What is text therapy and its effectiveness?

Text therapy services in Canada

Text therapy has become a popular option for mental health care in Canada besides video and voice therapy because it offers a convenient way for people to access mental health support without needing in-person appointments. Many individuals face busy schedules, financial constraints, and social stigma that prevent them from seeking help through traditional methods. This shift toward text-based services is especially evident in Ontario, where access to mental health resources varies by region.

988 and Kids Help Phone

Canada hosts trusted text-based mental health services such as 988 and Kids Help Phone. These services offer free, confidential, and immediate crisis support by text for those who prefer written communication over talking on the phone. For example,nearly 40% of 988 users choose text as their preferred method.

• 988: Suicide Crisis Helpline
  Launched in November 2023, this helpline provides round-the-clock support for individuals in crisis. With partner organizations across provinces, users can either send a text or call trained crisis responders.
• Kids Help Phone
  One of Canada’s longest-standing mental health helplines, Kids Help Phone offers text support nationwide. It remains a popular choice for young people who favour written messages as a way to reach out.

The widespread use of these text services highlights the growing demand for alternative support methods. Although these services do not offer formal therapy sessions, they show that text can serve as an effective tool in urgent situations.

Private therapy clinics

In addition to crisis support, several private therapy clinics now include text communication in their practice to handle with mental illnesses that clients are suffering. Centres such as Virtrapy connect clients with registered therapists via secure text messaging and hold structured sessions where clients discuss ongoing concerns with a consistent therapist. International platforms like TalkSpace also offer text therapy, demonstrating its effectiveness across different settings.

Types of text therapy

Text therapy is available in two main formats: asynchronous messaging and live text sessions. Each format has features that suit different client needs.

All-day messaging

All-day messaging, or asynchronous chat counselling, allows clients to send messages to their therapist at any time. Therapists reply within a set period—often once or twice per day. This option suits clients who need support but cannot attend scheduled sessions.

• Advantages: Clients have the opportunity to reflect on their thoughts, there is no need to set appointments, and it is often a more affordable option.
• Limitations: Replies are not immediate, the conversation may lack the structure of live sessions, and the boundary between therapy and everyday communication may become blurred.

Live text sessions

Live text sessions mimic a face-to-face conversation through immediate text exchanges. Clients and therapists set a specific time to chat, much like a traditional in-person or video session.

• Advantages: Offers prompt communication, maintains a clear session structure, and allows for a deeper examination of personal issues.
• Limitations: Clients who type at a slower pace may find the speed too fast, although voice-to-text technology can sometimes help.

Some centres provide both asynchronous messaging and live text sessions, while others, such as Virtrapy, focus solely on live text sessions to ensure effective therapy.

Effectiveness of live text therapy

Research shows that many proven therapeutic methods adapt well to text-based communication. One systematic review found preliminary evidence supporting the efficacy of real-time text-based communication with licensed therapists, particularly for individuals concerned about stigma and confidentiality. Additionally, linguistic analysis of text communications has been used to predict treatment progress and identify individuals at risk of serious mental health conditions and suicide.

Adaptability of therapeutic methods

While text therapy is still developing, more research is needed. Another systematic review concluded that CBT could be effective using virtual therapy, including text-based counselling. One study suggested that text-based interventions, whether asynchronous or synchronous, could build a strong therapeutic alliance, which is the basis of a successful intervention. There is also research indicating the effectiveness of text-based counselling using solution-focused brief therapy.

Reflective communication

One benefit of text therapy is that clients gain extra time to reflect before they respond, which leads to clearer and more thoughtful communication. Therapists also have time to review messages and decide on the next steps.

Meeting diverse needs

Text therapy appeals to many individuals. Younger clients often favour digital communication, while people with social anxiety or those uncomfortable with face-to-face meetings find text-based therapy more approachable. It also serves as a practical option for individuals who cannot speak or hear.

Key considerations

Text-based interventions have the potential to benefit both clients and therapists by offering flexible, accessible, and convenient communication channels. However, like every form of therapy, they also come with some drawbacks.

Absence of non-verbal cues

A major limitation of text therapy is the absence of non-verbal cues such as facial expressions, tone of voice, and body language. These cues play a vital role in traditional therapy by helping therapists understand emotional responses. When such signals are essential, text may not fully capture a client’s state.

Handling crisis situations

Crisis services like 988 use established protocols to assess risk via text messages. However, therapists in non-crisis settings may struggle to evaluate risk without the additional context provided by non-verbal signals.

Client experiences with text therapy

Centres like Virtrapy collect client feedback to improve their services. One client agreed to share her experience with live text sessions to help others understand what to expect.

Positive outcomes

“Using text therapy helped me open up about my feelings. I felt less pressure than in a face-to-face session.” This feedback underlines how live text sessions can quickly build trust through clear and supportive communication.

Managing expectations

“I felt anxious while waiting for a reply, but that experience led to a constructive discussion with my therapist about setting clear expectations and even became an example of one of the intervention topics.” This example shows that, even with limitations, text therapy remains a valuable part of a comprehensive treatment plan when expectations are set from the start.

Find a text therapist

Text-based psychotherapy is still relatively new in Canada, and while choices may be limited, innovative centres are paving the way. At Virtrapy, clients find a team of registered therapists who specialise in text therapy. Under the guidance of Mo Kiu, who has more than five years of clinical experience in text-based support, our practitioners conduct counselling sessions in a secure chat environment.

Begin your journey with a free consultation in our secure therapy hub and experience text therapy firsthand. You can then choose to continue with paid sessions via text or opt for video or voice sessions to receive the support that best meets your needs.