Is Online Therapy Effective and Is It Right For Me?

is online therapy effective
is online therapy effective

What is the effectiveness of online therapy?

Since the pandemic, so many jobs have turned from in-person to work from home… therapy included! Now that a lot of the world has opened up and returned to working in-person, you may be wondering if it is better to seek therapy in-person or online. Is online therapy as effective as in-person anyways?

Turns out, research has shown that yes, it very much is. One meta study looked at 64 studies comparing online to in-person therapy involving over 9,000 clients seeking therapy for anxiety and depression. They found that the effectiveness of online therapy was no different than in-person therapy.

In fact one study showed that online therapy might be MORE effective for people age 19-39. This may be partly due to a familiarity and comfort with technology. It also may be due to the anonymity and privacy that online therapy provides. It can be difficult at first to open up and be vulnerable with a stranger.

Some people may feel more reserved and closed off going into a therapy office compared to seeing someone in the comfort of their own home. When someone sees a therapist at home, they have more control over their immediate environment, and it turns out might end up being more open in their session.

4 Factors To Consider When Deciding If Online Therapy is Right For You

Ok, so you might be thinking, that’s great online therapy is just as effective as in-person therapy, but is it the right choice for me? Here are some factors that might be helpful to consider.


An important factor to consider is do you have a private space in your home where you can see yourself sharing details about your life? I think this might be one of the most important factors. If you live in a busy home, where it is likely that you will be disturbed, or might be worried about others over hearing you, online therapy might not be the best fit.

Do I see myself being more open at home or in-person?

This relates to privacy and the important finding from that study. Do you see yourself being more open at home or in-person? If you sense that you would be more likely to open up from the comfort of your home, then online therapy might be a better fit for you

Internet Connection

This might be an obvious one, but still important to consider. If you use your internet connection for Zoom calls and streaming services like Netflix you should be good to go for online therapy! Of course, if you don’t have a strong internet connection there are ways around this… maybe you talk to your therapist over the phone and mute your video call so you can still see them.

Will I be more likely to attend regularly if it is online?

Therapy has the greatest chance of success when it is attended regularly. An important question to ask yourself is do I have time to commute into a therapy office? If doing online therapy would make it more likely that you will attend regularly then this might be a better fit for you.

You are not struggling with psychosis

Research has shown that in-person therapy is more effective than online therapy for those struggling with psychosis. This may be that individuals struggling with psychosis find it difficult to connect with a therapist through a screen. If this is something you are struggling with, then in-person therapy is probably the best option.

Do what feels right to you!

Overall online therapy and in-person therapy are equally effective for treating anxiety and depression. I would suggest trying out what feels right to you. If you are someone that prefers seeing someone in-person, and there is a therapy practice close to you that you are likely to attend, then go for it!

If you are someone that likes the idea of being open to a therapist in your own personal space, and would find it challenging commuting into an office regularly, then try out online. Either way, you can always switch if it turns out that it’s not the right fit for you.

Interested in Therapy with Stephanie?

Emotions as Allies

We all know that being human means we experience a wide range of emotions; happiness, sadness, anger, fear, guilt, surprise, joy, loneliness, and love to name a few.

Yet quite often when a difficult emotion comes up, we try to avoid it, get rid of it, or beat ourselves up for having it in the first place.

Emotions contain messages

We forget that our emotions have evolved for a purpose and often contain important information. Here are some common messages an emotion might be telling us…

Anger often tells us that we have been hurt or treated unfairly. It can serve as a warning sign that there is something wrong that needs to be addressed.

Sadness often tells us we have experienced some type of loss. This could be an external loss such as the loss of a person, experience, or job. It can also be an internal loss such as a loss of meaning or perhaps we are not living up to some ideal we have about ourselves.

Fear has evolved to warn us of some type of danger, its purpose is to protect us. This was especially important back when we were living in caves and there was danger everywhere.

