CBT Online
CBT online raises its share of questions. Since the coronavirus pandemic, the majority of psychotherapy is conducted remotely which may spur people to ask: Is CBT online still effective? What adjustments does a therapist need to make to conduct CBT online? Can virtual technology tools actually improve the treatment?
Summary
- CBT online is just as effective as in-person sessions for treating depression, anxiety, PTSD, and panic disorder, making it a viable long-term treatment option, research shows.
- Teletherapy platforms provide tools such as whiteboards, secure document sharing, screening assessments, and treatment planners, which streamline assessment, psychoeducation, and progress tracking.
- Core CBT components including cognitive restructuring, coping skills training, exposure exercises, and behavioral activation can be adapted and delivered effectively through secure video, apps, and digital resources.
- Building trust online requires clear communication, tech readiness, professional presentation, and active listening techniques to ensure clients feel secure, supported, and engaged. Enrolling in a teletherapy course for therapists can help providers enhance their knowledge.
→ Click Here to Enroll in My Free On-Demand Top to Bottom Teletherapy Video Course [Enroll Now]
While Cognitive-Behavioral Therapy (CBT) is one of the most effective types of talk therapy for several psychiatric disorders, including depression and anxiety, past research has primarily focused on CBT conducted in person. Let’s examine the facets of conducting CBT online.
Streamline your practice with One EHR
- Scheduling
- Flexible notes
- Template library
- Billing & payments
- Insurance claims
- Client portal
- Telehealth
- E-fax
Is CBT online effective?
On its face, CBT is an excellent fit for telehealth. It is structured, skill-based, and goal-oriented, making it perfectly suited for digital delivery. While teletherapy has several advantages over in-person therapy, including convenience and accessibility, those factors are of little relevance if it isn’t effective. Fortunately, the early research on teletherapy is highly promising.
One study, using electronic delivery of a CBT protocol, found significant improvement in anxiety and depressive symptoms. Additional research, utilizing “therapist-assisted” online CBT with patients suffering from depression, post-traumatic stress, and panic disorder, discovered that “effect sizes and recovery rates were comparable to, or somewhat better than, those observed in previous controlled trials, and comparable to those of face-to-face routine practice CBT”.
Therefore, not only does it appear that online versions of CBT are helpful, but they seem to be as effective as traditional CBT. Whereas some people may prefer in-person therapy, those who choose CBT online need not worry about its efficacy.
Practice Management + EHR + Telehealth
Mange more in less time in your practice with TheraPlatform
Maximizing the teletherapy environment
One of the primary challenges of teletherapy is creating an environment conducive to feelings of safety and security.
The following suggestions can help make your client feel comfortable from a remote location:
- Use HIPAA-compliant video software from the best teletherapy platforms and maintain a secure internet connection to ensure data privacy and security.
- Provide access to a secure practice management platform to help your clients feel invested and aware of the therapeutic process. For example, TheraPlatform offers a HIPAA-compliant video platform with helpful accessories, including a built-in whiteboard and document sharing capabilities.
- Test your equipment to ensure it is working. Nothing threatens a client’s feelings of safety more than technological difficulties.
- Provide a well-lit, professional background that is free from distraction and encourage your clients to adopt the same.
Watch this video to find out more about launching teletherapy in your practice
Sign up for My Free Teletherapy E-Course
Delivering CBT Online
Let’s explore critical aspects of administering CBT using teletherapy:
Developing rapport through teletherapy
It can be challenging to establish client rapport when you aren’t in the same room.
Here are a few tips to help develop the therapeutic relationship online:
- Discuss tech security, video platform basics, and answer any questions to ensure the user is comfortable using the technology.
- Reviewing intake and consent forms is one of the earliest ways to build rapport with a client. Use your practice management platform to deliver documents and review them using HIPAA-approved video conferencing.
- A potential criticism of teletherapy is that the therapist may be distracted by their environment. To eliminate those questions, keep good eye contact, repeat back what is said, and use body language to show you are actively listening (e.g., head nodding).
Assessment and goal-setting using teletherapy
One of the most valuable aspects of using teletherapy platforms is the built-in resources. Many of these can aid with assessment and goal setting for CBT. For example, therapists can use a core beliefs worksheet to identify the distorted cognitions that lead to unrealistic emotions.
Additionally, many platforms have built-in screening assessments for common disorders. For instance, a therapist can find the Patient Health Questionnaire (PHQ-9) in Theraplatform’s library, send it to their client, and it will be scored automatically.
Finally, online treatment planners make creating individualized treatment plans a much less arduous process.
