Over eighty percent of people who have the symptoms of depression do not seek treatment or therapy, for reasons like time commitment, social stigma, or the cost.(Healthline) Using the changing technology of the world today, therapy can be accessible to many people who don't have the resources required for face-to-face therapy. The goal of this paper is to demonstrate how technology can be used effectively in therapy to expand and better patient care, without compromising mental health or ethics. Traditional, face to face therapy focuses on the therapist interpreting the patient’s input, online therapy can be more patient focused and driven. A patient exploring his or her mental issues and the reasons behind the decision to start therapy is also useful information for the therapist. (Arthur) While both traditional and technology based therapy can help improve a person's mental state, the constant availability and contact with a therapist can make technology based therapy a better option.

Now, in the twenty-first century, most people check and use their phone multiple times throughout the day. Smartphones allow people with busy schedules to use therapy that isn’t in real time, like through texting or emailing. For example, a person could compose an email to their therapist while on their lunch break, and receive a response later in the day. This is perfect for those who don’t have the time to commit to an hour every week and driving to an office and back. Usually this type of therapy is through a company and requires payment. Sites like In Your Corner do online therapy by having a therapist read journal entries and type up two page long responses or even video calls. (Arthur) Other sites, like Talkspace, allow someone to text or email their therapist an unlimited number of times in a given time period. One benefit to written forms of therapy is that the patient can choose how they wish to present their issue, proofread, and focus on something specific. However, some therapists feel that seeing the facial expressions, body language, and tone of the patient is beneficial. (Burgo) A therapist with those opinions could use Skype or telephone, as Joseph Burgo wrote in The Atlantic. In an interview with NPR, Lauren Kay described how she uses Skype with her therapist because she found it difficult to take off from work. (Singh) Some therapists chose to continue working with a patient over Skype after a far move. This option makes sense for those who have developed a personal and trusting relationship with a therapist, and brings the best parts of each form of therapy together.

Another reason that accessibility can make online therapy a excellent option is because even homeless, poverty-stricken, or unemployed people can have access to computers through libraries and shelters. People who are less fortunate might have even more reason and need to vent to someone, and free therapy sites are very useful for this. It also allows people who are less fortunate to access free therapy online, whereas in the past they would have no options. Also, people who do not have transportation or are disabled can still access a form of therapy. Sites like Vent and 7Cups of Tea are free and provide emotional support and a place to speak freely about their emotions, which is far better than no therapy or way to express themselves. These sites are resources that are not intended to be used as a suicide hotline, but rather as a way to destress at the end of the day. This is also a great way to create a safe space for teens who might need more support than that of friends.

Another new form of technology, smartphone apps, are paving the way for online therapy and the trend of “mindfulness”. One component of the typical online therapy app is mood mapping, which is when people answer questions throughout the day about their mood and energy level. It is correlated and graphed with the time, place, and activity the person did when they answered. (Morris) In a study by Dr. Margaret Morris, patients used a graph to show how high or low both their energy and mood was. By mapping their mood, patients knew what triggered their stress/depression and could begin to change it. One man in the study was able to use a combination of mood mapping and breathing exercises on the app to reduce stress from a 0.37 to 0.04 on the Behrens-Fisher t-test. (Morris) A woman in the study used mood tracking to prioritize her day. She realized that she was stressed about many small events in her day, and used that knowledge to help her calm down. Her anxiety lessened from a 3.06 to a 1.37 on the Behrens-Fisher t-test. (Morris)This type of therapy could be used alongside a therapist, or it could be used on its own for the average person to organize their thoughts.

Online therapy with a therapist has been proven to be very effective as well. In a study by Dr. Brigit Wagner, a group of sixty-two patients suffering from depression were split into two groups: online therapy and face-to-face therapy. (Wagner) The two groups used the same course of treatment and modules. (Wagner) Immediately after the eight week program ended, the two groups showed very similar rates of depression. (Wagner) However, three months later, the researchers checked back in with the participants and found that the group using online therapy had far fewer relapses and a far lesser rate of depression. (Wagner) This study along with Dr. Morris’s cements the fact that online therapy is a worthy alternative to the traditional face-to-face therapy.

Another reason the apps can be useful is their appeal to teens. Teens are the age group that spends the most time on their phones, and using an app is both fun and helpful. Since teens are on their phones frequently, they can update often to determine precisely what starts feelings or depression or anxiety in their day. Also, an app is less conspicuous, which can help prevent stigma against mental illness and may make it feel more like a game or social media site. One example of a current app is Mobile Mood diary. It is an app created by Gavin Doherty and Mark Matthews that collects data on the user’s mood, energy patterns, activities, and sleep. (Trudeau) It allows the therapist to have access to a more complete view of the patient’s day, and know all the various possible causes of the patient’s issues. According to a therapist piloting the app, Alan Delahunty, teens enjoy using the app and are more likely to fill out data throughout the day. (Trudeau) An example of positive social media is the 100 happy days challenge, which encourages people to find something positive about every day. Other positive social media is the publicity surrounding the app Vent. It is similar to social media in that you can “follow” people, but it promotes mental healthcare. Updating their “feed”, Vent allows users to chose from a range of emotions and type up a short description of why they feel it. Then, other users can interact by choosing from a range of emotions as a reaction, commenting, or liking. These apps begin to combine the social and attention seeking aspects of current social media with the beneficial effects of good mental health care instead of bottling emotions up.

The main reason that people choose online therapy besides accessibility is its cost-effectiveness. There are two types of online therapy: those that are free and those requiring payment. Free sites are typically less reputable and one isn’t as close with any specific therapist. Instead, one might rotate through or just talk to another person in a similar situation. In some cases, free online therapy could just be an unpaid volunteer or “life coach”.However, these sites are great for those who don’t have funds or who want to remain completely anonymous. A few examples are Vent and 7 Cups of Tea. Sites that require payment are more reputable and have registered, qualified therapists. Online therapy charges $29.95 per week, for daily communication and feedback on worksheets. Talkspace charges $25 per week for unlimited texting with a therapist, or $29 for a 30 min video session. In Your Corner charges $50 per 30 min video chat. Blah Therapy offers a combination, with $25 to speak with a therapist, and a free option to speak with a listener. A good part of online therapy is that you can shop around for a site that deals with your specific issue, as well as your preferred price range and format.

Some therapists still believe that online therapy cannot work as well as traditional face-to-face therapy because the therapist cannot develop as close a relationship with the patient. However, in  interviews with Ms. Arthur, creator and CEO of In Your Corner, and Dr. Morris, developer of Mobile Therapy, discussed how far therapists are comfortable taking online therapy. Arthur emphasized that online therapy is best for people who want therapy, not those who need She described how the accessibility and privacy of online therapy made her interested in starting her own company. They both said that online therapy should not be thought of as a suicide hotline or last alternative, but rather as a way to build a relationship like in face-to-face therapy. Arthur said that she did not believe that online therapy could completely replace face-to-face both because some people will always prefer it and that people with issues requiring more attention or medication will need to see a therapist in person in their state.

Technology based and online therapy may not be for everyone, but it can help people who are struggling with an issue and don't know how to talk about it. Accessibility for teens, affordability for those struggling with poverty, and ways to track your mood for better mental health are all positive components to online therapy. Depending on one’s mental health issues and personality, online therapy could work out better or worse, but it is certainly better than no therapy or way to vent. Online therapy is a valuable resource for people who can’t use face-to-face therapy or simply prefer the method, and will become more prevalent.