3 MIN READ | Counselling

Is Online Counselling Right for You?

Dr Julian Nesbitt

Reading Time: 3 minutes

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In today’s world everything is available online: from dating, to shopping, to learning. Every aspect of society, is having to remodel in order to satisfy the ever increasing demand for online options. There is no exception, not even in the world of mental and physical health. The world is changing at an unrecognisable speed and many who are not on board the e-train, are frightened of being left behind.

In today’s digital era, kids are almost arriving from the womb with a tablet in hand, ready to check out Duggie or watch a peer open a Kinder egg. It is quite acceptable therefore, to presume that the millennials and younger, are adept at working their way around the latest app or program. However many adults feel that there online skills are inadequate when it come to fulfilling their needs.

Online therapy is a fantastic addition to the more traditional therapy options. It not only offers video counselling but also secure instant messaging and email, depending on the needs and preference of the client.


It can make counselling accessible to those who otherwise may not be able to avail of it, due to disability, phobias, location or time constraints and can be offered as a stand-alone platform for therapy or in conjunction with face-to-face.

Suitability of a client is determined by their sufficient ability to use internet, a secure connection, reasonable speed, and that they have privacy in their chosen location. Without these factors, communication can be potentially hindered, which may interrupt the smooth running of the sessions or compromise the confidentiality of the therapy. This may leave clients feeling over or underwhelmed and possibly in a more negative place than when they started.

It is also not necessarily the best model for very serious mental illness unless the chosen therapist has competence and experience in these areas from working face-to-face. An ethical counsellor has a duty of care to their clients and will have protocols in place to ensure their clients’ safety. However this may prove difficult if the client is not wanting to be located, as unlike face-to-face therapy, the client is not physically with their therapist hence the problem in safeguarding them.

Therefore, an in-depth assessment must carried out before work would begin. Assuming then, that the client is proficient online and the therapist is competent in working with serious mental illness, can online counselling be effective?

Numerous studies have been done to suggest that online counselling is as effective as face-to-face, given the proficiency of the counsellor and the skills required by the client. But how can we determine whether or not a counsellor is skilled at working in this medium?

Various online counselling courses are offered to someone wishing to incorporate this medium into their practice, ranging from £25 to thousands of pounds and varying from as little as two online hours of video watching, to many months of monitored work. This can make it difficult to know exactly, how much training your chosen counsellor may have.

Working online is a relatively new platform for therapy; there are presently no regulations requiring counsellors to have undergone a minimum standard of training. There is however an association for therapist and counsellors who work in this medium. ACTO (Association for Counselling and Therapy Online) requires all its members to have completed a recognised course and adhere to strict ethical guidelines. It is, at present, the only such organisation in the UK.

So which form of therapy is best for you? Online or face-to-face? Like any decision, it depends on your needs and your constraints. Do you prefer the strength and reliability of the traditional steam train or are you wanting to climb on-board the new high speed bullet? Whatever the decision, sit back, have faith in the process and enjoy the journey to your chosen destination.


Dr Julian Nesbitt is a GP at the NHS and a clinical entrepreneur. He founded Dr Julian Medical Group out of his passion to improve mental health access in the UK. 


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