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  • imogenmcintyrecoun

What to Expect From Online Therapy

Updated: Apr 20, 2023



For someone who has never experienced online therapy before, it is natural to wonder what to expect. In many ways, online therapy is exactly like in-person therapy. Your appointment time is reserved just for you, and your therapist strives to create a safe, non-judgmental space characterised by sensitivity and emotional attunement.


Just like in-person therapy, online therapy is a place to engage in guided self-discovery, process events from the past and present, and learn new skills to improve quality of life. A significant body of research suggests that online therapy is just as effective as in-person therapy, and may be more accessible for some clients. One study, published in the Journal of Affective Disorders, found that online cognitive-behavioral therapy was just as effective as in-person therapy for treating depression. Another study, published in the Journal of Telemedicine and Telecare, found that online therapy was just as effective as in-person therapy for treating anxiety.

Preparing for Your First Online Therapy Session


The foundation of this work is the therapeutic relationship, which is just as warm, supportive and safe online as it is in-person. The basic structure of each session is essentially the same as well. Your therapist will check in with you about how you are doing, and what direction you’d like to take in the session. They may set goals with you for future work, and check on your progress on goals you’ve set in the past. The issues discussed in online therapy are the same types of issues that may be discussed in in-person therapy, and include things like grief, trauma, anxiety, depression, loneliness, or family and relationship challenges.


Our therapists use modalities such as CBT, DBT, EFFT, narrative therapy and Internal Family Systems. The session generally ends with a plan for the next areas you’d like to explore in therapy, or homework for you to try at home so that you can continue to make progress on your goals between sessions, followed by re-booking your next appointment. In terms of payment, most insurance providers have similar coverage for online therapy as for in-person therapy.

You do not need any special equipment or technological skill to try online therapy. I have seen clients ranging from youth to seniors. I use a platform called www.doxy.me, which was specifically designed to meet the legal privacy requirements for healthcare. It does not require that you download anything. Before your appointment I will send you a link, and you just click the link and log on. It will be the same link for each appointment. The only things you need are a quiet, private space where you feel comfortable doing counselling, and a device such as a phone, tablet, or computer that is capable of doing a video call. If you do not have this type of device, or if we experience technical difficulties (which are rare, but can happen!) we can use the phone instead.

Comparing Online and In-Person Therapy


Some people have a strong preference for therapy in person. After three years of the COVID-19 pandemic, many of us feel “Zoomed out” and long for the personal feel of in-person counselling. For these people, in-person counselling can be the right choice.


However, online therapy can have unexpected benefits, and many of my clients who believed they wouldn’t like it as much as in-person therapy have actually come to really enjoy it. Some of the benefits of online therapy include the flexibility, the portability, and the comfort of doing counselling from one’s own space.

One of the main benefits of online therapy is the flexibility. My clients are able to do their appointments from anywhere where they have a reliable internet connection and a private space. They don’t need to sacrifice travel time getting to my office, or fighting their way through rush hour traffic. I have met with clients from their car, or during their lunch break at work. It can be a great option for those with busy schedules or who balance many commitments to fit in an hour of dedicated self-care time during their day.

For queer people, one of the great benefits of online therapy is portability. I see many clients in rural BC who don’t have queer or trans affirming counselling available locally. As a queer person who grew up in a rural place before online counselling was widely available, I appreciate being able to reach people who may be feeling the pain of isolation, or who may not have connection to a supportive queer community. Similarly, I have been able to continue to work with clients who have moved away from the area, and they appreciate the continuity of care that it affords them. I am honoured to serve clients across BC, particularly those in smaller communities looking for a queer or trans affirming therapist. Because we offer a very specialised service at Stillwaters Counselling, our clients are often willing to try online counselling in order to get the right fit with a therapist, or to be able to work with a therapist who really understands their experience.

The Unique Benefits of Online Therapy


One concern that some clients have about online therapy is the idea that something will be lost in terms of body language and other non-verbal communication. It’s true that online therapy offers more limited information than in-person therapy, because you can usually only see the other person’s head and shoulders, instead of sitting in the same room and getting a bigger picture. On the other hand, I really appreciate the focus on small changes in facial expression or tone of voice that are necessary for online counselling; I think it requires that the therapist be highly attuned to these aspects of their clients non-verbal communication. Furthermore, there is something very personal and special about getting to see my online clients in their own environments. I genuinely enjoy getting to know my clients’ decorating style, meeting their pets, and knowing that they are comfortable and relaxed in their own space.

Similarly, some clients feel more relaxed in their own homes and feel they can participate more fully in counselling because of this. This could be because they have had negative experiences in clinical spaces in the past, or because they feel nervous or self-conscious going to a clinic. Particularly in small towns, there can be concerns about anonymity associated with going to a mental health clinic.

Build a Strong Therapeutic Relationship Online


If you are considering online counselling as an option, I would love to speak with you and answer any questions that you have about online therapy or how we work at Stillwaters Counselling.


Our free video consultations are a great way to get a feel for whether online therapy might be a good option for you, and to get a sense of whether one of our therapists might be the right fit.


Book a complimentary 15 minute consultation through our online calendar, or get in touch by email with any questions. Let’s start your journey towards growth together.

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