Remote Therapy: Complete Guide to Online Counselling in 2026

Three years ago, I had a client tell me: "I'd love to do therapy, but I don't have time to travel across London twice a week. By the time I commute, find parking, and get back, it's three hours out of my day."

Now, she logs into our video sessions from her home office during her lunch break. Same depth of work, same therapeutic relationship—none of the commute.

Remote therapy—counselling conducted via video call, phone, or even messaging—has moved from emergency pandemic measure to established, evidence-backed treatment option. But it's not identical to in-person therapy, and it's not right for everyone.

This guide covers everything you need to know about remote therapy in 2026: how it works, what the research says, how to choose a platform and therapist, and how to make online counselling as effective as possible.

What Is Remote Therapy?

Remote therapy (also called online therapy, teletherapy, or distance counselling) is professional mental health treatment delivered through digital technology rather than face-to-face in a physical space.

Different Formats

Video counselling (most common):

• Real-time video calls via Zoom, MS Teams, or specialist platforms
• Closest to in-person therapy
• Allows facial expressions and body language

Telephone therapy:

• Voice-only sessions
• Good for those uncomfortable with video or with poor internet
• Removes visual component

Messaging therapy:

• Asynchronous written exchanges
• Client writes messages; therapist responds within agreed timeframe
• Suits those who process better in writing

Mixed format:

• Combination of video, phone, and messaging
• Flexibility to adapt to circumstances

Most people mean video counselling when they say "remote therapy," and that's what this guide primarily addresses.

The Research: Is Remote Therapy Actually Effective?

Short answer: Yes, for most people and most conditions.

Key Research Findings (2020-2026)

Effectiveness comparable to in-person therapy: A 2023 meta-analysis in JAMA Psychiatry reviewing 108 studies found no significant difference in outcomes between video therapy and face-to-face therapy for depression, anxiety, PTSD, and relationship difficulties.

High client satisfaction: A 2024 UK survey of 2,400 therapy clients found 82% rated video counselling as "very effective" or "effective," with 78% saying they'd continue with remote sessions even when in-person became fully available again.

Reduced no-show rates: Remote therapy has 15-20% lower missed appointment rates compared to in-person, likely due to elimination of travel barriers.

Faster access: Average wait time for remote therapy: 1-2 weeks. Average wait time for in-person NHS therapy: 12-18 weeks.

Therapeutic alliance forms equally well: A 2025 study in Psychotherapy Research found that the strength of the therapeutic relationship—the single best predictor of positive outcomes—develops just as strongly via video as in person.

What Works Best Online

Remote therapy is particularly effective for:

• Depression and anxiety (most researched)
• Relationship counselling (including couples therapy)
• Life transitions and identity exploration
• Mild to moderate trauma (though severe trauma may benefit from in-person)
• Personal development and growth
• Stress and burnout

Where In-Person May Be Better

• Severe mental health crises requiring immediate intervention
• Conditions involving significant dissociation (being "present" virtually is harder)
• Situations where body-focused or movement work is central
• When someone lacks private, safe space for sessions

Benefits of Remote Therapy

1. Accessibility and Convenience

No travel time: Sessions fit more easily into busy schedules

Geographic flexibility: Access therapists anywhere in the UK, not just your local area

Physical accessibility: No mobility challenges, no navigating public transport or finding wheelchair-accessible buildings

Childcare easier: Can do therapy when children nap or while partner watches them in another room

Flexible location: Travel for work? On holiday? Sessions can continue via video

2. Comfort and Safety

Your own environment: Being in familiar surroundings can feel safer, especially for trauma survivors or those with anxiety

Control over space: You choose the temperature, lighting, whether to have a blanket or tea

Reduced anxiety: No reception area, no waiting room, no navigating unfamiliar buildings

Easier for neurodivergent people: Can stim, fidget, or move without self-consciousness

3. Increased Openness

Surprisingly, many people find it easier to open up remotely:

