As a psychodynamic psychotherapist, I was trained to maintain strict therapeutic boundaries, ensuring that no communication with clients occurred outside of scheduled sessions. In the traditional in-person setting, the consulting room creates a contained and secure environment where clients can explore their thoughts and feelings. At that time, online therapy was not widely practised, particularly for psychoanalytic work, which has historically been rooted in face-to-face interactions.

However, the COVID-19 pandemic transformed the landscape of therapy. As lockdowns made in-person sessions impossible, the demand for online therapy services surged. Clients who were already in therapy transitioned to virtual sessions, and many new clients sought support for the first time. The question is: why did so many people embrace online therapy so readily?

The pandemic brought unprecedented levels of anxiety, isolation, and uncertainty. Therapy became a vital lifeline for people struggling with existential fears, loneliness, and grief. However, as therapists, we were confronted with the need to re-evaluate traditional therapeutic boundaries in the context of virtual therapy.

In face-to-face sessions, the physical space of the consulting room provides containment. The room itself, along with the therapist’s physical presence, helps to establish clear boundaries. In an online setting, these boundaries can become more fluid. Clients may attend sessions from their living rooms, bedrooms, or other personal spaces, and distractions can easily interrupt the session. Moreover, the therapist is now a face on a screen, making it challenging to replicate the same sense of containment.

At the Online Therapy Clinic, we’ve adapted to these new conditions. I offer online therapy for individuals and couples in English, French, and Greek, working to ensure that our clients experience the same level of care and professionalism as they would in an in-person setting. My co-founder, Dr. Ruxandra Ion, a psychiatrist registered with the Royal College of Psychiatrists and an accredited CBT therapist, offers mental health assessments and CBT sessions in both English and French. Together, we are committed to delivering high-quality therapeutic care in this virtual format.

Online therapy has also shown some unexpected benefits. Some clients, especially those who feel vulnerable, may find it easier to open up when they are in the comfort of their own home. This can create new dynamics in the therapeutic relationship, allowing for deeper exploration and insight than might occur in a traditional setting.

One challenge that arises in online therapy is how to manage communication outside of scheduled sessions. In psychoanalytic thinking, communication between therapist and client outside the session is discouraged, as the therapeutic process is intended to remain contained within the session time. However, some clients may seek reassurance that their therapist is holding them in mind during moments of vulnerability. While it is generally advisable for therapists not to initiate contact outside of sessions, responding thoughtfully to a client’s need for reassurance can be beneficial. This approach requires experience and confidence, as breaking with traditional boundaries must be done carefully, ensuring that the therapeutic frame is preserved.

At the Online Therapy Clinic, we offer dedicated services tailored to the needs of our diverse clientele. For instance, we have a specific page for Therapy in Greek, offering sessions in my native language, and a page for Therapy in French, providing therapy and mental health assessments for French-speaking clients.

While the format of online therapy differs from in-person sessions, the core principles of psychoanalytic work remain the same. Transference, countertransference, and the therapeutic frame are just as crucial in online settings, though they require some rethinking and adaptation. As therapists, we must continue to evolve our approach to meet the growing demand for online therapy while maintaining the integrity of the therapeutic process.

At the Online Therapy Clinic, we are proud to offer a range of online therapeutic services in English, French, and Greek, ensuring that our clients receive the highest standard of care, wherever they are.

By Ari Sotiriou M.A. psychodynamic psychotherapist co-founder Online Therapy Clinic