• Therapists and clients have had to adjust to working solely online due to the coronavirus lockdown

  • Psychotherapist Giovanni del Vecchio explores the differences and pros and cons of the different methods

  • Our counsellors and therapists are available to see you online – find your therapist here

For many, especially in times of confinement, online counselling provides a vital lifeline and the only safe access to psychotherapy.

While much of my work is face-to-face, those patients who began counselling by visiting me in my clinic, describe both gains and losses in their transition to working online. As you can appreciate, we monitor the experience very carefully as part of the therapy. Without exception, they express the view that their online counselling is no less meaningful and helpful than meeting face-to-face. They discovered very quickly that the impact of the therapy, in whatever medium, depends on their commitment. In nearly every case, the transition has been seamless.

The differences between in-person therapy and online therapy

In an emergency or in acute distress, there is no substitute for the containment that is possible from being in the same room. In these circumstances, it might be necessary to also consult with your GP or local A&E.

Face-to-face therapy

The face-to-face meeting widens the therapeutic frame because it includes the journey to and from the session. (This can be viewed either as a positive or a negative, usually shifting between the two). By attending in person, all patients know they come to a safe and dependable address and to a familiar room which they inhabit as routine. For some patients, this provides their only place of safety.

Face-to-face counselling draws on all the senses, allowing for the full potential of non-verbal communication between two bodies; the interaction with space and objects; the temperature in the room; smells and outside noises; the silent language of entrances and exits.

Online psychotherapy

On the other hand, online psychotherapy requires a different kind of listening and a different kind of intensity. The senses are reduced to one or two: to sound, as in telephone therapy, and to sight and sound in video. Through online therapy, our reduced senses become sharpened and more acute. Video and telephone counselling provide a vehicle no less poignant and helpful to the therapeutic relationship.

It can take a slight adjustment, but being online is no barrier to the access and containment of thoughts and feelings, to understanding, and to being understood. 

Psychotherapy online offers the potential for greater flexibility in terms of scheduling. It is completely accessible and inclusive in bringing the therapy to you, whatever your circumstances and wherever you are.

What you need to get started with online therapy

  • A private space where you will not be disturbed during the session
  • Access to a computer, laptop, tablet or smartphone
  • A good stable internet connection
  • Access to a video camera with sound (usually integrated in your device)

Giovanni del Vecchio is a verified welldoing.org therapist in Central London and online

Further reading

Meet the therapist: Giovanni del Vecchio

Can online counselling be effective?

Coronavirus and lockdown: a psychoanalytic perspective

Online therapy: some considerations for beginners

How does online therapy differ from in-person