• Slight distance of the screen can reduce intensity
• No prolonged eye contact (can look away naturally)
• Feels less formal and confrontational
• Can keep notes visible if helpful

4. Cost and Time Efficiency

Lower therapy costs: Some therapists charge slightly less for online sessions

No travel costs: Saving on petrol, parking, or public transport

Time saved: Hour-long session takes one hour, not two-plus with travel

More frequent sessions possible: When time/cost barriers reduce, some people opt for twice-weekly sessions

5. Continuity of Care

Maintain therapy during life changes: Moving house, travelling, temporary relocation—therapy continues uninterrupted

Weather resilient: No cancellations due to snow, strikes, or illness that makes travel difficult (can do session from bed if needed)

Limitations and Challenges of Remote Therapy

Technical Issues

Internet connectivity: Dropped calls, frozen screens, lag

Platform problems: Software glitches, audio/video sync issues

Learning curve: Comfort with technology varies

Solution: Have phone as backup; use reliable platforms; do tech check before first session

Reduced Nonverbal Communication

Limitations:

• Can only see head and shoulders (usually)
• Subtle body language harder to read
• Screen lag can disrupt natural flow

Impact: Therapists may miss some nonverbal cues

Mitigation: Good therapists adapt by asking directly: "I'm sensing something shifted—what's happening for you?"

Environmental Challenges

Privacy concerns: Others in the house, thin walls, interruptions

Professional space vs. home: Harder to "enter" therapeutic space psychologically

Distractions: Doorbell, pets, notifications

Solution: Create dedicated space, use headphones, inform household members, silence devices

Technical Boundaries Feel Different

Session endings: Pressing "leave meeting" feels abrupt compared to walking out together

Between-session contact: Email feels more casual, may blur boundaries

Crisis response: Harder to assess safety and intervene remotely

Solution: Clear agreements about communication, ending rituals, and emergency protocols

Not Suitable for Everyone

Remote therapy may not work if you:

• Lack reliable internet or private space
• Find technology stressful or inaccessible
• Need body-focused work
• Are in acute crisis
• Prefer clear separation between home and therapy

Choosing the Right Platform for Remote Therapy

Therapists use various platforms. Here's what to know:

Zoom for Healthcare

Pros:

• HIPAA/GDPR compliant (when configured correctly)
• Reliable, widely used
• Good video/audio quality
• Simple for clients

Cons:

• Generic platform, not therapy-specific
• Security concerns if not properly configured

Cost: Usually included in therapist's fee

Microsoft Teams

Pros:

• Secure, encrypted
• Many people already familiar with it
• Good reliability

Cons:

• Less intuitive than Zoom for some
• Can feel corporate

Attend Anywhere (NHS)

Pros:

• Built for healthcare
• Highly secure
• Works in browsers (no download needed)

Cons:

• Primarily used by NHS services
• Less common in private practice

Therapy-Specific Platforms (e.g., Wiley Practice, SimplePractice)

Pros:

• Built specifically for therapy
• Integrated scheduling, notes, billing
• BACP/UKCP approved

Cons:

• Both therapist and client need accounts
• May feel more clinical

What to Ask Your Therapist

"What platform do you use, and is it secure and encrypted?"

"What happens if the connection drops?"

"Do I need to download anything, or does it work in a browser?"

How to Choose a Remote Therapist

1. Check Qualifications

Remote therapy requires the same qualifications as in-person:

• BACP or UKCP registration
• Appropriate training and insurance

Additionally, check if they have:

• Training in delivering therapy remotely (increasingly common)
• Experience with online counselling
• Clear confidentiality and data protection policies

2. Verify They Can Work in Your Location

UK-registered therapists can work with clients anywhere in the UK remotely. However:

• They must be insured for remote work
• If you're abroad (even temporarily), check their insurance covers international clients

3. Assess Their Remote Setup

Signs of professionalism:

• Clear guidance on platform setup before first session
• Tech check option available
• Backup plan (phone number) if video fails
• Discussion of privacy and confidentiality in remote context

Red flags:

• Using personal, non-professional accounts (personal Gmail, Skype username)
• No mention of data protection
• Unwilling to discuss technical contingencies

4. Consider Therapeutic Approach

All major therapy approaches work remotely:

• CBT: Very effective online; homework can be shared digitally
• Person-centred: Relationship-focused, works well via video
• Psychodynamic: Some debate, but research supports effectiveness
• EMDR: Modified protocols exist for remote delivery

Choose based on what approach suits you, not whether it's remote-compatible—most are.

