any therapy is better than none. 

So long as the provider is a fully licensed therapist, we support people getting care.

With so many options, it can sometimes be hard for people to decide where to start. Below are some considerations to make when you’re considering online therapy.

Why People Choose Online Therapy

An astonishing 98 percent of people say that online therapy is much more convenient than traditional in-person counseling. While this intuitively makes sense, it’s also stunning to see 98 percent of people agree on anything these days.

The two most-used methods of online therapy are texting and video chat. At first glance, being able to text your therapist at any moment may seem like the most effective and convenient way to get help. However, live sessions with a qualified mental health professional offer advantages that text therapy does not.

Online Therapy as Self-Care

The term “self-care” is all the rage these days, and for a good reason. When you set aside time to take care of yourself, you’re able to put your best foot forward in many areas of life. When you set aside an hour of therapy weekly, you are scheduling time for meaningful self-care.

While video chatting with your therapist may not be as Instagram-worthy as a nice bubble bath and a glass of your favorite beverage, it may be even more useful. Simply by setting aside time to work on yourself, you are declaring that you are worthy. Then, when you attend sessions, you learn skills that you can use in everyday life.

It’s challenging, freeing, and raw, but it’s also self-care.

Text-based therapy can teach you critical coping skills that can improve your life. However, it misses the important step of scheduling time for you to work on yourself. It may be more challenging to find an hour to have a conversation with your therapist, but it can also be more rewarding.

Venting Emotions When You Need It

One of the benefits of text therapy is that patients can send texts when they are struggling with difficult emotions at the moment. You can get thoughts out so that they don’t feel as overwhelming, and then you can address these thoughts later, when your therapist is available and you are in a better headspace.

Get Real-Time Feedback from Your Therapist

While text-based therapy allows you to send a message to your counselor at any time, there’s no guarantee that they will write you back right away. By the time you hear back, you could be in a completely different headspace.

If you choose video-based therapy, it’s true that you have to wait in between appointments. However, once you are in that appointment, you have the therapist’s full attention. They respond to you in real-time.

This immediate feedback is vital if you want to explore a difficult topic, but you are afraid of spiraling out of control. When your therapist is guiding you through it in real-time, you can explore tough subjects. And while it can be painful at times, these discussions are at the root of therapy. A qualified mental health care provider can keep you from spiraling and make sure you’re ok after these vital discussions.


View this post on Instagram


A post shared by LifeStance Health (@lifestancehealth)

Practice Skills Between Sessions

Part of the appeal of text-based therapy is the promise of reaching a qualified mental health professional immediately. Neither text-based nor video-based therapies are right for mental health crises. If anyone is in immediate danger, it’s best to get more immediate help.

If you are in a mental health emergency, contact the appropriate help line or go to your nearest emergency room.

Outside of true mental health crises, such as suicidal ideation, being able to text your therapist at any time sounds appealing. However, for some people, it can become a crutch. Instead of practicing important coping skills on their own, some people may start using text therapy as a coping skill.

On the other hand, live therapy sessions force people to work on their skills between appointments. This can be important for many patients. Of course, each person must decide for themselves what works best for them.

Ask yourself whether you’re more of an independent learner in need of some guidance or if you prefer a more hands-on approach at this time.

Communicate Your Way

Ultimately, getting mental health care is the most important thing. If you express yourself best in text, you may feel most comfortable with text-based therapy. You may also prefer this style if you’re not totally sure about therapy, but you’re curious enough to try something.

Alternatively, some people find it difficult to write about hard emotions. Talking to a therapist live – whether online or in-person – can help ease such patients into these conversations.

Not sure what’s right for you? You’re not alone. Many people struggle to find the right kind of mental health care at first. That’s why LifeStance Health offers a wide variety of services. Our nationwide network of providers offers online therapy, in-person sessions, psychiatric medications, and so much more. So you can find the customized treatment plan that works best for you.

Don't struggle alone.
Our providers can help.

Make an Online or In-Person Appointment