Can I attend therapy online?

Yes — and for many of the people I work with, online is not a compromise but the setting that makes therapy possible at all.

Online therapy is not a lesser version of therapy. For many people it offers continuity, privacy and access across countries and time zones. What matters is whether the work is clinically appropriate, confidential and steady enough for the person involved.

The most common doubt is whether real connection can happen through a screen. It is a fair question, and the honest answer — from research and from my own practice — is that it can.

The evidence on video-based therapy consistently shows outcomes comparable to in-person work for a wide range of difficulties, including anxiety, depression and trauma. More importantly, the thing that makes therapy work — a steady, attuned relationship in which you feel understood — travels well. Attunement is carried in voice, pacing, facial expression and the quality of attention. A screen transmits all of these.

Some people actually find depth easier online. Being in their own home, with their own tea and their own door locked behind them, lets their nervous system settle in a way an unfamiliar consulting room does not. Some things are easier to say from your own sofa.

Online therapy comes into its own for people living abroad who want a therapist in their own language; for those whose work or caring responsibilities make travel impractical; for people in places with few trauma-informed therapists nearby; and for anyone whose life moves between cities. It also offers continuity — the work does not have to pause because life relocates.

I work with English-speaking clients internationally, and for many of them the choice is not "online or in person". It is "online or nothing".

A quiet room, reliable connection and clear boundaries help online therapy feel contained.

This is the part that deserves real care. In a consulting room, the room does some of the holding: the same chair, the closed door, the hour that belongs only to this. Online, we build that container together. It means a private space where you will not be overheard or interrupted, a stable connection, headphones if they help, and a few minutes on either side of the session to arrive and to land — rather than clicking straight from a work meeting into therapy and back again.

When those conditions are present, meaningful relational work can happen through a screen. When they are not, we talk about it, because the frame is part of the therapy, not an accessory to it.

Honesty matters here: online is not identical to in-person, and pretending otherwise helps no one.

The screen crops the picture. I see your face and shoulders, not the whole of you — so I will sometimes ask about what I cannot see: what your hands are doing, what is happening in your legs, whether your body has gone still. You become a collaborator in noticing your own body in a way that in-person work asks for less explicitly. Many clients find this becomes a strength: they learn to read themselves rather than relying on me to do it.

The other difference is the threshold. There is no walk to the clinic and no journey home — the small rituals that mark the hour as separate from ordinary life. Online, we create the threshold deliberately, which is why those few minutes before and after the session matter more than they might seem.

Carefully, yes. Trauma-informed therapy — including EMDR, which has established online protocols — can be done well remotely, with attention to pacing, grounding and what we do if you become overwhelmed between the screen and the rest of your evening. For some people, in-person work is clinically the better choice, and I will say so honestly if I believe that is true for you. The setting should always serve the work, never the other way round.

Confidentiality online deserves a word as well. I use a secure platform, and my end of the call is as private as my consulting room. Your end is yours to arrange — and if privacy at home is genuinely impossible, that is worth telling me rather than working around, because a session spent half-listening for footsteps is not a session your nervous system can use. People get creative: parked cars, booked meeting rooms, a walk with headphones for a talking session. The container matters more than its shape.

If you are unsure whether online therapy would suit you, the simplest way to find out is to try a first conversation — online, of course — and notice how it feels.