Online therapy: is it as effective as in-person therapy?

Many people are sceptical about online therapy at first. When it comes to relationships, shame, anxiety, or low mood, it can be hard to imagine speaking openly about these things with a therapist through a screen. But often, this is not easy even when you and your therapist are sitting in the same room.

The questions are usually the same: can online therapy be as good as in-person therapy? Will there be a sufficiently good connection? Will I really be understood? Will the conversation feel colder, more superficial, or less helpful?

In most cases, the outcomes of online and in-person therapy are comparable.

In my practice, there are clients who were initially sceptical about the online format. Some wanted at least the first session to be in person. However, after trying the first online session, it becomes clear that this is a full format with its own important advantages that come specifically from working remotely.

Even before COVID-19, online therapy was more the exception. During the pandemic, many clients and therapists had to try it without much preparation. It turned out that remote therapy worked better than had previously been assumed. Since then, it has become a familiar way for many people to work with the therapist they have chosen.

What does research show about online therapy?

Online therapy has been studied extensively, and the overall picture is quite clear: in most cases, its outcomes do not differ substantially from those of in-person therapy. There is most evidence for depression, anxiety, and PTSD.

Client satisfaction with online therapy is also high in research. Meanwhile, the therapeutic alliance — the connection and collaboration between client and therapist — does not become weaker simply because the two people are not in the same room.

What can the online therapy format offer?

First, there is the practical matter of time. There is no need to plan the journey, allow for traffic, or spend extra energy getting to the therapist. For people with busy daily lives, demanding work, small children, or an already high level of strain, this can matter. Therapy can also often be continued more easily over the long term, because less logistics means fewer cancelled sessions. Regularity matters in therapy — it allows the process to gradually go deeper.

In a remote format, a person is not tied to a location. You can choose a therapist whose approach and working style genuinely suit you, rather than only the person who is convenient to get to. This is particularly important when looking for a specific type of therapy, such as IFS. Usually, at least half of my practice clients live abroad.

The therapy space itself is also different. For some people, it is easier in their own environment to feel more at ease and notice emotions and bodily sensations. A greater sense of safety can reduce defences and make it easier to work with difficult emotions.

Why does IFS therapy work well online?

IFS is well suited to an online format. In IFS therapy, a large part of the work takes place in your inner world — in your relationship with emotions, defences, wounds, and the way you relate to yourself. The therapist's task is to help you find your way in this process, offer support, and maintain contact. This can also be done when both people are not in the same room.

My experience suggests that online is usually even better than in person, because in your own space it is easier to stay in contact with yourself rather than focus too much on the environment provided by the therapist.

Early clinical research on online IFS therapy shows high client engagement and satisfaction, as well as a substantial reduction in symptoms. Many clients also note that being in their own space deepens their sense of safety, which is important for being able to stay in contact with strong emotions and wounded inner parts.

How to choose: online therapy or in-person therapy?

Online therapy is very suitable for many people, though not for everyone and not in every situation.

The online format may suit you if:

• you would like to save the time required to travel to a therapist;

• it is important to you to work with a particular therapist or therapy method;

• you live abroad, travel frequently, or distance makes regular in-person sessions difficult;

• you can engage more easily in the therapy process in your own environment.

In-person therapy may be more suitable if:

• you do not have a private and confidential space for sessions;

• your internet connection is not sufficiently stable;

• you are currently experiencing an acute crisis and being physically in the same room as a therapist would give you a greater sense of safety.

If it is important for you to understand whether the online format is right for you, you can read more about my approach to therapy. If you still have questions afterwards, you can request a free 20-minute consultation, where we can briefly discuss them.

Frequently asked questions about online therapy

Is online therapy as effective as in-person therapy?

For many people, yes. Research shows that video therapy often produces outcomes comparable to in-person therapy.

Can a sufficiently good connection with a therapist be formed online?

Yes. The therapeutic alliance in an online format can be as strong and deep as in person.

Is IFS therapy suitable for an online format?

Yes, often very much so. IFS is an inwardly oriented process, so it naturally adapts to working by video.

Who might online therapy not be suitable for?

If you do not have a private space, have unstable internet, or are currently in an acute crisis, in-person therapy may sometimes be more suitable.

Sources

Ally, D., et al. (2025). A pilot study of an online group-based Internal Family Systems intervention for comorbid posttraumatic stress disorder and substance use. Frontiers in Psychiatry.

Barak, A., et al. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human Services, 26(2-4), 109-160.

Batastini, A. B., et al. (2021). Are videoconferenced mental and behavioral health services just as good as in-person? A meta-analysis of a fast-growing practice. Clinical Psychology Review, 83, 101944.

Comeau, A., et al. (2024). Online group-based Internal Family Systems treatment for PTSD: Feasibility and acceptability of Program for Alleviating and Resolving Trauma and Stress (PARTS). Psychological Trauma: Theory, Research, Practice, and Policy, 16(Suppl 3), S636–S640.

Fernández, E., et al. (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy, 28(6), 1535-1549.

Psychiatry Advisor. (2023, May 10). Online therapy vs in-person therapy.