How Effective Is Online Therapy?

One of the most common questions people have about online therapy is: "Can I really build a meaningful connection with my therapist through a screen?"

The answer is yes. Research suggests that the quality of the therapeutic relationship is one of the most important factors in successful therapy—regardless of whether sessions happen online or in person.

In Gestalt therapy—and in related experiential therapies such as Emotion-Focused Therapy—the relationship between therapist and client is more than just a vehicle for change; it is part of the healing process itself.

Healing often happens through authentic contact: feeling seen, heard, accepted, and understood without judgment. Rather than focusing solely on changing thoughts or behaviours, these approaches invite you to become more aware of your emotions, bodily sensations, and patterns of relating, allowing new ways of experiencing yourself to emerge.

Decades of psychotherapy research have shown that the therapeutic alliance—the collaborative relationship between therapist and client—is one of the strongest predictors of positive therapy outcomes across different therapeutic approaches. A large meta-analysis by Horvath and colleagues (2011), which reviewed more than 190 studies, found that a stronger therapeutic alliance was consistently associated with better outcomes in psychotherapy.

Research on telepsychology has also found that meaningful therapeutic relationships can be developed online. Studies suggest that clients can experience a strong sense of connection, collaboration, and trust with their therapist through video sessions, with therapeutic alliance scores often comparable to those found in face-to-face therapy.

While meeting face-to-face has its own unique qualities, meaningful connection, emotional depth, and genuine presence can absolutely develop through a screen.

For many people, online therapy can even create a greater sense of comfort and safety. Being in your own familiar environment may make it easier to slow down, access emotions, and engage more openly in the therapeutic process.

Ultimately, therapy is not defined only by the room you are sitting in—it is shaped by the connection, trust, and presence created between therapist and client.

References

Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011).
Alliance in individual psychotherapy.
Psychotherapy, 48(1), 9–16.
https://doi.org/10.1037/a0022186

Norcross, J. C., & Lambert, M. J. (2019).
Psychotherapy Relationships That Work: Volume 1: Evidence-Based Therapist Contributions (3rd ed.).
Oxford University Press.

Hedman-Lagerlöf, E., Carlbring, P., Svärdman, F., Riper, H., Cuijpers, P., & Andersson, G. (2023).
Therapist-supported Internet-based cognitive behaviour therapy yields similar effects as face-to-face therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis.
World Psychiatry, 22(2), 305–314.

Simpson, S. G., & Reid, C. L. (2014).
Therapeutic alliance in videoconferencing psychotherapy: A review.
Australian Journal of Rural Health, 22(6), 280–299.

Greenberg, L. S. (2011).
Emotion-Focused Therapy.
American Psychological Association.