In today's rapidly evolving world, seeking therapy has become increasingly common as people prioritise their mental wellbeing. With technological advancements, individuals in Ireland now have access to two primary therapy options: online therapy and traditional face-to-face therapy. Both approaches offer valuable support for mental health concerns, but they differ in several important ways.
At Feel Better Therapy, we specialise exclusively in online therapy, providing accessible mental health support through secure digital platforms. This comprehensive guide aims to provide you with evidence-based information comparing online therapy (which we offer) with traditional face-to-face therapy, helping you understand the benefits of virtual counselling for your mental health care journey.
Understanding Online Therapy
Online therapy, also known as e-therapy, teletherapy, or virtual counselling, involves receiving mental health services through digital platforms. This approach utilises technology to connect clients with qualified therapists remotely while still maintaining a therapeutic relationship.
Online therapy in Ireland has grown significantly in recent years, with a substantial acceleration following the global pandemic. This growth reflects both technological advancements and changing client preferences for more flexible mental health support options.
The most common formats of online therapy include:
Video therapy: Live, face-to-face sessions conducted through secure video conferencing platforms, closely resembling traditional therapy but in a virtual environment.
Voice therapy: Phone calls or voice-only digital communications that focus on verbal interaction without visual elements.
Text-based therapy: Written communication through secure messaging platforms, emails, or chat functions, allowing for asynchronous communication.
In Ireland, video therapy has emerged as the most popular online format, as it most closely replicates the interpersonal experience of traditional therapy while offering enhanced convenience and accessibility.
Understanding Traditional Face-to-Face Therapy
Traditional face-to-face therapy, the established approach to mental health treatment, involves in-person sessions between a client and therapist in a physical setting. This method has been the cornerstone of therapeutic practice for decades.
In a traditional therapy setting, clients typically:
- Travel to a therapist's office, clinic, or healthcare facility
- Meet in a dedicated therapy room designed for comfort and confidentiality
- Engage in direct, in-person communication
- Attend sessions at scheduled times, usually lasting 50-60 minutes
Face-to-face therapy has deep roots in Irish mental health services, with established practices across urban and rural settings. Despite the growth of online alternatives, traditional therapy remains widely practised and valued for its direct, personal approach to mental health care.
Effectiveness: What the Research Says
One of the most common questions about online therapy is whether it's as effective as traditional face-to-face therapy. Extensive research, including studies specific to Ireland, provides valuable insights into this question.
Research Findings
A comprehensive meta-analysis published in the European Journal of Public Health examined 728 studies with over 17,000 participants and found that online therapy is generally as effective as face-to-face therapy for treating common mental health conditions. The effectiveness difference was remarkably small—under 0.4%—suggesting comparable outcomes between the two approaches.
In Ireland specifically, research conducted by the Royal College of Surgeons in Ireland (RCSI) found that online group cognitive behavioural therapy (CBT) can be as effective as in-person therapy. A study examining the efficacy of video conferencing versus face-to-face delivery of group CBT for depression in Irish outpatients showed no significant difference in improvements for depression, anxiety, and quality of life scores between the two delivery methods.
Effectiveness for Different Conditions
Research indicates that both therapy modalities show similar effectiveness for:
Anxiety disorders: Both approaches demonstrate comparable outcomes for generalised anxiety disorder, social anxiety, and panic disorder.
Depression: Multiple studies show equivalent effectiveness in reducing depressive symptoms through both online and face-to-face therapy.
Post-traumatic stress disorder: Trauma-focused therapies show similar efficacy rates in both delivery formats.
Relationship issues: Couples therapy and relationship counselling can be effectively delivered through both modalities.
It's worth noting that certain conditions may benefit from specific approaches. For instance, some research suggests that online therapy combined with self-guided, web-based CBT tools may be particularly effective for anxiety disorders, while conditions requiring physical assessment might benefit more from in-person sessions.
