What to know before you try online therapy

If you want help dealing with depression or anxiety, but don't have the time or money for traditional counseling or psychotherapy, a number of startups now offer a high-tech alternative. Sign up for one of these sites and you can reach out and communicate with a counselor via Internet, phone or text messages.

Several small studies have found the approach shows promise for certain patients.

Research published in the Cochrane Database of Systematic Reviews in March found that therapist-supported cognitive behavior therapy (CBT) delivered over the Internet appears to be an effective treatment option for anxiety in adults. Another review published in 2014 found that telephone or online counseling could help people with depression return to work sooner. And therapy delivered online or over the phone was even found to help reduce chronic pain in a small study of children and adolescents. In all of these cases, the researchers stressed that further study is needed.

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Abagail gets counseling via phone and Internet.
CBS News

Some clients say online therapy suits their needs. "There's very little financial risk to do it," said Abagail, a New York City actress who did not want to give her last name. She decided to try once-a-week phone sessions combined with some online assignments to help cope with her social anxiety and stage fright.

She's been pleased with the results. "The way I feel about my career and my social interaction in general is completely different," she said.

While online therapy may benefit people in some situations, experts warn it's not right for everyone -- and not all programs are created equal.

Some services, like Talkspace and Breakthrough, use licensed therapists. Others, like Joyable or 7 Cups of Tea, use coaches or trained listeners, and that has some mental health experts concerned.

"The potential harm is if patients start to think of coaches as mental health providers or start avoid seeing potential mental health providers because they're seeing a coach," Dr. Elias Aboujaoude, a psychiatrist in Stanford, California, told CBS News.

Peter Shalek, the co-founder and CEO of Joyable, says the coaches on his site use proven cognitive behavior therapy techniques to help clients deal with anxiety. "By having a solution that is technological, where people have an optional phone call, where they can interact only by email and text if they choose, it's a better fit for many people," Shalek said.

It is important to note that these services are not intended for people with severe mental illness, who should seek treatment from medical professionals in person.