Is Online Therapy Effective? Learn How Online CBT & Online EMDR Work

By Dr. Claire Plumbly, Clinical Psychologist, EMDR Consultant & Founder of Plum Psychology.

Is Online Therapy Effective? Learn How Online CBT & Online EMDR Work

I've worked in psychological therapy for over 20 years. I believe therapy should adapt to modern life. People shouldn’t have to travel far or rearrange their entire day just to access psychological support. This can lead to struggles with commitment and premature termination of therapy. At my practice, Plum Psychology, we often see this dilemma. People face the choice of waiting a long time for a local therapist or opting for an online therapist. It's a good question to ask: “Is online therapy any good?”

The short answer is yes. With the right setup, training, and expectations, online therapy can be as effective as in-person therapy. In many cases, it is more accessible and sustainable than traditional face-to-face therapy. Below, I explain why (with evidence) and what to consider when trying to choose between in-person and online options. This dilemma is particularly common for: busy professionals, those in remote areas, or anyone who values convenience, privacy, and flexibility. I will also discuss situations where online therapy may not be suitable.

A note on terms: 'online therapy' is synonymous with 'teletherapy', 'remote therapy', and 'video therapy'. All these terms refer to therapy sessions carried out live on the internet, with a therapist trained in using video-conferencing software.

Does Online Therapy Really Work?

Yes, it does. A growing body of research shows that sessions delivered by a qualified therapist over Zoom, Teams, or other secure platforms are just as effective as face-to-face sessions for many common difficulties.

• A large systematic review and meta-analysis found that outcomes in videoconference psychotherapy were comparable to in-person therapy.

• Studies of online CBT show similar results. It’s effective, acceptable, and produces comparable improvements in anxiety and depression to traditional therapy.

• There is growing evidence for the same outcomes for EMDR provided online. Clients have reported feeling more in control, while therapists find it 'safe and effective'.

  While sitting in the same room as your therapist can feel different, the evidence consistently shows that when therapy is delivered in real-time by a well-trained clinician, the outcomes are comparable to in-person.

How CBT and EMDR Therapy Work Online

How Can You Do CBT Online?

Cognitive Behavioural Therapy (CBT) and related therapies like Compassion-Focused Therapy and Acceptance & Commitment Therapy (ACT) translate particularly well to online work. These therapies focus on understanding the links between thoughts, emotions, physical sensations, and behaviour, and on making practical, collaborative changes in daily life. In these therapies, therapists and clients work together in real time to identify unhelpful thinking patterns, critical ways of speaking to yourself, avoidance cycles, and coping strategies, using discussion, guided exercises and visualisations, and between-session tasks.

How Can You Do EMDR Online?

Eye Movement Desensitisation and Reprocessing (EMDR) can also be delivered effectively online. EMDR works by helping the brain reprocess distressing or “stuck” memories that continue to trigger emotional or physical reactions in the present. In online EMDR, the bilateral stimulation (the left-right activation central to EMDR) is adapted for video sessions, using a computer programme with a curser that moves across the screen to stimulate the eye movements; headphones to create bilateral audio tones, or the butterfly hug is taught - a specific way of tapping yourself. Careful attention is paid to preparation, stabilisation, and pacing, with therapists ensuring clients feel grounded and supported throughout.

Potential Benefits to Online Therapy

1. It Fits Around Real Life

For many busy people, time is their scarcest resource. Online therapy eliminates the travel, parking, and logistics that can make in-person sessions hard to maintain. It can also be a wonderfully practical option if you're at home caring for dependents or are physically unable to travel.

You can meet your therapist from your home, office, or even your parked car - anywhere you feel comfortable and have privacy. This flexibility makes therapy sustainable. It means progress doesn’t get lost when work, family, or travel demands change. Consequently, people are less likely to drop out due to practical reasons.

2. It Can Feel Safer and More Grounded

Being in your own space can help some people relax. For clients dealing with trauma, anxiety, or burnout, this sense of safety and control is vital. You can use your own grounding tools - your favorite blanket, a nearby pet, or a cup of tea - to support yourself during tougher moments in therapy.

From feedback, many clients mention how online sessions felt less intimidating to start. This allowed them to open up faster.

3. You Get the Right Therapist, Not Just the Nearest One

Online therapy removes geographical limits. Instead of being restricted to local services, you can work with a psychologist who genuinely fits your needs and personality. Whether you need an EMDR specialist for trauma, a CFT-trained clinician for self-criticism, an ACT therapist for anxiety, or someone experienced in burnout recovery, the choice is yours.

