From couch to camera

From Couch to Camera: How the Shift to Online Therapy Changed the Therapeutic Experience

When lockdown forced many services online during the pandemic, therapy was no exception. In her piece for BACP, counsellor Francesca Francis reflects on how the shift from face-to-face sessions to digital platforms has reshaped the way therapists and clients connect — and what’s been gained — or lost — in the process. BACP

A Therapist’s Journey: From Office to Screen

Francesca trained partly in a traditional therapy room — sitting across from clients, observing body language, feeling the shared silence. Part of her training, however, was in an online world: appointments held through screens, sometimes from her own bedroom. That transition mirrored what so many of us experienced: suddenly the therapy room became pixelated faces and muted microphones. BACP

For many therapists in training, the shift meant losing out on real-life clinical experience. In fact, according to the American Psychological Association (APA), 43% of trainees saw their in-person hours drop during the pandemic. BACP

What Online Therapy Took — and What It Gave

• What could be lost: The subtle human cues — micro-expressions, body posture, the way a person shifts in their chair, the energy of a real room — all of that can be harder to pick up on screen. Early on, some clients felt uneasy showing their face; those spontaneous, unspoken moments of presence were sometimes lost. BACP
• What was gained: For many people, online therapy meant greater accessibility. Logging in from home can reduce the anxiety of stepping into a clinic, and reach people who may never have tried therapy otherwise. As Francesca notes, demand for remote/phone sessions soared during 2020. BACP

For therapists, this meant learning new skills — building presence, empathy, trust — even when the medium is a laptop screen. It required creativity and adaptability to nurture connection without being physically present. BACP

The Heart of Therapy Doesn’t Change

Despite the shifts in format, the core essence of therapy remains the same: a space for human connection, authenticity, empathy, and trust. Whether in a consulting room or over a video call, healing depends on the quality of the relationship. BACP

The real question now isn’t whether online therapy is better or worse than in-person. Instead, it’s how we — as therapists and clients — integrate both modes. The goal isn’t to replace the therapy room, but to expand access while preserving what is timeless in therapeutic relationships. BACP

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📝 Final Thoughts

The pandemic has forced change — fast. But out of disruption came opportunity. Online therapy has proven to be more than a stopgap: it’s a new way to reach, support, and heal. As therapists continue to explore and refine this medium, there’s a chance to make therapy more inclusive, flexible, and responsive — while still rooted in trust, empathy, and real human connection.

Whether you’re a therapist, client, or someone curious about mental health support, this shift deserves our thoughtful attention. Because at the end of the day: connection doesn’t require walls.

📚 References

#	Reference	Link
1	Francis, F. (2025). From couch to camera. British Association for Counselling and Psychotherapy (BACP).	https://www.bacp.co.uk/news/news-from-bacp/blogs/2025/blogs-and-vlogs/21-november-from-couch-to-camera/
2	BACP. Using digital technology in the counselling professions. Guidance & Research Overview.	https://www.bacp.co.uk/media/6308/bacp-using-digital-technology-in-counselling-professions-research-overview-gpia107-july2019.pdf
3	BACP. Online and Phone Therapy Competence Framework.	https://www.bacp.co.uk/media/10849/bacp-online-and-phone-therapy-competence-framework-feb21.pdf