Video Therapy Vs Text Therapy – What’s the Difference?

Dr. Pat Brawley
Updated on February 15th, 2024

Online therapy is becoming more popular than ever. It has many appealing benefits over traditional, in-person counseling, such as flexibility and convenience, since you can have your sessions at any time, from the comfort of your home.

If you are considering online counseling, you should know that there are different types of online counseling, with the most popular ones being video therapy and text therapy. Below, we’ll discuss these two types and focus on the differences between them, so you can opt for the most suitable one for your needs and preferences. 

What Is Video Therapy?

Online counseling means scheduling and attending face-to-face sessions with a licensed therapist. It is, in many ways, very similar to in-person counseling, the difference being that you don’t need to commute to their office. Instead, at the time of the session, you will join a video call via your preferred device. 

What Is Text Therapy?

Online text therapy is very different from online video therapy. It refers to connecting to a chat where you can text your therapist. There are a few platforms that provide live chats – so you have a scheduled session with your therapist and they answer in real-time. A more popular option is asynchronous messaging; essentially, you can message your specialist 24/7 and they will reply whenever they have time (usually once or twice per day). 

While video therapy and in-person counseling are very similar, text-based therapy is quite different because of this possible time lag in communication and lack of visual cues. 

Benefits and Drawbacks of Video Therapy

When taking part in video counseling, the experience is very similar to in-person counseling. Essentially, you will be face-to-face with your online video therapist and the session is conducted in real-time. These video sessions are secure and often based on the platforms you choose for e-counseling. 

One of the main advantages of online video therapy is that it is a highly efficient option for many individuals who cannot or prefer not to attend in-person sessions. For instance, if you are a busy individual and you find it difficult to go to the office, this type of e-counseling brings you the same benefits while saving time commuting to and from the office. It is also a viable option for people with mobility issues, busy parents with kids, and mental health illnesses like severe social anxiety, agoraphobia, and many more. 

In addition to this, video conferencing allows you some distance – if you find it difficult to go to a stranger’s office and open up about your feelings, video counseling means you can stay in the safety of your home instead, which may be a great benefit for some. 

It is very important to note that online counseling has been researched in the few years. A meta-analysis of no less than 452 studies concluded that patients were as satisfied with teletherapy as with in-person sessions. The same results were highlighted by a 2020 study, mostly focused on depression and post-traumatic stress disorder. 

One main drawback of this type of e-counseling (compared to both in-person and asynchronous text counseling) is that it is highly reliant on your internet connection. Most likely, if you cannot stream a movie, you won’t be able to have a video session either. This is not a major problem in the case of asynchronous text messaging – as you do not have a tight window for communicating with your therapist. 

In addition to this, if you are choosing e-counseling because you find it difficult to meet with a stranger or you suffer from issues like social anxiety, this type of counseling may still make you feel uneasy as you still have to connect to your specialist, and have a face-to-face discussion. 

Benefits and Drawbacks of Text Therapy

Online text therapy is less personal than video therapy. Usually, depending on the platform and subscription plan you choose, you have several options:

  • Asynchronous, 24/7 messaging 
  • Live chat
  • Combination of texting a therapist and face-to-face teletherapy sessions

Text-based therapy is a great way to receive the help you need if you suffer from agoraphobia, social anxiety, and other issues that make you feel uneasy in a social situation. For many people, text counseling can be a much calmer experience. 

In the case of asynchronous texting, you can discuss with your specialist at any time, tell them your problems as they happen in real-time, and you will always have a history of all the advice and help you receive, so you don’t have to worry about forgetting previous sessions. 

Hence, text counseling may be beneficial for some people, especially those who do not have very severe symptoms. It can be a quick and easy way to discuss your experiences and feelings with a professional.

Related to research, unfortunately, not many studies have been conducted on text counseling alone – at least compared to those conducted on online (video) counseling. 

Current studies’ methodologies are also sometimes poorly designed. For instance, this study showed that the patients managed to form a strong relationship with their specialists while communicating via email (which is just like asynchronous texting). However, the study only included only 55 individuals and no control group. 

While research is still in its infancy, texting a therapist may be worth a try if you have no severe symptoms. Perhaps one of the main benefits is convenience. You can text your therapist at virtually any time, whenever you need it. There’s no need to schedule fixed appointments with asynchronous texting. 

Availability is a huge issue with some therapists, even when opting for e-counseling. With text-based therapy, your counselor will reach back to you whenever they are available – typically once per day or so. 

Another advantage is that, for some people, it may be easier to open up when texting than during a face-to-face video call. In fact, evidence indicates that writing in itself helps you to improve your mood, relieve your stress, track your symptoms every day, and help you identify negative thoughts and behaviors. Hence, only writing to your therapist in itself can make you feel better, even before they reach out to you. 

