The short answer
Online couples therapy can be a useful option, and a small randomized study found improvements in both video and face-to-face groups without significant differences in measured outcomes. That does not prove the formats are equally effective for every couple or concern. Privacy, safety, technology, clinical needs, and therapist fit all matter.
Online counseling may sound convenient and still feel a little strange. You might wonder whether a therapist can understand the tension between you through a screen, or whether talking from your own living room will feel too much like another conversation that goes nowhere.
Those are fair questions. Video care can make appointments easier to attend, and research offers some reason for confidence. The format still needs to work for your privacy, your safety, and the kind of help you are seeking.
What does the research actually show?
A 2022 study by Kysely and colleagues randomly assigned 30 couples, totaling 60 participants, to video or face-to-face delivery of a six-session Couple CARE program. The program combined behavioral relationship education and self-change work.
The researchers measured outcomes before treatment, afterward, and at three-month follow-up. Both groups improved on measures including relationship satisfaction and mental health. They did not find significant differences between delivery groups in the measured outcomes, and therapeutic alliance ratings increased in both groups.
This supports video delivery as a promising option for that program and sample. It does not establish that every online therapy service is equivalent to every in-person treatment. The study was small and involved a particular intervention; no significant difference is not proof of universal equivalence. It also cannot predict how an individual couple will respond.
What might make online care a good fit?
Online sessions remove the commute and can expand access to a clinician who works with your concern. For some couples, that makes consistent attendance more realistic. Video also allows a therapist to hear the conversation and observe some nonverbal responses in real time.
Consider whether you can:
- Join from a space where you can speak freely without being overheard.
- Use a stable connection and a camera setup that captures both partners clearly.
- Set aside uninterrupted appointment time.
- Follow the therapist's plan if the connection drops or conflict escalates.
Think about what it would actually feel like to speak openly in the space you have. Would you be listening for a child in the next room? Could someone overhear at work? Are smart devices nearby? Ask the therapist about the platform and privacy precautions, and make a plan for interruptions. Being at home can be comfortable without automatically being confidential.
When might another format or service be preferable?
In-person care may be easier if you do not have a private space, find video communication difficult, or need a service that cannot appropriately be provided remotely. A clinician should assess your specific needs.
If there is violence, coercive control, intimidation, or fear of retaliation, ordinary joint therapy may be unsafe regardless of whether it is online or in an office. The issue is not simply choosing a better camera or location. Seek confidential individual assessment and safety support.
Can we join from different locations?
Ask before booking. The clinician needs to consider licensing, privacy, safety, and whether the arrangement works for treatment. Each person's physical location matters, including during travel. Do not assume being an Ohio resident is the same as being located in Ohio for a session.
What does this practice offer?
Brian Girton offers online-only couples and individual therapy for people located in Ohio. A free 15-minute phone consultation can help clarify the format and fit. If you prefer in-person treatment, ask for help identifying a provider offering that service.
Research source
- Kysely et al., Couples Therapy Delivered Through Videoconferencing: Effects on Relationship Outcomes, Mental Health and the Therapeutic Alliance, Frontiers in Psychology, February 4, 2022. DOI: 10.3389/fpsyg.2021.773030. The findings concern a small trial of a specific six-session program, not a guarantee of outcomes.