What is online therapy and is it as effective as face-to-face therapy? Learn how online psychologist sessions work, their advantages and their limits.
Spending an hour in traffic after work and then rushing to a therapy session, being unable to leave a young child at home, not finding a specialist in your city who works in the area you need, or looking, while living abroad, for someone you can speak to in your own language... All of these situations have made sessions held over a screen a real option for many people in recent years. Online therapy is a form of sessions that brings psychological support to wherever you are. But does it really work, can it replace face-to-face sessions, and who is it suitable for? In this article we answer the questions people most often ask about online psychologist sessions.
What Is Online Therapy?
This form of sessions means psychotherapy delivered by video call, with the client and therapist in different places. Sessions generally last the same time as face-to-face ones, about fifty minutes, and are bound by the same ethical principles. The only thing that changes is the room itself: instead of the therapist's office, you are in a safe and quiet space of your own choosing.
Remote psychotherapy is not a new idea; however, its spread during the pandemic accelerated both clients' and therapists' familiarity with this form of sessions. Today many professionals offer face-to-face and online sessions together, and some clients combine the two methods at different times. For example, sessions can be online during busy periods of work travel and face to face at other times.
An important distinction needs to be made here. Video psychotherapy does not mean getting brief advice over messaging apps, watching general content on social media or chatting with AI-based chat tools. A genuine remote therapy process is regular, structured work with a trained mental health professional, based on assessment and goals.
Does Online Therapy Work?
This is the most frequently asked question, and the answer is encouraging. Many studies in recent years show that psychotherapy delivered by video can give results similar to face-to-face therapy, particularly for anxiety disorders, depression and stress-related complaints. Structured approaches such as Cognitive Behavioural Therapy adapt quite easily to the online setting thanks to tools such as thought records, homework and psychoeducation.
One of the most important factors determining the effect of therapy is the trusting relationship between client and therapist. Although many people at first think this relationship cannot be built over a screen, experience often shows the opposite. Some clients even say they can open up more easily in the familiar setting of their own home.
Even so, it would not be right to say that video sessions are equally suitable for everyone and in every situation. Effectiveness depends on the type of problem the person is experiencing, the technical conditions, the suitability of the place where they will have sessions and the therapist's experience of this form of sessions. Suitability should therefore be considered together in the first assessment.
Who May It Suit Better?
Video sessions can comfortably be chosen for many areas, such as mild to moderate anxiety, stress, sleep problems, depressive complaints, relationship difficulties and problems adjusting to work and school life. They can also be a good starting point for people with social anxiety, those who find entering a new setting challenging, or those who hesitate to take the first step. In addition, for people who find it hard to leave the house, for example those who avoid going out because of intense panic attacks, having the first sessions over a screen can make it easier to start the process. Of course, approaching avoided situations over time will be one of the goals in therapy.
Teenagers, for their part, are often more used to communicating over screens than adults. Some young people find talking in their own room, in a familiar setting, less threatening. In this case, though, it is very important to set up an arrangement in which the teenager's conversations cannot be overheard by the family, and to talk openly about the limits of confidentiality with both the young person and the parents.
What heals in therapy is not the room itself, but the safe relationship built in that room, or even across the two ends of a screen.
What Are the Advantages of Online Sessions?
The conveniences offered by video sessions can make a marked difference, especially for people living in Turkey's big cities and for those with particular circumstances.
Ease of Time and Travel
In big cities such as Istanbul, Ankara or Izmir, getting there and back for a fifty-minute session can take two or three hours. Online sessions remove this burden and make it easier to keep therapy going regularly. Continuity in therapy is one of the important conditions for progress.
Geographical Access
Someone living in a small district may not be able to reach a nearby specialist who works with children and adolescents or who is trained in areas such as couple therapy. Online therapy lets you reach the right professional for your needs wherever you are. It is also a valuable option for people living abroad who want to talk in their own native language with someone who knows their cultural context.
Privacy and Comfort
In small towns, the worry "What if someone sees me going to the psychologist?" is still common. Online sessions can reduce this reservation. Also, for people with social anxiety or those who find it hard to enter a new setting, taking the first step may be easier in an online session.
Fitting Particular Life Circumstances
For new mothers, people caring for an elderly or sick relative, people with limited mobility, shift workers and frequent travellers, sessions held over a screen can be a realistic way of reaching support. Online sessions also played an important role in providing continuity for people who had to move to other cities after the 6 February 2023 earthquakes and were trying to build a new routine.
The Limits of Video Therapy and What to Watch For
Like every method, remote work has its limits. Knowing them helps you start with realistic expectations.
- Crises and emergencies: In situations where there are intense thoughts of self-harm or suicide and ensuring safety is the priority, face-to-face assessment and support from a psychiatrist may be needed. In an emergency you should call 112 (emergency services) or go to the nearest emergency department.
- Some severe mental health conditions: In situations where the connection with reality is weakened, or in cases such as heavy substance use, video sessions alone may not be enough.