Psychoeducation
Educating clients about cognitive theory (thoughts→feelings→behavior) is a core aspect of CBT. The internet has a wide collection of resources and information for online therapy.
For example, therapists can teach CBT theory using whiteboards and review educational worksheets and videos with screen sharing. Plus, no therapist is needed to access books, online modules, and apps that teach CBT concepts.
Behavioral treatments using teletherapy
The other half of CBT interventions involves developing behaviors that help people deal with difficult emotions and problem situations. This behavioral work can be divided into three main concentrations: coping skills, exposure, and behavioral activation.
Coping/relaxation skills
Deep breathing, guided meditation, and grounding exercises are basic coping skills that therapists can easily administer online. Therapists can do a live demonstration via secure video or share their screen and introduce media that does it for them.
It is quite easy to find apps, audio recordings, and YouTube videos to practice coping skills between sessions, and many of them are free of charge.
Exposure work
Exposure is a necessary ingredient when addressing anxiety, obsessive-compulsive disorder (OCD), and past trauma. While you can’t perform in vivo exposure directly online, therapists can guide clients through live and imaginal exposure exercises through secure video.
Therapists can also find several guided imaginal exposure scripts on YouTube for clients to practice in between sessions.
Virtual exposure may be the best option for certain situations that are difficult to replicate (e.g., wartime violence, flying, and snake phobias). Virtual reality software can be used at home with the proper equipment.
Promoting behavioral activation
Behavioral activation is the process of engaging in activities that align clients with their values and treatment goals. These activities aim to improve mental health, often replacing maladaptive behavior.
Mental health apps and AI chatbots can provide consistent daily encouragement and motivation that traditional weekly therapy cannot match. Behavioral activation worksheets can also be shared through client portals and then reviewed using screen sharing.
Cognitive restructuring
The other main aspect of CBT is learning to develop more adaptive thinking that usually involves identifying cognitive distortions and replacing them with more realistic thoughts.
Therapists commonly use a thought record for clients to report their problematic thinking as it occurs during the week.
Thought records can be delivered through e-mail or a client portal and then reviewed using screen sharing. Clinicians can then use live secure video to role-play different responses to cognitive challenges.
Free Resources for Therapists
Click below and help yourself to peer-created resources:
Evaluating progress through teletherapy
An integral part of CBT is the ability to track behavioral and cognitive changes and adjust treatment accordingly accurately.
Therapists can use the following online techniques to gauge a client’s progress regularly:
- Homework reinforces concepts and measures client gains in specific areas. Clinicians can deliver, receive, and edit homework through practice management portals, secure e-mail, and tools like Google Docs.
- Self-report screening measures, such as the PHQ-9 and GAD-7, can be administered at regular intervals to track progress in specific areas. These can be delivered and returned online. As mentioned previously, particular applications can even score these automatically, and therapists can use screen sharing to review results.
- Discussing weekly wins and challenges via video check-ins.
- One of the top advantages of practice management software, such as TheraPlatform, is the ease with which electronic health records can be written and reviewed. Progress note and treatment plan templates make creating and revising documents as simple as possible.
Is CBT online better?
While it is premature to say that teletherapy has improved the administration of CBT, its benefits are hard to ignore. With technological advances, almost all the crucial components of CBT can now be performed online.
Advances and options for secure video conference platforms now allow nearly all essential components of CBT like structured sessions, homework review, cognitive restructuring, and skills practice to be delivered online.
This makes therapy more accessible, flexible, and convenient for clients while preserving the core effectiveness of in-person CBT.
Additionally, the internet is teeming with valuable resources and emerging technologies that make the implementation of CBT easier than ever. In particular, practice management software, such as TheraPlatform, provides almost everything a therapist needs to conduct CBT.
The use of technology always raises concerns, but as its reliability improves, it would not be surprising to find that teletherapy becomes the future gold standard for CBT delivery.
Why therapists choose TheraPlatform as their teletherapy platform
Whether for solo practice or larger clinics, therapists choose TheraPlatform for its blend of usability, flexibility, and robust telehealth tools.
Here are top reasons why therapists choose TheraPlatform for teletherapy:
- Efficiency and convenience: Everything down to payments, scheduling, documentation, and insurance claims is managed in one integrated platform, saving time and reducing friction.
- Security and compliance: TheraPlatform is fully HIPAA and PIPEDA compliant, with encrypted video sessions, secure data storage, and 24/7 monitoring for peace of mind.
- Engagement tools: Built-in interactive features like whiteboards, games, media sharing, screen annotation, and therapy-specific “apps” enhance client engagement especially useful in pediatric and speech therapy.
