Online Trauma Therapy: How I Work, and What the Research Says
If you are looking for online trauma therapy, you may have noticed that every therapist describes something different. That is because there is no single “trauma therapy” that suits everyone. This page explains how I work, why I don’t follow a fixed programme, and what the research does and doesn’t tell us, so you can decide whether to get in touch.
What online trauma therapy looks like with me
One size does not fit all, so I don’t offer a set programme. I draw on a mix of three things, and the balance changes from person to person:
- DBT skills, to help you understand your emotions and stay steady when things feel like too much.
- Parts work, using Internal Family Systems (IFS), which looks at the different “parts” of us, such as the part that protects you, the part that carries the pain, and the part that criticises.
- Body-based (somatic) work, because trauma is often held in the body as well as the mind, and noticing what your body is doing can be a way in.
A lot of the work happens through our relationship and the feeling of safety within it. The techniques matter, but the experience of being with someone who goes at your pace, and doesn’t push, is a large part of what changes.
If, later on, EMDR feels right, I explain how I use EMDR for complex trauma. It is one possible part of the work, never the starting point.
How we begin
A first session involves taking some history and getting to know you and what brought you here. This can take a few sessions, until we have covered the goals of therapy and made a plan together. I will present the options and we will see where you want to go. You can read more about what the early sessions look like.
Questions people ask before starting
Which trauma therapy is the “right” one? There is no clear winner. This is why I tailor the work to you, instead of fitting you into one method. The research below looks at the parts of my approach one at a time, and says what is known and what isn’t.
Does the relationship with the therapist really matter? Research suggests it does. A systematic review of 34 studies found that a stronger therapeutic alliance was linked to better outcomes in PTSD therapy, in both in-person and remote work. This is an association, not proof that the relationship causes the improvement, and the authors rated most of the studies as weak to moderate quality. But it supports what I see: safety in the relationship comes first.
Does online therapy work as well as in-person? Evidence suggests it can. A 2022 review of 13 trials found no differences between video or phone therapy and face-to-face for PTSD severity, depression, therapeutic alliance or satisfaction, although most of the studies were with veterans. An earlier review found similar results at the end of treatment for video therapy, but slightly weaker results at the 3 to 6 month follow-up. Overall it looks promising, and more research is needed.
Do DBT skills help with trauma? There is evidence for DBT-based treatments designed for PTSD. A 2024 meta-analysis of 13 studies (663 people) found moderate improvements in PTSD symptoms and depression compared with control groups. These were specific PTSD programmes, mostly for people who also have difficulties with emotion regulation, so I can’t claim the same results for any single DBT skill. But it supports using DBT skills as a foundation.
What is parts work (IFS), and why do you use it? Internal Family Systems is a way of understanding ourselves as having different “parts”, some that protect us and some that carry old pain, and it helps people relate to those parts with more curiosity and compassion. Research on IFS for trauma is still emerging. In a 2026 randomised trial of 60 people with PTSD, an online group programme based on IFS was found to be feasible and acceptable: people attended more sessions and reported higher satisfaction than a comparison group, and PTSD symptoms fell in both groups. I use it because many people find it a gentler way to make sense of their reactions.
Does body-based work help? There is some promising evidence. A randomised trial of Somatic Experiencing with 63 people with PTSD found that symptoms and depression improved after 15 weekly sessions, compared with a waiting list. It was the first trial of that method, and because it was compared with waiting, it can’t show whether it is better than other therapies. It tested one specific method, and body-based work covers many.
Will I be pushed to talk about what happened? No. I go at the pace your body feels comfortable with, and I treat resistance as important information, not something to override.
Is this right for you?
I would encourage you to book a free call if:
- you want a therapist who adapts to you, instead of following a fixed programme
- the relationship and feeling safe matter to you as much as the technique
- you are open to talking about different approaches and choosing together
- you want to work in English, online, from Spain, the UK or elsewhere in Europe, or while travelling
You can see my fees before you decide anything.
This article is general information and isn’t a substitute for individual professional advice. If you’re in crisis, call 999 (UK), 112 (EU) or Samaritans on 116 123.
