Addiction is a dysfunction in the brain system between reward, memory, and motivation. We often think of addiction being substance-related, like smoking, but this isn’t always the case. It can be a lack of self-control in other areas of life, like gambling our money away or spending too long on video games.
Cognitive Behavioral Therapy (CBT) is one of many therapy techniques that has proven to be effective for treating addiction, along with group and abstinence-based recovery methods. Over the past few years, these therapy techniques have become available online.
This article explores these companies, what they offer, and what advantages each one possesses. Addiction has become one of the main drivers of seeking therapy online, and it’s proven time and time again that online therapy is just as effective as traditional face-to-face therapy.
Substance abuse affects almost half of all U.S. families, with all demographics being affected; from male churchgoers to female college grads. The issue with current research is that most polls are looking for substance abuse, thus ignoring the millions of other addiction sufferers, be it pornography or the 2+ million forgotten gambling addicts.
It’s understandable that the focus is on substance abuse, because there are immediate medical risks. Opioids and pain relievers are rife all around the world and are on the rise in many places.
Some other addictions are harder to spot, though. Family members may not be aware of more seemingly benign addictions at first, but they can quickly tear a family apart. Untreated addictions of any kind can skew our dopamine and reward system, making it difficult to be productive or peaceful in many other areas of life, like work.
Evidently, the only way out is often intervention. Those that were going (or would have eventually gone to) traditional therapy like Alcoholics Anonymous or face-to-face meetings have been increasingly migrating online. Some of this was enforced due to the pandemic, where group meetings were made unviable, but others simply live in rural areas or do not have the time or money.
Often, it is pushed by family members, but for those with more private addictions, finding therapy themselves is all the more important. And, this is where online therapy really took off, with its relentless influencer marketing campaigns and social media adverts. Online shopping addiction therapy among many others have cropped up due to this demand.
Online therapy is the only choice for some, because it’s cheaper and more accessible. But for many, it’s the first choice they find, because we stumble across sites like Talkspace, Betterhelp, and many others on a daily basis. They’re everywhere recently, and they’re here to stay.
Below are the 5 most popular treatments for addiction, most of which can be done via virtual therapy sessions. These are all geared towards fixing negative thought patterns, changing habits and developing a healthier lifestyle and daily habits. As such, they are designed to provide a fairly immediate, short term solution.
However, at some point your therapists might propose a change in treatment to try and deal with the more deep-rooted issues that have triggered your addiction to begin with. Such treatments (Psychodynamic therapy or Psychoanalysis for example) are also available on most of the best online therapy sites.
Cognitive Behavioural Therapy has become the gold standard of therapy. It’s being taught to pretty much all licensed therapists, and has been relied on for treating a wide range of issues, from depression and anxiety to addiction and OCD. It’s the dominant form of online therapy due to being conversationally based.
CBT is essentially a psychological treatment that helps the patient notice the relationship between their thoughts, feelings, and physical sensations. It helps us notice that negative thoughts can lead to negative feelings, or even physical sensations like dizziness, and this can cause worse thoughts. We can get caught in these vicious cycles, and CBT helps break them by breaking them down into small parts.
Addiction is very much related to this. Often our addictive behaviour is a result of an impulsive thought or a defensive reaction to a certain feeling. Perhaps we smoke each time we get stressed or rely on alcohol when anxious, or video games when bored. CBT has been proven to successfully reinforce positive adaption and break up these addictive behaviour cycles. It’s also shown that online therapy is more effective than face-to-face therapy for delivering CBT to patients with addiction. As a result, paid and free online therapy for addiction often uses CBT.
Rational Emotive Behaviour Therapy (REBT) is a form of CBT that was developed by Albert Ellis. REBT is grounded in the principles of CBT, whilst focusing on action-oriented results. We can think of REBT being a little less focused on the actual negative behavior (which CBT focuses on), and is more concentrated on showing the upsides and positive aspects of the situation.
In this sense, REBT is founded in self-acceptance, a little bit like 12 steps and Alcoholics Anonymous. Some argue CBT is more surface-level, whilst REBT is more philosophic. Ultimately, CBT will focus on challenging your cognitive distortions, whilst REBT will go a little deeper into a person’s beliefs and how these are influencing things.
REBT is a powerful method of therapy for many conditions, including addiction and substance abuse. There will always be debates over which is better between CBT and REBT, but all we know is that REBT is effective for addiction and is widely available to receive treatment online. Deciding between the two is a good problem to have for a therapist or patient, and actually, they are more similar than they are different.
Contingency Management (CM) is a therapy technique centered around motivation. CM interventions are where the patient receives a reward for hitting a treatment goal. And, as we discussed earlier, addiction is all about “reward, memory, and motivation”.
If we consider how important reward is in gambling, it’s no surprise CM is sometimes used for online therapy for gambling addiction. CM is considered to be highly effective, but not all that commonly taught to therapists.
