Online therapy is today one of the best-documented forms of psychological support in recent clinical literature. A meta-analysis by Krzyżaniak et al. (2024), covering five randomized controlled trials, found no significant difference between teletherapy and in-person therapy for reducing anxiety, depressive symptoms, or functional outcomes. Greenwood et al. (2022) confirm these results across a broader spectrum of anxiety and mood disorders, with high patient satisfaction rates.
A frequently asked question concerns the quality of the therapist-patient bond through a screen. Research answers this directly. For example, the meta-analysis by Seuling et al. (2023), published in the Journal of Telemedicine and Telecare, found no significant difference in assessments of the therapeutic alliance between video conference psychotherapy and in-person therapy — whether from the patients’ or therapists’ side. What research confirms is what experienced clinicians observe: the therapeutic relationship is built in the quality of presence and listening, not in the room’s setup.
The context of expatriate life
Expatriation produces a set of stress factors that accumulate and mutually reinforce one another. People living far from their origins have a higher risk of depression, sleep disorders, anxiety, and concentration difficulties. Difficulties adapting to local life, in social relations, relationships with work, and integration into the host country, can lead to psychological distress. High-quality socio-emotional support, meaning the opportunity to talk to someone who understands, constitutes one of the most robust protective factors. Loneliness and social isolation, identity shifts linked to navigating between two cultures, and professional pressure in an environment where you haven’t mastered all the codes are all dimensions that affect the daily well-being of people living abroad. These feelings often remain unspoken, because the expatriation process has very positive connotations and expectations and hopes often exceed the lived reality. Added to this is the language barrier, which is the central medium of connection.
Online therapy can reduce these obstacles
Regularity and commitment are the conditions for therapeutic success — and anything that hinders them (distance, logistics, incompatible schedules, lack of a suitable therapist nearby) directly compromises the process. For the expatriate, online therapy helps overcome all these difficulties. It allows for choosing a therapist trained in the appropriate approach, working in the patient’s native language (Borcsa & Winkler, 2024), familiar with the challenges of expatriation, regardless of the country where the patient lives. It makes continuity of care possible during business trips, visits home, and relocation periods. It offers a space entirely disconnected from the local social network — precious for those who must maintain a certain image in their everyday life (Borcsa & Winkler, 2026).
The therapeutic work itself
Online therapy with a trained therapist mobilizes the same foundations as in-person therapy: the quality of presence, attention to what is happening in the relationship, exploring how you make contact with yourself and with the other. It is precisely the quality of the therapeutic relationship that determines the success of the process. It is established just as well through a screen as in a consulting room.
For many expatriates, online therapy does not represent a compromise. It is simply the form of support and development that matches their lifestyle.
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