BERLIN — The understanding voice, the way the therapist slides the box of tissues over when you get emotional, the warm pat on the shoulder and the handshake as you leave. Can you imagine psychotherapy without these comforting human niceties? If so, consider replacing these face-to-face sessions with online therapy.

Results of a University of Zurich study found virtual analysis surprisingly effective. Researchers divided moderately depressed patients into two therapy groups: One underwent classic in-person sessions with the therapist and the other an online version of cognitive behavioral therapy with the therapist. After eight sessions, the researchers conducted an evaluation — and the Internet group won.

Both groups benefited, because all the patients were less depressed at the study’s end than they had been at the start of the experiment. But immediately after a session, 53% of the patients who had undergone Internet therapy showed no signs of depression. For the patients who had undergone face-to-face consultation, that figure was 50%. Not a spectacular difference, but three months after the experiment another 15% of patients who had the online sessions reported feeling less depressed.

This result could be interpreted as yet another indication that people are increasingly relating more poorly one on one, perhaps because they prefer not to. And yet 96% of the online group characterized their contact with the therapist as “personal.”

How to explain this success? The onliners, who could participate orally or in writing, had something the others didn’t: records of the sessions. Some of them said that they read the records or listened to the sessions later and that having them on hand to review was particularly helpful. Conventional patients had only memories of their sessions.

Internet consultations are of course not the solution to all problems. In fact, they generate new ones. Communication in writing can often lead to misunderstandings — and misunderstandings can have dire, sometimes even fatal, consequences in a psychotherapeutic context. There is also the question of whether it's a good idea to have such explicit written records that could get into the hands of third parties.

But while Internet therapy sessions may pose a few disadvantages, they could also prove to be a godsend for patients who don’t feel up to making their way to a therapist’s office. All that’s missing is that warm handshake.