FREE MENTAL HEALTH ASSESSMENT. start here
Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
It seems everyone is texting these days. Even grandparents seem to know how to text, send emojis and sometimes bitmojis.
But texting is also becoming a norm in healthcare, with text reminders, text surveys and now, text therapy.
Text therapy can be an easy, affordable therapy choice, or just one part of multiple options for therapy.
Read on to learn more about what text-based therapy looks like to determine if it’s a good fit for you.
Text therapy is much like it sounds: Unlike traditional therapy alone, during which you’d meet and talk with a therapist, text therapy involves written messages in the form of texts.
Text therapy works by having you and a certified mental health professional exchange messages.
For example, this could mean texting about your life, questions or any specific therapy goals you might have.
You can obtain text therapy as a service through an online therapy platform and in conjunction with other forms of online services (like video therapy sessions and phone calls).
It’s important to note that there is currently no research suggesting that texting alone is an effective modality for psychotherapy.
This means that you and your healthcare provider should consider whether text therapy may be best used in conjunction with other mental health services, vs. as a standalone treatment.
Pricing varies based on the approach and may be more expensive if it’s part of other services.
To start text therapy, you’ll fill out a detailed assessment about the support you are looking for or issues you want to address. This is typically used to match you with a therapist who can help you.
With many text therapy platforms, you may be automatically matched to a professional, as opposed to getting to select one you think is best — which may be a downside. However, you can usually change professionals if it’s not a good fit.
Texting takes place either synchronously, meaning it almost mimics a live chat, as you and your therapist are texting at the same time, or you can text asynchronously, meaning you and your therapist simply text back when it works for you both.,
A common benefit of text therapy is that you’re ensured a response within a certain amount of time — typically within a few hours or a day. You may also be able to have access to unlimited texting depending on the therapy provider.
To determine if text-based therapy is a good fit for you, you’ll want to consider the potential benefits and challenges that may come with text therapy.
When it comes to the benefits of text therapy, there are plenty that may actually present an edge over traditional in-person therapy.
Are you someone who has always considered or wanted therapy but hasn’t found the time to go? Texting could be an easy way to start.
If you feel hesitant about going to a full session or finding a therapist, texting a therapist might be a good place to start.
This way, you can see what potential questions you have, establish your therapy goals (whether that’s stress management, relationship concerns or something else) and see how a therapist would support you and if that’s helpful for you.
Text therapy can be easier to fit into a busy schedule.
If work is super busy, you are traveling a lot, or you just don’t have time for a weekly session, texting a therapist may be an easy way to get support when you need it.
Do you ever wonder if you are more truthful over text?
A study by the University of Michigan found that people are less likely to lie over text. 4
For therapy, telling the truth is super important! Research shows being open and honest with your therapist allows them to better support you.
You may just find that writing out text responses keeps you more truthful. You can think of it as an active journal, which may have its own mental health benefits.
In comparison to in-person sessions and sometimes even video chats, text therapy can be an affordable option overall.
Of course, the price will vary, depending on what your therapy plan is and whether or not the service you’re using accepts health insurance.
Generally speaking, text therapy is often a less expensive virtual-therapy option.
As convenient as text therapy sounds, it’s not without some challenges. Some of the downsides may include:
One of the challenges of text therapy can be its sporadic nature.
You may have to wait for a response, which means that if you’re seeking an immediate response or want to mimic the feel of an individual session, text therapy may not provide you with exactly that.
You could ask about a live text therapy session to avoid inconsistency, so you are both online.
Given that in-text therapy is written, this naturally will require reading and writing.
Although texting can offer a quick and casual tone, you’re still likely to spend time drafting messages and reading your therapist’s responses.
This is definitely something to consider if you find that you’re not a “texter,” or if you have a hard time communicating in a written form.
Likewise, reading and interpreting a text can be challenging.
Depending on your therapy goals, text therapy may not be the best way to achieve them.
Some mental health conditions such as bipolar issues, schizophrenia, PTSD or other specific conditions are outlined by many health therapy platforms as not being a best fit for online-only therapy formats.
These conditions may require specific behavioral therapy, treatment therapy, somatic therapy and more.
