Therapy over the Internet – “The effectiveness of online therapies has long been proven”

Depression can be treated with psychotherapy, which can also be carried out over the Internet.


Professor Knaevelsrud, even people with serious mental problems often have to wait months today before they find a psychotherapist who is licensed by health insurance. On the other hand, there are now a number of Internet portals that also offer online therapies. Are such treatments via computer or smartphone a real alternative?

I don’t want to play off online therapy and conventional therapy against each other. Because one thing is certain: everyone who needs it should have access to psychotherapy within a reasonable period of time. At present, however, we reach far fewer than half of the patients with conventional consulting room psychotherapies. So we have to look for complementary ways. The Internet offers further possibilities here.

Which of these are serious?

This is currently an undefined gray area. As a registered psychological or medical psychotherapist, you cannot offer online therapies and bill them to the health insurance company. But that doesn’t mean that the current commercial offerings are all worthless. Two years ago, the professional societies of psychologists and psychiatrists set up a task force to establish quality criteria that could lead to certification. The focus is on questions about the training of the provider, proof of the effectiveness of the therapies offered, but also about transparency with regard to the duration of treatment, financing, possible termination and data protection. For integration into standard care, it is also necessary to check whether the diagnostic clarification can also be carried out at the beginning by telephone or video conference.

And who helps if a patient gets into a serious crisis during treatment?

Wenn wirklich eine Psychotherapie angeboten wird, müssen die gleichen Voraussetzungen gelten wie bei der klassischen Behandlung: Der Therapeut muss den therapeutischen Prozess individuell begleiten. Unproblematischer ist es, wenn online nur einzelne Module in Anspruch genommen werden, die primär dem Monitoring dienen, etwa ein Schmerztagebuch.

Are there enough studies that prove the effectiveness of online therapies?

There is no lack of evidence. Its effectiveness has long been proven. In countries such as Great Britain, Sweden and the Netherlands, they are already part of standard care. The separation of both types of treatment is actually an artefact. There is nothing to be said for withholding online offers from insured persons, for example people who, for various reasons, can no longer go out the door. For example, there are large studies with thousands of participants on the treatment of depression. Studies from the Netherlands and Denmark show that good results can be achieved with online interventions even in patients who are at risk of suicide. And my working group was able to show in its own studies that online treatments help traumatized people in war zones. For example, an Arabic-language program that was used in Iraq a few years ago. The Federal Ministry of Research has now advertised a funding program in which such concepts are used to care for refugees.