- Privacy problems: If you do not have a space at home where you can express yourself freely, for example if you live in a crowded household or your conversations can be overheard by others, this can reduce the value of the session.
- Technical glitches: A weak internet connection and dropouts in picture and sound can disrupt the flow of the session. It is therefore important to discuss a backup plan beforehand.
- Limited view of body language: Only the face and shoulders being visible on screen can mean some cues are missed. Experienced therapists make up for this by asking more questions and encouraging feelings to be put into words.
In work with children, especially younger age groups, approaches such as play therapy are often more suitable face to face. Even so, parent sessions and some adolescent counselling processes can also be carried out online without difficulty.
How to Prepare for an Online Session: Practical Tips
A few simple preparations make a big difference to getting more out of video sessions:
- Choose a quiet, private space: Choose a room where no one will come in during the session and your conversation cannot be overheard. If you cannot find such a space at home, even a parked car can sometimes work.
- Use headphones: Headphones let you hear more clearly and stop others from hearing what is said.
- Do a technical check beforehand: Check your internet connection, camera and microphone a few minutes before the session. Make sure your device is charged.
- Turn off notifications: Phone and computer notifications can distract you. It helps to silence them for the duration of the session.
- Allow time before and after the session: In face-to-face therapy, the journey provides a natural gap for preparing for the session and digesting it. In online sessions this gap can disappear. It can be a good idea to take a few minutes to collect yourself before the session and not to move straight into a meeting or housework afterwards.
- Think about your agenda: Briefly noting the topics you want to talk about before the session makes it more productive.
- Discuss a backup plan: Agree with your therapist from the start who will call whom if the connection drops and whether the session will continue by phone.
Say you are a parent of two children and finding a quiet moment at home is almost impossible. Timing your session for when the children are at school or asleep, and agreeing in advance with your partner or a relative about this hour, can be a practical way of protecting your own fifty minutes.
When Should You Seek Professional Support?
Whether online or face to face, you can look out for the following signs when thinking about seeking support:
- If anxiety, sadness, anger or tension has lasted for several weeks and is making daily life harder,
- If your sleep pattern, appetite or energy has changed markedly,
- If you are experiencing recurring conflicts or distance in your relationships,
- If you are finding it hard to adjust after a major life change, such as a move, migration, separation or loss,
- If your work or school performance has dropped and you find it hard to concentrate.
These signs do not amount to a diagnosis on their own. But talking to a professional can help you make sense of what you are going through and decide on the form of support that suits you. If you are experiencing intense symptoms or are wondering whether medication might be needed, an assessment by a psychiatrist can also be considered.
How Does the Online Session Process Work in Therapy?
The process carried out remotely goes through broadly the same stages as face-to-face therapy. In the first session the therapist tries to understand your reason for seeking help, the history of the difficulties you are experiencing and your current life circumstances. In this session, whether this method is suitable for you is also considered together: is the place where you will have sessions private enough, are the technical conditions suitable, and what will be done in an emergency?
Goals are then set and a suitable therapeutic approach is planned. For example, Cognitive Behavioural Therapy, often used for complaints related to anxiety or depression, is very well suited to reviewing worksheets together through screen sharing, keeping thought records digitally and planning practice between sessions. In couple therapy, it is possible for both partners to sit in front of the same screen or, when necessary, to join with separate connections.
Confidentiality is the most basic principle in work done over a screen too. Holding sessions on secure platforms, not recording them and protecting personal data are among the therapist's responsibilities. You can also take care not to share session links with others and to log out of your session on shared devices.
Another matter is the pattern of sessions. Sessions over a screen can sometimes be perceived as "easier to postpone"; because you are not on the road, cancelling at the last minute can feel tempting. Yet regular sessions are the foundation of progress in therapy. For this reason, taking your session time as seriously in your calendar as a meeting, and talking to your therapist in advance when a change is needed, helps the process go well.
If you would like to learn in detail how online sessions are planned, you can look at our online therapy page. For what to look out for when choosing a professional, you can find help in our article on how to choose a psychologist.
Frequently Asked Questions
Is online therapy as effective as face-to-face therapy?
Research shows that video psychotherapy can give results similar to face-to-face therapy for many complaints such as anxiety, depression and stress. However, effectiveness varies by person, problem and circumstances; suitability is therefore considered together in the first session.
How is my privacy protected in online sessions?
The therapist holds sessions on a secure platform, does not record them and keeps the information you share confidential within professional ethics. Your being in a place where others cannot hear during the session also strengthens confidentiality.
I live abroad. Can I see an online psychologist?
Yes, many people living abroad prefer to work online with a professional who speaks Turkish and knows their cultural context. The time difference and the support resources in the country where you are, for use in emergencies, should be discussed in the first session.
Can I switch to face-to-face sessions after starting online?
In most cases this is possible. Some clients start the process online and continue face to face later, or combine the two methods at different times; whichever form you choose, you can find support that suits your needs.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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