Teletherapy, Video Counseling, and Online Mental Health Treatment Now Outpace In-Person Sessions in California

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Majority of Californians Now Rely on Teletherapy

A growing number of Californians are turning to video calls and phone sessions for mental health and substance misuse treatment, with virtual care surpassing traditional in-person visits. Recent data reveals that nearly half of the 4.8 million adults who sought mental health services in 2023 did so exclusively through teletherapy.

An additional 24% combined both teletherapy and in-person treatment, while only 23% used face-to-face sessions alone. This shift underscores the growing role of technology in behavioral health care, accelerated by the pandemic.

Studies Show Teletherapy Matches In-Person Effectiveness

Experts say remote therapy can be just as effective as traditional methods. Studies comparing the two approaches report similar recovery rates, with many patients preferring the comfort of receiving therapy at home.

“It allows for greater comfort and openness,” said one expert, pointing to improved patient engagement during virtual sessions.

Limitations of Remote Therapy

Despite its convenience, teletherapy comes with challenges. Therapists may miss subtle cues like body language or facial expressions, particularly during phone sessions. Technical issues and lack of visual engagement — such as participants turning off their cameras — can further limit the therapeutic connection.

Some individuals also find it harder to emotionally bond with a therapist without physical presence, especially in group settings.

Mobile Apps Are Reshaping Access

Popular mental health apps like Talkspace and BetterHelp are expanding access to care, offering subscription-based therapy often covered by insurance. Patient satisfaction remains high, but researchers have noted concerns, including sudden therapist departures and inconsistent care quality.

Both companies say therapist compensation has improved, with annual earnings reportedly ranging from $65,000 to over $90,000, depending on platform and workload.

Growth in Demand for Mental Health Support

California has seen a sharp increase in mental health-related visits. Between 2009 and 2023, the number of adults seeking help rose by nearly 2 million. From 2019 to 2023 alone, the number climbed 10%, adding over 400,000 new patients.

Inequities in Access to Telehealth

Despite its rise, teletherapy has not reached all communities equally. Lower-income Californians and those living in rural areas are less likely to use teletherapy due to barriers like poor internet access, lack of privacy at home, or limited digital literacy.

While 81% of Bay Area residents who sought mental health care used teletherapy in some form, only 62% of residents in rural regions did the same.

Therapists Also Embrace the Shift

Many therapists have embraced virtual care, closing physical offices and setting up home-based practices. The pandemic made this shift mainstream, cutting overhead costs and offering professionals greater flexibility while expanding patient access.