Over the past five years online therapy has shifted from a niche alternative to one of the most common ways people in the UK access mental health support. Remote counselling can now be booked in minutes, offers more flexibility around work or childcare, and — crucially — can feel less intimidating than walking into a clinic for the first time.
But many people still wonder: Is online therapy legit? How much does it cost? Do you need a GP referral? And how do you choose between dozens of platforms?
Let’s break it down clearly, using everyday examples, real pricing, and what UK patients typically experience.
What is online therapy, and who is it for?
Online therapy (sometimes called remote counselling, digital therapy, or telehealth) refers to structured mental health support delivered through video calls, phone calls, chat messaging, or a mix of all three. Sessions are typically provided by trained counsellors, psychotherapists, or clinical psychologists registered with professional bodies such as:
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BACP — British Association for Counselling & Psychotherapy
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UKCP — UK Council for Psychotherapy
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BABCP — British Association for Behavioural & Cognitive Psychotherapies
In practice, online therapy can suit a wide range of needs including anxiety, stress, mild to moderate depression, confidence issues, workplace struggles, parenting pressures, and grief. For more complex conditions — such as bipolar disorder, eating disorders, or high-risk crisis situations — online therapy can still help, but often alongside NHS specialist teams.
Do you need a GP referral?
Short answer: no, not for most private online platforms. You can self-refer, sign up, and start therapy within days. That convenience is one of the big reasons platforms like BetterHelp, Self Space, and Spill have grown in the UK.
If you’re unsure whether what you’re experiencing “counts” as something a GP might help with, you may find it useful to skim our guide on How to Access Mental Health Services in the UK (internal link):
→ https://allhealthandcare.co.uk/resources/how-to-access-mental-health-services-in-uk
That guide explains when to see a GP, when to seek private support, and how crisis pathways work.
Real example: Zara (Manchester, 26)
“I work shifts in retail, so the idea of weekly sessions at the same time didn’t seem realistic. I joined an online therapy platform where I could message my therapist throughout the week and book video calls on my days off. I didn’t need a referral and got matched to someone trained in CBT for anxiety.”
This pattern is now typical: flexible schedules + asynchronous messaging + occasional video calls.
How online therapy compares to NHS mental health pathways
The NHS offers psychological therapies through IAPT (Improving Access to Psychological Therapies), now being renamed NHS Talking Therapies. These services are free but — like many NHS pathways — waiting times vary significantly.
In many areas of England, waits for first assessment are between 4–18 weeks, with treatment beginning later depending on demand.
Private online therapy avoids long waits, but has costs attached. Some people use a hybrid approach: NHS therapy for core structured CBT, while supplementing with private online counselling for work stress, relationships, or parenting support.
Types of online therapy available
Online platforms in the UK tend to offer:
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CBT (Cognitive Behavioural Therapy) — common for anxiety, depression, intrusive thoughts, rumination, and panic
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Integrative counselling — blends multiple approaches in a more human, conversational format
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Psychotherapy — longer-term, insight-oriented work
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Couples therapy — relationship-focused, often with structured tasks
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Specialist services — e.g. trauma-informed therapy, bereavement support, or online ADHD coaching
Most services begin with a screening questionnaire or consultation to match you to the right therapist.
How much does online therapy cost in the UK?
Prices vary more than many expect. As of 2026:
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Private independent therapists (1:1 video call):
£40–£90 per session (50 mins typical) -
Platform-based therapy (messaging + video options):
£45–£240 per month depending on plan + frequency -
Couples therapy:
£60–£120 per session -
Student/low-income concessions:
Some platforms and independent therapists offer reduced fees
This might sound expensive, but cost comparisons help:
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Standard physiotherapy session: £40–£80
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Personal trainer session: £30–£60
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Speech therapy session: £60–£120
Therapy sits in a similar economic bracket to other professional healthcare services.
Choosing a provider: practical questions to ask
Here are real-world considerations people overlook:
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Do you want structured treatment or supportive conversation?
CBT tends to be structured; integrative counselling can feel more open and relational. -
Do you need flexibility or routine?
Shift workers favour messaging + flexible evenings; students often prefer weekly daytime slots. -
Is matching algorithm-based or manual?
Algorithmic matching is fast; manual matching can be more accurate. -
Does the platform specialise in your concern?
E.g. workplace burnout (Spill), couples (Relate), general mental health (BetterHelp/Self Space). -
Do they offer therapist switching?
Most reputable platforms allow switching without awkwardness. -
Do you prefer UK-trained clinicians?
International platforms vary in supervision and standards; check registration bodies.
Insurance and workplace benefits
A growing number of UK employers now fund online therapy through EAPs (Employee Assistance Programmes). These typically include 4–8 free sessions, often by phone or video.
Students may have access via their university wellbeing services.
Private health insurance can cover psychological therapy, though policies differ between Bupa, Vitality, and AXA Health. Some require GP referral; others self-refer.
What does a first session feel like?
Most people expect therapy to feel like talking about “problems”. In reality, first sessions are more about mapping:
What brings you here?
How long has it been affecting you?
What does a better outcome look like?
Online sessions feel surprisingly personal. Video isn’t identical to face-to-face, but many clients say the home setting reduces anxiety and helps them open up sooner.
Common concerns & misconceptions
“Is online therapy less effective?”
Research published through the NHS and NICE suggests CBT delivered remotely can be as effective as face-to-face for mild to moderate anxiety and depression.
“What if I don’t click with my therapist?”
This is common and not a failure. Most people switch once before settling.
“Will they prescribe medication?”
Counsellors and psychotherapists cannot prescribe. Medication decisions remain with GPs or psychiatrists.
(See our guide: How GP Registration Works in the UK — internal link: https://allhealthandcare.co.uk/resources/how-gp-registration-works-in-the-uk)
Safety & crisis situations
Therapy platforms are not emergency services. In crisis (e.g. active self-harm, suicide risk, acute psychosis), the correct pathway remains via:
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GP or NHS 111
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A&E for urgent psychiatric review
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Local crisis teams
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Samaritans (116 123)
For more structured local mental health access, see our internal guide:
→ https://allhealthandcare.co.uk/resources/how-to-access-mental-health-services-in-uk
How to tell if online therapy is working
Signs therapy is doing its job are subtle at first:
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reduced avoidance
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fewer panic spirals
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better sleep routines
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clearer boundaries
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more realistic thinking patterns
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or simply: “Life feels slightly less heavy.”
Therapy isn’t about perfection; it’s about improved functioning and agency.
So — is online therapy worth it?
For many people, yes. It’s flexible, faster to access, and less intimidating than traditional clinics. It suits those with jobs, childcare roles, or social anxiety around healthcare settings. It’s not a complete replacement for specialist NHS psychiatry or crisis teams, but as part of the broader mental health ecosystem, it fills a gap that didn’t exist a decade ago.
If the alternative is “wait months and deteriorate”, online therapy gives people somewhere to start — and for many, somewhere to stay.
