Guide · 5 min read · September 22, 2026
What online therapy is like, and what to set up first
Practical guide to how video, phone and messaging therapy differ and what to set up before your first online session.
If you are thinking about online therapy, you probably want a clear sense of how it actually works - not a pitch or technical jargon. This piece walks through the three common formats - video, phone and messaging - and gives a plain checklist of what to sort out first.
Some therapists in this directory name Jungian therapy among their approaches. Naming an approach is not the same as having completed specialist training in it, and this directory checks no training records. The clinicians listed are licensed or registered where they practise.
A simple picture of online therapy
Online therapy usually means meetings that happen by video, by phone, or by messaging. Each format shapes the pace and the kind of conversation you have. There is often a regular appointment rhythm for open-ended work - weekly or fortnightly - but that is an arrangement you make with the clinician.
Clinicians in this directory are licensed or registered where they practise. A US therapist typically holds a licence issued by a state board and usually an NPI. A UK therapist is registered with a membership body such as the BACP or NCPS. An Australian therapist is registered with PACFA, AASW or ACA. If you are unsure about someone's credentials, ask them directly about their training and registration.
This piece is not advice or diagnosis, and a clinician who is actually talking to you is the person who can say what is appropriate for your situation.
Video sessions - closest to being in the room
Video is the most similar to an in-person meeting because you can see faces, gestures and some body language. It tends to support a slower, conversational pace. Many people use video when they want a fuller sense of presence without travelling.
Practical differences to expect - small lags in audio, occasional frozen frames, and the need to buy a few minutes at the start for a quick tech check. If you find eye contact or being on camera tiring, say so - clinicians can adapt the session to make it easier on you.
Phone sessions - focused and without the screen
Phone sessions remove the visual layer and put the emphasis on voice. For some people that creates more freedom to speak without worrying about appearance. For others it feels less connected.
Phone can be a helpful fallback when your internet is unreliable, or when you prefer to move around while talking. Make sure your device is charged and that you have a quiet spot where you will not be interrupted.
Messaging - slower, more reflective, and asynchronous
Messaging means exchanging text or audio messages over time rather than meeting live. It can give you space to write, reflect and return to an idea. It also changes the rhythm - conversations take longer to develop.
Expect differences in turnaround times, length of messages and boundaries about when replies are sent. Some clinicians treat messaging as a supplement to live sessions; others offer it as the main format. Check a clinician's profile or ask them directly about how they use messaging.
What to set up before your first session
Sort out a few basics so the meeting can focus on the conversation rather than the logistics.
- Choose a quiet space where you will not be interrupted - a room with a door, or a time when others will not intrude.
- Check your device - camera, microphone and battery. Do a short test call with a friend if you can.
- Use headphones if you have them - they help with sound and make it easier to hear each other.
- Know the time zone for the appointment and confirm start and end times with the clinician.
- Have a backup plan for tech failure - a phone number or a way to reconnect if video drops out.
- Decide how you will pay and whether you need receipts for insurance. Ask the clinician about fees, availability and cancellation policies - this directory does not state anyone's fees or wait times.
- Consider practical documents - an ID, a list of medications only if the clinician asks, and emergency contact information that the clinician may request.
Before your first session, it is reasonable to ask a clinician how they manage boundaries - for example, their response times to messages, whether they keep notes, and how they handle emergencies. These are things you can ask directly when you contact someone through /therapists/ or read about when you visit /how-to-choose/ on this site.
Consistency, boundaries and safety
Open-ended therapy usually works best when you keep a regular time and a familiar space. That steadiness helps the conversation deepen over weeks or months. If you struggle with a consistent slot - for work or childcare reasons - discuss options with the clinician; some people agree on fortnightly sessions or a more flexible arrangement.
Set simple boundaries for yourself - a place you go for sessions, a way to finish a session so it does not linger into the rest of your day, and a rule about messaging between appointments. Those boundaries make it easier to keep the work separate from daily life.
If you are feeling distressed, overwhelmed or in immediate danger, reach out for urgent support. In the United States call or text 988. In the United Kingdom contact the Samaritans at 116 123. In Australia call Lifeline at 13 11 14. If there is an immediate threat to life or safety, call your local emergency number - for example 911, 999 or 000 as appropriate. Your clinician can only assess risk if they are actually speaking with you, so in a crisis use the local emergency and crisis services above.
Finally, remember that naming an approach on a profile does not guarantee particular training. Some therapists name Jungian therapy among their approaches, but naming an approach is not the same as completing specialist analyst training, and this directory checks no training records. If training history matters to you, ask the clinician directly and look for practitioners who are licensed or registered where they practise.