Guilt shows up when we believe we have done something wrong. It can tell us that we need to make amends with someone.  

Love tells us that we appreciate someone, and we want to be close to them. It motivates us to connect with others.  

How can our emotions help us?

When we try to hide, or fight, or runaway from our emotions, we often miss the message they might be trying to tell us. To help think about this, the next time you’re experiencing a difficult emotion, ask yourself:

  • Is this emotion telling me I need to address, solve, or come to terms with something?
  • What does this emotion tell me about what I care about? Are there any values underlying this emotion?
  • Is this emotion telling me I need to do something differently?
  • Can this emotion help me empathize with other people who may be experiencing something similar?

Sometimes when we experience a difficult emotion there might not be a clear purpose, or message. In these situations, an emotion like this can be a reminder to be more self-compassionate. To read more about this idea click here.

When we reframe any difficult emotion as having a purpose, or a message (even if it is just to be more compassionate to ourselves), our emotions can become an ally, instead of an enemy we need to run away from.

Connecting with Your Values (Part 3)

This article goes into practical ways we can start living by our personal values. If you have not clarified your own values yet, check out part two of this article series here.

Flavour and Savour

Any given value has an infinite number of possible actions. Take kindness for example. This could include complimenting a friend, petting your dog, making yourself a nice dinner, giving someone you love a hug…the list goes on.

One simple way we can bring our values into play is to pick one or two values from your list. Throughout your day try to flavour your actions with that value. Whenever you do a value-based action, notice how you feel afterwards. Is this action more in line with the person you want to be or less? If it is more in line, then try to savour how that feels.

SMART Goal Setting

Another, more formal way, to bring our values into play is to set a goal around a given value. The SMART acronym is a popular way to do this. The acronym is as follows.

Specific – we want the goal to be as specific as possible. If your goal is to be kinder to yourself, what does that actually look like? An example of a specific goal would be “I’ll practice a self-compassion meditation 2 times this week, once on Monday and once on Wednesday”.

Motivated by Values – is this goal motivated by your values? Is it helping you become more like the person you deep down want to be?

Adaptive – is this goal going to help you improve your life in some way? If no, then it is not very likely you will complete it.

Realistic – this one is very important, and often why we do not end up meeting our goals. When we set unrealistic goals for ourselves, and then end up failing, it can lead us to lose confidence in our abilities and that pesky inner critic can rear its ugly head. Always ask yourself, on a scale of 0 to 10, how realistic is this goal (0 being this goal is completely unrealistic to 10 being this goal is completely realistic)? We want a 7 or higher.

Time-framed – always put a time limit on your goal. This allows us to see that the goal has been completed, which can improve our confidence in our ability to complete our goals.

How do I know if these are my real values?

This is a very common question. The interesting thing about this question, is it is not really something that can be answered by going over it in your head.

This question can only be answered by getting out there, trying out actions in line with a specific value, and noticing whether or not this brings you closer or further away from the sort of person you want to be. There is an old proverb that sums this up nicely

“The proof of the pudding is in the eating.”

So, get out there, and test it out for yourself!

Connecting with Your Values (Part 2)

This article contains 3 written exercises that are designed to help clarify your own personal values. To get some background on what I mean by values, check out part one of this article here.

I highly suggest taking out a pen and paper to write these answers down. It is way more helpful then just going it over in your head. These exercises were created by psychotherapist Russ Harris’. To check out his ACT program click here.

Okay so you have your pen and paper, right?

10 Years Into the Future

I want you to imagine that we fast forward 10 years into the future. Finish the following sentences:

I spent too much time worrying about…

I did not spend enough time doing such things as…

If I could go back in time, what I’d do differently from today onwards is…

Your 80th Birthday

I want you to imagine that starting today, you lived your life exactly as you wanted to live it. Difficult thoughts and feelings did not get in your way and you behaved exactly as the person you truly wished to be. You treated yourself, others and the world the way you deep down wanted to treat them.

