Over the last few years, online therapy has become an everyday part of how many people access emotional support. Whether you’re considering starting therapy for the first time or returning to it, you may be weighing up two main options: reaching out to a therapist in private practice, or signing up through a digital platform like BetterHelp or Regain.
I offer both. And in this post, I want to share a few reflections from my experience as a therapist working online across both settings—with individuals and couples—so that you can better understand what each route involves and make the choice that’s right for you.
Why So Many Therapists Work on Platforms
I first joined BetterHelp during the pandemic, when the shift to remote work was both necessary and immediate. What drew me in was what draws many clients too: it’s quick, convenient, and offers a steady flow of people looking for support. If you’re struggling right now, if the idea of searching for a therapist feels overwhelming, or if finances are tight, the platform model might feel like the best place to start.
But working in that model also raises important questions—both for clients and for therapists. And not all of them are easy to resolve.
Boundaries, Containment, and the Space for Thinking
One of the cornerstones of psychoanalytic therapy—particularly in the British tradition—is the notion of the frame. The frame refers to the agreed structure of the therapy: regular sessions, a consistent setting, and a clear boundary around time and contact. It’s not about rigidity, but about creating a reliable space in which deeper emotional work can take place.
In private practice, I can offer that. We meet at the same time each week, in a secure online room. There’s time and space to think—not just during the session, but between them. I carry you in mind, and the work has time to settle and evolve.
On platforms like BetterHelp, the model is different. There may be more messaging, more flexibility, and less predictability. For some people, this feels supportive and accessible. But for others, especially those with early relational trauma or fragile internal structures, the absence of firm boundaries can be unsettling—an unconscious echo, perhaps, of experiences in which care was inconsistent or unreliable.
Short-Term Support vs Longer-Term Change
Many clients come to platforms looking for help with something immediate: a relationship crisis, anxiety at work, a sudden wave of sadness. And often, some relief can be found within a few sessions. But meaningful change, especially in patterns that repeat across time and relationships, usually takes longer.
In private practice, we can take our time. Therapy becomes a place to explore—not just what’s happening now, but what might lie beneath. Together we might notice patterns that stretch back to childhood, identify internal conflicts, or uncover hidden beliefs about the self. As we think about these things together, the mind begins to move—towards integration, towards freedom.
That kind of work is more difficult in the faster-paced world of the platform. Not impossible, but harder to hold.
My Capacity as a Therapist
To make working on a platform financially viable, I need to see many clients each week. The platform sets the rates and the structure, and as therapists we’re expected to respond to messages in between sessions as well. While I always do my best to be fully present with each client, I know that in private practice I’m simply more resourced—less rushed, more reflective, more able to think deeply and hold the work with care.
There’s also something relationally different when a client chooses to work with me directly. It’s a mutual agreement, not an algorithmic match. That initial contact, the reaching out, is in itself a meaningful first step. It sets the tone for the therapeutic relationship—one based not on convenience, but on conscious choice.
So—Which Route Might Be Right for You?
If you’re looking for immediate support, if you’re unsure about committing to longer-term therapy, or if budget is your main concern, then BetterHelp or Regain may be a good starting point. I continue to see clients there and try to offer as much consistency as the platform allows.
But if you’re looking for something more sustained and deeper—if you want to think more carefully about how past experiences are shaping present difficulties, or if you value the stability of a regular, ongoing space—I encourage you to consider working with me directly through my private practice.
You can find my private practice calendar and book an initial consultation here: https://online-therapy-clinic.com
Or, if you’d prefer to connect via the BetterHelp platform, you can find me there as well: BetterHelp/Regain profile.
In the End, It’s About the Relationship
Therapy is ultimately not about advice, diagnosis, or quick fixes. It’s about relationship—about being met, thought about, and understood. Whether we meet on a platform or in private practice, my aim is always the same: to offer a thoughtful, attuned presence that helps you reflect, feel, and move forward.
If you’re considering therapy and want to talk through your options, I’d be glad to hear from you.
Best wishes,
Ari
I am a psychotherapist offering online therapy for individuals and couples. I draw on the British Psychoanalytic tradition to support clients working through relational struggles, anxiety, depression, trauma, and life transitions. I work from a quiet home office at the foothills of the Pyrenees and see clients across the UK, Europe, and beyond.