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Text Therapy: A Comprehensive Guide to Online Counseling for Grief and Loss

What is Text Therapy?

Text therapy, also known as online therapy or text counseling, is a type of mental health counseling that is carried out through written communication, usually over the internet or through mobile apps. Instead of face-to-face sessions, text therapy lets people communicate with licensed therapists through text messages, emails, or in-app messaging platforms. (1,2)

In recent years, text therapy has gained significant popularity, especially in light of the physical distancing guidelines enforced during the COVID-19 pandemic. As a result, an increasing number of individuals have turned to their phones to seek much-needed support and counseling.

What is the Process of Text Therapy?

The process of text therapy typically involves the following steps: (3)

  • Platform Selection: Clients choose a secure and confidential platform or app that offers text therapy services. These platforms often have measures in place to ensure the privacy and confidentiality of the communication between the client and therapist.
  • Therapist Matching: Clients may be matched with a licensed therapist or counselor based on their specific needs and preferences. Many text therapy platforms have a screening process to assess the client’s requirements and connect them with an appropriate mental health professional.
  • Message Exchange: Once the client is paired with a therapist, they can begin the therapy process by exchanging text-based messages. Clients can write messages at their convenience, allowing them to express their thoughts and emotions as they arise. Therapists, in turn, respond to these messages, typically within a set timeframe, such as within 24 to 48 hours.
  • Confidentiality and Security: Reputable text therapy platforms use encryption and other security measures to ensure that the communication between the client and therapist remains confidential.
  • Therapeutic Techniques: Text therapists use various therapeutic techniques to help clients cope with their challenges, including grief and loss. These techniques can include cognitive-behavioral therapy (CBT), mindfulness-based approaches, emotion-focused therapy, and more.

Does Text Therapy Help Those Dealing with Grief and Loss?

Text therapy can be a valuable resource for individuals experiencing grief and loss. This form of counseling allows people to communicate with licensed therapists through written messages, providing a safe and accessible space to express their emotions and thoughts related to the loss.

Writing about grief can be a cathartic process, and text therapy offers a non-judgmental platform for clients to share their feelings at their own pace and convenience. The anonymity provided by text-based communication can be particularly beneficial for those who find it challenging to discuss their grief openly or who are concerned about the stigma surrounding seeking mental health support.

Therapists can employ various techniques, such as cognitive-behavioral therapy (CBT) or mindfulness-based approaches, to help clients cope with their grief and develop healthy coping strategies. (4) However, text therapy does have limitations, as it lacks non-verbal cues and may not be suitable for individuals in crisis situations. Nevertheless, for many, text therapy has proven to be a valuable tool in navigating the complex emotions and challenges that come with grief and loss.

When you look at what evidence is there to support this, recent research has provided promising results regarding the effectiveness of text therapy in delivering mental health support:

  • A study conducted in 2020 revealed that individuals with anxiety or depression reported reduced symptoms after participating in text-based therapy. (5)
  • Another study in 2022 suggested that text therapy could be equally effective in alleviating symptoms of post-traumatic stress disorder (PTSD) compared to traditional therapy methods. (6)
  • In the same year, a separate study demonstrated that text therapy may have the potential to reduce suicidal thoughts, offering a potentially life-saving intervention. (7)
  • Additionally, a study from 2017 indicated that text therapy can aid participants in maintaining beneficial practices from cognitive behavioral therapy, further supporting its usefulness as a therapeutic approach. (8)

These findings highlight the growing recognition of text therapy as a valuable and accessible form of mental health support that can positively impact individuals dealing with various emotional challenges.

Benefits and Drawbacks of Text Therapy

Some of the benefits of text therapy are as follows:

  • Emotional Expression: Writing about one’s grief can be a cathartic process. Text therapy provides a safe space for clients to express their feelings, thoughts, and memories related to the loss.
  • Flexibility and Availability: Grief is a complex and individual experience that may affect people at different times and intensities. Text therapy allows clients to engage with their therapist when they feel the need, whether it’s immediately after a triggering event or during quiet moments of introspection.
  • Anonymity and Reduced Stigma: Some people may feel more comfortable discussing their grief anonymously or without the perceived stigma often associated with seeking help for mental health issues. Text therapy allows individuals to access support without disclosing their identity, making it more appealing to those who may be hesitant to seek traditional counseling.
  • Continuity of Care: Grief is not always linear, and its effects may persist for an extended period. Text therapy offers ongoing support, providing a consistent therapeutic relationship with the same therapist, which can help clients navigate the different stages of grief and adjust to their new reality over time.

