Everything You Need to Know About Online Therapy

Everything you need to know about online therapy and how to get the most out of your sessions. While the covid pandemic has transformed how we access healthcare and how we use technology in our lives generally. Online therapy has been around for many years.  I’d always seen a few clients online who found it difficult to meet face-to-face for various reasons, but I had my reservations.

Two years later, I’m now happily operating a hybrid clinic of online and face to face therapy and I can honestly say that I’ve been pleasantly surprised by the results of providing online therapy, if I’m honest been sceptical about how well it would work.

What are the Benefits of Online Therapy?

I’ve been really interested in what the research would find and to date, the research has consistently shown that online treatment can be very effective for many mental health issues. For example, a 2014 study published in Behaviour Research and Therapy found that online cognitive behavioural therapy was effective in treating anxiety disorders. While more research needs to be done in this area the initial findings are very promising.

Many people find online communication very comfortable, especially younger adults or those who use technology often. As more people are using email, webinars and text messaging to communicate, it can seem easier than talking to someone in person, especially when revealing personal or private information.

Online therapy significantly improves accessibility for many people. Students or people who travel for work have previously experienced fragmented care due to living in a number of locations and In many rural communities, the nearest therapist may be an hour or two drive away.

Some people with chronic illnesses who are carers or who have disabilities may not be able to drive or easily able to leave their homes. In these situations, online therapy may be their only option for help and this new trend is improving accessibility for all.

Don’t forget the outcome of your therapy is greatly influenced by the relationship you build with your therapist this is the same online as it is for face to face therapy.  When starting therapy it’s important you give the therapeutic relationship time to build, you need to feel like your therapist is the person to help you have a sense of trust, feel connected and comfortable.

Here are a few other benefits…  

  • For many of us, being in our own homes feels more comfortable and safe.
  • Online therapy provides a great deal of flexibility and makes it easier to prioritise your mental health alongside other responsibilities and commitments.
  • People have much more choice around who they work with as location is not a barrier.
  • It’s less time-consuming and removes the need to travel to and from your appointments along with reducing the associated costs.
  • Some people record sessions to listen back to at another time to improve learning.
  • You will have a wider choice of therapists instead of being limited by location.

What to Expect and How to Get the Most Out of Your Session

Prior to your first therapy session, you should have discussed the platform that you will use for your sessions and have a link to follow for the day.

I generally use Zoom to deliver online therapy. As well as being safe and secure, it’s very easy to use. Payment is taken just before the session via BACS transfer or PayPal.

Ahead of your appointment, find a nice, quiet therapeutic space in your home where it’s ok to feel emotional and talk about the tough stuff. Think carefully before opting for your bedroom. Could its association with therapy later disturb your sleep?

Make sure other people in your household know that you don’t want to be disturbed during the hour.

Switch off notifications on the device you are using to avoid any distractions. Make sure it’s fully charged and where possible ask other people in your home to avoid using the internet. Certain things like downloading movies could slow down your Wi-Fi and interrupt your session.

When having CBT online, therapists often have diagrams and information they want to share to help you make sense of things or to help you understand things differently,  so the ability to share our screens is really useful. Sharing a screen is easier on a laptop or Ipad where the screen is larger if you have smaller device documents can be emailed in advance.

Using an ethernet cable instead of Wi-fi significantly improves connectivity and speed when having online sessions so there are fewer disruptions.

Try to sit central to the screen at about an arm’s distance with a light above you or in front of you, this improves what’s called telepresence and helps us to feel more connected during the session.

Put your video on, if this is out of your comfort zone let your therapist know but I’d really encourage you to give it a go it’s surprising how quickly you will forget it’s on. It improves connection and communication.

During online therapy some body language cues can be missed,  If you feel your therapist has missed something do let them know. Therapists don’t mind being corrected at all and it’s important you feel heard and understood, therapy is an important investment in you, these are your sessions.

Maintaining the confidentiality of your therapy is always of paramount importance. One way to improve confidentiality is to wear earbuds or headphones, sound quality will also be improved.

Using a stable platform for your device is really helpful. Place your device on a table or stand, handholding for an hour will cause your arm to ache and can give your therapist motion sickness.

Finally, if you were to have a face-to-face therapy session as the session draws to a close there is some informal chat and goodbyes before you head out for your journey back to work or home, this gives you time to digest what you have just talked through and to generally decompress, which is useful especially if it’s been emotional.

When you have therapy online you are already at home generally and you may have been discussing some emotionally charged topics.  I encourage people to have a post-session plan – move rooms, get changed, go for a walk, connect with a friend or partner, listen to some music or watch TV. Shake it off and decompress.

Some people find it helpful to follow each session with some journaling time. Read my post about using a therapy journal for more information.

Links worth clicking

Book – Digital Delivery of Mental Health Therapies

For Therapists – Free guide – Top Tips for Digital Delivery of CBT

Does Online Therapy Work

How to Choose a CBT Therapist

Getting the Most Out of CBT


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Sarah Rees

Sarah is a fully accredited Cognitive Behavioural Therapist and mental health writer delivering Modern Mental Health for you and with you in Mind. Sarah is the author of ‘The CBT Journal’ which helps you write for your wellbeing incorporating CBT techniques. For more information and to keep in touch have a look at sarahdrees.co.uk.