It is a question I am asked often, sometimes directly, and sometimes it sits quietly behind someone's hesitation to book a first session. Can therapy really work through a screen? Is something lost by not being in the same room?

What the research says

The short answer is yes, for most people and most types of difficulty, online therapy is genuinely as effective as in-person work. This is not simply a reassurance I offer, it is well supported by research across a range of approaches and presenting problems, including anxiety, depression, and trauma.

What tends to matter far more than the medium is the quality of the therapeutic relationship, the skill and approach of the therapist, and the person's own engagement with the process. A strong connection can be built and sustained online. I see it happen every week.

Can EMDR really work online?

This is one of the questions I hear most, since EMDR involves bilateral stimulation, movement, focus, that people sometimes assume needs to happen in person. In practice, EMDR translates well to online work. Eye movements can be guided on screen, and alternative forms of bilateral stimulation, such as tapping patterns you do yourself, work just as effectively as a therapist-led version in the room. Many of my clients complete full courses of EMDR entirely online, with outcomes that mirror what I would expect from in-person work.

What online therapy actually offers

Working online is not simply a substitute for what happens in person, it comes with its own genuine advantages.

Access. If you live somewhere without easy access to a specialist in trauma, ADHD, or autism, online therapy removes that barrier entirely. You are not limited to whoever happens to practise nearby.

Comfort and safety. Some people find it easier to talk about difficult material from a familiar space, their own home, rather than an unfamiliar clinic room. This can be particularly true for people processing trauma, or for autistic clients who may find new environments harder to settle into.

Consistency. No travel time, no waiting rooms, no disruption to your day around the session itself. This tends to support more consistent attendance, which matters more to outcomes than almost anything else.

Flexibility. Sessions can more easily fit around work, caring responsibilities, or health conditions that make travel difficult.

What to consider

Online therapy is not the right fit for every situation. If you are in acute crisis, or need a level of support that requires in-person, wraparound care, other options may be more appropriate, and I would always discuss this openly with you. A private, confidential space and a stable internet connection also matter for sessions to work well.

For most people seeking support with anxiety, trauma, ADHD, autism-related difficulties, or general psychological wellbeing, though, online therapy offers a genuinely equivalent, and for many people preferable, way of working.

A different kind of closeness

There is sometimes an assumption that a screen creates distance. In my experience, it is less true than people expect. Many clients say that being in their own space, on their own terms, actually helps them feel more able to be open, not less. The work itself, the safety, the pacing, the depth of what we explore together, is shaped by the relationship and the approach, not by the room.

If you have been holding back from starting therapy because you are unsure whether online work can really help, I would be glad to talk it through with you. We could also do a trial online session if you wwanted to see how the session feels.