CM is a type of behavioral therapy too, like the others, but will involve often physical rewards like money for succeeding in their absence milestones. This is a very practical, brute-force approach in one sense, but it can change our behaviors because of the shift in reward systems.
Most of the historical uses of CM have been in physical settings, not online. Cost is also a limiting factor due to the rewards often being materialistic, making it not the go-to first choice for online rehab counseling programs and such. But, there have been some positive studies on technology-based CM so far.
12 Steps is a tried and tested abstinence-based approach to overcoming addiction. It was founded by Alcoholics Anonymous but could be used for other addictions too. Some of the highest praise in regard to 12 steps is that when completed successfully, it’s so much more than just dealing with one addiction, but is a new way of life.
Some swear by it, and the group meeting aspect of AA and other 12 Step programs brings in some other potential benefits. Efficacy studies are mostly positive, but sometimes mixed. 12 Steps is very much possible online through group video calls, but it remains to be monopolized by Alcoholics Anonymous.
12 Steps could be criticized for being rooted in religion, with faith being the second step. Some find religion on this path to recovery and are thankful for it, whilst some see it as an unnecessary obstacle. We suggest you check our list of the best Christian Therapy sites if you feel that approach can work well for you.
Medication Therapy is a broad category for treating addiction, but it’s rooted in using medication or other substances to overcome addiction. To take this to the very fringes of current research, psilocybin – the psychoactive compound found in ‘magic mushrooms’ – has been helping patients with alcohol addiction.
It may sound counter-intuitive, but such substances and medication are mind-altering in supposedly beneficial ways. And, when combined with talking therapy, can help patients open up more. Medication therapy could be many things outside of psilocybin of course, but ultimately it’s usually a way to leverage talking therapy or potentially subdue other cognitive behaviors.
Some may say it’s not healing, but instead swapping one substance for another, but ultimately such methods have been shown to work. For example, Naltrexone is a medication that blocks the good feeling response that alcohol causes. This can reduce the urge to drink, and could be administered through online alcohol addiction therapy.
There is no such thing as the perfect online therapy platform, nor is there a single best company for everyone. Instead, there are simply different aspects that make up how competently a therapy provider behaves, and we rate each aspect individually. It’s important to note that some patients may care about different aspects, thus taking the overall ratings with a pinch of salt.
The aspects we look at when we review online therapy platforms include:
Some of these categories, like price and treatments available, are fairly straightforward to objectively rate. However, for app performance and customer service we use a mixture of personal experience and customer reviews to aggregate a consensus on how well the provider is meeting expectations.
BetterHelp is to the online therapy industry what Uber is to online taxi ordering: it was one of the first to do it and quickly got a good grip on the entire industry.
It’s not an unwarranted reputation by any means. BetterHelp has the most licensed therapists to choose from (over 20,000), over 1.6 million subscribers, and has incredibly high ratings on the App stores regarding software performance.
Users are matched with a therapist within a day, but remain in power of who they choose as a counselor. Furthermore, it’s very competitively priced with a 50% discount for the first month.
Pricing: $60-$90 per week with 50% discount for the first month. Doesn’t work with insurance, Medicare, or Medicaid.
Riding on the taxi analogy from earlier, Talkspace is to BetterHelp what Lyft is to Uber. Talkspace is perhaps the only serious competition when it comes to offering a similarly incredible app experience with a rapid matching process to a counselor – though again, it remains in the patient’s control who they pick.
We can consider Talkspace’s infrastructure and company size to be comparable to BetterHelp. But, Talkspace has more subscription plans (3 tiers), as well as being open to insurance.
Talkspace also offers psychiatric evaluations for an additional cost. This makes their addiction services online more versatile. Hiring psychiatrists is not something that is common for therapy sites, and there is even the possibility of having medical prescriptions through Talkspace too.
Pricing: $65-$90 per week with $80 discount for the first month. Accepts many insurance plans, Medicare, and Medicaid. Read here for other therapy sites that take insurance.
Founded in 2020, Calmerry is perhaps the latest competitor to pop up and offer licensed online therapy. In response to the pandemic, Calmerry quickly picked up clients and began to grow through word of mouth due to its exceptional customer support.
Customer support isn’t just the only advantage of being a smaller company. Price is also what makes Calmerry compelling, as it’s one of the cheapest therapy options on the internet. Despite its smaller infrastructure, clients are still matched to a therapist within 24 hours and also have the benefit of weekly subscriptions, in case monthly is too much of a financial commitment.
There are also multiple plans to choose from, somewhat similar to Talkspace’s 3-tier subscription model. But, whilst the customer service is excellent, its app and safety are mediocre.
Pricing: $42-$90 per week with 30% discount for the first month. Doesn’t work with insurance, Medicare, or Medicaid. If you feel Calmerry isn’t for you, check our list of the best affordable therapy platforms.