Factors Influencing Effectiveness
Several factors can influence the effectiveness of either therapy approach:
Client engagement: The client's active participation and commitment to the therapeutic process is crucial regardless of the delivery method.
Therapist expertise: The therapist's qualifications, experience, and ability to adapt to different formats significantly impact outcomes.
Therapeutic relationship: The quality of connection between client and therapist remains a key predictor of success in both settings.
Technical factors: For online therapy, reliable internet connection and comfort with technology can influence the experience.
Environmental factors: The client's ability to create a private, comfortable space for therapy sessions affects both approaches differently.
Accessibility and Convenience Factors
One of the most significant differences between online and traditional therapy lies in accessibility and convenience, which can be particularly important in the Irish context.
Geographic Accessibility
Ireland's population distribution presents unique challenges for mental health service delivery. While urban areas like Dublin, Cork, and Galway have relatively abundant therapy resources, rural communities often face limited access to mental health professionals.
Online therapy effectively eliminates geographic barriers, allowing clients from remote areas of Ireland to connect with qualified therapists without lengthy travel. This is particularly valuable in regions like the West of Ireland, where mental health services may be sparse and travel distances considerable.
Research indicates that over 18% of rural residents in some countries suffer from mental illness, yet access to care remains a significant challenge. Online therapy helps bridge this gap by bringing professional mental health support directly to clients, regardless of their location.
Time Flexibility and Scheduling
Traditional therapy typically operates within standard business hours, which can create challenges for:
- Working professionals
- Parents with childcare responsibilities
- Students with busy academic schedules
- Shift workers with irregular hours
Online therapy offers enhanced scheduling flexibility, with many therapists providing evening and weekend appointments. This flexibility makes it easier to integrate therapy into busy lifestyles without requiring time off work or other commitments.
Travel Considerations
The travel requirements for traditional therapy can be substantial, particularly in rural Ireland. Consider these factors:
Time commitment: A 50-minute therapy session may require 2-3 hours of total time when accounting for travel.
Transportation challenges: Public transport limitations in rural areas can make accessing therapy difficult for those without personal vehicles.
Weather factors: Ireland's weather can sometimes make travel difficult, leading to cancelled appointments.
Cost implications: Travel expenses, including fuel, public transport fares, and potentially parking fees, add to the overall cost of therapy.
Online therapy eliminates these travel-related barriers, requiring only a device and internet connection to access professional support.
Waiting Times and Immediate Availability
Mental health services in Ireland, like many countries, often have waiting lists for traditional face-to-face therapy. Online therapy platforms frequently offer shorter waiting periods and sometimes even same-day appointments, allowing clients to begin their therapeutic journey sooner.
This immediacy can be particularly valuable for those experiencing acute distress or those who might lose motivation during a lengthy waiting period.
Accessibility for People with Disabilities
For individuals with mobility issues, chronic health conditions, or disabilities, travelling to therapy appointments can present significant challenges. Online therapy removes these physical barriers, making mental health support more accessible to people with diverse needs and abilities.
Privacy and Confidentiality Considerations
Privacy and confidentiality are fundamental aspects of any therapeutic relationship. Both online and traditional therapy approaches have distinct considerations in this area.
Privacy in Physical vs. Virtual Spaces
Traditional therapy offers a dedicated, professional environment designed specifically for therapeutic work. These spaces typically feature:
- Soundproofed rooms
- Waiting areas separate from therapy rooms
- Professional settings free from household distractions
Online therapy relies on the client's ability to create a private space at home or another location. This can present both challenges and opportunities:
Challenges:
- Potential for household members to overhear sessions
- Possible interruptions from family, roommates, or pets
- Difficulty finding completely private spaces in shared living situations
Opportunities:
- Some clients feel more comfortable discussing sensitive topics from their own space
- No possibility of encountering other clients in waiting rooms
- Reduced anxiety about being seen entering a therapist's office
Data Security and Digital Privacy
Online therapy involves digital communication, raising important considerations about data security:
Encryption and secure platforms: Reputable online therapy services use end-to-end encryption and secure, GDPR-compliant platforms to protect client information.
