Online Therapy: The Honest Truth About What Works (and What Doesn't)
A therapist's perspective on digital therapy after five years of online practice across the UK
When the pandemic pushed therapy online almost overnight, many of us wondered: can real therapeutic connection happen through a screen? After five years of providing online or telephone therapy throughout the UK and working with over 70 individuals through digital sessions, I can offer you an honest perspective on both the genuine benefits and the real limitations of online counselling.
If you're considering online therapy - whether you're in Worcester, Manchester, London, or anywhere across the UK - this is what I wish every potential client knew before their first video call session.
Amy Hughes - Psychotherapist sat next to a lake with her laptop
The Unexpected Benefits of Online Therapy
Comfort of Your Own Space
There's something genuinely powerful about receiving therapy in your own environment. You're surrounded by your own things, your own energy, your chosen lighting and comfort items. Many clients tell me they feel more relaxed and open when they're in their familiar space rather than an unfamiliar therapy room.
I've had clients curl up with a cup of tea, wrap themselves in a favourite blanket, Sit in their car in a local beauty spot or have their pet nearby for comfort. I always have a candle and incense burning and my crystals in the background - small touches that made our sessions feel more personal and less clinical.
No Travel Stress (A Game-Changer for Busy Women)
Especially for women juggling multiple responsibilities, the ability to have therapy without travel time is genuinely liberating. No rushing through traffic, finding parking, or worrying about being late. You can have your session during lunch break, while children are at school, or in the evening as part of a wind down after work.
For my clients across the UK - from busy Birmingham professionals to rural Welsh mothers - this flexibility has been transformative.
Greater Accessibility Across the UK
Online therapy opens doors for people who might struggle with in-person sessions due to:
Physical health challenges or mobility issues
Caring responsibilities that make leaving home difficult
Living in rural areas with limited local therapists
Anxiety about being seen entering a therapy office
Work schedules that don't align with traditional office hours
Geographic limitations if there’s not a local therapist who specialises in women and people-pleasing difficulties.
Easier to Start (Especially for Therapy Newcomers)
For many people, booking an online session feels less intimidating than walking into a therapy office for the first time. There's something about the psychological safety of the screen that can make vulnerability feel more manageable initially.
Consistency During Life Changes
Online therapy can continue seamlessly through house moves, travel, illness, or other life disruptions. The therapeutic relationship doesn't have to pause just because life gets complicated - you can reach a video session from your mobile as well as a computer, something particularly valuable in our increasingly mobile world.
The Real Limitations (Let's Be Honest)
Missing Body Language and Energy
This is perhaps the biggest challenge. In person, I can sense when someone's energy shifts, notice tension they're holding, or pick up on subtle changes in posture that tell me something important is happening. Through a screen, I still pick up a lot (I have been doing this for long enough now to pick up the most subtle of cues, but all I see is a small window - your face and background, and could miss some body language off screen.
Technology Barriers (The Reality Check)
Despite our best efforts, technology sometimes fails us. Poor internet connections, audio delays, or screen freezing can interrupt the flow of a session. While we always have backup plans, these disruptions can break the momentum of important therapeutic moments. It can be very frustrating for a screen to freeze while you're mid-conversation and then have to repeat some of what was missed, because lets face it, its never quite the same!
Boundary Challenges
When therapy happens in your home, it can sometimes feel harder to create clear boundaries between your therapeutic work and your daily life. Some clients struggle to shift out of "therapy mode" when their session ends in the same space where they cook dinner or help with homework. Picking a space in your home environment can be incredibly important to what energy you bring to a session - for example for me I cannot have my own personal therapy from my work office, its the wrong headspace for me to be in. For you maybe you feel safer in your bedroom - but is that going to impact your sleep later on?
Limited Crisis Support
While online therapy is excellent for ongoing support and personal growth work, it has limitations when someone is in acute crisis. Physical presence and immediate support options are sometimes necessary. If I feel you may not be suitable for online therapy I will help to find a face to face therapist local to you.
