In the past few years, we’ve become more used to living our lives online. We work remotely, we attend doctor’s appointments virtually, and we can do our grocery shopping with the click of a button. With the rise of online services has also risen an abundance of online therapy. Still, a common question I often get asked is whether online therapy is any less or more effective than in-person therapy.

It’s fair to say that online and in-person therapy are not the same. Recent MRI studies have shown that different parts of the brain are activated when people do therapy online compared to in person. However, it doesn’t necessarily mean that one is better than the other. The good news is that the research shows very little difference in outcomes in online versus in-person therapy. This means that online therapy is a useful and effective platform for those who want to access it.

Below, I’ll discuss the advantages and disadvantages of online therapy, what to ask therapists who practice online, and what you can do to get the most out of your online therapy sessions.

Advantages of online therapy

Another benefit of online therapy is the ability to do sessions in the comfort and familiarity of your home. Surrounded by familiar objects and in a safe environment, the therapy process can feel less vulnerable and more supportive than in a foreign and sometimes impersonal clinical space. For people who are new to therapy, this sense of familiarity can help make therapy feel less threatening or overwhelming.

Online therapy can address nearly the same range of issues as in-person therapy: working with depression, anxiety, self-esteem, and relationship therapy are all possible in an online setting.

Logistically, online therapy is helpful for people living in remote or regional areas who lack access to quality healthcare. It’s suitable for those who work busy or long hours, for parents and carers who have to juggle caring responsibilities and who cannot step away for long periods.

Disadvantages of online therapy

There are drawbacks to online therapy. It may not be appropriate for treating severe psychiatric illnesses such as schizophrenia or psychotic episodes or in instances where someone is in physical danger. It is also more challenging for a therapist to co-regulate with you should you become too distressed.

Sometimes, the technology can be disrupted, and depending on the quality of the local infrastructure, internet connections may be slow in some areas or drop out entirely. This can cause a shock when it happens during the middle of a session or a vulnerable moment. However, any skilled therapist online should be able to manage those difficulties and support you with dealing with any disruption to the session.

Other concerns may be the privacy and security of the online sessions and the location of your therapist; it’s important that therapists maintain the same level of privacy in their online spaces as they would for an in-person session.

While the familiarity of doing therapy in the comfort of your own home can be an advantage, it can also be a drawback. There’s more potential for distraction online, and a familiar environment may be an impediment to getting out of your comfort zone and exploring unfamiliar or uncomfortable parts of your life.

Questions to ask a therapist about online sessions

It can be useful to ask a therapist the following questions if you are enquiring about online sessions:

• How is therapy conducted

Some therapists only do text-based therapy, some only do phone consultations, and many use video platforms. Any platform that requires more modes of interaction (e.g., voice, face, gesture, etc.) will be more effective. For simple problems, text might be more appropriate, but for more complex issues, a video session may be more appropriate.

• What security do you have?

Video platforms such as Zoom or Skype are encrypted and, therefore, safer. Some proprietary healthcare software systems are also set up for online therapy and meet the confidentiality requirements of professional bodies. Less formal platforms such as Google Meet or Facebook Messenger are not likely to maintain the same level of confidentiality.

• Where do you practice?

It’s important to know where a therapist practices and if there is likely to be anyone else around while a session is in progress. Therapists should maintain the same level of confidentiality and privacy for online sessions as they would for in-person sessions. That includes using a private and soundproofed room and ensuring nobody else is in the space while a session is conducted. Ideally, a therapist would also wear headphones to ensure privacy and a microphone for clarity.

How to get the most out of your online sessions

As a general rule, find a space where you feel comfortable having the session, where you can hear and speak without interruption or intrusion and without distractions.

Just as you would expect a therapist to be alone and maintain privacy, it’s essential that you set up your session somewhere where you can speak freely and not have to worry about others who could listen in. This is especially important for partners or family members you might discuss during a session.

Because you are online, the usual temptations to respond to emails or participate in chats will arise. If possible, turn off your notifications and commit to remaining focused and present for the duration of the session. Responding to messages in the middle of a session will reduce the therapeutic benefits. This is your hour, so set the intention of showing up as much as you can for it.

In summary, while online therapy has advantages and disadvantages (like anything else), it is no more or less effective than in-person therapy and is a viable option for many people who don’t have access to in-person services.

If you are curious about whether online therapy is right for you and your relationship, get in contact to learn more.