Effectiveness of Text Counselling
Imagine getting real, effective therapy support right from your phone—simple, accessible, and tailored to your needs. Text therapy has gained widespread recognition, but its success depends on the context, the population served, and how well it's implemented. While some therapists might initially be skeptical, research shows that text-based counselling can be just as effective as traditional therapy for certain clients, especially when best practices are followed.
Research on the outcomes of text counselling
While text therapy may seem unconventional compared to in-person counselling, empirical research supports its effectiveness. Studies have explored how text-based interventions compare to face-to-face therapy, focusing on therapeutic alliance, symptom reduction, and crisis intervention.
Efficacy of text therapy compared to traditional therapy
A growing body of research suggests that text therapy can achieve similar outcomes to verbal therapy, particularly in treating depression, anxiety, and crisis-related distress.
Text therapy is as effective as other forms of therapy
- Dwyer et al. (2021)reviewed 18 studies and found that text-based e-mental health services were effective in treating mental health conditions, with outcomes comparable to traditional face-to-face counseling. Additionally, a single session of text-based counseling significantly reduced anxiety levels, and text-based interventions increased hope among young people.
Therapeutic alliance in text therapy is as strong as in face-to-face therapy
- A study by Hanley and Reynolds (2009)compared therapeutic alliance ratings between text-based and in-person therapy. Results showed no significant difference which indicated that strong emotional connections can still be formed through written communication when therapists use intentional, reflective, and empathetic responses.
Therapy is effective because of two key elements: the therapeutic relationship and a structured approach. Without both, it risks becoming either a casual chat or a lecture. Research shows that text therapy can maintain these elements just as well as other forms of therapy which proves it more than just a conversation. It’s a meaningful therapeutic journey.
Crisis intervention and text-based support
Text therapy is increasingly used in crisis support services, particularly for youth populations and individuals experiencing acute distress. Research highlights its effectiveness in de-escalation, emotional regulation, and suicide prevention.
Text-based crisis support effectively reduces distress
- A studyanalyzing crisis text conversations from Shout (UK) examined 1.3 million crisis text interactions and found that 91% of texters reported feeling significantly better after a session (Shout, 2021). Clients appreciated the anonymity, immediacy, and non-judgmental nature of written communication.
Text therapy is effective for suicide risk reduction
- An evaluationof Hong Kong’s 24/7 text-based counselling service, Open Up, analyzed over 81,000 sessions and found that 85.3% of high-risk and crisis-level texters were de-escalated by the end of the conversation (Yip et al., 2022).
These findings reinforce that text-based crisis counselling is not just an alternative to phone or in-person support. It is a valuable and research-backed method for crisis intervention.
As with any field of research, there are also studies that challenge the effectiveness of text-based therapy. Some argue that it may not be suitable for all clients or conditions. Potential limitations such as the absence of vocal cues and the need for strong written communication skills. However, ongoing research continues to explore these concerns while reinforcing the value of text therapy as a viable therapeutic approach.
Who benefits most from text therapy?
Text therapy is not a one-size-fits-all approach, but research has shown that certain populations benefit significantly from this mode of intervention. While it may not replace traditional therapy for everyone, it offers unique advantages for specific groups which makes mental health support more accessible and effective for those who may struggle with other therapy formats.
Youth and young adults
Younger generations have grown up communicating digitally, which makes text-based interaction a natural and comfortable medium for them. Many teens and young adults feel more at ease expressing themselves through text than in face-to-face or verbal conversations.
Young people have been raised in a digital communication era
Why text works for them:
- Comfort with digital communication
Many young people are accustomed to texting and find it easier to engage in therapy this way. - Immediate accessibility
Youth can reach out anytime, without needing to schedule or verbally communicate their needs. - Non-judgmental environment
Some young clients fear judgment in face-to-face settings, but feel safer expressing themselves through text.
Individual with social anxiety or communication barries
For individuals with social anxiety, selective mutism, or trauma-related avoidance, traditional therapy settings can feel overwhelming and intimidating. The pressure of verbal conversation, eye contact, or being physically present in a session may make it difficult for these clients to fully engage in therapy.
Text therapy removes these barriers and allows them to communicate at their own pace, without the stress of face-to-face interaction. Additionally, individuals who are neurodivergent (e.g., autism, ADHD) or have speech impairments may find text-based therapy more structured, predictable, and accessible than verbal communication.
Why text works for them:
- Reduces pressure from face-to-face interaction
No need for eye contact, tone adjustments, or verbal speech. - Provides time to think before responding
Clients can carefully process and structure their thoughts without feeling rushed. - More accessible for neurodivergent clients
Those who struggle with sensory overload, impulsivity, or speech difficulties may feel more comfortable communicating through writing. - Less intimidating than in-person therapy
Text therapy allows clients to open up at their own pace, rather than feeling put on the spot.
Individuals who process emotions better through writing
Some people naturally process emotions more effectively through writing than through verbal conversation. Writing allows for greater self-reflection, which gives clients the ability to slow down, revisit messages, and engage in deeper cognitive restructuring.
Why text works for them:
- Encourages deeper self-reflection
Writing allows clients to process emotions before responding. - Provides a written record for review
Clients can revisit past messages, reinforcing therapeutic insights. - Enhances structured therapeutic techniques
Text therapy pairs well with CBT, DBT, and journaling-based interventions. - Gives clients control over their expression
Some individuals struggle to verbalize emotions but feel more comfortable writing them out.
Key takeways
Text therapy is not just "better than nothing". It is an evidence-based, effective form of intervention for people, especially for specific populations. Text therapy is not just a substitute for verbal therapy. It is a powerful tool in its own right and offers unique advantages that make mental health care more inclusive, accessible, and effective.