Online therapy across the UK
I see adults, teenagers and children by secure video anywhere in England, Scotland, Wales and Northern Ireland. Specialist OCD treatment is not available in every area, and online the practice happens where the difficulty happens.
Why exposure work can go well online
Exposure and response prevention (ERP) means facing the situations that set the anxiety off, in planned steps, without doing what you normally do to make the feeling stop. Almost none of those situations happen in a consulting room. By video I can coach you through a task in your own home, so what you learn does not have to be carried over from somewhere else.
Online sessions let the practice happen where the problem is: the bathroom with the taps you have avoided, your own front door at the time you normally leave, the hallway on a real school morning, or your own phone at the moment the urge to search arrives.
What an exposure session looks like from your side
We plan the step first, then you take the laptop to wherever the task is and carry out the agreed step while I coach you. Afterwards we go over how you managed the anxiety without doing the compulsion.
What you need
- A private space where you will not be overheard.
- A stable connection. If video drops, we switch to audio.
- A laptop or tablet with a camera, and a phone for exposure tasks.
- No software. I send a link before each session.
How sessions with children and teenagers work
How each session is divided between parents and the child or teenager is agreed with each family and changes as treatment goes on. Younger children need shorter segments, games and a parent nearby, so for a nine-year-old with OCD a parent might run the practice task while I coach both of them. Where a child or teenager will not attend, treatment can go entirely through parents using SPACE, in which only the parents take part.
Confidentiality and safety at a distance
Sessions are on an encrypted platform and I work from a private room. I do not record sessions, unless you ask me in writing to record one for your own use, for example to listen back to an exercise. The limits of confidentiality are the same as in person: serious risk to you or someone else, safeguarding, a court order, or a specific legal duty. They are set out in full in section 6 of the privacy policy, and unless it would increase the risk I would tell you first. In the first session I take your address, your GP’s details and an emergency contact, and note the urgent mental health route where you live. If someone becomes acutely unwell during a session, I stay on the call and we follow that plan.
When in-person work is the better choice
Video does not suit everyone, for example if you have nowhere private to talk. Some tasks cannot be done on a screen, such as a needle phobia that needs a clinical setting. Where risk is significant and changing, or someone needs a local team, private video work is not the right arrangement, and some people concentrate better in a room with another person. I also see people in person in Nottinghamshire, in their own home or at my office in Ravenshead. If you are not sure which suits you, we can decide on the free introductory call (20 minutes).
Sources
- Wootton, B. M. (2016). Remote cognitive-behavior therapy for obsessive-compulsive symptoms: A meta-analysis. Clinical Psychology Review, 43, 103-113. doi.org/10.1016/j.cpr.2015.10.001 (opens in a new tab)
Common questions
Is online therapy as good as in person for OCD and anxiety?
For CBT and ERP, treatment by video has been tested in trials and appears comparable to treatment in the room for many people (Wootton, 2016, for OCD), and for OCD it has a practical advantage, because many of the situations that trigger the difficulty are at home. Where in-person work would clearly be better for you, I will say so.
Can you see me if I live outside England?
Yes. I am registered with the HCPC and work with people across the UK, including Scotland, Wales and Northern Ireland. Crisis and NHS pathways differ between the four nations, so in the first session I note your GP and your local urgent care route.
Does online work for young children?
It can, with some adjustments, such as shorter segments, games and props, and a parent nearby to help with tasks. The practice has to happen at home in any case.
Free 20-minute call
Not sure whether this is the right fit?
Start with a free 20-minute call. We talk through what is going on, I answer any questions you have, and I tell you whether I think I can help. If I cannot, I will try to point you to someone who can. The call is free and there is no obligation to book.
Weekdays, 9am to 5pm. No GP referral needed.