The Online Therapy Unit shows the advantages of emailing your therapist

Accessibility has always been one of the benefits of online therapy, enabling people to connect with therapists wherever they are. A pioneer of online therapy is the University of Regina’s Online Therapy Unit, led by Dr. Heather Hadjistavropoulos.

The Online Therapy Unit began in 2010 with funding from CIHR and has been assessing the effectiveness and best practices of internet cognitive behavioural therapy (I-CBT) ever since.

“We’re especially interested in studying how to take what you normally do in face-to-face treatment and putting it online effectively,” says Dr. Hadjistavropoulos. “Another goal is to determine how to personalize the I-CBT approach and when tailoring it to the client is most effective.”

About 10 million Canadians report having poor or fair mental health, and about 1 in 3 of those Canadians report not having their mental health needs met. That means there is a large gap that accessible, online therapy can help fill.

Perhaps uniquely in our post-COVID world of Zoom, Teams, and FaceTime, the Online Therapy Unit maintains an email-first approach, with therapists and clients emailing each other and occasionally calling each other rather than meeting online.

The Online Therapy Unit has found numerous benefits to email conversations with a therapist. In addition to being convenient and offering another option for obtaining care, it gives clients the ability to collect their thoughts and to look back on them. “Clients get clarity, benefit, and emotional expression from writing,” says Dr. Hadjistavropoulos. “It also provides a written record for the client to review. For the therapist, when you get an email from a client you can organize your thoughts and respond to them in a clear and efficient way that can get lost in an emotionally charged conversation.”

“It’s a very different type of conversation,” says Dr. Hadjistavropoulos. “We think it’s really helpful for clients to learn this process of reading and thinking about their mental health. The clients report high satisfaction with the approach and the ability to form an alliance with their therapist in this way, as well as gain insight and make changes to their mental health.”

The email-first approach has shown positive results, including “large improvements in depression and anxiety, panic, social anxiety, PTSD, reduction in alcohol consumption, improved sleep, reduced physician visits, and improved quality of life,” reports Dr. Hadjistavropoulos.

At a glance

Issue

Millions of Canadians are in therapy or looking for access to it, but not everyone can make it into a therapist’s office or wants to. Finding easy, accessible alternatives to in-person therapy is therefore a growing interest in Canada.

Research

The University of Regina’s Online Therapy Unit has been offering online cognitive-behavioural therapy since 2010. Alongside offering therapy services, the Unit has narrowed down best practices in online therapy, including using email and offering standardized approaches.