Elena Darmenko

Expat Psychotherapist

Online Therapy for Expats.
Innovations vs Traditional Sessions

Online Therapy
I've started providing an online therapy to expats two years ago. Prior to that I was doing counseling exclusively in traditional face-to-face format. My personal reaction upon hearing about of a teletherapy was curiosity.

I've asked myself same questions you probably have about an online psychological service if you haven't tried it before. How does it work? What are the possible pros and cons? Is it effective? What can I expect?

Research shows that online therapy can be just as effective as in-person therapy for various mental health conditions.

One literature review of studies found online Cognitive Behavioral Therapy (CBT) to be just as effective as in-person therapy in treating moderate depression. Another one found that online CBT was equally effective as a face-to-face treatment for panic disorder, social anxiety disorder, and generalized anxiety disorder.

I give online counseling for individuals and couples, and I also provide intensive group sessions. In my work I use methods of a Cognitive Behavior Therapy (CBT), Art Therapy and a cross-cultural training (for career counseling). I'm giving sessions only in a video format as I've found them more effective than audio ones.

Here's what I've learnt from my personal experience with online therapy.

Beneficial Aspects of Online Therapy

Watching my clients, I've found that I'm working with more authentic versions of themselves as they used to talk to me from the comfort of their own homes. Feeling relaxed, people tend to speak honest about their problems, and this makes the therapeutic process much more effective.

Other beneficial aspects of an online counseling include:

- Flexibility and convenience in scheduling, resulting in fewer cancellations than in traditional in-person settings.
- Saving time from commuting to and from appointments.

There are two most common questions I'm usually asked. Is it as effective as a traditional therapy? And don't you miss the signs of body language when working online? From my own study about the effectiveness of an online therapy I've found it's as effective as a traditional one, as my clients usually need the same number of sessions to get positive results. And concerning the body language – I always ask my clients to sit a bit further from the screen, and so do I. This creates a comfortable space and allows me to watch not only their facial expressions, but also their moves and gestures.

Of course, there are disadvantages of an online therapy. The most notable refer to the technological glitches – an inconsistency of internet connection or possible problems with Internet platforms – frozen screens, echoing, low-resolution video feeds, and dropped calls are not conducive to the therapeutic experience. However, I may note only three cases for the last two years when I was obliged to cancel sessions due to the technical reasons.

Additionally, there are personal concerns and fears about an online therapy. This is natural to have them – a therapeutic contact is, anyway, a matter of trust.


For my practice of an expat psychologist an online therapy means an easy and quick access to help for people who need it. I support people all over the world, living in different time zones and conditions. Technical innovations became a significant part of our lives and I'm sure we should use their advantages. I leave it to you to decide if an online therapy is the right fit for you. I'm ready to answer all your questions and discuss all your concerns about an online therapy, and as an old saying says "Don't knock it until you've tried it".