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When I tell people that I offer online therapy sessions, the reaction I get is almost always the same. It’s usually some version of “That’s a shame you don’t do in-person,” or “Does that work as well?” It has really made me realise how stigmatised online therapy still is, and how deeply many of us hold the belief that if support isn’t delivered in-person, it must be a lesser option. But I believe flipping those attitudes could actually remove a huge barrier to care, especially for rural men.
In Australia, accessing mental health support can be challenging for anyone, but for men living in rural and remote areas, the barriers are even greater. Despite growing awareness of mental health issues, a significant treatment gap remains for those outside major cities.
There are a range of factors that make it hard to provide services in rural and regional Australia which I won’t list because we are all aware of them. And, generally when these services are offered, it requires a lot of effort for the client to book appointments and attend each time. It is hard enough getting people to reach out. For men in particular, norms around masculinity can discourage help-seeking especially when support is only offered through traditional, face-to-face channels.
This is where online therapy is not just the convenient option, it’s often the best option. Telehealth has developed rapidly in recent years, with strong evidence showing that therapy delivered via video or phone can be just as effective as in-person sessions. A recent meta-analysis (Snoswell et al., 2023) found telehealth sessions were as effective, if not more, than usual care. In fact, online sessions have been shown to reduce drop-out rates and improve attendance, particularly when clients face structural or logistical barriers to in-person treatment (Snoswell et al., 2023).
Online therapy also supports core psychological needs that are crucial to effective therapy. Studies suggest that virtual therapy can enhance a client’s sense of autonomy, control, and safety. Clients often report feeling more comfortable opening up in familiar environments like their own home. The flexibility of online sessions alongside the ability to avoid public waiting rooms can help reduce feelings of shame or embarrassment, especially among men who might otherwise avoid mental health services altogether (Backhaus et al., 2012).
For rural men juggling work, shift jobs, community and family responsibilities, or all three, online therapy removes many of the obstacles to care. There’s no need to take half a day off to drive to an office, and no awkward waiting room to sit in. Sessions can be held in the privacy of your own home, car, or shed on your own terms. For men who are used to keeping things to themselves, this privacy can be a powerful enabler of honesty and change.
Online therapy offers both anonymity and distance, two things that can make a world of difference. Tightly knit rural communities often mean that everyone knows everyone. The thought of being seen walking into the local clinic or even having your name associated with a counsellor can be enough to stop someone from seeking help. Online therapy gives people the option to remain anonymous. That distance and privacy matters. What’s more, when you’re embedded in a small town, it can be hard to tell the difference between normal behaviour and community dysfunction. Having someone outside your local area, someone who isn’t entangled in the community’s culture or politics, can bring a fresh, non-biased perspective that helps you see things more clearly.
There is a need to meet men where they are. Online therapy offers flexibility, discretion, and a modern way of receiving support that aligns with the realities of rural life. While face-to-face care still has value, it’s time we stop seeing online therapy as a second-best option. In many cases, it’s the most effective and accessible way to reach those who would otherwise go without.
If you’re living in a rural area and wondering if therapy could help, consider whether online or phone sessions might work for you. With the right support, a better life could be just a call or click away.
References
Backhaus, A., Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D., Rice-Thorp, N. M., Lohr,
J., & Thorp, S. R. (2012). Videoconferencing psychotherapy: a systematic review. Psychological services, 9(2), 111–131. https://doi.org/10.1037/a0027924
Snoswell, C. L., Chelberg, G., De Guzman, K. R., Haydon, H. H., Thomas, E. E., Caffery, L. J.,
& Smith, A. C. (2023). The clinical effectiveness of telehealth: A systematic review of meta-analyses from 2010 to 2019. Journal of telemedicine and telecare, 29(9), 669–684. https://doi.org/10.1177/1357633X211022907
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