Online Therapy: 10 Myths About Psychologists on the Web
Online Therapy: 10 Myths About Psychologists on the Web
What are the prejudices about online therapy, and what does research say about them? What prevents people from turning to an online psychologist? And what are the 10 most frequent misconceptions that an online psychologist has to face in clinical practice?
Online therapy is still a frontier to be fully explored. Many people approach it out of curiosity or initiative, wanting to try an alternative way of doing therapy that challenges the widespread belief that psychologists can only work in their offices.
The beauty of online therapy is that you can do it comfortably from home, without having to travel, and still achieve the same results you would have in a psychologist’s office. In my clinical practice, I have often had to confront certain prejudices brought by users—some are curious to try, while others fear the method may not be effective or may not replace traditional therapy.
The public’s interest in this type of intervention, and people’s sometimes ambivalent attitude toward it, have also been the subject of research, which shows that online therapy is rapidly expanding. Let’s look in detail at the 10 most frequent misconceptions I have encountered in my work as an online psychologist.
1. “A psychologist can only help me in their office”
Many people still believe that psychologists can only help if sessions take place in person. Yet as early as December 2012, research comparing over 1,100 studies on the effectiveness of online psychological counseling showed that, when carried out rigorously by a trained therapist, it can be just as effective—not only for depression and anxiety disorders, but also for gambling addiction, social phobia, and even certain sexual dysfunctions.
International research has confirmed that online therapy can achieve results equivalent to in-person therapy, often with long-term improvements in quality of life.
Online therapy is increasingly recognized as a genuine path of personal growth, allowing people to better understand themselves, reframe their difficulties, and experiment with new coping strategies.
2. “It’s impossible to build a therapeutic alliance online”
The therapeutic alliance is the emotional connection between therapist and client that supports healing and goal achievement. According to Bordin, it consists of:
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Clear agreement on therapeutic goals
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Defined responsibilities for both parties
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An emotional bond built on trust and respect
Several empirical studies show that online therapy can establish a therapeutic alliance comparable to face-to-face therapy. Online services can also reach people with limited mobility, those in remote areas, people with tight schedules, expatriates, individuals with disabilities, and even adolescents who isolate themselves at home.
Meta-analyses suggest that online therapeutic relationships are not significantly weaker than in-person ones, though further research is needed to understand the role alliance plays in online settings.
3. “How can an online psychologist understand me if I don’t meet them in person?”
Some believe trust requires a handshake or physical presence. In reality, online psychologists adapt their skills to the digital medium and can create the same atmosphere of trust, listening, and understanding.
A meta-analysis found that therapist-guided online treatments were especially effective for depression and anxiety, highlighting the importance of professional guidance even at a distance.
4. “It’s better to talk to a friend than an online psychologist”
Friends can offer valuable listening, but therapy goes beyond listening. An online psychologist uses theoretical and practical tools tailored to the individual, helping overcome dysfunctional behaviors, cognitive distortions, and relational difficulties, while teaching effective emotional management strategies.
5. “If I send an email request, I might never get an answer”
In my practice, I always respond to online counseling requests within 24 hours, often asking for a phone number to arrange a first call. Online clients usually expect faster responses than in-person clients. A timely reply helps build trust and ensures that help is readily accessible.
6. “Online therapy lasts only one session”
An initial online consultation is just the first step: it reconstructs the history of the problem, clarifies the request, and sets goals. If the person wishes to continue, a structured online therapy plan is developed, working step by step toward broader objectives through multiple sessions.
7. “Who’s really behind that email or video?”
Some people fear anonymity or impersonation. In my experience, a phone call right after the first contact reassures clients and builds trust. Being able to talk directly to a professional who listens and responds in real time increases confidence and the likelihood of starting video sessions.
8. “Is my privacy guaranteed?”
An online psychologist must guarantee the same confidentiality as in an office. Sessions must not be recorded, informed consent must be obtained, and sensitive data must be stored securely on password-protected devices.
9. “If online therapy works, why isn’t it widespread in Italy?”
Online psychological services are already widespread in English-speaking countries and Northern Europe. In Italy, cultural hesitation slowed their adoption, just as it once did with e-commerce. But things are changing: more and more Italians are turning to online therapy each year.
10. “I don’t believe in psychologists—let alone online ones”
This is one of the most common prejudices, reflecting the stigma that psychologists are “only for crazy people.” In truth, those who seek therapy are healthy individuals who want to improve their lives, face difficulties more effectively, and restore emotional balance.
I remember a client who entered my office claiming he didn’t “believe in psychologists.” Within a few sessions, he felt emotionally better, more competent in relationships and work, and regained hope for the future. His eyes reflected the confidence of someone who had rediscovered the possibility of change.
Final Thoughts
Online therapy is not a substitute of lesser value, but an alternative method that expands access, flexibility, and continuity of care. It is a valid, scientifically supported approach that allows people to take a step toward personal growth, often overcoming barriers that would otherwise prevent them from seeking help.
Bibliography
- Apolinário-Hagen et al. Public Acceptability of E-Mental Health Treatment Services for Psychological Problems: A Scoping Review. JMIR Ment Health. 2017
- Bordin, E.S. (1979). “The generalizability of the psychoanalytic concept of the working alliance”. In «Psychotherapy: Theory, Research, and Practice», 16, 1979
- Apolinario-Hagen, J. A. & Tasseit, S. (2015). Access to Psychotherapy in the Era of Web 2.0 – New Media, Old Inequalities?. International Journal of Health Professions, Volume 2, Issues 2.119-129
- Andersson, G.; Paxling, B.; Roch-Norlund, P.; Östman, G.; Norgren, A.; Almlöv, J. & Silverberg, F. (2012a). Internet-based psychodynamic versus cognitive behavioral guided self-help for generalized anxiety disorder – A randomized controlled trial. Psychotherapy and Psychosomatics, 81(6), 344–355
- Preschl, B.; Maercker, A. & Wagner, B. (2011). The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression. BMC Psychiatry, 11, 189
- Berger T, The therapeutic alliance in internet interventions: A narrative review and suggestions for future research. Psychother Res. 2017 Sep;27(5):511-524
- Andersson et al. Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry. 2014 Oct; 13(3): 288–295
- Spek, V.; Cuijpers, P.; Nyklicek, I.; Riper, H.; Keyzer, J. & Pop, V. (2007b). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety – A meta-analysis. PsychologicalMedicine,37(3),319–328.
