Is telemental health effective – how does it measure up?

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It seems like all of a sudden, you’re seeing and hearing more and more about telemental health. Your colleagues are getting trained and embracing the new technology. They  provide online counseling and online therapy. You’re still on the fence. You’re not alone.

A good number of therapists are still unsure about the effectiveness of telemental health or teletherapy (online therapy). This skepticism is well-founded. After all, being able to connect virtually is relatively new technology and the field is still growing. Rules and practice standards are evolving. And, let’s be honest, for lots of therapists trained in the days of face-to-face, paper-and-pen notetaking sessions, this new-fangled way of delivering services can seem daunting and almost too good to be true.

So instead of taking someone’s word for it, let’s look at the facts.

A little history

Would it surprise you to know that the concept of telemental health or teletherapy (online therapy) has been around since the mid 1950’s? That’s long before the internet was even a thing.

In the mid-1950’s, Cecil Wittson, MD, used a closed-circuit television system to provide live transmissions of therapy sessions. While it was just for training purposes, the groundwork was laid. The late 1960’s saw the emergence of tele-psychiatry services mostly through links with major metropolitan medical centers.1

The Veterans Administration (VA) embraced the technology early on and continues to expand its telehealth services such as teletherapy (online therapy) and online counseling. They have been using telehealth and telemental health for 30+ years to treat the thousands of veterans needing services. This means of delivery translates into service accessibility for veterans who are geographically limited or who prefer online services.2

More recently, insurance and managed care companies have recognized the need for greater access to mental health services. Many of these companies are now allowing for the provision of some mental health services via telemental health.

Most importantly, state boards are establishing standards for the provision of services.

So, telemental health and online therapy has been around while.

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What does the research say?

The research into telemental health has consistently shown it to be an effective delivery system for mental health services. A 2013 review of the literature found that telemental health is as effective and comparable to in-person care.3  More specifically, the use and effectiveness in telemental health has been demonstrated in:

  • diagnosis and assessment (good inter-rater reliability)
  • many populations (adult, child, geriatric, and ethnic)
  • most mental health disorders
  • a variety of settings including ER’s, home health, private practice, agencies and schools
  • providing access to geographically distant clients
  • improved client satisfaction


A 2017 review of the current literature supports these earlier findings and recognizes telemental health such as online counseling as an effective solution for service delivery and is especially advantageous for geographically isolated communities.4

Some studies have even found that telemental health services may actually be preferable to in-person care in certain populations and situations. Children and adolescents and veterans in particular, seem to especially benefit from the use of telemental health. 5,6

What about the efficacy with certain diagnoses or higher-risk populations? Again, the literature seems to support the use of telemental health (online therapy). Studies have found that this means of service delivery to be effective with clients who are:

  • Hearing impaired7
  • Diagnosed with dementia8
  • At higher risk or have serious mental illness9

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There is even emerging research to suggest that telemental health services could be leveraged following a disaster.10 Imagine being able to rapidly deploy clinicians to places where getting “boots on the ground” could take days!

As you can see, there is growing research to support telemental health. This is but a small sample of the research in this rapidly expanding area of mental health.

To be sure, telemental health is NOT the be-all and end-all in the delivery of therapy. Nor is it for every client or every clinician. Clearly, there are limitations. These may be limits in terms of the presentation of a particular case. The limitations may be driven by a particular provider’s level of skill or confidence in treating certain cases online.


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As with any service or treatment modality, the most important thing is to do your due diligence. Read the literature. Make sure your training and skills meet the client’s needs. Work within your scope of practice and stay up-to-date with best practices. This will allow you to provide the best services possible for your client.

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1. Telemental Health Is Becoming the Norm. (2017, December 11). Retrieved from

2. Office of Public and Intergovernmental Affairs. (n.d.). News Releases - Office of Public and Intergovernmental Affairs. Retrieved from

3. Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The effectiveness of telemental health: a 2013 review. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 19(6), 444-454.

4. Langarizadeh, M., Tabatabaei, M. S., Tavakol, K., Naghipour, M., Rostami, A., & Moghbeli, F. (2017). Telemental Health Care, an Effective Alternative to Conventional Mental Care: a Systematic Review. Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH, 25(4), 240-246.

5. Pakyurek M. Yellowlees PM. Hilty, DM.(2010) The child and adolescent telepsychiatry consultation: Can it be a more effective clinical process for certain patients than conventional practice? Telemed J E Health. 16, 289–292.

6. Morland LA. Greene CJ. Rosen C, et al. (2009). Issues in the design of a randomized noninferiority clinical trial of telemental health psychotherapy for rural combat veterans with PTSD. Contemp Clin Trials. 30, 513–252.

7. Crowe, T. (2017, May 15). Telemental Health Services as a Targeted Intervention for Individuals who are Deaf and Hard of Hearing. Retrieved from

8. Moussa, Y., Mahdanian, A. A., Yu, C., Segal, M., Looper, K. J., Vahia, I. V., & Rej, S. (2017). Mobile Health Technology in Late-Life Mental Illness: A Focused Literature Review. The American Journal of Geriatric Psychiatry25(8), 865-872.

9. Pratt, S. I., Naslund, J. A., Wolfe, R. S., Santos, M., & Bartels, S. J. (2014). Automated telehealth for managing psychiatric instability in people with serious mental illness. Journal of Mental Health, 24(5), 261-265.

10. Augusterfer, E. F., Mollica, R. F., & Lavelle, J. (2018). Leveraging Technology in Post-Disaster Settings: the Role of Digital Health/Telemental Health. Current Psychiatry Reports20(10).

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