Who prefers online therapy for mental health problems? A cross-sectional study in Japan

Online therapy has the potential to reduce social barriers to receiving professional treatments and evidence supporting its effectiveness has been increasing. However, one of the challenges in implementing online therapy is that most people prefer traditional face-to-face therapy over online therapy. This study aimed to investigate how individual characteristics are associated with preferences for face-to-face therapy and online therapy (via e-mail, chat, or videoconferencing). Participants were recruited from survey panels of a large Internet survey company in Japan. 2000 Japanese adults aged between 18 and 98 years (M_age = 51.83, SD = 13.05, 50% female) completed the online survey in February 2022. Chi-squared test, Fisher's exact test, and Welch's t-test were used to explore characteristics of individuals who prefer face-to-face/online therapy. Most participants preferred face-to-face therapy (49.9%) over online therapy (34.7%), yet the proportion of people preferring face-to-face therapy were lower compared to prior studies. The individual characteristics uniquely associated with preference towards online therapy were lower scores in extraversion and prior experience of online therapy. People with lower scores in stigma, confidence in internet use, higher educational background, and educational experience in psychology showed preference for both face-to-face and online therapy. These findings provide an insight into who to target when implementing online therapy and underscore the importance of psychoeducation to reduce stigma and promote people's knowledge about available services.