A Different Kind of Intimacy
Online therapy creates a different type of connection than in-person work. It's not necessarily better or worse, but it is different. Some people find the screen creates helpful psychological safety, while others miss the full presence that comes from sharing physical space. It’s a personal choice and why I felt really drawn to offer both walk and talk therapy as well as online sessions.
What Online Therapy Works Best For
Personal Growth and Self-Discovery
Online therapy is excellent for exploring patterns, understanding yourself better, and developing new ways of thinking and responding. The reflective nature of this work translates beautifully to digital sessions.
Anxiety and Overthinking Patterns
Many clients find that online therapy actually helps with anxiety because they're in their safe space. The slight psychological distance of the screen can make it easier to explore difficult feelings without becoming overwhelmed.
People-Pleasing Recovery and Boundary Work
Working through people-pleasing patterns, good girl conditioning, and learning to set boundaries works exceptionally well online. The skills and insights developed transfer directly to your real-world relationships.
Spiritual and Alternative Perspectives
Online therapy can feel safer for exploring spiritual beliefs or alternative practices that you might worry about being judged for. The privacy of your own space allows you to speak more freely about these important aspects of yourself - something particularly relevant for women who identify as spiritual seekers, witches, or pagans and have had negative experiences in therapy previously. Not to mention you can surround yourself with any items you feel useful and create your own sacred space for therapy.
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Making Online Therapy Work Best for You
Create Your Therapeutic Space
Choose a private, comfortable space where you won't be interrupted
Consider lighting that feels warm and supportive
Have tissues, water, fidget toys and comfort items nearby
Use headphones if possible for better audio quality and an added layer of confidentiality
Establish Clear Boundaries
Let family know you're on a call and shouldn't be disturbed
Turn off notifications on your devices and your mobile on aeroplane mode
Ensure no devices like Alexa’s or other voice controlled technology are nearby
Plan for a few minutes after your session to transition back to daily life
Communicate Your Experience
Tell your therapist if you're finding it hard to connect or if something isn't working
Share when technology issues are disrupting your experience
Be honest about whether you're getting what you need from online sessions
The Future: Combining Online and Walk & Talk Therapy
As I now offer both online therapy and walk and talk therapy sessions in Worcestershire and Shropshire, I'm excited about offering clients choice in how they access support. Some people prefer the consistency of online sessions, others are drawn to the immersive nature experience of outdoor therapy, and many benefit from a combination of both.
Online therapy has taught me that healing can happen in many different ways and environments. While it's not perfect (what is?), it has genuinely transformed access to mental health support and created new possibilities for therapeutic connection.
Is Online Therapy Right for You?
Consider online therapy if you:
Value convenience and flexibility
Feel more comfortable in your own space
Have limited local therapy options
Are looking for ongoing support for personal growth
Appreciate the psychological safety the screen provides
Live anywhere across the UK and want specialised support
You might prefer in-person (or walk & talk) therapy if you:
Find technology stressful or distracting
Value the full presence that comes from sharing physical space
Are seeking body-based or movement-oriented approaches
Are drawn to nature-based healing approaches
My Honest Recommendation
Having provided both online therapy across the UK and walk and talk therapy in beautiful Woodland locations, I believe the best therapeutic approach is the one that feels right for you. Online therapy isn't a compromise or a lesser option - it's a different way of connecting that offers unique benefits alongside its limitations.
The key is finding a therapist who is skilled in online work, who creates genuine connections across a digital space, and who can help you navigate any challenges that arise from this format.
Whether you're considering online therapy from anywhere in the UK or curious about walk and talk sessions in Worcestershire and Shropshire, I'd love to chat about what approach might feel right for your needs.
Ready to explore your options? Book a free consultation call and we can discover together which approach feels most aligned with your healing journey.
Online therapy available UK-wide | Walk & Talk Therapy in Worcestershire and Shropshire
Amy Hughes is a qualified psychotherapist registered with the National Counselling & Psychotherapy Society
