Is Online Therapy Effective
One of the most common questions people have before starting online therapy is whether it actually works. This page summarises the evidence.
Yes. A substantial body of research demonstrates that online therapy is as effective as in-person therapy for the majority of concerns, including anxiety, depression, PTSD, and relationship difficulties. The therapeutic alliance – the quality of the relationship between therapist and client – can be established just as strongly online as face-to-face. Online therapy is not a compromise; it is a fully effective way to access professional support.
Online therapy is not a lesser version of in-person therapy. It is a different way of accessing the same process — and the evidence shows it works.
Many people considering online therapy worry that something will be lost without being in the same room. This is a reasonable concern. But the research consistently shows that online therapy delivered via video produces outcomes that are comparable to face-to-face therapy across a wide range of mental health conditions.
What the Research Shows
A meta-analysis by Fernandez and colleagues (2021), published in Clinical Psychology Review, examined randomised controlled trials comparing live video therapy with in-person therapy. The findings showed that video therapy is no less effective than in-person delivery, with the strongest results seen for anxiety, depression, and PTSD (Fernandez et al., 2021, Clinical Psychology Review).
Thomas and colleagues (2021), writing in Psychology and Psychotherapy: Theory, Research and Practice — a British Psychological Society journal — reviewed the empirical literature on videoconferencing therapy for adults. They identified seven well-powered randomised controlled trials specifically for PTSD delivered via video, all showing significant symptom reduction comparable to in-person treatment (Thomas et al., 2021, Psychology and Psychotherapy: Theory, Research and Practice).
A UK-based randomised controlled trial published in The Lancet Psychiatry (Duffy et al., 2023) examined therapist-assisted online therapy for PTSD. The study found that online trauma-focused therapy was both effective and acceptable to patients, and was superior to non-trauma-focused approaches. This is particularly relevant because the treatment studied — internet-delivered cognitive therapy for PTSD — is based on one of the NICE-recommended first-line treatments (Duffy et al., 2023, The Lancet Psychiatry).
Research by Turgoose and colleagues (2020), published in Current Treatment Options in Psychiatry, reviewed telehealth interventions for PTSD and found that evidence-based treatments delivered via video consistently demonstrated feasibility, significant symptom reduction, outcomes that were non-inferior to face-to-face, and comparable dropout rates (Turgoose et al., 2020, Current Treatment Options in Psychiatry).
A systematic review by Rafieifar and colleagues (2025) in Research on Social Work Practice found that online interventions were at least comparable to face-to-face approaches, with decreased symptoms reported across a range of conditions including PTSD, depression, anxiety, and social phobias (Rafieifar et al., 2025, Research on Social Work Practice).
What This Means for You
The therapeutic relationship — the connection between you and your therapist — is what drives change, regardless of the medium. Research supports this. What matters is the quality of the work, not whether you are in the same room.
All my sessions are held via Google Meet. You do not need specialist equipment — just a stable internet connection and a private space. If you are unsure whether online therapy is right for you, a free introductory call is a good way to experience the format before committing.
Scope and Boundaries
This page is educational and draws on published research into online therapy outcomes. It does not constitute clinical advice or a recommendation for any specific individual. Whether online therapy is right for you depends on your circumstances, preferences, and clinical needs. If you are unsure, a free introductory call is a good place to start.
Is online therapy as effective as face-to-face therapy?
Yes. Research consistently shows that online therapy is as effective as in-person therapy for the majority of concerns. The therapeutic alliance – the most important factor in therapy outcomes – can be established just as effectively online.
Can you do psychotherapy online?
Yes. Psychotherapy, including depth-oriented and longer-term work, can be delivered effectively online. The structure, depth, and quality of the work are maintained. Online Psychotherapy UK
What if I don't feel connected to my therapist online?
The therapeutic relationship takes time to build, whether online or in person. If after a few sessions you do not feel connected, it is worth discussing this openly. Sometimes it takes adjustment; sometimes it means a different therapist might be a better fit. I will always prioritise what is right for you.
Are there any conditions that online therapy cannot treat?
Online therapy is effective for a wide range of concerns. However, there are some situations where additional in-person support may be needed – for example, if you are in acute psychiatric crisis. In such cases, local crisis services and your GP would be the first point of contact. Crisis and Emergency Guidance
If you would like to try online therapy, I offer a short, free introductory call. There is no obligation.