A pivotal finding for mental health care
As the world navigated the disruptions of the COVID-19 pandemic, mental health services faced a rapid shift from clinic rooms to screens. A large Swedish study followed 2,300 patients over six years, spanning three years before the pandemic and three years during it. The results offer reassurance to clinicians, policymakers, and patients: when online therapy is implemented with care, it can achieve outcomes comparable to traditional in-person treatment.
What the study tracked
Researchers examined common mental health conditions including depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). The number of remote visits rose dramatically—online chats, video sessions, and other telehealth modalities accounted for nearly half of all visits during the pandemic (up from about 4% before). Yet, the measured treatment outcomes remained stable, indicating that the switch to remote care did not compromise effectiveness.
Why online care can work just as well
The researchers stressed that “the most important parts of good therapy”—trust between patient and therapist, the use of evidence-based treatments, and consistent follow-up—can be delivered effectively online. For some patients, video sessions even reduce barriers to participation, such as travel time, scheduling conflicts, or discomfort with in-person visits. The study suggests that with well-implemented care, the delivery method matters less than the quality of treatment itself.
Practical benefits of remote care
Online therapy offers notable advantages for everyday life. Patients living in rural areas or with mobility challenges can access specialists without long commutes. People with tight schedules can fit sessions into busy days, reducing the likelihood of missing care. During the pandemic, maintaining continuity of treatment likely helped many individuals stay on track rather than slipping into relapse or worsening symptoms.
Limitations and considerations
The study is not without its caveats. It did not include children, individuals in acute psychiatric crisis, or those with severe psychotic disorders—groups for whom in-person care may be essential. Additionally, online care requires reliable private space, steady internet access, and comfort with digital communication, which are not universal. The authors note that turning on a webcam alone is not a guarantee of effectiveness; it must be paired with evidence-based practices and careful monitoring of progress.
Implications for the health system
The findings support a shift from viewing online therapy as a temporary workaround to recognizing it as a core component of mental health care. When implemented with proven therapies and ongoing assessment, remote care can match the outcomes of traditional in-person sessions. The study also emphasizes patient choice: providing multiple delivery options while maintaining high-quality standards can maximize access and satisfaction.
Conclusion: care that works, wherever it’s delivered
In the end, the key takeaway is clear: what matters most is not where care happens, but that it happens and that it is effective. As healthcare systems continue to integrate telehealth, patients can expect flexible, reliable access to treatment that supports long-term mental health goals.
Fabian Lenhard, a researcher at the Department of Clinical Neuroscience, Karolinska Institutet, contributed to the study, which adds to a growing body of evidence supporting online therapy as a legitimate, effective care option.
