If you’re considering therapy by video, there’s usually a quiet question underneath the practical ones: is this the lesser option? Am I settling for something second-best because it’s convenient? It’s a fair thing to ask, and it deserves an honest answer rather than a sales pitch.
What the research broadly indicates
A growing body of research has compared therapy delivered by video with therapy delivered in person. Broadly, systematic reviews and meta-analyses of randomised controlled trials have found that videoconferencing-delivered psychotherapy tends to produce outcomes comparable to face-to-face therapy for many common presentations, including depression and anxiety, and the Australian Psychological Society has summarised telehealth as an effective way to deliver psychological services for many people. For example, a 2022 systematic review and meta-analysis of randomised controlled trials published in JMIR Mental Health found no significant differences between psychotherapy delivered by telehealth and the same therapy delivered face-to-face across outcomes including symptom severity, functioning, the client–therapist working alliance, and client satisfaction (Greenwood et al., 2022). This isn’t a blanket guarantee — the evidence is stronger for some conditions than others, some studies have found the therapeutic alliance rated a little lower over video, and researchers, including the authors of that review, note that more evidence is still needed for certain serious mental health conditions. But the overall picture does not support the assumption that video therapy is simply a watered-down version of the “real” thing.
Why it works better than intuition suggests
Part of why this surprises people is that we tend to imagine therapy is mostly about being in the same room. In practice, a great deal of therapy is a conversation — and the working relationship between you and a therapist, which matters a lot, can and does form over video. Being able to see each other’s faces and hear tone carries much of what makes that connection possible.
The real advantages
Video therapy also has genuine upsides, not just trade-offs. You can attend from your own space, with no commute and no waiting room. Geography stops determining who you can work with, which matters a lot if you’re rural, remote, or simply want a particular fit. And continuity is easier to protect — you can keep seeing the same person through a move, a busy stretch, illness, or a new baby, when getting to an office might otherwise mean stopping.
Where it has real limits
An honest answer includes the limits. Some people simply find video harder or more tiring than being in a room, and that’s a valid preference. A poor internet connection can genuinely disrupt a session. Some approaches lend themselves more readily to in-person work. Privacy at home isn’t a given — it can be difficult in shared housing or a full household to find a space where you feel free to speak openly. And some situations, including acute crisis, may be better served by in-person care or local supports. Video suits many people well; it doesn’t suit everyone, in every circumstance.
What a session actually involves
Practically, a telehealth session looks much like an in-person one, held over a secure video link. You’ll need a private-enough space, a device with a camera, and a reasonably stable internet connection. It’s worth taking a moment to think about where you’ll sit so you can talk without being overheard, and sessions are run over secure, privacy-conscious platforms.
An easy way to find out
The most reliable way to know whether video works for you is to try a short, low-stakes conversation. A free 15-minute call is a good way to test how it feels before committing to anything.
You can read more about how telehealth works, or begin an enquiry to arrange a free 15-minute call.