It is a fair question and people are often slightly embarrassed to ask it, as though preferring to be in a room with someone is a sign of being behind the times. It is not. Something does feel different about a screen, and it is worth being straight about what the evidence says and where the honest limits are.

What the research shows

Systematic reviews and meta-analyses of randomised controlled trials have repeatedly found that psychological therapy delivered by video achieves outcomes comparable to face-to-face treatment for most common presentations, including anxiety and depression. That is a reasonably settled finding rather than an early or contested one.

Research on the therapeutic alliance, which is the working relationship between client and clinician and one of the better predictors of whether therapy helps, has generally found it holds up well over video.

One consistent and slightly awkward finding is worth mentioning: clinicians tend to expect telehealth to be less effective than it turns out to be, and that expectation can itself affect the work. Which is a good reason to ask a psychologist how they feel about it rather than assuming.

Where it genuinely wins

Access, obviously. If you are in Beaufort or out through the Pyrenees, the alternative to telehealth is frequently not an in-person session. It is no session.

Consistency, which matters more than people realise. Therapy works better when it is regular. Sessions that survive a wet week, a sick child, a night shift or a car that will not start are worth a great deal, because the ones that get cancelled are the ones that quietly end a course of treatment.

And for some people, distance helps. Difficult material is sometimes easier to say from your own kitchen than from a chair opposite someone. Younger clients in particular are often more forthcoming on video, having conducted a good deal of their emotional lives through a screen already.

Where it is harder

I would rather name these than pretend they do not exist.

You lose some of the body. Not all of it, but a screen crops you at the shoulders and a certain amount of information lives below that line. Experienced clinicians adapt, and it means asking more directly about things that might otherwise be read.

Privacy at your end can be the real obstacle, especially in a full house or a share flat. If you cannot speak freely, the session will be shallow, and that is not a failure of the technology.

Some work is better in person: certain trauma processing, anything where physical monitoring matters, and situations where risk is high enough that being in the room is safer. If that is your situation I will say so.

Connection quality also matters more than people expect. A conversation stuttering every twenty seconds is a poor container for a hard subject.

You do not have to choose one

The most common arrangement in my practice is a mix. In the rooms when the week allows, online when it does not. Winter in Ballarat, a sick kid, a roster change, and the session still happens.

Medicare treats them identically. The rebate for a telehealth session with a clinical psychologist is the same $141.85 as an in-person one, and my fee is the same $225 either way. There is no financial reason to prefer one over the other. The fees page sets it out in full.

Try it before deciding

Most people who are unsure have not actually done it. One session usually resolves the question in one direction or the other, and there is no commitment involved in finding out.

If you would like to know what a session involves practically, I have written a short setup guide. You can also read more about telehealth counselling, or send an enquiry and mention that telehealth is what you are after.