One study showed that text therapy could be a good tool in addition to other therapeutic methods for schizophrenia.
Another study found that those who seek online therapy may be more likely to seek in-person help, too.
Although there is extensive research on the benefits of therapy, text therapy is a newer area of mental health treatment, and as mentioned above, hasn’t yet been studied much.
Therefore, the library of research available proving the efficacy of text-based therapy is unfortunately still limited.
It’s still unclear exactly how impactful text therapy can be for the general population, although initial study results look promising, and show some mental health benefits.
One reason text therapy may be a good fit is that it’s a relatively affordable treatment choice.
Many platforms offer low-cost subscription models ranging from $240 to $360 a month for text therapy.
Many online therapy providers accept health insurance policies. However, the specifics of what your plan might cover and/or how much of the text therapy service will be covered depends on your health insurance plan.
You’ll want to call your health insurance provider and ask about mental health options and online therapy services so you know what’s covered.
The good news is if text therapy doesn’t seem like a good fit, there are many alternative options out there. In addition, access to therapy doesn’t have to be limited to one medium and can include digital therapy options and traditional in-person talk therapy sessions.
Also via phone, teletherapy comprises live sessions with a certified mental health professional over the phone.
Teletherapy options are plentiful, include online platforms and involve counseling from individual mental health professionals.
Benefits: Want to go for a walk while going to therapy? With a teletherapy phone session, you can multitask and take the call from anywhere.
Challenges: The cost is likely similar to a video or in-person session, but you don’t get to see your therapist’s body language. (They also can’t see yours.)
Video therapy has expanded exponentially in the last couple years (particularly with the COVID-19 pandemic), with more than three-quarters of mental health professionals offering some virtual option.
With individual therapists, online health platforms and apps, you have multiple options for finding a video therapist.
In addition, many health insurance providers have started offering more mental health benefits that may include video sessions or coverage for them.
If you are using an online platform, the service will likely ask a series of detailed questions to help better match you with your new therapist.
Sessions are held via video chat, so you can get that similar feeling of sitting with a therapist, getting immediate visual feedback from each other.
Benefits: Video can be a safe and easy option to get that feeling of in-person therapy, and you and your therapist can have immediate visual and verbal feedback for one another — from the privacy of your home.
Challenges: The cost can sometimes be similar to an in-person session. Although many therapists offer a digital option, some may prefer treating patients in person.
Group therapy is typically held in person (although there are some easy-to-access online video options as well) with usually five to 10 other individuals.
Group therapy is often targeted toward a specific set of challenges or ways to treat them. For example, common group therapy options and topics include behavioral issues, relationship education or support.
There is usually one group facilitator during group therapy sessions, and every individual gets a chance to speak for a limited amount of time.
Benefits: Group therapy is a cost-effective option that allows you to meet a community of other people facing similar challenges.
Challenges: Speaking up in a group requires talking about your vulnerabilities in front of others, and you get less one-on-one attention from a therapist.
Historically one of the oldest forms of therapy, talk therapy — also known as psychotherapy — is probably what most people imagine when they think of therapy.
These sessions involve meeting with a mental health professional in person, and typically at the therapist’s office.
Meeting in person allows you to build a relationship with your therapist. In addition, in-person sessions enable and allow you and your therapist to not just pick up on verbal cues, but body language and facial expressions as well.
Benefits: There are tons of studies on how beneficial in-person therapy can be.
If you find meeting people in person establishes more of a connection, this might also be better for you vs. text therapy, from a therapeutic relationship sense.
Challenges: In-person sessions are typically the most expensive therapy option, and you’ll also need to mind scheduling considerations. There are ways to find affordable therapy sessions, however.
It’s likely researchers will learn more about text therapy and how it may benefit people in time. For now, you can take the above information and decide whether or not text therapy might be a good fit for you.
You might love it because you're busy, or perhaps you like the idea of having a therapist on hand for whenever the moment hits you.
Or maybe you’re seeking a more intimate setting where you can read your therapist’s body language — in which case an online video session might be right for you.
A good place to start would be with a consultation with your healthcare provider. You can also learn more about therapy online, and find a wealth of mental health resources and information.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
Start your mental wellness journey today.