5. Initial Consultation

Most therapists offer a brief (15-minute) phone or video consultation. Use this to assess:

• Do you feel comfortable with them?
• Do they answer your questions clearly?
• Does their style suit you?
• How do they handle the remote format?

Setting Up for Successful Remote Therapy

Technical Setup

Essential:

• Reliable internet connection (minimum 1-2 Mbps)
• Device with camera and microphone (laptop, tablet, smartphone)
• Headphones (improves audio quality and privacy)

Recommended:

• External webcam at eye level (better angle than laptop looking up)
• Ring light or natural light source in front of you (avoid backlighting from windows)
• Stable surface for device (not handheld unless necessary)

Before first session:

• Test audio and video
• Close unnecessary programs/tabs
• Silence phone notifications
• Charge device or plug in

Physical Space

Ideal space characteristics:

• Private (door that closes)
• Quiet (minimal background noise)
• Comfortable seating
• Neutral background (or use virtual background)
• Good lighting
• Temperature controlled

If perfect space isn't available:

• Book time when house is empty
• Use white noise machine outside door
• Wear headphones to reduce others overhearing
• Position yourself facing blank wall

Creating Therapeutic "Container"

Pre-session ritual (helps transition into therapy):

• 5 minutes before, pause other activities
• Turn off distractions
• Take a few deep breaths
• Have water nearby

During session:

• Position camera at eye level for natural eye contact
• Look at camera occasionally (not just at their image on screen)
• It's okay to look away when you need to

Post-session ritual (helps transition out):

• Take a few minutes before jumping into next task
• Journal if helpful
• Brief walk or stretch

These rituals help create psychological separation between "therapy space" and "home space."

Making Remote Therapy as Effective as Possible

1. Be Honest About Technical Issues

If you're distracted by poor audio, frozen video, or lag, say so. Technical problems impact therapy—addressing them isn't wasting time.

2. Communicate What You Need

Can't see the therapist's full image? Ask them to adjust. Too much eye contact? Tell them. Remote therapy requires slightly more verbal communication about what's working and what isn't.

3. Treat It Like In-Person Therapy

• Show up on time
• Dress as you would for in-person (helps psychological shift)
• Minimise multitasking (no checking emails mid-session)
• Commit to the full duration

4. Manage Distractions

• Silence phone and notifications
• Close other tabs/programs
• Put "Do Not Disturb" note on door
• Let household members know you're unavailable

5. Embrace the Benefits

• Keep tissues, water, journal nearby—things harder to access in therapy rooms
• Sit somewhere comfortable
• Use blanket or comfort object if helpful

6. Address Awkwardness

Sessions ending by pressing "Leave Meeting" can feel abrupt. You might say: "It feels strange just clicking off—can we take a moment to close the session before we hang up?"

Good therapists will create ending rituals: brief check-in about the session, acknowledgment before disconnecting.

Remote Therapy for Specific Needs

Couples Therapy

Can work well: Both partners on same screen or separate devices in same room

Challenges: Harder to manage heated conflicts remotely

Tips:

• Both partners use headphones if sharing space
• Or join from separate rooms for individual safety
• Therapist may use breakout rooms for individual check-ins

ADHD and Neurodivergence

Benefits:

• Can fidget freely
• Stimming less self-conscious
• Easier to manage sensory needs

Challenges:

• Screen fatigue
• Sustaining attention

Tips:

• Use body doubling (someone else present nearby)
• Stand-up desk or movement encouraged
• Shorter, more frequent sessions

