Online therapy refers primarily to the use of video calls, allowing real-time, face-to-face interaction between therapist and client. It can also include phone calls, email and direct messaging.
Research supports that online therapy isn’t just convenient, it is a distinct and effective way of working. Compared to in-person therapy some differences include: a more balanced dynamic – the shared virtual space can create a different kind of connection that feels more equal; feeling closer yet comfortable – on screen, our faces are closer than in-person which can foster a sense of closeness without feeling intrusive; and a sense of safety in distance – for some, being in their own space while connecting remotely allows for deeper openness.
Is online therapy a good fit for you? To help you reflect on this I highlight some of the key benefits and considerations below:
Key Benefits of Online Therapy
Increased Accessibility
- Ideal for those in rural areas, with mobility or accessibility issues.
- Offers increased choice of therapist to all clients.
- Reduces travel time and costs.
- Can enable therapy across time zones and borders.
Effectiveness Comparable to In-Person Therapy
- Studies show online therapy is just as effective for conditions like anxiety, depression, and PTSD.
- There is strong evidence for online therapy as an effective mode for CBT (Cognitive Behavioural Therapy), Humanistic and Psychodynamic approaches.
- Evidence suggests that elevated facial proximity in online therapy can enhance the quality of the client therapist relationship. This relationship is a significant factor in successful therapy outcomes across all types of therapy.
Comfort & Convenience
- Clients can feel more at ease in their own space with research suggesting this optimises the potential for change and growth.
- Research also suggests an online space helps those with social anxiety or shame-related issues to engage more openly.
Flexibility & Continuity
- Reduces disruptions due to travel, relocation, or significant life changes.
- Can provide longer term continuity where either client or therapist locations change.
Considerations for Online Therapy
While online therapy has many advantages, it may have potential drawbacks for some. Here’s what to keep in mind:
Privacy & Confidentiality
- Maintaining a safe, confidential space is integral to all types of therapy. Noise or physical interruptions will likely be detrimental to therapy sessions.
- You can discuss privacy measures with your therapist, but consider switching your phone, tablet or laptop to do not disturb mode and playing white noise or wearing headphones.
Technology Challenges
- Lagging video/audio can disrupt emotional flow and create stress and anxiety.
- The online platform used should be secure (e.g. Zoom, doxy.me). Check with your therapist which platforms you feel comfortable using.
- Ensure a stable internet connection, test equipment beforehand and have a plan in case of disconnection.
Not Ideal for All Conditions
- Lack of in-person cues and a therapist’s limited knowledge of the client’s local support and amenities may mean online therapy is not advisable in severe or crisis situations (e.g. active suicidality, addiction, domestic abuse).
- Some people are not comfortable with online communication or prefer an in-person connection. The client’s ease and comfort will significantly benefit the therapeutic work – personal preferences are important.
- The commute to and from in-person sessions can be valuable processing time that doesn’t readily feature in online therapy. Can you create time for yourself to digest the session before going back to ‘reality’?
Therapist Competence Matters
- A great in-person therapist isn’t necessarily skilled online. Factors that make the experience different for the client also apply to the therapist.
- Consider therapists that have specialised training or membership with an online association as well as experience with your concerns.
In Summary
Online therapy is not only a convenient option. It’s a different, yet equally powerful, form of therapeutic support compared to in-person therapy.
Research supports that relational depth, empathy, and strong therapeutic relationships can thrive online – important aspects of successful therapy outcomes.
Ultimately, finding a therapist and a way of working that suits your needs and preferences is key. Initial online consultation calls allow you to easily explore options.
I would be happy to discuss whether online therapy is a good fit for you during a free online consultation.
Research references:
Gonzalez, D. M. (2016). Client variables and psychotherapy outcomes. In D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic psychotherapies: Handbook of research and practice (2nd ed., pp. 455–482). American Psychological Association.
Mitchell, E. (2020) ”Much more than second best’: Therapists’ experiences of videoconferencing psychotherapy’. European Journal for Qualitative Research in Psychotherapy, (10) pp. 121–135.
Novotney, A. (2019, November). CE Corner: The science behind satisfying relationships. Monitor on Psychology, 50(10). [Online]
Suler, J. R. (2016) Psychology of the Digital Age: Humans Become Electric. Cambridge: Cambridge University Press.
Worley-James, S. (2022) Online Counselling: An essential guide. Monmouth: PCCS Books.
Philippa Lyons Therapy 