Text counseling lets you access a mental health provider via messages. Unlike in traditional therapy, you don’t need to wait until a specific appointment time. It can be helpful, but it has some drawbacks.
You probably use your smartphone for a lot of things: keeping in touch with friends, ordering food and groceries, and maybe even reading articles like this one.
But what about accessing therapy?
Text therapy has enjoyed a rising level of popularity in recent years, particularly due to the physical distancing guidelines still in place during the COVID-19 pandemic. Since then, more and more people have started using their phones to reach out for support.
You’ve most likely noticed an ad or two yourself on your social media feeds or while browsing the internet.
Perhaps you’ve considered giving text therapy a try, but you might wonder exactly how it works. Can texting a therapist really be that easy… or that helpful?
We’ve got answers to those questions and more.
The following are a few popular providers of text therapy. Click on a link to read our reviews.
Is there a way to text a therapist for free?
There is an option to text a counselor for free through the Crisis Text Line. However, this is more appropriate for help in an immediate mental health crisis and isn’t a replacement for ongoing therapy.
Preliminary research has shown that text therapy can be an effective way to get mental health support:
2020 studyhas found that people living with anxiety or depression experienced fewer symptoms after undergoing text-based therapy.
2022 studyfound text therapy may be as effective in reducing symptoms of post-traumatic stress disorder (PTSD) as more traditional therapy.
2022 studyfound that text therapy may be able to help reduce thoughts of suicide.
2017 studyfound that using text therapy may help participants keep up with helpful practices from cognitive behavioral therapy.
Text therapy services generally operate as follows:
- You’ll typically begin by answering questions that help the service match you with a therapist who can offer the kind of support you need. Whether you have the option to select your own therapist may depend on the service you use.
- Once you have a therapist, you can start sending messages detailing what you want to work through. Most text therapy services offer unlimited text messaging. Some also offer audio and video chat, though these services might cost a little more.
- You can text your therapist anytime. They may not reply immediately, especially if you text late at night or in the small hours of the morning, but you can usually expect a response within a day.
- You can also request a “live text” session when you exchange texts with your therapist in real-time. This lets you bring up issues whenever they’re on your mind.
Like in-person therapy, text therapy offers privacy.
The app may collect information or data (always read privacy policies and terms of service), but your chat with your therapist is secure and won’t reveal any identifying details.
So, you’re safe to open up about personal issues and share anything you want.
Your therapist will help support you by exploring the issue and identifying ways to cope.
The cost of text therapy can vary depending on the platform you use and the additional services it includes. But you’ll usually pay less than you would for in-person therapy.
Some platforms charge a weekly rate but bill monthly, so be sure you know how much the service will charge you and when.
The cost of in-person therapy can really vary from state to state, but therapists may charge between $75-$99, according to the American Association for Marriage and Family Therapy (AAMFT).
Many insurance plans do cover some costs associated with mental health treatment, but this will usually only include in-person therapy, according to the American Psychological Association (APA).
Some insurance companies might cover the cost of text therapy or other web-based therapy services, but they often don’t or won’t reimburse you for the costs.
If you plan to use your insurance to pay for therapy, it’s best to check with your insurance provider first to see whether they’ll cover text therapy or offer at least partial reimbursement.
Keep in mind, though, that if you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you may be able to use it to pay for text therapy.
While text therapy may not work well for everyone, it does offer some benefits that make it an effective approach for many people.
You might feel more at ease
Text therapy may help some people with certain mental health conditions reduce their symptoms and even enter remission in some cases. According to a
It might be effective for some people who find online interactions less stressful than face-to-face interactions.
It’s fairly inexpensive
Therapy isn’t cheap, especially if you’re paying out of pocket. The costs can quickly add up if you see a therapist weekly.
But even if you pay for text therapy yourself, depending on your choice of provider, you may pay less each month than if you saw a therapist in person. If you don’t have insurance, text therapy might be affordable.
It can help you manage temporary or minor distress
Temporary life challenges can still cause a lot of pain. Talking to a therapist, even over text, can help you sort through your emotions and get guidance on the next steps.
It lets you connect even if you can’t get out
Everyone who wants help can access text therapy regardless of their location. Text therapy can also help you access a wider pool of professionals.
In spite of its benefits, especially for people who have trouble getting to a local therapist, experts generally agree text therapy is far from perfect.
Before you sign up, consider these potential downsides.
It can lack a professional, therapeutic relationship
Therapists have a specific role. They can become an important person in your life, but they provide a specific service that you pay for. They aren’t your friend, partner, or part of your day-to-day routine.
By communicating with a therapist through text messaging, your relationship might feel less professional. This casualness could detract from the goal of therapy, especially in a text format.
Not all platforms are completely secure
Before you sign up for a text therapy service, make sure it’s private and secure and verify the therapist’s credentials. Even well-protected web applications can sometimes face security breaches or data leaks, so this is an important risk to consider.
The app you choose should at least offer a baseline level of privacy: compliance with HIPAA (the Health Insurance Portability and Accountability Act) and identity verification (both your identity and that of your therapist).
There’s often a delay between messages
Most of the time, you and your therapist won’t text back and forth at the same time. Their schedule may only allow them to reply once or twice a day. This can feel frustrating when you need support at the moment.
Text messages can’t convey tone or body language
Tone doesn’t always come across clearly in written formats, and body language doesn’t come through at all. That’s one main drawback of text therapy since the tone of voice and body language carry a lot of weight in communication.
That said, text can make it easier to put difficult feelings into words, especially if the topic is one you struggle to discuss openly.
It requires a lot of reading and writing
Needless to say, therapy through text means you have to write a lot. Some of your messages can get pretty long. Putting difficult emotions into words usually takes more than a few sentences.
If you don’t find it easy to communicate in writing, this format might exhaust you pretty quickly.
It may not work for treating serious mental health symptoms
Text therapy might work best for temporary or mild crises and distress. This might include things like:
- mild stress or anxiety symptoms
- problems with friends or family
- relationship issues
- life changes
The therapy platform you’re considering may have more information on what issues they can best help you with. A crisis text line can offer some immediate support.
If you’re facing challenges, getting the support that works is what matters. Text therapy helps many people, and it could make a difference for you, too.
But if you find it challenging to connect with your therapist, you may not notice much change. If you fail to see any improvements with text therapy, it may be time to consider other approaches, such as video counseling or in-person therapy.
Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease the stigma around mental health issues.