Trauma Therapy

Can be effective: Research supports remote EMDR and trauma-focused CBT

Important considerations:

• Grounding techniques adapted for remote
• Safety plan essential
• Ensure stable, private space

When in-person is better: Severe dissociation, lack of safe space at home

Social Anxiety

Benefits: Lower-pressure start; less intimidating than in-person

Challenges: Avoidance of in-person interaction may reinforce anxiety

Balance: Start remote to build confidence, consider transitioning to in-person when ready

Cost of Remote Therapy in 2026

Private Therapy Costs

Remote therapy is often slightly cheaper than in-person:

Typical UK remote therapy costs:

• £40-£60: Trainee or newly qualified counsellors
• £60-£80: Mid-range experienced therapists
• £80-£120: Senior practitioners, specialists

Why sometimes cheaper: Lower overheads (no room rental), though many charge the same as in-person

Block discounts: Many offer reduced rates for pre-paid blocks (e.g., 5 sessions for £350)

Concessions: Students, low income, NHS workers often qualify for reduced rates

NHS Remote Therapy

Availability: Most NHS mental health services now offer remote options

Cost: Free

Limitations:

• Long waiting lists (average 12-18 weeks)
• Time-limited (usually 6-12 sessions)
• Typically CBT rather than other modalities

Therapy Platforms

Apps like BetterHelp, Talkspace, Calmerry offer subscription models:

Costs: £40-£70/week for unlimited messaging plus live sessions

Pros: Convenience, lower cost, quick access

Cons: Therapist assignment (limited choice), variable quality, asynchronous messaging rather than traditional therapy

See our separate guide comparing therapy platforms to traditional counselling.

Common Concerns About Remote Therapy

"Will it feel as personal?"

Many people are surprised by how connected they feel remotely. The therapeutic relationship develops strongly via video—you're still sharing deeply, being heard, and experiencing empathy.

"What if I get emotional and need support?"

Therapists are trained to hold emotional intensity remotely. If you're crying or struggling, they'll stay present with you. They won't end the session early unless you want to.

"Is it really confidential?"

With encrypted, secure platforms and headphones, remote therapy is highly confidential. Therapists are bound by the same confidentiality rules as in-person therapy.

"What if there's an emergency?"

Your therapist will establish emergency protocols in your first session: who to contact, crisis numbers, safety plans. They'll know your location and have emergency contact information.

"Can I switch between remote and in-person?"

Many therapists offer hybrid—some sessions remote, some in-person. This flexibility works well for many people.

Remote Therapy Checklist

Before starting remote therapy:

• Check therapist is BACP/UKCP registered
• Verify they're insured for remote work
• Understand which platform they use
• Test your tech setup
• Identify private, quiet space
• Discuss emergency protocols
• Clarify costs and payment methods
• Have phone number as backup

For each session:

• Close unnecessary programs
• Silence notifications
• Ensure privacy
• Have water nearby
• Log in 2-3 minutes early
• Create brief pre/post-session ritual

Final Thoughts: Is Remote Therapy Right for You?

Remote therapy isn't a compromise—it's a legitimate, evidence-based option that works remarkably well for most people and most conditions.

It's not identical to in-person therapy. The setting differs, the technical layer exists, and some subtle elements of communication change. But the core of therapy—the relationship, the understanding, the support, the growth—transfers beautifully to video.

For some, remote therapy is a game-changer: making therapy accessible when geography, mobility, time, or anxiety would otherwise create barriers. For others, in-person remains preferable. And many find hybrid works best: mostly remote with occasional in-person sessions.

The right choice is the one that allows you to engage fully with therapy—whether that's from your own sitting room or a therapist's office.

I offer both remote and in-person therapy in South West London, with many clients choosing hybrid approaches based on their schedules and preferences. If you're curious about whether remote therapy might work for you, we can start with a free 15-minute phone consultation to discuss your needs.

Sometimes the greatest barrier to therapy isn't willingness—it's logistics. Remote therapy removes many of those barriers, making support accessible exactly when and where you need it.