Seeing a psychologist online: how it differs from meeting in person

“Online isn’t real therapy, is it?” That view is out of date: over the past few years the online format has turned from a stopgap into a fully fledged way of working^[1]. But the formats do have real differences, and the choice deserves some thought.

Lyudmila Chernysheva, psychologist and hypnotherapist
Updated: September 28, 2026

A laptop on a desk by a window, a cup of tea and an empty armchair

What stays the same

In my practice the two formats stand on an equal footing: the method, the structure of the session, confidentiality, session length and price are the same in both. Meta-analyses comparing therapy by video link with in-person therapy find comparable results: what does the work is the relationship and the method, not the furniture^[2]^[3].

What online offers

Access: your psychologist doesn’t have to live in your city — for people living abroad this is often the only way to work in their native language. Your own space: many people find it easier to open up from their own armchair, and where a subject is tinged with shame, the distance of a screen sometimes helps you begin. Continuity: the work is not interrupted by business trips or moving house. Time saved: an hour’s session doesn’t come with two hours of travel attached.

What the consulting room offers

A separate space: the work begins the moment you leave the house, whereas at home you have to build that boundary yourself (a door, headphones, “don’t disturb me for an hour”). Full presence: in the consulting room I can see the whole of you, not just a head-and-shoulders shot, and for some of the work that matters. And no temptation to cut it short: nobody steps out of the consulting room “just for a minute to see to something”.

Which suits whom

Online suits you if you are abroad, have a tight schedule, feel comfortable speaking on video and have a room to yourself for at least an hour. Meeting in person suits you if there is nowhere private at home, if the screen is a barrier for you, or if the subject calls for full presence. In-person sessions are preferable if you are in acute crisis, if it is not safe at home or you might be overheard, and also for work with young children. Hypnotherapy can be done in both formats, given a quiet place and a stable connection; the details are on the hypnotherapy page.

If you can’t decide, start with either: the format can be changed later, and nothing of the work is lost.

Sources

Batastini A. B., Paprzycki P., Jones A. C. T., MacLean N. (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, DOI 10.1016/j.cpr.2020.101944
Fernandez E., Woldgabreal Y., Day A., 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, DOI 10.1002/cpp.2594
Norwood C., Moghaddam N. G., Malins S., Sabin-Farrell R. (2018). Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clinical Psychology & Psychotherapy, DOI 10.1002/cpp.2315

The limits of this article

This article is for information only: it does not replace a consultation or a doctor's help.

If you feel very bad right now — in Kazakhstan call 112 or 103; free round-the-clock psychological help — 1303 (Almaty).

If you would rather first understand how the work is set up — the consultation page has the format, the price and what happens at the first meeting.

How a consultation works Book a session