Now we fast forward to your 80th birthday, and someone very special to you gets up to make a speech about you. What would you most like to hear them say about…

The sort of person you were…

Your 3 greatest strengths and qualities…

The way you treated them…

Something that is painful today

Last scenario. I want you to pick out a situation you are struggling with today. Now let’s fast forward 1 year into the future and we are looking back on this situation. I want you to imagine you handled it in the best possible way, behaving like the person you deep down want to be. From this perspective…

What did you stand for in the face of this adversity? What values did you live by? For example, did you stand for courage, persistence, kindness, compassion, honesty, integrity?  

How did you treat yourself as you dealt with this?

How did you treat others you care about?


What did you find in these answers? Were there any values you could see in your responses? Try writing a list of what values came up.

If you are confused by what I mean by ‘values’, check out this list of common values here.  

Connecting with Your Values (Part 1)

The word ‘values’ can trigger different meanings for different people. Some people will instantly think of valuing their family or their relationship. When I speak of ‘values’, I mean something much more specific.

I mean deep down how do you most want to treat yourself, others, and the world? How do you want to treat your family? What kind of partner do you want to be?

In this definition, values are defined as desired global qualities of ongoing action. They are something that can be done in any moment. For example, loving, kindness, compassion, respect, courage, cooperation, adventure, curiosity are all examples of values.

Values vs. Goals

It is very common to confuse values with goals. One way to look at it is values are in the here and now, goals are in the future. If it is something that can be checked off a list, like getting married, then it is a goal. Being a loving partner would be a value.

What is helpful about this distinction is that we might never reach a certain goal, for example we might never get married. However, we can always connect with our value of being loving, whether that be towards ourselves, others, and the world. Conversely, we may reach our goal of getting married, but not be living by our value of being loving.

If you were going on a road trip your compass is like your values, pointing you in the direction you want to go, whereas goals are the things you do along the way. Values can help guide our goals, and we can reconnect with them in any moment to remind ourselves of the person we truly wish to be. This helps give our life meaning and purpose. 

How you want to behave, not how others want you to behave

Values are about how we deep down want to behave, not how we think we should behave, or how the people in our lives want us to behave.

Our values never need to be justified. They are simply preferences, just like we all have different preferences for ice cream flavours. We would never argue that my taste in chocolate ice cream is superior to your taste for strawberry. The same goes for our values.

Values and Pain – The Double Sided Coin

There are many different exercises that can help clarify our values. One simple way is to spend a moment to reflect on what causes you pain. What causes you to be most upset with others, or most upset with yourself? Chances are your values are hidden in there.

Are you upset with yourself when you are short or snap at someone you care about? Perhaps that means you value kindness. Do you not like it when a friend gossips to you about someone in your life? Perhaps you value honesty.

Values and pain are two sides of the same coin.

As psychologist Steve Hayes put it, we hurt where we care, and we care where we hurt. If we cannot turn towards our pain, that means we also cannot turn towards the things that truly matter to us. We lose contact with our values, and by extension lose contact with what gives life meaning and purpose.

Check out this Ted Talk where Steve Hayes goes into how pain and values are intimately connected, and how we cannot have one without the other.

Handling Our Minds

Have you ever been somewhere beautiful, maybe on a vacation with the people you care about most, yet you just can’t seem to get out of your head? You feel unable to enjoy the moment and relax even though this is the very thing you came here to do? Your mind then starts beating you up for not enjoying the time away? I know mine has!

It’s natural for our minds to wander

Our minds have evolved to look out for danger, solve problems, plan for the future. It is quite extraordinary what the human mind can do, but there is also a dark side to this. There are times when we do not want our minds to be solving problems, planning for the future, or dwelling on the negative, but we can’t seem to shut it off.

Unfortunately, this is because we can’t shut off our mind. More and more research is actually showing that the more we try to stop our thoughts the more this can backfire.