Record keeping: Digital records must be securely stored and protected from unauthorised access.
Technical safeguards: Password protection, secure networks, and other technical measures help maintain confidentiality.
In Ireland, therapists providing online services must adhere to strict data protection regulations under GDPR, ensuring that client information remains confidential and secure.
Legal Protections for Therapy Clients
Irish clients benefit from robust legal protections regardless of therapy modality:
GDPR compliance: All therapy providers must comply with General Data Protection Regulation requirements.
Professional standards: Accredited therapists adhere to ethical guidelines from professional bodies like the Irish Association for Counselling and Psychotherapy (IACP) or the Psychological Society of Ireland (PSI).
Informed consent: Clients must receive clear information about how their data is used and stored in both therapy formats.
Anonymity Benefits
Online therapy can offer a degree of anonymity that some clients find beneficial:
- Reduced concern about being recognised when attending therapy
- Potential for greater openness due to the "online disinhibition effect"
- Easier access for those concerned about stigma associated with seeking mental health support
This anonymity factor can be particularly valuable for clients in small communities where privacy concerns might otherwise prevent them from seeking help.
The Therapeutic Relationship
The relationship between client and therapist is widely considered one of the most important factors in successful therapy outcomes. Both online and face-to-face approaches offer different experiences in building and maintaining this crucial connection.
Building Rapport
Establishing a strong therapeutic alliance is possible in both settings, though the process may differ:
Face-to-face therapy facilitates connection through:
- Full access to non-verbal cues and body language
- Shared physical space creating immediate presence
- Traditional rituals of greeting and farewell
- Environmental factors that create a sense of safety
Online therapy builds rapport through:
- Focused attention on facial expressions and tone of voice
- Convenience and consistency that builds trust over time
- Written communication (in some formats) that encourages reflection
- The comfort of connecting from familiar surroundings
Research published in the Clinical Psychology & Psychotherapy journal indicates that therapeutic alliance in online settings can be just as strong as in face-to-face therapy, though it may develop differently.
Non-verbal Communication
Non-verbal cues play an important role in human communication and therapy:
Traditional therapy allows therapists to observe:
- Full body language and posture
- Subtle physical responses
- Micro-expressions and gestures
- Overall presentation and appearance
Video-based online therapy provides:
- Facial expressions and upper body language
- Vocal tone and pacing
- Limited environmental context
- Focused attention on what's visible on screen
While some non-verbal information may be lost in online settings, many therapists and clients report adapting quickly to the video format, developing heightened awareness of the non-verbal cues that are available.
Depth of Connection
The depth of therapeutic connection depends on multiple factors beyond the delivery method:
- Therapist skill and approach
- Client openness and engagement
- Consistency of sessions
- Quality of communication
- Shared therapeutic goals
Studies suggest that meaningful therapeutic relationships can develop in both settings, with many clients reporting feeling deeply understood and supported through online therapy.
Client and Therapist Perspectives
Feedback from both clients and therapists provides valuable insights:
Client perspectives:
- Some report feeling more comfortable discussing difficult topics from home
- Others value the ritual and boundary of travelling to a dedicated therapy space
- Many appreciate having options that fit their changing needs
Therapist perspectives:
- Many report successful adaptation to online formats
- Some note different dynamics in building rapport online
- Most value offering flexibility to meet diverse client needs
A survey of Irish therapists found that many who initially transitioned to online therapy out of necessity during the pandemic have continued offering this option due to positive experiences and client demand.
Technology Requirements and Limitations
Online therapy relies on technology, which introduces both opportunities and challenges that don't exist in traditional face-to-face settings.
