Online Therapy in the UAE: When the Screen Works as Well as the Room, and When It Doesn't

Oct 12

8 min read

Updated: Oct 15

By Sarah El Nabulsi, M.Sc., M.A., M.A. | DHA Licensed Clinical Psychologist, Dubai

Picture someone sitting in a parked car at lunchtime, laptop balanced on the steering wheel, earphones in. The car is the only place in their day where nobody can overhear them. A few minutes into the video call, they say something they have never said out loud to anyone.

That scene surprises people who assume therapy on a screen must be a thinner version of the real thing. It is also a fair picture of what online therapy asks of you. The session itself can be every bit as serious as one in a clinic. The room around it is your responsibility.

If you are deciding whether to see an online psychologist in the UAE, the question you are probably asking is whether it actually works. The research gives a clearer answer than you might expect, and I will go through it. But I want to argue for a different question, one I think matters more: what does a therapy room do for you, and can you build enough of it where you are?

What the research says about therapy by video

Video therapy has been studied for more than two decades, long before it became ordinary. In a meta-analysis of 57 studies, Batastini and colleagues (2021) found that treatment delivered by videoconference produced effects largely equivalent to the same treatment delivered in person, across 281 outcomes and 4,336 clients. Assessments carried out by video did not appear to lead to different clinical decisions either.

A second meta-analysis, by Fernandez and colleagues (2021), compared video and in-person therapy directly in 47 studies with 3,564 participants. The difference between the two was negligible. Improvement within video therapy was most pronounced when the approach was cognitive behavioural therapy (CBT), and when the problem being treated was anxiety, depression or post-traumatic stress.

Two honest caveats. Batastini's team pointed out that the number of randomised controlled trials is still limited, and that many studies report their methods incompletely. And every one of these figures is an average. An average can tell you that the screen is not, in itself, a barrier. It cannot tell you whether it is the right choice for you, this year, in the home you actually live in.

The relationship travels better than people expect

If you hesitate about online sessions, the worry is probably not about technique. It is about connection: will you feel anything through a screen, and will the person on the other side really understand you?

That worry deserves a serious answer, because the relationship between you and your therapist matters. Across 295 studies and more than 30,000 patients, Flückiger and colleagues (2018) found a consistent link between the strength of the therapeutic alliance and how well therapy went. For internet-based therapy, the link was about the same size as for face-to-face work.

So can that alliance form on a screen? A review of 23 studies by Simpson and Reid (2014) found that clients in video therapy rated their bond with the therapist, and their sense of the therapist's presence, at least as strongly as clients seen in person. Therapists also rated the alliance highly, though often not quite as highly as their clients did early in treatment.

The picture is not entirely rosy. When Norwood and colleagues (2018) pooled 12 studies, the alliance in video therapy came out somewhat weaker than face to face. The difference was not statistically significant, but the study could not rule out a meaningful gap either, while improvement in symptoms was no worse. I read that as a reason to protect the relationship on purpose online, not as a reason to avoid it. A screen removes some of the small signals a room gives for free: the way someone walks in, how they settle into the chair, the silence before they answer. Online, those things have to be asked about more directly, and said more often in words.

When the room is the better choice

There are situations where I would suggest sessions in the room rather than on a screen, and none of them are about the technology.

When there is nowhere private to talk. Therapy depends on being able to say the thing you have never said. If the only place available is a bedroom with thin walls, a shared flat, or a family home where someone may knock at any moment, part of your mind will stay on guard for the whole hour. That is not a failure of willpower. It is your nervous system doing its job. In close-knit families, where an overheard conversation can travel, privacy is often the first thing to solve.

When the screen becomes a way to keep a distance. Some people find it easier to stay guarded online. The camera goes off, a message arrives in another window, and the session becomes something to get through between meetings. A room takes those exits away. If you notice that you are using the screen to hold therapy at arm's length, that is worth saying out loud, and it may be a reason to come in person for a while.

When things are at their most acute. Online therapy is not an emergency service. It works best as part of a steady weekly rhythm, not as the only support in a moment of crisis.

There is also a practical limit for anyone looking for a psychologist across borders. My online sessions are for people who live in the UAE, in Arabic, English or French. I am licensed by the Dubai Health Authority, and online sessions follow the same DHA clinical and ethical standards as sessions in the room at Dr Reuter Medical Center in Jumeirah. I have answered the practical questions about how they work on my online therapy page.

Turning a screen into a room

If you choose online sessions, part of the work of building the room falls to you. None of it is complicated, but each part matters.

Use the same place each time. Your mind learns that this chair, this corner or this parked car is where the difficult things get said. Consistency does some of the work a clinic does.

Close the door, and tell the household. An hour marked as not to be disturbed is a boundary in itself, and for some people setting it is already part of the therapy.

Wear headphones and silence everything else. Notifications off, other tabs closed, phone face down. Divided attention is the quickest way to make a session feel thin.

