In the realm of modern technological solutions, online therapy, especially for couples, has emerged as a robust arm of psychological support. It has transcended the barriers of geographical distances, time constraints, and stigma often associated with traditional forms of therapy. However, like every new venture, there are certain things one wishes they knew before embarking on the journey. Here are five such elements that could prepare you better for the journey of online therapy for couples.

Firstly, understanding the nature and premise of online therapy is critical. Online therapy, often referred to as teletherapy, e-therapy, or cyber therapy, leverages digital platforms to facilitate psychological counselling, support, and treatment. It's relevance in the age of digitalization is immense and growing steadily. For couples, it offers a safe, accessible, and flexible platform to address relational issues. However, it is important to manage expectations. Online therapy may not provide the same sense of intimacy and personal touch as traditional face-to-face therapy. It is designed to provide a platform where professional help is accessible, not necessarily identical to conventional therapy.

Secondly, the efficacy of online therapy is significant. A 2018 study in the Journal of Psychological Disorders found that online cognitive behavioral therapy is, "effective, acceptable and practical health care." The effectiveness of online therapy, although not universally applicable, is statistically comparable to traditional therapy. However, it is important to acknowledge that couples therapy requires both parties to be actively engaged and committed to the process. The technology, no matter how advanced, cannot compensate for a lack of commitment or engagement.

Thirdly, confidentiality is a hallmark of any therapeutic relationship, and online therapy is no different. Legitimate online therapy platforms comply with HIPAA (Health Insurance Portability and Accountability Act) standards, ensuring that your information is protected and confidential. However, it's important to note that the responsibility of privacy extends to the clients as well. Discussions should be conducted in private, secured spaces to maintain confidentiality and efficacy.

Fourthly, the technological requirements for online therapy are not as daunting as one might imagine. A stable internet connection, a device with video and audio capabilities, and a quiet, private space are the basic necessities. Yet, technological glitches can happen and they may interrupt the therapeutic process. It's important to prepare for these contingencies and have back-up plans to ensure continuity.

Lastly, the cost of online therapy can vary greatly. Some platforms offer packages or subscriptions, while others charge per session. Insurance coverage for online therapy is also increasingly common and should be explored. While online therapy is often praised for its accessibility, it is important to consider these financial aspects before engaging in therapy sessions.

Analyzing these points through the lens of game theory, it could be argued that online couples therapy is an example of the "prisoner's dilemma". Both parties must be committed and engaged to reap optimal benefits, but if one party does not fully invest in the process, the other party's efforts are undermined. Therefore, communication about expectations and commitment is essential prior to starting therapy.

To conclude, online therapy for couples is a powerful tool in our digital age, making professional help more accessible to all. It is, however, not a one-size-fits-all solution, and careful consideration of the above factors can lead to a more informed, successful therapeutic journey. As with any significant decision, it is crucial to conduct thorough research and consider all elements with nuance and perspective.