The rebound effect

One famous study asked participants to try and not think about a white bear for 5 minutes. Can you guess what happened? Well, they spent the entire time thinking about white bears! Interestingly, afterwards this group also ended up having more thoughts about white bears than a control group who was instructed to actively think of white bears, suggesting that asking someone to not think about something could produce a rebound effect where they end up thinking about it more.

If we can’t make our mind not think about something as simple as white bears, how are we supposed to stop our mind from thinking about the bigger and more personal issues present in our lives? Relationship issues, financial issues, thoughts of not being good enough?

Of course, sometimes we need to think about our issues. We might have real problems that need to be addressed, or changes that need to be made. In these times our minds can be quite effective.

However, in times when we want to be in the moment, whether that be engaging with our loved ones, focusing on a specific task, or even trying to fall asleep, this dark side of our mind can creep in and pull us away from what we are doing.

What to do?

One way to better handle our mind in these times is to practice not reacting to thoughts when they show up. Instead of getting caught up in our thoughts, we practice seeing thoughts for what they are, simply words or pictures going through our mind. Like anything, this takes practice.

My favourite exercise that does this is called Leaves on a Stream, try it out for yourself below. Obviously, we might not be able to do a formal exercise like this if we are in the middle of doing a specific task. It is better to think of an exercise like this as going to the gym for your mind. The more you exercise this muscle. The better you will be able to detach from unhelpful thoughts in the moment when they naturally show up.

Leaves on a Stream Exercise

Why is it so hard to be happy?

Happiness! We all want it, but why does it sometimes seem so far out of reach? Quite often when someone is asked what they want out of life, a common answer is ‘I just want to be happy!’ Seems reasonable enough. But what if this chase for happiness is actually making us all miserable?

Dr. Russ Harris, a psychotherapist, argues there are 3 common myths our culture holds about happiness and if we buy into these myths, they can end up making us miserable. He calls this the Happiness Trap.

Myth 1: Happiness is a natural state

The first myth is that happiness is a natural state for humans. You give humans food, water, shelter, loving relationships, and we will all just naturally be happy. This is far from the case.

Being human means we experience a constant changing flow of emotions; anger, joy, sadness, guilt, jealousy, surprise, anxiety… the list goes on! Emotions are like the weather, they always change. We would never say the natural state of the weather is a bright sunny day. The same goes for our emotions.

Myth 2: Happiness means feeling good

The second myth is that happiness means feeling good. If you look up happiness in the dictionary, you’ll most likely come across this definition. The issue though is that if this is your idea of happiness, then there is no such thing as lasting happiness. Think about the greatest day in your life, did this day only give rise to pleasant feelings? Or did other feelings also show up?

The other issue with this notion, is that the things that give life meaning and purpose never give rise to only pleasant feelings. Parenthood, building a career, developing meaningful relationships… do these give rise to only pleasant feelings? Absolutely not! They give rise to an entire range of feelings; contentment, pride, love but also guilt, anxiety, and frustration to name a few.

Myth 3: If you are not happy, you are defective  

The third myth is that if you are not happy, you are defective and there is something wrong with you that needs to be fixed. This is not true. If you are not happy, you are normal. Life is hard! We all struggle and we all suffer at multiple points in our lives.

When we buy into this myth that we’re defective, then it can lead us to beat ourselves up for having difficult emotions in the first place. To read more about this idea click here.

What is happiness then?

Dr. Russ Harris defines happiness as living a rich, full, and meaningful life in which we experience the full range of human emotion.

What makes life rich, full, and meaningful will depend on getting in touch with our own personal values. One thing is for sure though, the things that make life meaningful will always give rise to both pleasant and unpleasant feelings.


To learn more about this idea of the Happiness Trap, Dr. Russ Harris has both a book and an online course. Both resources teach practical tools for how to handle difficult feelings when they naturally come up, as well as how to live a rich, full, and meaningful life. Check them out!

