Online Therapy for Expats, in English

If you're looking for an English-speaking therapist online, I offer counselling for expats by secure video from the UK, wherever work or a partner's job has taken you. I'm a trainee person-centred counsellor and BACP student member, working under supervision. Sessions cost £45, with evenings in UK time, for culture shock, loneliness and identity, with one counsellor who stays the same when you move.

Expat stress: what living abroad can feel like

From the outside, it can look like an adventure. From the inside, it's often a long run of small, tiring moments.

Imagine you moved to Munich for a job. Eight months later the work is fine, but you still don't have a friend you could call at 10pm. Posting a parcel takes three attempts and a translation app. You're a capable adult who suddenly needs help with things a child could do back home.

Or you're the one keeping in touch across time zones. You call your parents during your lunch break because it's evening for them. You missed a cousin's wedding and watched it on a shaky phone stream. When a grandparent was ill, you were checking flights at 2am and wondering whether you'd made a terrible choice by leaving. If someone has died while you were far away, my page on grief far from home is written for that.

None of this means you made the wrong decision. It means you're carrying more than people at home can see.

What are the stages of culture shock?

The anthropologist Kalervo Oberg made the term "culture shock" widely known in a 1960 paper. He described it as the anxiety that comes from losing "all our familiar signs and symbols of social intercourse": the small cues that tell you how to greet someone, when to tip, what a pause in conversation means.

Oberg described four stages:

1. Honeymoon. Everything is new and fascinating. He wrote that this may last "from a few days or weeks to six months", depending on circumstances.
2. Crisis. Real life sets in, with language trouble, housing trouble, school trouble. Oberg noticed people becoming hostile towards the host country and retreating into groups of fellow expats to complain.
3. Recovery. You pick up some of the language, start to find your way around and begin to joke about your own difficulties.
4. Adjustment. Local customs become "just another way of living". There are still hard days, but the place no longer feels against you.

This pattern is often drawn as a U-shaped curve: high at first, then a dip, then recovery. Later researchers have questioned whether people really move through these stages in order. A longitudinal study put the U-curve "on trial" (Ward and colleagues, 1998), and a 2021 study of Erasmus students found that most didn't describe the expected crisis or the four stages at all (Viol and Klasen, 2021).

So the stages are best used as a rough map, not a timetable. If your hardest month was the first one, or the third year, nothing is wrong with you. You can read a short definition of culture shock in my glossary.

Culture shock counselling doesn't have to mean something has gone badly wrong. It can simply be a place to say how strange and tiring the place still feels, without having to sound grateful.

Psychologist John Berry's work on acculturation describes a related idea, acculturative stress: the strain of adapting to a new culture while deciding how much of your own to keep (Berry, 1997).

Expat loneliness and low mood

Loneliness is one of the most common reasons expats look for an English-speaking therapist abroad. In InterNations' 2023 Expat Insider survey, as reported by The Local, 36 percent of respondents worldwide said it was hard to make local friends. In Denmark the figure was 66 percent.

Loneliness abroad isn't only about having no one to see on a Saturday. It can be the absence of anyone who knew you before, who knows your family, or who understands the joke without explanation. I've written more about expat loneliness and what can make it so hard to talk about. The short loneliness test can help you notice how much of it you're carrying.

Over months, loneliness and strain can settle into a lower mood: flat weekends, poor sleep, less interest in things you used to enjoy. People sometimes call this expat depression. I don't diagnose, but if that description sounds familiar, my page on low mood abroad may help, and it's worth seeing a local doctor too.

Identity shifts: who am I here?

Moving countries can quietly change how you see yourself. At home you were quick and funny. In a second language you might feel slow and a little invisible.

There are other shifts too. You might become "the foreigner", or be read through a stereotype about your nationality, skin colour or accent for the first time. You might find you're more attached to your home culture than you expected, or less. Children raised abroad may grow up with a sense of home that doesn't match yours. My page on identity and belonging looks at this more closely.