Necessary Equipment and Internet Requirements
To engage effectively in online therapy, clients need:
Basic equipment:
- Computer, tablet, or smartphone with camera and microphone
- Headphones or speakers
- Stable internet connection
Internet specifications:
- Broadband connection (minimum 1 Mbps upload/download speed)
- Unlimited data plan or sufficient data allowance
- Reliable service with minimal interruptions
While these requirements are standard for many households in Ireland, they may present barriers for some potential clients.
Digital Literacy Considerations
Comfort with technology varies widely across different demographics:
- Younger clients typically adapt easily to online formats
- Some older adults may face challenges with digital platforms
- Previous experience with video calling often eases the transition
Most online therapy platforms are designed to be user-friendly, requiring minimal technical knowledge. Many therapists also offer brief orientation sessions to help clients become comfortable with the technology before beginning therapeutic work.
Technical Difficulties and Solutions
Technical issues can occasionally disrupt online therapy sessions:
Common challenges:
- Internet connectivity problems
- Audio or video quality issues
- Platform access difficulties
- Device malfunctions
Practical solutions:
- Having backup plans (e.g., phone sessions if video fails)
- Testing connections before sessions
- Keeping devices updated and charged
- Having technical support resources available
While technical difficulties can be frustrating, most clients and therapists develop effective strategies to minimise disruptions and maintain therapeutic continuity.
Irish Broadband Coverage and Implications
Ireland's broadband infrastructure has improved significantly in recent years, but coverage remains uneven:
- Urban areas generally have excellent connectivity
- Rural areas may have limited or unreliable service
- The National Broadband Plan aims to address these disparities
For clients in areas with poor connectivity, options include:
- Phone-based therapy sessions
- Finding locations with better internet access for sessions
- Using text-based therapy formats that require less bandwidth
- Hybrid approaches combining online and in-person sessions
Cost Comparisons
Financial considerations often play a significant role in therapy decisions. Both online and traditional therapy have different cost structures and considerations.
Average Costs in Ireland
Therapy costs in Ireland vary based on location, therapist qualifications, and session format:
Traditional face-to-face therapy:
- Average session costs range from €60-€120
- Urban areas typically have higher rates
- Specialised approaches may command premium pricing
Online therapy:
- Session costs typically range from €50-€90
- Some platforms offer subscription models with weekly or monthly rates
- Group therapy options may provide lower-cost alternatives
While online therapy sessions are often priced slightly lower than in-person sessions, the most significant cost difference comes from associated expenses.
Hidden Costs and Savings
Beyond the session fee itself, consider these additional factors:
Traditional therapy additional costs:
- Transportation expenses (fuel, public transport fares)
- Parking fees in urban areas
- Childcare during session and travel time
- Lost income from taking time off work
Online therapy additional costs:
- Internet service
- Device costs (though most clients use existing devices)
- Potential data usage charges
For many clients, particularly those travelling significant distances for in-person therapy, these associated costs can substantially impact the overall financial commitment.
Long-term Financial Implications
When considering therapy as a longer-term investment in mental health, several factors affect the financial picture:
Consistency factors:
- Online therapy's convenience may result in fewer missed sessions
- Reduced barriers may support longer-term engagement
- Flexible scheduling can minimise work disruption
Practical considerations:
- Weather-related cancellations are eliminated with online therapy
- Illness-related cancellations may be reduced (clients can still attend when mildly ill but not contagious)
- Travel-related stress and costs are eliminated
For many clients, the accessibility of online therapy supports more consistent attendance, potentially improving therapeutic outcomes while maximising the value of their financial investment.
Suitability for Different Client Groups
While both therapy modalities can be effective, certain client groups may find one approach more suitable than the other based on their specific circumstances and needs.