Self-Care: Why we all struggle with it

Self-care simply means doing things to look after your own health and well-being. It’s very broad and can include anything from sleep to hobbies to going to a doctor’s appointment to taking on new challenges.

It’s no surprise that caring for yourself provides the basis for good mental health. It sounds simple yet so many of us struggle with it. Why? I believe it’s partly due to two common misconceptions.

1.) We think that self-care is selfish

I think many of us believe that self-care is selfish. Why should I care for myself? Why should I focus on myself? There are other people that are struggling way more than me! I should be there for them. I don’t need to care for myself, I am fine!

Caring for ourselves is not selfish. We all have needs, and if we cannot meet these needs ourselves we tend to over rely on others. The other truth is that if we are able to care for ourselves we are better able to be present and there for the people in our life. Self-care can actually make us less selfish!

2.) We think that self-care should only give rise to pleasant feelings

Another misconception about self-care is that it is supposed to give rise to only pleasant feelings. While sometimes this can be the case, for example when we make time to pursue a new hobby or engage in some type of pleasurable activity, self-care can also give rise to very difficult feelings, for example when we have to go to that doctor’s appointment we have been putting off or when we need to be assertive with an aggressive person in our life.

If we only use self-care as a way to give rise to pleasant feelings, and avoid the necessary self-care that produces difficult feelings our health and well-being will most likely suffer in the long run.

Where to start?

Food, sleep, and exercise make up the essentials of self-care. This is always a good place to start, and can be difficult in itself to maintain. Remember, there is no need to be perfect. We cannot eat healthy all the time, and exercise all the time. Even small changes can make a big difference.

Another thing to do is brainstorm a list of self-care ideas. Are there certain activities you used to enjoy but have not had time for? Is there a new hobby you have always wanted to try? Is there a simple way you could break up your workday, like taking a walk around the block at lunch? Is there something difficult you have been putting off that you know needs to get done?

Once you have a list, try scheduling out some self-care time during the week. Start small, you don’t need to do everything all at once!

Listening to Our Boundaries

When we hear the word “boundaries” we often think of boundaries with other people. While it can be helpful to set boundaries with others, boundaries are really about how we care for ourselves.

Our Inner Yes and No

Sarri Gilman is a therapist that focuses on boundary work. She argues that we are all born with an inner Yes and No. Yes, this is okay, No, that is not okay. As we grow up, our culture, our environment, and our upbringing tells us what yes and no is acceptable and we often lose touch with this inner voice.

This inner Yes and No may be drowned out, but it is still there. Boundary work starts by getting in touch with your personal Yes and No.

7 Common Boundary Struggles

Gilman discusses 7 ways we typically struggle with boundaries, and stop listening to our inner Yes and No. People may struggle with one in particular, or a combination of several.  

1. Workaholic: this is someone who takes on more tasks at work than they would like. They tend to say yes to things they know they don’t have time for. They try to do it all which can leave them feeling overwhelmed with not much time for anything else.

2. Caretaker: this is someone who takes care of people that can actually care for themselves. They spend so much time caring for others in their life that they negate their own needs. Another consequence of this is that their loved ones don’t learn how to care for themselves.

3. Sacrificer: this is similar to a caretaker but a little different. A sacrificer focuses on the needs of other people often at the expense of themselves. They believe that other people’s needs are more important than their own.

4. Lover: people that struggle with this boundary have a great deal of love for others but often find that they never get that love in return. This is usually because they do not share much about themselves, often due to a fear of judgment.

5. Number: this is someone who goes out of their way to not feel what they are feeling. They may do this by bingeing TV, taking drugs, alcohol, overspending, overeating etc. They numb out their inner Yes and No.

6. Isolator: an isolator wants connection with others but has given up on this connection and alienates themselves. This leads them to feel very isolated and alone. Their boundary is too rigid.

7. Protector: this person protects others in their life by shielding the truth or is afraid to even hear the truth. This person often does not have a lot of support from others as no one knows what is truly going on in their life.

