Online Therapy vs. Face to Face Therapy

Online Therapy vs. Face to Face Therapy

Online therapy is just a COVID thing right?

Typically, when most of us think of therapy, we think of sitting in a calm, peaceful room with a therapist sat opposite us writing notes. However, for many years now, alternative routes to therapy have been available and have been researched. All COVID did with online therapy is bring it into our consciousness.

Research into these collective studies is showing that not only is online CBT therapy at least as effective as face to face in adults (Fernandez et al, 2021, Luo et al, 2020, Germain et al 2009), but that online CBT is also effective in the older-adult population (Ando et al, 2023) and with young people (Howes, Gorey and Charron, 2023).

I set up My Online Psychologist, so I am, of course, biased. Confirmation bias is a thing (we tend to see things that confirm what we believe). Due to the positive feedback I received for online therapy, I was conscious I could be skewed into thinking it must work really well for all. This is where the research has been pleasing. It has supported the belief that it has really good outcomes.

When I started my private practice in 2010, I started with just in-person sessions. The idea of a video session was alien to me. Sure, I'd used Skype on a couple of occasions (namely chats with friends abroad), but never therapeutically. Indeed, it was only in 2014 that I offered my first online CBT appointment. Essentially, a client was stuck at work in London. There was no way they could come to the clinic but they really wanted to keep the appointment so they asked if it could be over video. We were both aware that it was unknown territory for each of us, but we both found the session went really well. And so, I started offering this as an option.

As the years have progressed, online therapy has become more and more easy to administer. For me, the introduction of screen-sharing was a game-changer. As was the ability for both of us to edit the same document on screen. This allowed sessions to flow easily, and made it easy to work together on working out the maintaining factors keeping a mental health difficulty going.

The ability to save files on the computer instantly meant no lost pieces of paper drawn up in session and taken away by the client. Now we can start a document, edit it, continue it for homework and come back to next session with ease. It's these things that I really value about online therapy, as well as it's convenience - no rush getting to and from an appointment, no need for a parent to wait in a waiting area whilst their child is having a session (they can get on with other things at home instead), having creature comforts with you like your favorite cup of coffee.

That said, there are times where I believe face to face CBT therapy is a better option. In particular, if an individual has high levels of suicidal ideation then not only are face to face sessions more suitable, but also, likely, a team approach. This is where an individual has access to a psychologist, psychiatrist and other mental health practitioners. These practitioners should ideally work in the same team enabling them to work together easily.

During your initial call we can discuss whether online therapy could be right for you or your child. My aim is to ensure you receive therapy that is right for you/them, ideally from the first therapist you see. This is one reason I offer the free telephone screening/assessment appointment. On this call, whilst also working out if online therapy is suitable for you, we'll also talk about the difficulties you're experiencing and what your goals of treatment are so that I can try and match you up with an associate most suited to help with your specific difficulties/aims.

As always, any questions, please do not hesitate to contact me.