Teen Counseling is an online therapy platform dedicated to serving teens between the ages of 13 and 19. As it’s operated by BetterHelp, all of the online chat, messaging, and live session infrastructure is just the same.
Much of the benefits and drawbacks associated with BetterHelp can be extended to Teen Counseling. The major difference is that it’s specialised, which is a unique benefit, as the therapists will be even more experienced with teen-related issues.
This platform makes a lot of sense to exist considering that teens are arguably spending the most amount of time online. This is where the issues may be stemming from (i.e. cyber bullying), but it could be where they stumble across a teen-focused therapy app.
Pricing: $60-$80 per week with no discounts. Doesn’t work with insurance, Medicare, or Medicaid. Read our best teen therapy sites comparison to see why we think this one is the best.
Brightside is a telehealth company that focuses on anxiety and depression. Brightside offers more healthcare credibility than many of the industry leaders, as it has licensed psychiatric providers and can combine medication with talking therapy.
However, Brightside is less focused on addiction than it is with anxiety and depression, which is a potential drawback. For many, they can treat the cause underlying the addictive behaviors, but it’s best to speak to a consultant directly and understand they likely won’t have addiction-focused treatment methodologies.
Brightside has a simple signing-up process, good customer service, a modern platform, and works with many insurance companies. On top of that, it’s very affordable. Perhaps the only drawback is that you cannot choose your own therapist.
Pricing: $90-$349 per month with no discount. Works with some insurance plans, Medicare, and Medicaid.
Sesame Care is a 2018-founded telehealth company that has quickly built up a credible reputation in the US. Sesame care takes the holistic telehealth approach, offering services across the board, from dermatologists and birth control consultants to online therapy and psychiatric prescription medication.
For someone dealing with addiction, Sesame Care can help with a psychiatric evaluation and potentially some medication intervention if needed. This is a powerful option when receiving therapy, because it takes the friction away from migrating to different platforms for different treatments.
Sesame Care has a unique selling point: it offers same-day appointments. Along with its excellent customer service and affordable pricing, Sesame is a powerful platform for an addiction sufferer. The main drawback is that there’s a serious lack of mobile infrastructure – no app and no text messaging.
Pricing: $45-$120 per week with 20% discount off the first meeting. Partially works with insurance reimbursements and doesn’t accept Medicare or Medicaid.
Online therapy is as effective as traditional, face-to-face therapy. In countless studies, CBT is proven to help patients just as much (sometimes more), than face-to-face therapy.
Of course, there are always caveats. There are limitations as to what therapy methods can be delivered over the phone. For example, more experimental medication being used during talking therapy is less likely to be delivered remotely. And, of course, going into a rehab facility is outside of what remote therapy can achieve.
But, for people receiving the standard treatments of CBT, REBT, medication, and to a degree, 12 steps, remote delivery is just as effective.
Whilst there are plenty of ways to seek out online shopping addiction therapy, or online therapy for food addiction, when a person’s life is in danger from a substance, a rehab facility is often relied upon.
A rehab facility can help with immediate treatment and “getting clean”. This is thought to be the more brute force way to save a life; something that online rehab counseling doesn’t offer. But, it’s important to remember that rehab facilities are voluntary. Some states accept involuntary commitment, as well as court orders for rehab, but ultimately this isn’t what we are comparing. Of course, online rehab cannot replace this, but it isn’t trying to.
They say for a patient to have successful treatment, they have to want to get better. And, for voluntary rehabilitation, online rehab counseling programs are very much effective as shown in the earlier studies.
Rehab facilities have their unique pros and cons to consider. We must consider that, if the patient is surrounded by patients who aren’t there voluntarily, they may be surrounded by stories of using and poor behavior, possibly making their own addictions worse.
We should equate online drug and alcohol counseling to being comparable in delivery and effectiveness to outpatient rehab treatment. So, the question of online counseling vs rehab facility is somewhat similar to in-patient vs out-patient rehab.
Evidently, the answer to the question “what is the best therapy for addiction” will depend on the person and situation. Online rehab programs are effective, but cannot be a substitute for a patient who must go into in-patient care.
Knowing when to seek help can be difficult, but if any addictive behaviors are getting in the way of day-to-day life or impeding your time or finances, then it’s time to seek help. Online therapy for addiction recovery is perhaps the first step because it’s cheap and instantly accessible.
If you need a psychiatric evaluation or more intensive care, this is something that an online therapist will help you decide on. But for immediate and free help, addiction hotlines are available here.
It’s important to understand that online drug and alcohol counseling – along with CBT more specifically – is just as effective when delivered online as it is face-to-face. All of the therapy sites we review offer quality services at an affordable rate, so we are sure you’ll be able to find at least one to your liking.