Short answer
A 2022 meta-analysis of trials comparing video or phone therapy with face-to-face therapy found insufficient evidence of a difference, for the conditions studied. That does not guarantee any outcome for you, and the evidence is thinner for more serious conditions. On InnerHub, a 50-minute online session is $59.90 AUD, with no referral and no subscription.
If you are weighing online counselling against sitting in a room with someone, it is reasonable to ask whether you are settling for less. It would be odd not to. A screen can feel like a smaller version of the real thing.
Here is what the research has found, what it cannot tell you, and a few practical ways to judge whether online suits you.
What does the research say about online versus in-person?
A 2022 meta-analysis published in JMIR Mental Health (Greenwood and colleagues) pooled 12 randomised trials of telehealth and face-to-face psychotherapy for less common mental health conditions, and found insufficient evidence that the two differ.
That is a careful sentence, and it is worth reading carefully. It says the studies did not find a gap. It does not say online is better, and it does not say online will work for you.
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Find a therapistWhat can the research not tell you?
Quite a lot, and being clear about it matters more than a confident headline.
- It describes groups, not individuals. An average result across many people says little about how one person will find a particular practitioner.
- Conditions differ. The same JMIR Mental Health review noted that for some serious conditions there was no usable evidence to include. Counselling is not a substitute for specialist care where that is what someone needs.
- Formats differ. Many trials test structured, manualised therapy delivered by video. A counselling session is often more open. The studies are a guide, not a match.
- Trial settings are not everyday life. People in trials are chosen and followed. Real use is messier.
InnerHub does not claim online counselling works better than in-person, or that it will resolve anything for you. What can be said is narrower: for many people, video is a reasonable way to have the same kind of conversation.
Does the relationship still form over video?
For most people it does, though it can feel different at first. The relationship with a practitioner is a large part of what makes counselling useful, and the usual advice applies online as much as anywhere: you should feel listened to, and able to say what you came to say.
You do not have to take that on trust. The first session tells you a lot. Our post on how to find a counsellor who is the right fit sets out what to notice, and on InnerHub, changing practitioner costs nothing extra.
Who might find in-person works better?
Online is not for everyone, and saying so plainly is part of being useful.
- People who want the room. Some prefer the physical presence of another person. That is a legitimate answer.
- People without a private space. You need somewhere you can talk freely for 50 minutes. Headphones and a closed door go a long way, but not everyone has that at home.
- People with an unreliable connection. A video session needs a reasonably steady connection.
- People whose situation needs more than counselling. If what you are carrying needs a doctor or specialist care, the right step is a GP or specialist, online or not.
How can you tell if online counselling is working for you?
Look at the experience rather than waiting for a verdict. After a few sessions, ask yourself:
- Do I feel heard? Not agreed with, just heard.
- Can I say what I came to say? Even the awkward parts.
- Do I leave with something? A new way of seeing it, or simply some relief at having said it aloud.
- Is the format getting in the way? If the screen is the problem, try a different setup, or say that in-person suits you better.
If the answer is mostly no, that is useful information. It may mean a different practitioner, a different approach, or a different format.
What does it cost to find out?
On InnerHub a 50-minute video session is $59.90 AUD. There is no referral, no subscription and no gap fee, and you book one session at a time. Our pricing page has the whole price, and our guide to why online counselling costs less explains where the difference comes from.
InnerHub practitioners are experienced and qualified in their own countries and are not AHPRA-registered, so sessions sit outside Medicare and no rebate applies. If that matters to you, our guide to sessions outside Medicare sets out the trade-off. To see who is available, get matched with a therapist.
Not sure where to start?
Take the two-minute quiz to see what kind of support fits, or read how matching works.
Take the quizIs there free support while you decide?
Yes. The Beyond Blue Support Service offers free phone (1300 22 4636), webchat and email support at any hour, and a GP can talk through options.
What counselling cannot do
Counselling is a place to work through what you are carrying. It does not replace a doctor. InnerHub practitioners work within their training and refer honestly: if what you are carrying needs a GP or specialist care, they will say so.
When to get help sooner
InnerHub is not a crisis service. If you are in immediate danger, call 000. For support at any hour, Lifeline is on 13 11 14.
This article is general information for adults 18 and over. It is not financial, clinical or medical advice, and not a substitute for professional care.
General information, not clinical or medical advice. For adults 18 and over. InnerHub is not a crisis service: in an emergency call 000, or Lifeline on 13 11 14.