Where do I start?

Do any of these patterns resonate with you? Boundary work is an ever-evolving process. The first step involves spending some time getting in touch with what your inner Yes and No is saying. Boundary work also starts with making a self-care plan.

If you think you need help with boundary work I highly suggest Sarri Gilman’s book Transform Your Boundaries. This book walks you through how to begin to set boundaries in your own life, as well as how to set boundaries with difficult people.

What if anxiety was not the problem?

Anxiety, it’s painful, it’s annoying, it’s inconvenient, sometimes it can feel downright unbearable. But what if anxiety itself was not the issue?

Anxiety is there to protect us

Anxiety is an emotion that we all get to experience. It shows up to protect us from some type of danger. This could be a physical threat to our life, social rejection, or perhaps the possibility of failure.

Our brains are wired to protect us. The caveman that spent most of their day scanning the environment for any type of threat was more likely to survive and pass their genes onto future generations. The result? We all have minds that are wired to be anxious.

So, what can we do with anxiety? Fight hundreds of thousands of years of evolution? Seems like an unimaginable feat. What if there was something easier we could do?

The costs of trying to get rid of it

What if anxiety was not actually the problem but the problem was all the things we rely on to get rid of anxiety?

The wine we might overindulge in at the end of the night, the person we didn’t ask out on that date, the challenge we turned down at work, the party we did not go to.

What if the problem was also how we treat ourselves when anxiety shows up? All those harsh things we say to ourselves to make anxiety go away.

The struggle

Whenever an uncomfortable emotion shows up our mind almost always starts struggling with it.

For example, let’s say anxiety shows up, a very natural human emotion. Our mind does not like anxiety, it’s unpleasant, so what does it try to do? It tries to get rid of it. Our mind might start saying oh no! There’s anxiety, I don’t want anxiety, why is it coming up right now, what’s wrong with me? Now we have anxiety about anxiety. Our mind might start beating us up, what’s wrong with me, no one else seems to be struggling, I’m pathetic. Now we have sadness about our anxiety about our anxiety. This struggle can seem never ending and create a cascade of even more difficult emotions!

How to drop the struggle

What if there was a way to drop the struggle with anxiety? Anxiety shows up, and it’s not that we like it or want it, but we choose to not struggle with it. This takes a lot of practice, and does not come natural to any human!

There are generally 3 steps to dropping the struggle with any unpleasant emotion.

  1. Acknowledge: the first step is simply acknowledging the emotion. Often times we can get so caught up in a feeling, that we might not even notice what is happening. Acknowledging can be as simple as saying to yourself “I notice a feeling of anxiety” “I notice this feeling in my stomach”.
  2. Allow: the next step is practicing allowing it to be there, even though it is unpleasant. This can include saying to yourself “aha, anxiety, there you are, I recognize you are here to protect me from danger, thank you for trying to do your #1 job!”
  3. Accommodate: the final step is the hardest one. Accommodating means making room for the feeling. Allowing it to come and stay and go in its own time. In practice this can involve taking some deep breaths around the feeling, and as you are breathing around the feeling imagine that you are creating a space for it. If the anxiety grows, try to give it even more space.

How will this be helpful?

Anxiety is an inevitable part of life. It shows up for everyone. Often the issue is not anxiety itself but all the things we do to avoid anxiety in the first place.

When we practice dropping the struggle with anxiety, it’s freer to come and stay and go in its own time. With practice it doesn’t have to hold us back from doing the things we want to do, it can actually come along for the ride.

Practice, practice, practice

This idea sounds simple but requires a lot of practice. If you’d like to practice dropping the struggle with anxiety (or any unpleasant feeling you may be struggling with) check out this guided exercise where I walk you through the steps by imagining an emotion as an object.

If you’d like to learn more, check out this short youtube clip on the struggle switch which explains this idea of dropping the struggle (I reference it in the beginning of the audio exercise).