Age Considerations
Different age groups may have varying experiences with therapy formats:
Children and adolescents:
- Some young clients engage well with technology-based approaches
- Play therapy and certain interventions for children work better in person
- Adolescents sometimes prefer the perceived privacy of online sessions
Adults:
- Working-age adults often appreciate the flexibility of online options
- Individual preferences vary widely based on comfort with technology and personal circumstances
Older adults:
- Some may face challenges with technology
- Others value online therapy for eliminating travel barriers, particularly important for those with mobility issues
- In-person sessions may provide valuable social connection for isolated seniors
Cultural Considerations in the Irish Context
Ireland's diverse population has varying needs and preferences:
- Rural communities may particularly benefit from online access to specialists
- International residents may connect with therapists who understand their cultural background
- Irish expatriates living abroad can maintain therapeutic relationships with Irish therapists who understand their cultural context
Suitability for Different Mental Health Conditions
Research suggests varying suitability based on condition:
Well-suited to online formats:
- Anxiety disorders
- Depression
- Stress management
- Grief counselling
- Many forms of cognitive behavioural therapy
May benefit more from in-person sessions:
- Severe mental illness requiring close monitoring
- Conditions with significant risk factors
- Therapy involving physical components
- Some forms of trauma therapy (though many trauma approaches work well online)
Crisis Intervention Capabilities
Both modalities offer crisis support with different considerations:
Traditional therapy:
- Direct in-person assessment of risk
- Immediate physical intervention if needed
- Established protocols for emergency situations
Online therapy:
- Requires clear crisis plans established in advance
- May involve local emergency services when necessary
- Can provide immediate support regardless of location
Many therapists develop specific protocols for managing potential crises in online settings, ensuring client safety remains the priority.
Client Experiences and Testimonials
The experiences of therapy clients provide valuable insights into the practical differences between online and traditional approaches.
Transitioning Between Modalities
Many clients have experienced both therapy formats, particularly since the pandemic:
"I was sceptical about switching to online sessions when the pandemic started, but I was surprised by how quickly it felt normal. Now I actually prefer it because I can fit therapy into my workday without the stress of rushing across town." - Client, age 34
"After trying online therapy for six months, I decided to return to in-person sessions. I found I needed that physical space away from home to really focus on my therapy work. The ritual of going to my therapist's office helps me transition mentally." - Client, age 42
Success Stories from Both Approaches
Clients report meaningful progress through both therapy formats:
"Through online therapy, I've been able to work through my social anxiety at my own pace. Being able to connect from my safe space at home actually made it easier to open up about difficult topics." - Client, age 28
"Face-to-face therapy has been transformative for me. Something about sitting in the same room with my therapist helps me feel truly seen and understood in a way I wasn't sure would be possible online." - Client, age 51
Challenges Encountered and Overcome
Clients have found ways to address the limitations of each approach:
"At first, I struggled with distractions during my online sessions—family members interrupting, notifications on my computer. Creating a dedicated space and setting boundaries helped me focus." - Client, age 37
"The commute to my therapist's office was becoming a barrier—I was missing sessions when work ran late. Switching to an online therapist made a huge difference in my consistency." - Client, age 45
These diverse experiences highlight that neither approach is universally superior—the "best" option depends on individual circumstances, preferences, and needs.
Hybrid Approaches and Flexibility
As therapy continues to evolve, many clients and therapists are discovering the benefits of flexible, hybrid approaches that combine elements of both online and face-to-face therapy.
Combining Online and Face-to-Face Therapy
Hybrid approaches can take various forms:
- Alternating between in-person and online sessions
- Primarily using one format with occasional use of the other
- Seasonal adjustments (e.g., online during winter months)
- Responsive changes based on client circumstances
This flexibility allows therapy to adapt to changing needs while maintaining continuity of care.
Transitioning Between Modalities
Many therapeutic relationships successfully navigate transitions between formats:
- Beginning with in-person sessions to establish rapport, then transitioning to online
- Starting online for accessibility, then moving to in-person for specific interventions
- Temporarily switching formats due to circumstances (travel, illness, etc.)