Trailing spouse counselling

Some people move because they wanted to. Others move because their partner's career did.

Oberg noticed this in 1960. Writing in the language of his time, he thought culture shock affected wives more than husbands, because the husband had his professional duties to occupy him while the wife faced the new environment more directly. The gendered framing is dated. The underlying point still holds for whichever partner arrives without a job, a team or a reason to leave the flat each morning.

Research on accompanying partners has looked at how little organisational support they often receive compared with the employee (McNulty, 2012). You may have given up an income and a professional identity, and you may be expected to be grateful. The trailing spouse page goes into this in more detail, and trailing spouse counselling can be a place to grieve what you gave up without being told to count your blessings. Many of the situations on my page about online counselling for women begin with a move like this.

Reverse culture shock after moving home

Going home can be harder than leaving. John and Jeanne Gullahorn extended the U-curve into a "W-curve" in 1963, suggesting that returning home brings a second round of adjustment.

You come back changed, and home has changed without you. Friends have moved on. Your family may expect the person who left. You might feel foreign in the place you used to call yours, and oddly homesick for the country you complained about.

Reverse culture shock counselling can be a place to make sense of both lives, the one you built abroad and the one you came back to, without having to choose which one was real. I've collected free reading on living abroad and migration, including returning home.

An English-speaking counsellor in Europe, across moves

Many expats move more than once. Each move can mean finding a new counsellor who speaks your language, explaining your history again and waiting for a space.

Online counselling can offer continuity. If you move from Amsterdam to Lisbon, or back to the UK, we can usually carry on. The relationship stays, even when the city doesn't. A 2021 meta-analysis found negligible differences in outcomes between therapy delivered live by video and in-person therapy (Fernandez and colleagues, 2021), so choosing online sessions doesn't have to mean settling for less.

If you moved for good rather than for a posting, my page on counselling for immigrants may fit you better.

How to find a therapist abroad

You have broadly three options: a local therapist who works in English, an online counsellor in your home country, or an international practice. Each has trade-offs around cost, insurance and continuity. My guide on how to find a therapist abroad walks through what to check, and can a UK counsellor see clients abroad? explains what working across a border does and doesn't mean.

For a particular country or city, start with my English-speaking counsellor pages. There are city pages for Berlin, Munich, Frankfurt, Vienna, Amsterdam, Paris and more.

How online therapy for expats works: time zones and practicalities

I'm based in Shrewsbury in the UK. Evening sessions are available in UK time, which is useful if you're in another time zone. Most of continental Western Europe is one hour ahead, so an evening session can start after work for you. If you live further east, we'll find a time that works for both of us.

Sessions last 50 minutes, by secure video, in English. You'll need a private space and a reliable connection. The counselling is delivered online from the UK. It isn't part of the healthcare system in the country where you live, and it doesn't replace local care.

My training, the fee and how to book

I'm a Trainee Person-Centred Counsellor and a student member of the BACP, completing an MSc in Counselling and Psychotherapy at Keele University. I work under regular clinical supervision. I've worked as a placement counsellor in Sri Lanka and in the UK, and I'm particularly interested in culture, migration and the pull between belonging and independence.

A session costs £45 for 50 minutes, charged in pounds. Your bank sets the exchange rate if you pay from another currency. I keep a few lower-cost places for students, trainees and people on a low income, and I ask for 48 hours' notice to cancel. The fees page has the details.

When you're ready, you can book a first session. If you'd like to ask something first, email hello@michellefernando.com and I'll reply within 48 hours.

When you need local or urgent help

Online counselling can't replace emergency care. If your life or someone else's is in danger, call 112 anywhere in the EU, or 999 in the UK. Each of my country pages lists verified local crisis lines, and the international helplines directory covers many more countries, with the source for every number. I don't work with active suicidal crisis, psychosis, eating disorders, addiction, couples or children, and I'll help you look for local support if that's what you need.