On the other hand, while text therapy can be beneficial for grief and loss, it also has certain limitations:

  • Non-Verbal Cues: Text-based communication lacks the non-verbal cues present in face-to-face interactions, such as tone of voice and body language. These cues can provide therapists with additional information about the client’s emotions and help them tailor their responses more effectively.
  • Real-Time Interaction: Unlike traditional therapy, text therapy does not allow for real-time conversations. Clients may have to wait for their therapist’s responses, which could be challenging during moments of intense distress when immediate support is needed.
  • Crisis Situations: Text therapy may not be suitable for individuals in crisis or experiencing severe emotional distress. In such cases, traditional in-person therapy or crisis hotlines may be more appropriate.
  • Technology Limitations: Technical issues, such as poor internet connectivity or app malfunctions, can disrupt the therapeutic process and cause delays in communication.

Cost of Text Therapy

The cost of text therapy can vary based on the platform and services offered, but generally, it is more affordable than in-person therapy. For instance, a platform like BetterHelp typically charges around $60-$90 per week, while Talkspace costs approximately $70-$110 per week, depending on the chosen plan. Some platforms may bill weekly but charge monthly, so it’s essential to understand the payment schedule.

When it comes to insurance coverage, many plans cover some expenses related to mental health treatment, but they often focus on in-person therapy, as stated by the American Psychological Association (APA). (9) It’s recommended to check with your insurance provider beforehand to determine if they cover text therapy or provide partial reimbursement.


Text therapy is a promising and effective option for individuals coping with grief and loss. Its accessibility, convenience, and anonymity create a supportive space for emotional expression and healing. While not a complete replacement for in-person counseling, text therapy can complement existing mental health services and offer valuable support during challenging times. As research continues, its role in providing mental health support for grieving individuals is expected to expand further in the future.


  1. Shapiro, J.R., Bauer, S., Andrews, E., Pisetsky, E., Bulik‐Sullivan, B., Hamer, R.M. and Bulik, C.M., 2010. Mobile therapy: Use of text‐messaging in the treatment of bulimia nervosa. International Journal of Eating Disorders, 43(6), pp.513-519.
  2. Finitsis, D.J., Pellowski, J.A. and Johnson, B.T., 2014. Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials. PloS one, 9(2), p.e88166.
  3. Katahn, M., Strenger, S. and Cherry, N., 1966. Group counseling and behavior therapy with text-anxious college students. Journal of Consulting Psychology, 30(6), p.544.
  4. Aguilera, A. and Muñoz, R.F., 2011. Text messaging as an adjunct to CBT in low-income populations: A usability and feasibility pilot study. Professional Psychology: Research and Practice, 42(6), p.472.
  5. Hull, T.D., Malgaroli, M., Connolly, P.S., Feuerstein, S. and Simon, N.M., 2020. Two-way messaging therapy for depression and anxiety: longitudinal response trajectories. BMC psychiatry, 20(1), pp.1-12.
  6. Malgaroli, M., Hull, T.D., Wiltsey Stirman, S. and Resick, P., 2020. Message delivery for the treatment of posttraumatic stress disorder: longitudinal observational study of symptom trajectories. Journal of Medical Internet Research, 22(4), p.e15587.
  7. Klomek, A.B., Benistri, A., Doron, Y. and Hull, T.D., 2022. The Moderating Role of Working Alliance in the Association Between Depression and Suicide Ideation in Messaging Therapy. Telemedicine and e-Health, 28(10), pp.1479-1488.
  8. Aguilera, A., Bruehlman-Senecal, E., Demasi, O. and Avila, P., 2017. Automated text messaging as an adjunct to cognitive behavioral therapy for depression: a clinical trial. Journal of medical Internet research, 19(5), p.e148.
  9. Psychotherapy works (no date) American Psychological Association. Available at: https://www.apa.org/topics/psychotherapy/works (Accessed: 25 July 2023).

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 7, 2023

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