- Client-centered functionality: The secure client portal empowers clients to book sessions, complete forms, submit documents, and make payments, reducing admin work for the therapist.
- Customization and flexibility: Therapists can create and customize templates for notes, treatment plans, and intake forms allowing them to tailor workflows to their practice style.
- All-in-one practice management: Combines telehealth, EHR, billing, insurance, scheduling, and documentation, eliminating the need for multiple tools or software.
- Therapy-specific design: Unlike generic telehealth platforms, TheraPlatform is purpose-built for mental health, speech therapy, OT, PT, and more with features tailored to each specialty.
- Professional credibility: Recording features, branded portals, and compliance tools help therapists present a more professional, trustworthy experience to clients.
- Positive user experience: Therapists appreciate having everything in one place and often report a smoother workflow, fewer tech issues, and faster onboarding.
What therapists are saying about TheraPlatform
Therapists praise TheraPlatform for its ease of use, seamless scheduling, and built-in billing tools like superbills. They value the platform’s features including intuitive charting, customizable notes, and interactive telehealth tools as well as the responsive support team, which listens to feedback and implements updates.
Many highlight that the platform offers the best of all worlds, combining excellent video conferencing with resource sharing and an engaging, client-centered teletherapy experience.
"There's seriously no better platform out there! Easy to use … syncs to your personal schedule, provides superbills …"- Jacqueline S. (Source)
“It is not just the platform, it is the team behind TheraPlatform, always willing to help and receptive to feedback to bring updates requests to live,” Orly, Smarty Therapy PC (Source)
"The video conferencing is excellent and the ability to share resources and the interactive screen make Telehealth a rich experience."- Kathy J. (Source)
"TheraPlatform has been the best of all worlds! … intuitive charting, in-system billing, customizable notes …"-Kendrah B. (Source)
Streamline your practice with One EHR
- Scheduling
- Flexible notes
- Template library
- Billing & payments
- Insurance claims
- Client portal
- Telehealth
- E-fax
Resources
Theraplatform is an all-in-one EHR, practice management and teletherapy solution with AI-powered note taking features that allows you to focus more on patient care. With a 30-day free trial, you have the opportunity to experience Theraplatform for yourself with no credit card required. Cancel anytime. They also support different industries including mental and behavioral health therapists in group practices and solo practices.
More resources
- Top-to-bottom approach to launching teletherapy on-demand video academy
- Teletherapy worksheets
- Teletherapy blog
References
Alavi, N., Moghimi, E., Stephenson, C., Gutierrez, G., Jagayat, J., Kumar, A., Shao, Y., Miller, S., Yee, C. S., Stefatos, A., Gholamzadehmir, M., Abbaspour, Z., Shirazi, A., Gizzarelli, T., Khan, F., Patel, C., Patel, A., Yang, M., & Omrani, M. (2023). Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial. Frontiers in Psychiatry, 14, 1113956. https://doi.org/10.3389/fpsyt.2023.1113956
David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9, 4. https://doi.org/10.3389/fpsyt.2018.00004
DeSena, D., Tischler, S., Miner, K., Rimer, J. University of Michigan Medicine. Cognitive-Behavioral Therapy (CBT)Group Program for Depression: Adult Patient Manual. Behavioral activation for depression. https://medicine.umich.edu/sites/default/files/content/downloads/Behavioral-Activation-for-Depression.pdf
Moghimi, E., Stephenson, C., Agarwal, A., Nikjoo, N., Malakouti, N., Layzell, G., O'Riordan, A., Jagayat, J., Shirazi, A., Gutierrez, G., Khan, F., Patel, C., Yang, M., Omrani, M., & Alavi, N. (2023). Efficacy of an electronic cognitive behavioral therapy program delivered via the online psychotherapy tool for depression and anxiety related to the COVID-19 pandemic: Pre-post pilot study. JMIR Mental Health, 10(10), e51102. https://doi.org/10.2196/51102
Ruwaard J, Lange A, Schrieken B, Dolan CV, Emmelkamp P (2012) The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS ONE 7(7): e40089. https://doi.org/10.1371/journal.pone.0040089
FAQs about CBT Online
Can CBT be delivered effectively through telehealth?
Yes. Most core components of CBT, such as cognitive restructuring, skills training, and homework review, can be delivered online with outcomes comparable to in-person sessions.
What are the main benefits of CBT via telehealth?
Telehealth makes therapy more accessible, flexible, and convenient while reducing barriers like travel, scheduling conflicts, and stigma.
Are there any limitations to online CBT?
While highly effective, telehealth CBT may require strong internet access and adaptation for clients who struggle with technology or need hands-on support.
