The Rise of Online Therapy: History of Telehealth

While telemedicine therapy has grown in availability over the last years, it has been around in different forms for decades. It is an effective therapeutic approach for assessing and diagnosing many mental health disorders across many populations. Moreover, it appears to be as effective as in-person therapy.

There is no denying that in recent years, online mental health treatment has taken off and soared to new heights. The days of going into a therapist’s office for a face-to-face therapy session are slowly becoming a thing of the past. People no longer have to give up mental health treatment because they have to wait for non-traditional work schedules, live in rural areas, can’t travel a lot due to disability or caregiving responsibilities, or don’t feel comfortable in person with a doctor. In such cases, teletherapy or telepsychology has proved convenient for both the client and the therapist.

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What Is Online Therapy?

Online therapy, also known as virtual therapy, teletherapy, or telepsychology, refers to mental health treatment provided by a certified and licensed telehealth therapist remotely rather than in person. It involves the use of the internet and other telecommunication technologies, such as:

  • videoconferencing
  • remote patient monitoring
  • email or instant messenger
  • phone call
  • group chat
  • virtual reality
  • interactive services available through apps
  • live chat on a website

All online therapy sessions must comply with a specific set of HIPAA standards. The platform used should be private, and users must have a secure Internet connection, access to a phone, tablet, or computer, and a private, quiet place to talk. Telehealth therapy sessions proceed as they would in person, with your therapist asking questions and talking about your issues. Teletherapy may be offered as a standalone treatment but can also be used in conjunction with the traditional face-to-face sessions.

How Is Teletherapy Used?

Online therapy can be a convenient option for individuals who cannot access mental health care due to transportation, location, or time issues. It may also be appealing to people who feel more comfortable communicating remotely than in person with a telehealth counselor. Also, telemedicine therapy can improve access for people with chronic health conditions and those recovering from diseases like cancer. Staying at home can help keep them healthy and reduce the risk of infection.

Online therapy can address many mental health conditions, including:

  • Depression
  • Anxiety
  • Attention deficit hyperactivity disorder (ADHD)
  • Stress
  • Eating disorders
  • Learning differences
  • Aphasia
  • Parenting issues
  • Relationship issues
  • Obsessive-compulsive disorder (OCD)
  • Conditions affecting thinking or speech
  • Post-traumatic stress disorder
  • Substance use disorder

A telehealth psychologist can administer a wide range of phone or video call therapy, including:

  • Mindfulness interventions
  • Cognitive-behavioral therapy (CBT)
  • Group therapy
  • Speech therapy
  • Dialectical behavior therapy
  • Occupational therapy
  • Marriage and family therapy
  • Eye movement desensitization and reprocessing therapy

The History of Online Therapy and Telehealth

Online therapy is not a new concept. While the COVID-19 pandemic forced mental health professionals to make the switch to online therapy to continue treating their patients safely, remote therapy sessions have been available since the 1890s. For example, Sigmund Freud, the father of psychoanalysis and psychotherapy, was known to exchange letters with his patients. It allowed him to receive feedback and provide support to people in his care.

By the 1950s and 1960s, some mental health professionals were conducting therapy sessions by telephone. With the advent and rise of the internet in the early 1980s, people began discussing their mental health issues in chat rooms. In 1986, Cornell University launched Dear Uncle Ezra — the first online advice column. Some of the questions asked and answered were about mental health, including suicidality. It has been confirmed that “Uncle Ezra” has a background in mental health.

In 1997, several mental health providers established the International Society for Mental Health Online (ISMHO) to provide support and develop standards for online interactions between clients and practitioners. In the 2010s, online-only counseling services were founded.

Online therapy went mainstream in the wake of the COVID-19 pandemic. Beyond the fear and fatality of the virus itself came a wave of mental health problems. What had been an adjunctive intervention for individuals in geographically isolated settings suddenly became the standard mental health care approach, thanks to social distancing mandates. Many insurance providers also expanded coverage of online counseling services. Experts believe that the popularity of online therapy will continue to grow.

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What Are the Benefits of Telehealth Therapy?


Online therapy has been found to be as effective as in-person therapy for various mental health conditions. For instance, a 2014 study (B. Wagner, Journal of Affective Disorders, 2014) found that online treatment for depression was as effective as face-to-face treatment and even had more significant long-term results. A 2018 meta-analysis (G. Andrews, Journal of Affective Disorders, 2018) found that online CBT had a high satisfaction rate and was equally helpful for treating depression, anxiety disorder, and panic disorder as face-to-face therapy. Telehealth counseling helps lessen the severity of mental health symptoms and yields better outcomes.

Increased Comfort

You don’t have to force yourself off the couch or drive to a therapist’s office across town when you’re feeling down. With online therapy, all you need is an internet connection and a phone or a laptop. Wearing what you want, having your special mug, and being inside the comfort of your own home or another location that works for you can make you feel at ease and willing to share your thoughts and feelings.

No Commuting Hassles

You no longer have to worry about travel-related issues with phone therapy or video therapy sessions. Online therapy offers access to mental health treatment to people in remote areas, those who are disabled or housebound, and those with scheduling issues. When you remove hassles like flat tires, traffic jams, or car accidents, your appointments are more likely to start on time. What’s more, you can schedule your sessions for times that are the most convenient for you.

Low Barrier to Entry

People may feel comfortable talking about physical health issues, but not feel the same about mental health concerns. For such people, it can take a lot of courage to make their first appointment. Going to a new environment and waiting in a lobby to meet with a therapist for the first time can be stressful. Online therapy makes it easier to overcome the stigma associated with mental health issues and make their first counseling appointment.


Online therapy can be more affordable than traditional in-office visits. Some teletherapy services provide lower rates, which can bring more people toward getting the help they need. Today, many insurance providers cover online therapy, but it’s best to check with your insurance company before making your first appointment.

The Takeaway

Online therapy can be a convenient and effective way to get mental health care. It improves access to care and provides greater flexibility. Whether or not it will work for you depends on your condition and its severity. Start with a free assessment at EZCare Clinic, and we’ll develop a personalized treatment plan that will work for you!


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