Even five years after certifying as a 'cyber' therapist, the romantic in me can still relate to scepticism. The thing is, the evidence in my room mounts: online clients tend to get the changes they seek.

To be clear, online therapy is an additional way of expressing oneself; it's not a substitute for face-to-face therapy. Or indeed vice versa: face-to-face therapy cannot offer some of the benefits of online counselling, such as accessibility and inclusivity. I'm talking about voice and video sessions here by the way. And I'm using the terms 'therapy' and 'counselling' interchangeably.

Let's return to romanticising a moment. Web-based therapy is not romantic in the original sense of the word. Web-based therapy is intimate, though. Laptop or not, I still sometimes shed a tear with my clients, I still share their heartbreak, or delight, or fury, or bewilderment.

Yes, working online I'm able to observe less or sometimes nothing at all if it's a voice call. So one sense is diminished, but I find that other senses become sharper. I am even more focussed on sound. What I know is that clients frequently get what they need - or if they haven't, it is rarely because of the medium.

This glorious outcome is far from serendipitous, though. Both clients and I work at it. Much relies on their capacity - their readiness - for the effort and commitment needed for any kind of therapy. If there are challenges with online working - just like any other - my hope is that my clients and I will be able to talk about and review those.

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When online therapy is not your bag

Listening to a gut feeling that online therapy just isn't right for you is crucial, and a position I respect entirely.

Further, if you are feeling particularly unwell or desperate, face-to-face support is certainly preferable if possible. Or in case of emergency, contact your GP or local Accident and Emergency service.

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When online therapy is your bag

Just like with face-to-face therapy, choosing the right online therapist for you is key. Here are the things I'd be looking out for - basically an awareness of the ethics of working in this medium.

• Have they had any training in offering online therapy?
• Have the nuances around confidentiality been discussed? For example that you need a confidential, soundproof, and interruption-free space to speak from - and preferably not from bed?!
• Are they using a secure platform like Zoom or Vsee rather than Skype ?
• Have they made clear how a bad connection will be handled, including implications for payment?
• Do they review how well the online element is working for you?