Key Takeaways
- 26% of respondents to a Healthline survey about online therapy report seeking therapeutic help for trauma
- No matter how you identify, your age, or time since trauma(s), research shows teletherapy is effective for trauma if your rapport with the therapist is strong
- According to Healthline’s mental health survey, BetterHelp is the top choice for trauma therapy
Most know online therapy can be helpful for couples counseling, general anxiety, even phobias, or concerning behavioral traits, but does it work for healing after living through trauma? Where do you turn when in-person isn’t your best option, but you need help for post-traumatic stress?
Our expert and two individuals managing PTSD explain why online trauma therapy is not only a thing, but can often be the safest place to maintain healing. Plus, we’re sharing 7 vetted and proven services to start or continue online therapy.
Mary, in her late 20s, experienced an in-home assault during college. She was already in therapy online (during the pandemic), so they were able to pivot to online trauma therapy.
Mary did sessions once per week or twice per month for years. When her insurance changed due to a new job, her therapist was no longer covered. In this interim, she tried BetterHelp.
What Mary liked about online trauma therapy
- being able to control your therapy setting
- having a therapist who was OK with the video off (she felt she could speak more freely this way)
- most teletherapy services make it much easier to switch or cancel appointments without having to call an office
What Mary didn’t like about online trauma therapy
- some teletherapy services don’t accept insurance, so price can be a barrier
Matilda is also in her late 20s and experienced childhood sexual trauma by a family member. Her symptoms manifested as irritability, and her parents didn’t know the source of her angst.
She was put in in-person therapy as a child—with a therapist who also treated her offender, so she didn’t divulge until adulthood. You can read her review of MDLIVE here.
What Matilda liked about online trauma therapy
- licensed therapists and platform presentation of therapists’ specialties and experience make it easy to search for trauma-informed expertise
- easy to switch therapists
- for Matilda, the therapist who fit was a match because she didn’t try to “fix” Matilda. Used phrases like: “Yeah, that must’ve been really difficult.”
What Matilda didn’t like about online trauma therapy
- some platforms say they can’t do trauma treatment methods over video chat like EMDR; you’ll need to ask up front, ideally before committing
Dr. Nicole on “the best online therapy”
Dr. Nicole Washington, DO, MPH, holds her own practice in addition to being a co-host on two of Healthline’s mental health podcasts.
As an ABMS board certified psychiatrist, she’s helped many folks with trauma therapy in-person and virtually.
“Finding a therapist is hard. You’re sharing with your therapist things and secrets that those who love you most might not even know.”
She says the best trauma therapy, whether in-person or online, has less to do with the format and more to do with how well you align with the trauma therapist.
“I think it’s more about you having the right support in place, either way [from the therapist]. Because there’s always going to be someone who [the platform or clinician] doesn’t fit for.” She says it’s not about making sure the circumstances are just right, it’s about finding “someone versed in addressing the specific trauma that dictates.”
• $0 to $284 per session
• $25 to $414 per session
• $69 weekly
• $200
• psychiatry $250
Our Medical Standards and Insights team has carefully researched and vetted over 11,000 products and services. We evaluate services for consistency with standards of care and best practices, and we look into each brand’s reputation before sharing products and services on Healthline.
To choose the online therapy platforms on this page, we considered all the platforms that passed our vetting process. Then, we personally tested some of them to narrow down our list even further. Read more about how we review online therapy platforms.
We also referenced Healthline’s 2022 Online Therapy Study of 315 respondents who gave insights into 12 teletherapy services.
Our picks were cross-referenced against services most reported for certain nuances and vetted by our Medical Standards and Insights Team.
A small 2024 study of 66 participants demonstrated that 98% reported working with therapists having psychoeducation on childhood interpersonal trauma (CIT), for example, was highly acceptable for them.
Psychoeducation is defined by more than education on how CIT affects the brain; it also provides skills and strategies for emotional self-regulation.
Dr. Nicole on complex ptsd online therapy
Dr. Nicole said that having a licensed, trauma-informed therapist is a must.
“These treatments will be walked through and directed step-by-step by your trauma therapist. Just because you do these online with a therapist, does not mean you can freestyle at home by yourself or on anyone else!”
Having said that, she explained that it is possible to do more complex PTSD therapy online. Dr. Nicole says if it’s EMDR (eye movement desensitization and reprocessing), for example, the clinician will advise you where to put focal points in your space, whether they are sticky notes or the like.
