Professional website of Avi Soudack

Mental Note

Musings on therapy and psychological health by Avi Soudack, RP

Therapy online: Does it work?

Oct 2023

Emmet always looked forward to his therapy sessions with Joanne. So, he was unsure what to think when she suggested they hold sessions online. He wondered: What would they be like? Would it even work? Going to his therapist's office always felt like taking time out for himself. At her offices, he was able to leave the stress of daily life behind and really tune in to the work they were doing together. But online? On a computer screen? Really? He was worried it would be impersonal and cold.

Online therapy - also called telepsychology or teletherapy - has been a growing trend around the world for years. With the onset of the Covid 19 crisis, its use has grown dramatically. Mental health professionals have moved their services online to help minimize the risk of infection to their clients and to limit the spread of the virus.

Emmet understood why Joanne suggested online therapy, but he had a number of questions and concerns.

How does online therapy work?

Before Emmet had his first online session, Joanne discussed with him how they would work, the pros and cons of using the system, and the backup and emergency plans they would use. She wanted to be sure that Emmet could make an informed decision about continuing online. Then she asked him if he wanted to continue or not. Therapists are required to get "informed consent" from their clients to participate in online psychotherapy. Emmet was reassured and curious to give it a try.

Are online therapy sessions secure?

Emmet was used to being online for work meetings and he Skyped with his family and friends regularly. But he wondered about the privacy of what he would discuss with Joanne during his sessions. Joanne explained that the system she used—which allowed them to see and hear each other over the web—was a secure one that protected privacy at the strict levels required by the regulations that governed her practice.

Will I be comfortable doing psychotherapy online?

Joanne had suggested to Emmet that he find a quiet space in his home where he would not be interrupted during the session. He reserved some time just before and after so he could transition to and from the rest of his day. Emmet found her suggestion not to sit at his desk to be particularly helpful; finding a comfortable chair away from his work space put him at ease. And turning off all unnecessary programs and notifications on his computer removed distractions and helped him focus. All in all, it took just a few minutes to become familiar with the system and they were soon comfortably talking about his progress.

What about technical or other problems during online therapy?

Emmet was happy to learn that he didn't need any special equipment - just a laptop with a camera and an internet connection. Joanne had discussed with Emmet what they would do if their Internet connection was interrupted. And they decided what to do in the unlikely event that an emergency arose. She suggested that they use their phones for voice and the web-based software for the video. That way they could be sure that even if there were lags in the video their conversation could go ahead smoothly.

Does online therapy actually work?

Emmet didn't have to worry about online therapy working or not. Studies have shown that it is as effective as traditional face-to-face treatment for anxiety and depression and many other conditions. It has been found to be effective for diagnosis and assessment for adults, children, and the elderly.

Same time next week?

Emmet found that a few minutes into his session he had stopped noticing that they were online and really got into it. Before he knew it, his session was over. With Joanne's assistance and a little accommodation to the new situation, he found himself looking forward to his next online therapy session.

Things to remember

  • Therapists must get informed consent from you to do therapy by electronic means.
  • All electronic media, including email, have some risk of privacy breaches. But therapists must use a secure online platform for online therapy to minimize privacy concerns.
  • A regular computer or mobile device and internet connection are all that you need.
  • Give yourself time to get used to it and find a time and a place in your home to make it as private and comfortable as you can.


Berger, T. (2014, October). Internet-based psychotherapy treatments. [Web article]. Retrieved from:

Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The effectiveness of telemental health: a 2013 review. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 19(6), 444–454.