While the number of online counseling sessions is limited, texting is not. Depending on the chosen platform, you will most likely have to opt for a subscription that includes 2-4 video sessions per month. This means you need to be well-organized and cover all the necessary topics during your short meetings with your specialist. On the other hand, texting is usually unlimited. 

While it does come with some advantages, text therapy also has some drawbacks, apart from the lack of research on its efficiency. For instance, texting with your specialist can feel very impersonal, which means that it may take a while for you to develop a relationship with them. 

Also, since all the body language is missing, your therapist will have a harder time understanding your problems. Your communication skills should be very sharp in order to avoid miscommunication when texting your therapist. 

Another major drawback is the delayed response. Unless you opt for live chat – which will be limited to a few sessions just like video counseling -, your specialist will get to you whenever they are available. Hence, texting a therapist is not a good option for emergencies or severe symptoms. The other side of the coin is that you can reach out whenever you want. 

Video Therapy vs Text Therapy – Which One Is Best for You?

Overall, video therapy and texting a therapist are very different. The best choice depends on your issue and your preference. For instance, if you have reasons not to go for face-to-face sessions via video calling, texting is the next best option. 

If you have a chaotic schedule and cannot stick to fixed appointments, texting allows you to contact your specialist at literally any time – although they will reply to you with a delay. It is usually less costly (but often not included in insurance plans) than face-to-face e-counseling, so it could be an affordable way to try out therapy if you are still unsure which one you prefer. 

Texting a therapist is a life-saving experience for many people. If it makes you feel better about therapy, it’s best to try it out – an asynchronous connection to a specialist is always better than no connection whatsoever. For some people, features like impersonal and delayed nature are why texting is more helpful than video sessions. 

However, if you don’t have a strong reason for opting for texting, face-to-face e-counseling may still be a better fit. One main reason is that current research indicates it is as efficient as in-person counseling but has added benefits such as flexibility and convenience. 

It’s worth noting that many platforms offer subscription plans with a few video sessions and 24/7, unlimited texting in between. This could be a highly convenient combination – you can discuss pressing matters with your specialist during the video sessions, and also keep in touch with them outside the sessions via texting, reaping the benefits of both types of e-therapy. 

Top Platforms for Video and Text Therapy 

  1. Calmerry 

Calmerry is perhaps the top platform if you are considering text therapy. It is also one of the most accessible options for virtual therapy sessions, too. Essentially, you will get access to messaging with the ability to add video sessions if you wish. Calmerry provides non-stop but asynchronous messaging, so you will have to wait until your therapist gets back to you. 

Calmerry offers broad services and helps to treat many issues, including depression and anxiety, eating or sleeping disorders, relationship problems, anger management, and many others. If you’d like to know more about what Calmerry provides, check out this in-depth review of its services, pricing, and more. 

  1. BetterHelp 

BetterHelp is one of the most popular online therapy platforms right now. It supports video, phone, and messaging sessions. One of the main advantages would be the possibility to opt for a live chat instead of asynchronous messaging. Phone sessions are also a good compromise between the anonymity of text sessions and the auditory feedback received via video sessions, so you could also try out this option. 

BetterHelp has thousands of specialists licensed in all US states. One of the main drawbacks of using the platform is that, although the subscription plan shows you weekly rates, you will actually be billed monthly. To find out more about the platform’s advantages and disadvantages, you may want to check out this BetterHelp review

  1. Talkspace 

Talkspace is one of the oldest platforms in this industry as it was founded in 2012. It has multiple subscription plans available, but only the more expensive ones include video calling. Other than that, you can still text your specialist at any time, but they usually reply only once per day, within working hours. 

On the good side, Talkspace’s specialists can also cover medication management. While it is generally seen as more expensive than other mental health platforms, some insurance packages will cover the Talkspace therapy cost, unlike other platforms, apart from Medicare and Medicaid. To find out how it works and how to start with Talkspace, you can check out this review

Bottom Line

Video and text therapy have their own advantages and disadvantages. Perhaps one of the main differences between the two is the cost – texting a therapist will always be cheaper than a subscription plan that also includes live video sessions. If you are unsure if e-counseling is right for you, starting with just messaging is an affordable way to try it out. 

If you prefer a more personal experience, receive auditory feedback, and like talking about your issues, video therapy is what you need. However, if you are good at writing, prefer writing rather than speaking, or face-to-face interactions make you feel uneasy, texting enables you to get the help you need without the discomfort. 

If unsure which one is best, you can opt for the hybrid alternative – a subscription with video therapy and unlimited texting. Most platforms nowadays offer this option and, to see what alternatives you have, you can also check out this comparison of the best platforms.

Dr. Pat Brawley
Dr. Pat Brawley

I have a Master of Science degree in Counseling Psychology and a Ph.D. in Psychology. I am a licensed professional counselor in private practice. In addition to individual and group therapy, I consult with physicians, attorneys, professionals, and athletes.

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