Does Online Therapy Actually Work?

It is a fair question — and one that is worth answering honestly rather than with enthusiasm alone.

Online therapy has become significantly more common over the past several years, and with that growth has come a corresponding rise in both advocates and sceptics. The honest answer sits somewhere between the two.

What the research suggests

A substantial body of research has examined the effectiveness of video-based psychological therapy compared to in-person therapy for a range of concerns including depression, anxiety, trauma, and relationship difficulties. The findings, taken together, suggest that for many people and many presenting concerns, online therapy can be comparably effective to in-person therapy.

This does not mean online therapy is superior, or that it is equally suitable for every person or every situation. Research in this area continues to develop, and findings vary depending on the concern being addressed, the therapeutic approach being used, and the individual characteristics of the client. What it does suggest is that dismissing online therapy as a lesser option is not supported by the available evidence.

What online therapy actually looks like

Online therapy conducted through a registered psychologist typically involves a secure, encrypted video platform — not a standard video call application. Before beginning virtual sessions, a responsible clinician will review privacy considerations with you, discuss what to do if there are technical difficulties, and ensure you have a private and comfortable space from which to attend sessions.

The session itself looks much like an in-person session. You speak, the therapist listens and responds, and the work unfolds through conversation, reflection, and the gradual building of insight and skills. The primary difference is the medium — and for many people, that difference turns out to matter less than they expected.

What it tends to work well for

Online therapy is often particularly useful for people who live outside major urban centres and have limited access to registered psychologists locally. It is also valuable for people whose schedules, caregiving responsibilities, physical health, or mobility make in-person attendance difficult.

For people who are already comfortable communicating through screens — which, for many, is simply a feature of contemporary life — the adjustment to online therapy is often minimal.

Where it may be less suitable

Online therapy is not appropriate for everyone or every situation. There are clinical presentations where in-person assessment and treatment may be more appropriate, and situations where the level of care required goes beyond what can safely be provided through a video platform.

A responsible psychologist will be transparent with you about whether online therapy is clinically appropriate for your specific situation, and will not proceed with virtual sessions where doing so would compromise the quality or safety of your care.

Practical considerations

If you are considering online therapy, a few practical things are worth thinking about in advance. Having a private space where you can speak freely is important — being overheard is a common concern that can affect what people feel able to say. A stable internet connection and a device with a working camera and microphone are also necessary. Some people find that having headphones improves both the audio quality and their sense of privacy.

Beyond the practical, it is worth giving yourself some time to adjust. Some people find online sessions feel slightly unfamiliar at first, and that familiarity builds over the course of a few sessions.

Disclaimer

The suitability of online therapy varies depending on the individual, the nature of their concerns, and other clinical factors. The information in this post is general in nature and is not intended as clinical advice or a recommendation for a specific format of therapy.

Heartwill Elewosi is a Registered Provisional Psychologist with the College of Alberta Psychologists. This article is for informational purposes only and does not constitute psychological advice or establish a therapeutic relationship.