“Even if we’re using EMDR, brainspotting, EFT (emotional freedom technique), or prolonged exposure therapy—any of them that are going to have you bring up stuff you have not brought up or suppressed—most licensing boards are going to have guidelines in place.”
Dr. Nicole specified that, for example, EMDR International Association has guidelines for virtual administration of the treatment method with specifics on how to set up, what to do with distractions, and overall ethics.
“Encryption should be set up; certain platforms have this in place and are HIPAA compliant,” Dr. Nicole said.
What our testers suggest when choosing online therapy for childhood trauma and other forms of PTSD
Mary and Matilda both discussed the need to have a qualified trauma therapist who understands how important it is for you to be comfortable during the video chat.
“Since I was assaulted in my house, my therapist—on a call—helped me and guided me to rearrange my space so I could reclaim my space, so having little tangible things to have authority or autonomy in my room since assault takes away your power,” Mary recalled.
Matilda said she and her husband sought marriage counseling to help with some issues carrying over from her childhood sexual trauma. “We saw a [licensed social worker] who literally sai,d ‘I don’t know how to help you.'”
Matilda said you’ll be able to suss out which teletherapy services aren’t catered toward trauma a few ways:
- bio and background of therapist or psychiatrist doesn’t mention “trauma-informed” or experiences with trauma
- intake questionnaire doesn’t have specific trauma questions
- privacy policy might have exclusions if there are active legal actions open regarding your trauma
Note: If you’re a parent of a child or children you’re interested in being treated for trauma, it may be wise to seek separate therapists for family members. In Matilda’s case, her parents took both her and a sibling to the same therapist, and her sibling initiated the trauma. This made her reticent to open up in therapy until she was an adult.
Yes.
Research from 2021 shows that online trauma therapy can be as effective as in-person therapy. The review found that live video talk therapy and virtual cognitive behavioral therapy (CBT) sessions were as effective as face-to-face sessions, particularly for PTSD, anxiety and depression.
Many platforms use questionnaires to match you with therapists but it’s just as important that you observe, ask questions, and do your own vetting.
“Anyone who’s not trauma informed can be a turn off,” Matilda emphasized.
Dr. Nicole suggests that in choosing the right online trauma therapist, only consider therapists specializing in trauma treatment. “You want to make sure your therapist is trained in the protocoled therapies they advertise.”
To do this, you’ll research therapist bios and reviews on company websites, and consider having a short consultation before committing to sessions. You can ask about their approach to trauma therapy, expected outcomes, and how they measure your progress.
“Do they have a protocol in place for how they will approach modalities online? Is that written somewhere? What are we going to do when internet drops, if something big environmentally happens? When reprocessing, what are we going to do if big emotions come out?” Dr. Nicole suggests asking.
She adds that these protocols can’t just be verbal that one time, they need to be “written down or very well communicated. Modalities should be phased into during the (first few sessions) education phase.”
For more insight, you can check out Psych Central’s article how to vet a therapist.
Dr. Nicole says to spend a bit before your first session thinking about what makes you feel comfortable physically, and where you feel you have the most privacy.
“If you’re a busy mom and you’re in the closet and kids are coming knocking that’s probably not a good safe space. […] I see a lot of [folks] in their car or bathroom” (not using the bathroom!).
Our tester Mary agreed. “In person felt very formal, very stale, […]. With online, I would literally be in therapy in my bed, I could be so comfortable. With online I could take calls from the car, from home, or be on a bench in between classes.”
Two studies from 2021 and 2024 both show that internet-based CBT is effective for treating mental health conditions, including PTSD.
Dr. Nicole also emphasizes that a good therapist will draw out of you your goals with therapy and provide landmarks so you both know you’re growth is headed in the intended direction.
“No one should be the same as this time last year or the year before. You want to see progress mentally and emotionally.” She concludes that if your relationship with your therapist is strong and you’ve changed for the better, it’s working.
There are quite a few options for online trauma therapy. You can search by price point per session or week, trauma therapies offered, and how intuitive it is for you to pick or switch therapists, among other features.
We’ve provided 7 teletherapy brands for trauma that are vetted and reliable.
Our expert psychiatrist and both testers who live with PTSD all agree that the most important factor is how much rapport, trust, and comfort you have talking with your licensed trauma therapist.