Leave a few minutes on either side. Going straight from a meeting into a session and back again leaves what was said nowhere to settle. Five minutes to arrive and five to come back make a difference.

Say when it is not working. If the format is getting in the way, say so. Some people combine the two, starting in person and continuing online, or the other way round.

The question is not the screen

Research comparing therapy by video with therapy in the same room has found very similar outcomes on average, and clients in video therapy tend to rate their bond with the therapist about as strongly as clients seen in person. What decides whether online therapy works for a particular person is usually less the screen than the conditions around it: a private space, undivided attention, and a relationship both people protect on purpose. When those conditions cannot be met, sessions in the room are the better choice.

So the question to bring to a first online session is not whether it will be as good as the real thing. It can be the real thing. The better question is whether you have given yourself a room to have it in. If you are still deciding who to see, I have written separately about the questions worth asking before you book.

Sometimes that room is a clinic in Jumeirah. Sometimes it is a parked car at lunchtime, with the engine off and the phone face down.

References

Batastini, A. B., Paprzycki, P., Jones, A. C. T., & MacLean, N. (2021). Are videoconferenced mental and behavioral health services just as good as in-person? A meta-analysis of a fast-growing practice. Clinical Psychology Review, 83, 101944. https://doi.org/10.1016/j.cpr.2020.101944

Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy, 28(6), 1535–1549. https://doi.org/10.1002/cpp.2594

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340. https://doi.org/10.1037/pst0000172

Norwood, C., Moghaddam, N. G., Malins, S., & Sabin-Farrell, R. (2018). Working alliance and outcome effectiveness in videoconferencing psychotherapy: A systematic review and noninferiority meta-analysis. Clinical Psychology & Psychotherapy, 25(6), 797–808. https://doi.org/10.1002/cpp.2315

Simpson, S. G., & Reid, C. L. (2014). Therapeutic alliance in videoconferencing psychotherapy: A review. Australian Journal of Rural Health, 22(6), 280–299. https://doi.org/10.1111/ajr.12149

About the Author

Sarah El Nabulsi, M.Sc., M.A., M.A. is a DHA Licensed Clinical Psychologist based in Dubai and Director of the National Office of Transcendental Meditation in the U.A.E. With over 15 years of experience supporting adults and couples across the UAE through anxiety, stress, burnout, and relationship challenges, she is regularly featured on MBC, Sky News Arabia, Dubai TV and BBC Arabic, and the creator of the online courses Anxiety 101 (Level 1) and Master Yourself (Level 2).

Frequently asked questions

Is online therapy as good as seeing a psychologist in person?

For many problems, the research finds very little difference on average. Two large meta-analyses, covering dozens of studies and thousands of clients, found that therapy delivered by video produced outcomes close to those of the same therapy in the room, with the clearest evidence for cognitive behavioural therapy and for anxiety, depression and post-traumatic stress. That is an average, though, not a promise about any one person. Online sessions tend to work less well when there is nowhere private to talk, when attention is divided, or when the screen becomes a way of keeping therapy at a distance. In my view, the more useful question is not which format is better in general, but which one you can actually show up to fully, week after week.

Is online therapy private, and who can see my sessions?

Online sessions carry the same confidentiality as sessions in the room, within the limits that apply to every licensed clinician in the UAE. My sessions take place over an encrypted, secure video call, and they follow the same DHA clinical and ethical standards as in-person work. The limits of confidentiality mainly concern serious risk to your safety or someone else's, and they are explained at the start, so nothing comes as a surprise. The weaker point in privacy is usually not the technology but the room you are sitting in. Thin walls, a shared laptop or a family member who might walk in are worth solving before the first session. Headphones, a closed door and a device that only you use go a long way.

Can I have a session from my car or my office?

Yes, as long as the space is private and you can give the hour your full attention. A parked car with the engine off can work well, because it is often the one place in a busy day where nobody can overhear you. An office works only if the door closes and nobody will knock. What matters is not how the space looks but whether you can say what you need to say without lowering your voice. Avoid sessions while driving, walking through a public place or sitting in a café, because part of your mind will stay on the surroundings. If you use the same place each time, it starts to do some of the work a clinic room does: your mind learns that this is where the difficult things get said.

How will I know whether online therapy is working for me?

Look for movement in your everyday life rather than at how a single session felt. Useful signs include noticing patterns between sessions that you could not see before, trying something new in a situation that used to stop you, and finding it easier to say more in sessions as the weeks go on. Some sessions will feel flat, and that is true in the room as well. What is worth raising is a pattern: feeling unable to open up on camera, sessions that keep being interrupted, or a sense that you are performing rather than talking. Say it, because the format can change. Some people move to sessions in the room for a while, some combine the two, and some find that a different psychologist suits them better. Any of those is a reasonable choice.