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Is online therapy as good as face to face therapy? Psychotherapist perspective

Is online therapy as good as face to face therapy?

I have recently had to move my business online and while it was something I was already considering it was certainly made more urgent by Covid-19. Online therapy comes under different names like teletherapy or telemental health and although it seems quite recent to many it has been in situ for many years. I have always wondered if I could achieve that same level of ‘containment’, ‘holding’ and’ treatment’ for my clients through the medium of Zoom/Skype. 

I am glad to say I have been pleasantly surprised at how well this new medium is working, not just as a support for but also as a space for some really deep work. While I had already built up a relationship with most of my clients previous to our online work, I have taken on new clients whose only experience of therapy is through technology. Whether online or in person, the first port of call is to assess where this individual is in their process and to determine if I am the best fit for them.

As I move forward in my practice, I have had to find ways to transfer all of the fundamentals I use in in-person work to the online platform. I feel breaking down the different parts of in-person work has allowed me to see what I need to put in place online. Some issues to transfer include, insurance, contracting, creating a safe space, confidentiality, financial arrangements/payments, cancellation policies, session structure, continuity, no-judgement, genuineness, containment and safe-guarding. I am also comforted by research which has shown that online therapy or telemental health is as effective compared to in-person care (HIlty, 2013)

I don’t view telehealth as a replacement for face-to-face work,  I think they can exist in the same space, the beauty is that it offers people another avenue to access treatment and support. For some, the idea of attending a face-face therapy session can be an anxiety provoking process so online therapy can offer individuals a space to take the first step that feels less intimidating. support. The idea of blended treatment comes to mind, with the option of moving between in-person treatment and teletherapy if and when it is needed.

It is also important to mention that teletherapy is not fit for purpose in some instances of mental health care. Some people require close and direct treatment or in-person intervention for example if someone has a serious addiction or more severe or complex symptoms of mental health. Online therapy in these instances may only be recommended if other treatments or interventions are involved in the care plan of particular individuals.

Overall I am enjoying this new space and while it poses challenges if the wifi signal drops but these things are rare and can be worked around.

If you would like more information either as a therapist using an online platform for the first time or a client considering online therapy please contact us on 0863788002 or



Hilty.D.M. et al (2013) The effectiveness of Telemental Health: A 2013 Review [online] available at accessed January 2020