Is online counselling as effective as in-person?

What the Research says

A 2023 meta study found ‘negligible differences in treatment outcomes between the two formats’, and that the therapeutic relationship can be just as strong online as in-person.This is true for individual and couple sessions, although there may be a perception that in-person provides human presence which is a more intimate connection, and body language is harder to read on a video call. Conversely, there can be comfort in talking openly through a screen. Online therapy is credible option, not a diluted version of in-person therapy, and each has particular benefits: 

Online works well when couples are based overseas, or have demanding schedules or are in separate locations.  Online can support couples with limited childcare, although in-person sessions do ensure a couple leave the house and kids for valuable time to themselves. 

Online works well for people who benefit from the comfort of familiar surroundings or have restricted mobility. In-person works better when one of both partners struggle to engage via a screen or to stay present and risk being reactive and dropping out of the session. While walking out session is always an option, leaving the therapy room is more difficult, and that can benefit the client.  A therapist may feel they have more leverage in the room to help dysregulated clients. 

Online sessions may not be safe where there is coercive control, intimidation or domestic abuse. Particularly if one partner cannot speak freely or may be monitored at home. 

The therapist’s ability to create and maintain a safe and collaborative alliance is central to therapeutic work and in comparison studies, satisfaction with the connection and counselling work was judged by clients and therapists to be similarly effective be it online or in person.