Soolmaz Dehghanidowlatabadi

Online Counselling: Does It Work, and What Happens in a First Session?

Is online counselling as effective as meeting in person? What research says, how a first online session works, and how to prepare so it feels comfortable.

By 3 min read

Online counselling has become an ordinary way to get psychological support. It saves travel time, fits around work and family, and lets people speak with a counsellor in their own language wherever they live. Many people still wonder whether it really works, and what actually happens in a first session.

Does online counselling work?

A woman faces a monitor displaying a remote mental-health professional.
Documentary photograph of a remote mental-health consultation at Hope Family Health, Tennessee, 2018. This is not Dr. Dehghani's practice or a participant in the studies discussed. Lance Cheung / USDA, 2018. Source and original. Public domain. Resized/converted for display.

Research on psychotherapy delivered by live video has grown quickly. A meta-analysis comparing live video with in-person psychotherapy found no meaningful overall difference in efficacy between the two formats (Fernandez et al., 2021). For many people and many common concerns, such as anxiety, low mood, stress and relationship difficulties, online sessions are a practical option.

Online work does not suit every situation. In a crisis, or when someone needs more intensive or in-person care, other services are more appropriate.

What happens in a first session

A first session is mostly about getting to know each other. You can expect:

  • a conversation about what brings you now and what you hope will change;
  • questions about your background, relationships and daily life;
  • a discussion of how sessions work, including confidentiality;
  • time for your own questions about the approach and the process.

You do not need to have the right words or a clear plan. Many people begin with “I am not sure where to start”, and that is completely fine.

How to prepare

  1. Find a private space where you will not be overheard, and use headphones if you can.
  2. Check your connection and device a few minutes before the session.
  3. Write down a few points you would like to mention.
  4. Keep water and tissues nearby.
  5. Give yourself a few minutes afterwards before returning to work or family life.

Online sessions with Dr. Dehghani

Dr. Soolmaz Dehghani offers online counselling for individuals and couples, in English and Persian. Her work draws on six years of clinical practice and on approaches including cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), mindfulness, compassion-focused therapy and schema therapy. You can book through Therapy Mantra, send a message, or write on Telegram from the online sessions page.

Common questions

Is online counselling confidential?

Sessions are held privately, and counsellors follow professional standards of confidentiality. Choosing a private space on your side helps too.

Do I need to have my camera on?

Video helps build connection, but if you feel uncomfortable at first, you can mention it when you get in touch and discuss the options.

References

  • Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy, 28(6), 1535-1549. https://doi.org/10.1002/cpp.2594

This article is for general information and does not replace individual professional advice. If you or someone else is in immediate danger, contact your local emergency services.

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