At Plum Psychology, we match you with a team member whose expertise aligns with your particular life experience and goals, regardless of your location in the UK.

4. It’s Private, Professional, and Regulated

It's crucial to ensure your therapist uses a secure, encrypted platform and follows the same professional standards as in-person sessions. Confidentiality, data protection, and ethical practice are non-negotiable. At Plum Psychology, we have established protocols for good practice in our online sessions. You will receive the same standard of care, no matter who you see.

5. It’s Backed by Professional Guidance

While online therapy gained popularity during the pandemic, its strong evidence and convenience have shown that it is not just a temporary workaround. It is now recognized as a legitimate form of care.

• NHS England formally includes video consultations within its remote-consulting framework, noting they can increase access and flexibility for patients.

• The British Psychological Society (BPS) has published guidance for psychologists delivering therapy online, confirming it’s an effective and ethical way to practice when confidentiality and consent are carefully managed.

  
  

This means online therapy isn’t a compromise; it’s a recognized, evidence-based part of mental health care in the UK.

Is the Relationship/Connection the Same Online?

Some people worry that therapy through a screen will feel less personal. Some studies do find subtle differences. For instance, a meta-analysis in 2018 reported that while outcomes in terms of therapy gains were equal, clients sometimes rated the therapeutic alliance slightly lower in online sessions. However, a newer study in 2024 helps explain this: less experienced therapists may struggle to read emotional cues online, while seasoned clinicians adapt more easily. They adjust tone, pacing, and nonverbal warmth to maintain connection.

This point is crucial. Some large therapy providers became popular during the pandemic by offering very cheap sessions. They often engage newly qualified therapists, which can be unsafe. These therapists may lack team support and adequate pay, which can negatively impact the therapeutic relationship.

At Plum Psychology, we pride ourselves on our team of clinicians, each with a minimum of 10 years of experience in mental health. This experience allows us to translate relational skills online effectively. In fact, our clients often describe sessions as more focused and less intimidating. The connection remains, just through a different lens.

During team discussions about best online practices, we’ve observed a pattern. Clients familiar with interacting on screens in other areas of life tend to find online therapy natural and accessible, with no barriers to the therapeutic alliance.

When Online Therapy Might Not Be the Best Fit

There are a few situations where online therapy isn’t ideal:

• When someone is in acute crisis or needs local, in-person support from a multi-disciplinary team.

• If there’s poor internet connection or no private space to talk freely.

• If you have no moments between your scheduled therapy session and the next meeting. It’s helpful to build in at least a 30-minute buffer (for example, booking a session before a lunch break). If you were seeing a therapist in person, the travel time home allows some decompression time. Something similar can be beneficial to build in if seeing your therapist online.

  
  

TL:DR - Quick FAQs About Online Therapy

Does online therapy work as well as in-person?

Yes. Multiple studies and meta-analyses have found that outcomes and therapeutic connection in video-based therapy are comparable to face-to-face work.

How much does online therapy cost?

At Plum Psychology therapy sessions cost the same as in-person sessions.

Is face to face therapy better than online?

The evidence suggests that face to face therapy is comparable to online therapy in terms of effectiveness for many presentations. The main considerations are 1) your preference, 2) whether you are accustomed to working online, 3) the privacy of your space, and 4) the experience of your therapist - where more experienced therapists are adept at building a therapeutic relationship and being attuned to their clients whether they're seen on screen on in-person.

Is online therapy recognised by UK professional bodies?

Yes. NHS England supports remote consultations, and both NICE and the British Psychological Society (BPS) include online therapy within their recommended and ethical frameworks.

Can EMDR be done online?

Yes. Many EMDR practitioners (including our team) are trained to deliver EMDR safely online using online bilateral-stimulation tools or teaching a tapping technique. We also consider safe stabilisation techniques that you can use at home. Read this blog Will EMDR Be Right For Me to learn more.

What do I need for an online therapy session?

Just a private space, a stable internet connection, and ideally a pair of headphones. We’ll send you a secure link and talk you through what to expect before your first session.

How to Get Started with Safe Online Therapy

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In conclusion, online therapy offers a viable, effective alternative to traditional face-to-face sessions. It provides flexibility, safety, and access to the right therapist for your needs. If you're considering this option, know that you are not alone. Many have found success and healing through online therapy, and we are here to support you on your journey.