Before Covid, counsellors, like all mental health professionals, were used to working with people in person. 2020 drastically changed the way counsellors had to work with patients.
Online counselling feels relatively normal in 2021, with more online services available than ever before, but the shift to online has no doubt been fast-tracked by the pandemic.
Is there a difference between online and face-to-face counselling, and is it here to stay?
What is online counselling, and how is it different from face-to-face counselling?
When thinking about counselling, most people will imagine sitting down in an office talking to a counsellor. This is the traditional form of face-to-face counselling, which is still commonly practiced.
Face-to-face counselling can be delivered in groups or individual sessions. A counsellor will encourage the group or individual to share their feelings, thoughts, and emotions. Their role is to listen without judgment or criticism and help the individual better understand why they feel the way they do.
Most importantly, the counsellor will support the individual to find their own solutions to their issues, not giving specific advice or telling them exactly what to do.
Of course, at the start of the pandemic, counsellors had to stop delivering in-person sessions. Counselling sessions were all delivered remotely, either by phone, email, or video call.
The fundamentals of counselling online did not change, but the way patients connected with counsellors was different.
Online counselling services the NHS offers include:
Instant messaging counselling
Self-help courses with online support from a counsellor or therapist
There are also private online counselling services which many are taking up due to longer waiting times for NHS support.
These services vary with their approach and include counselling via text messages and online video calls via secure platforms. Remote chat-based therapies are certainly growing in popularity with platforms like
What are the pros and cons of online counselling?
All counselling, whether accessed face-to-face or online, should provide a safe space for people to feel comfortable to discuss their feelings. One of the biggest challenges for counsellors when delivering sessions online is providing the same safe space and building enough trust for patients to feel comfortable speaking honestly about their feelings.
For some, online counselling will never offer the same feeling as face-to-face sessions.
Problems faced when trying to provide counselling online are:
Patients may not be able to find a safe and private space to discuss their feelings openly. During lockdowns, this was more challenging for those who were isolating in busy households.
Lack of intimacy. Counsellors and patients are not in the same physical space, so there are concerns that the intimacy of face-to-face sessions some patients need is lessened.
Unreliable internet connections. We’ve all experienced a frustrating online meeting. If this happens during counselling sessions, it can become very jarring and impact the effectiveness of the counselling.
Loss of non-verbal communication. Counselors often use nonverbal communication to analyse a patient. Online or phone sessions remove some or all of the ability for counsellors to assess the patient’s eye contact and body language.
Benefits of online counselling include:
Reduction of social stigma. Some patients may be nervous about going to a counsellor in person as they have to travel to an appointment at a medical centre or clinic, and some may have to take time off work. This increases the likelihood of having to disclose that they are receiving counselling when many people do not feel comfortable doing so. Online sessions give patients greater anonymity.
Online anonymity. As well as the anonymity of not having to tell people you are receiving counselling, many patients find online sessions, especially via email or instant message, help them feel more anonymous and open up more with their counsellor.
Convenience and flexibility. For many people sticking to a regular appointment can be difficult, especially if it involves travelling. Online counselling often allows you to email or message your counsellor whenever you want to and to be able to have sessions at home at a time that suits you.
No travelling. People who suffer from anxiety may find travelling to an appointment to be a barrier to accessing counselling. Online and phone services offer those people the opportunity to have counselling when they would otherwise have not gone in person.
More counsellors to choose from. Without the restrictions of travelling to see a counsellor, patients can have more choice about who they want to see as their counsellor. For some, including those in the LGBTQI+ community, finding someone who understands them and has more connections with their life experiences can be desirable.
There are many differences and benefits to online counselling, but studies show no difference in the effectiveness of online and face-to-face counselling.
The Journal of Affective Disorders, Behaviour Research and Therapy, and the Journal of Psychological Disorders published studies demonstrating that online counselling is as effective as face-to-face therapy in helping people with anxiety, depression, and other issues.
Will online counselling lose popularity after the pandemic?
After over 18 months of life being experienced online, it’s no wonder online counselling has become more and more popular. People are used to communicating digitally, and with an increase in NHS waiting lists for face-to-face therapies and increasing mental health issues, it seems that online counselling could be here to stay.
Text-based counselling services such as BetterHelp, PlusGuidance, and Talkspace all have tens of thousands of users. The NHS is also increasing access to digital services with self-help apps available to download for free, self-help online courses, and new online counselling services being launched across the UK.
The need for face-to-face counselling certainly isn’t going anywhere, but with more options for people in need of counselling support being made available digitally, the future of counselling is looking more digitally enhanced than ever before.