If you’re considering counselling, you might be wondering how in-person, online and telephone counselling compare, and which format would suit you best. This blog is designed to help you make an informed, confident choice.
Most people can picture what in-person counselling involves: arriving at the counsellor’s venue, sitting together while you talk, then leaving. Online and telephone counselling can feel less familiar at first, and they bring practical, emotional and privacy-related considerations that may not be immediately obvious. The choice of format can be especially important if you are neurodivergent, anxious, have health or mobility needs, or notice that different environments affect how comfortable you feel.
The key thing to remember is that there is no hierarchy in terms of which format is best. Each offers a different experience, but all should support you to feel safe, heard and understood.
Research shows that in-person, online and telephone counselling can all be effective, and that a strong therapeutic connection can be built in each format. [1] So your decision should be based on your own circumstances, comfort, and preferences.
Below are some points to consider. You don’t need to agree with every point for a format to be right for you; instead, notice what feels most practical, supportive and manageable overall.
In-person counselling
This involves meeting me in my counselling room, giving you a dedicated space away from home where the session begins and ends in a physical setting that I have designed for counselling.
For some people, sharing a physical space can make connection and co-regulation feel easier, although research suggests that a strong therapeutic relationship can be built across all the different formats.[2] Your personality and communication preferences are still valid considerations.
My counselling room is private and confidential and aims to provide a calm, welcoming environment. Some people appreciate having a dedicated therapeutic space away from home. Travel can create a helpful buffer before and after sessions, although it also brings time and cost considerations.
If you became ill or very distressed during in-person counselling, I would be physically present and able to support you, including arranging medical help if needed.
Online counselling
This involves us meeting on a secure video call, so you can access counselling from a private space that feels comfortable and manageable for you.
Online counselling can make therapy more accessible if mobility, health, anxiety, travel time or cost make in-person sessions difficult. Being in your own home, or another chosen space, can also reduce anxiety and increase comfort.
It is worth thinking about privacy and practicalities. Will you be overheard or interrupted? If others share your computer, could your browsing history or Zoom use be visible, and would that matter for you? I may also be able to see part of your space or whatever is in your background, although you can choose to limit this by where you sit.
Technology is another consideration. If you already use email, Zoom or similar platforms, online counselling may feel straightforward. If not, we can think together about whether you would feel comfortable learning. Broadband speed and connection also matter. If your connection or mine becomes unstable, it may disrupt a session, although we will agree a backup plan, such as switching to a phone call.
I use encrypted systems, virus protection and other security measures, but no online platform is completely risk-free.
If you became very distressed or unwell during an online session, I would support you remotely and follow the safety steps we had agreed together. Online counselling may not be suitable if you are currently suicidal, using alcohol or drugs in a way that affects your safety, or experiencing risks that require in-person support. If this applied, we would talk together about what kind of support would be safest for you.
You will see both my face and your own on screen. Some people find self-view distracting, although it can be turned off. Research also highlights an online “disinhibition effect” [3]. People can find it easier to open up online and may share more quickly. This can deepen the work, but it can also lead to feeling exposed afterwards or worrying that you have said too much too soon. I will work with you to pace sessions safely.
Telephone counselling
This involves us speaking by phone, so you can have counselling without being on camera or needing to travel. Many of the same benefits as online counselling apply: you can be in your own space, avoid travel time and costs, and access support if leaving your home is difficult.
Some people find it easier to open up when they are not seen or observed. If visibility feels daunting, telephone counselling can be a gentle starting point.
Because I cannot see your facial expressions or body language, I may ask more clarifying questions, and you may need to describe your thoughts and feelings more explicitly. The disinhibition effect can apply here too: voice-only conversations can feel surprisingly intimate, and people often speak less guardedly.
For many of us, phone conversations are associated with talking to friends and family, which can make the tone feel warm and familiar. This is not a problem; the therapeutic boundaries remain clear. It is still helpful to remember that counselling is a professional relationship, not a friendship.
A flexible, personal choice
I offer counselling from my counselling room in Worthing and in Littlehampton, as well as online and telephone counselling for clients across the UK who prefer remote support. I have experience and training in all three formats.
If you’re considering working with me, we can talk together about which format feels right for you, based on your needs, preferences and circumstances. It is completely okay to start with one format and switch to another as your needs change.
References
[1] & [2] Stefana, A., Fazia, T. and Nova, A. (2026) ‘The therapeutic relationship in in-person, video call, and telephone psychotherapy sessions.’ British Journal of Clinical Psychology, 00, p1-23..
[3] Suler, J. (2004) ‘The online disinhibition effect.’ CyberPsychology & Behaviour 7(3) pp321-326.
Photo by Cristofer Maximilian on Unsplash
