Does Online Counselling Work? What Virtual Sessions Are Like

For most of the concerns people bring to counselling, the research has generally found virtual sessions about as effective as meeting in person. The more useful question is therefore not whether it works, but whether it suits you, your situation and what you are working on.

For a lot of people on Vancouver Island it is the difference between having counselling and not, which makes it a fairly easy call.

Why It Matters Here Particularly

Nanaimo is reasonably well served. Much of the rest of the Island is not. If you are in Ladysmith, Parksville, Port Alberni or further up-Island, the choice is often between a long drive each way or a smaller pool of local options.

Virtual sessions remove that, and they remove the other barriers that quietly end counselling for people: childcare, shift work, a car that is unreliable, weather, and the weeks where leaving the house is itself part of the problem.

That last one deserves emphasis. For someone whose anxiety makes going out difficult, requiring them to go out in order to get help for it is a poor design.

What a Session Is Actually Like

Much the same, which surprises people. You join a secure video call at the appointed time. The conversation runs as it would in a room.

Differences worth knowing about: eye contact works differently on video and takes a little adjustment, silences can feel longer, and you lose some peripheral information about posture and movement. Counsellors working virtually generally compensate by checking in more explicitly about what is happening for you.

Some people find it easier to say difficult things from their own home. Others find the distance unhelpful. Both are common, and you will know within two or three sessions.

What You Need

Less than people expect. A device with a camera, a reasonably stable connection, and a private space for the hour.

Privacy is the item most often underestimated. A room with a door you can close is ideal. Headphones help considerably. People have sessions from a parked car more often than you would think, and it works.

If your connection is unreliable, tell your counsellor in advance and agree what happens if it drops: usually a switch to phone, which is a legitimate format in its own right.

Who It Suits Well

• Anxiety, low mood and stress
• Work and life transitions
• Grief
• Relationship difficulties, including couples work where both partners can be in the same room or dial in separately
• Ongoing work with someone you already have a relationship with
• Anyone whose barrier is distance, schedule or mobility

When In Person Is Worth the Drive

Virtual is not always the right format.

Where safety is a concern, whether risk to yourself or a home situation where you cannot speak freely, in person is better and sometimes necessary.

Some trauma work, particularly approaches that rely on tracking bodily responses closely, is easier face to face. Our post on somatic therapy covers that kind of work.

Where you have no private space at all, the format undermines itself.

If you have tried virtual and found you cannot settle into it. That is reason enough, and it does not need justifying.

Confidentiality and Platforms

Ask what platform is used and whether it meets Canadian privacy requirements. A general-purpose consumer video app is not the same as a clinical platform, and a registered clinician will have thought about this.

Ask also where your counsellor is registered and whether they can see you in the province you are physically in. Registration is provincial, which matters if you travel or move.

Getting the Most From It

Treat the appointment as an appointment. Sitting on your bed with the television on produces a different session than sitting somewhere you have deliberately arranged.

Log in a few minutes early rather than arriving breathless. Keep a notebook. And give yourself ten minutes afterwards instead of going straight into a meeting, because the transition is much shorter than it is when you have a drive home.

Practical Takeaways

For most common concerns, virtual works. Privacy and a stable connection matter more than equipment. Give it two or three sessions before judging it. Where safety, no private space, or certain body-based trauma work is involved, in person is the better choice.

When to Reach Out

Reach out when something has been affecting you for weeks rather than days, or when the reason you have not started counselling is logistics rather than doubt about whether you need it.

If you are in crisis: call or text 9-8-8, the Suicide Crisis Helpline, at any hour. The Vancouver Island Crisis Line is 1-888-494-3888. In an emergency, call 9-1-1.

Getting Started

The Counselling HUB offers individual counselling in person at our office in Nanaimo and virtually anywhere in British Columbia. A free 15-minute consultation is a good way to test whether the format works for you. Get in touch.