- Gradual transitions with careful attention to maintaining the therapeutic relationship
Tailoring Approaches to Individual Needs
The most effective therapy often involves customisation based on:
- Client preferences and comfort
- Therapeutic goals and methods
- Practical considerations like schedule and location
- Changing circumstances over time
This personalised approach recognises that mental health support is not one-size-fits-all, and the delivery format should serve the client's unique needs.
Making the Right Choice: Decision Factors
Choosing between online and traditional therapy is a personal decision that depends on numerous factors. Consider these questions when making your choice:
Practical Considerations
- How far would you need to travel for in-person therapy?
- Do you have a private, quiet space for online sessions?
- What is your comfort level with technology?
- How flexible does your therapy schedule need to be?
- Do you have reliable internet access?
Personal Preferences
- Do you feel more comfortable opening up in person or from your own space?
- How important is non-verbal communication to you?
- Do you value the ritual of going to a separate therapy space?
- Would you prefer to avoid travel time and expenses?
- How do you best connect with others generally?
Therapeutic Needs
- What are your primary reasons for seeking therapy?
- Do you have specific mental health conditions that might influence the choice?
- Would you benefit from more frequent, shorter sessions (often easier online)?
- Do you need specialised therapy that might only be available in one format?
- Are there physical components to your therapy needs?
Trial Approaches
Many therapists offer initial consultations in both formats, allowing you to:
- Experience both approaches firsthand
- Discuss your specific needs with a professional
- Make an informed decision based on experience rather than assumptions
- Consider a hybrid approach if appropriate
Remember that your choice isn't permanent—many clients successfully transition between therapy formats as their needs and circumstances change.
Practical Tips for Getting the Most from Online Therapy
If you choose to pursue online therapy, these practical tips can help you create an optimal experience:
Setting Up an Effective Therapy Space
Create a dedicated space for your sessions that offers:
- Privacy and quiet
- Comfortable seating
- Good lighting (facing you rather than behind you)
- Minimal distractions
- Reliable internet connection
Consider using headphones for better audio quality and enhanced privacy.
Technology Preparation
Before beginning online therapy:
- Test your device's camera and microphone
- Ensure your internet connection is stable
- Familiarise yourself with the therapy platform
- Have a backup plan (phone number, alternative device) in case of technical issues
- Close unnecessary applications to improve performance
Mindset and Engagement Strategies
Approach online sessions with:
- The same commitment as in-person therapy
- Clear boundaries (turning off notifications, informing household members)
- A transition ritual to help you shift into "therapy mode"
- Openness to the unique benefits of the online format
- Patience with any technical learning curve
Communication Techniques
Enhance your online therapy experience by:
- Speaking clearly and at a moderate pace
- Positioning yourself where your therapist can see your facial expressions
- Being explicit about emotions that might be less visible online
- Using the chat function for clarification when needed
- Providing feedback about your experience of the online format
Conclusion
Both online therapy and traditional face-to-face therapy offer valuable pathways to improved mental health and wellbeing. Research consistently shows that both approaches can be highly effective, with the "best" choice depending on individual circumstances, preferences, and needs.
Online therapy excels in accessibility, convenience, and flexibility, making mental health support available to people who might otherwise face significant barriers to care. Traditional therapy offers the familiarity of in-person connection, complete access to non-verbal communication, and a dedicated therapeutic environment.
Many clients find that their preferences evolve over time, and the growing availability of both options—as well as hybrid approaches—means that therapy can adapt to changing needs throughout one's mental health journey.
The most important factor is not which format you choose, but that you take that crucial first step toward supporting your mental health. Whether online or in person, connecting with a qualified therapist can provide the support, insights, and tools needed to navigate life's challenges and work toward greater wellbeing.
Taking the Next Step in Your Mental Health Journey
If you're considering therapy, we encourage you to complete our form so we can match you with an online therapist best suited for your specific needs. Our team is committed to providing compassionate, effective support for your mental health journey through our secure online therapy platform, designed to offer the convenience, accessibility, and effectiveness that modern mental health care demands.
