Online therapy for low self-esteemA steady, honest relationship with yourself.

Self-esteem is the opinion we have of ourselves. When it is healthy, we feel broadly positive about ourselves and about life, and we can cope with setbacks without deciding we are worthless. When it is low, we tend to see ourselves and our lives in a much more negative and critical light¹.

Most people with low self-esteem can trace it, at least partly, to experiences: critical or demanding environments, bullying, comparison with siblings, a lack of praise and warmth, difficult relationships, or periods of stress and loss in adult life. These experiences leave behind conclusions such as "I'm not likeable" or "I have to be perfect to be accepted", which then filter how we interpret everything that happens.

Self-esteem is not only about how you feel; it is connected to your wellbeing over time. A meta-analysis of longitudinal studies, covering 77 studies on depression and 18 on anxiety, found that low self-esteem predicted later depression more strongly than depression predicted later self-esteem, supporting a "vulnerability" model². A broad review of research, including several meta-analyses, concluded that self-esteem is associated with benefits in relationships, school, work, mental health and physical health, across age and gender³.

That does not mean the aim is inflated or fragile self-esteem. The aim is a steady, realistic sense of your own worth that does not collapse every time you make a mistake.

A systematic review and meta-analysis of CBT-based interventions built on Fennell's model of low self-esteem found large effects for weekly sessions, along with reductions in depressive symptoms⁴. A separate meta-analysis of 19 trials found that psychotherapy for adult depression also improved self-esteem⁵.

Our therapists work in an integrative, evidence-informed way. For self-esteem, sessions often include:

• Understanding where it comes from: the experiences that shaped your view of yourself and the "rules for living" you developed to cope.
• Recognising the inner critic: noticing its voice, its predictions and its double standards.
• Techniques from cognitive behavioural therapy, where helpful, to test negative beliefs against real evidence and to build more balanced ones.
• Behavioural experiments: trying things you have avoided, such as saying no, asking for help or sharing an opinion, and seeing what actually happens.
• Self-compassion: learning to treat yourself with the fairness you would show a friend, which is different from letting yourself off the hook.
• Boundaries and relationships: noticing where you over-give or accept poor treatment.
• Noticing strengths and qualities in a way that feels genuine rather than forced.

The NHS also suggests practical steps such as recognising what you are good at, building positive relationships, learning to be assertive and challenging negative beliefs¹. Therapy helps you do these consistently and with support.

Online sessions can feel less exposing for people who struggle with how they come across, and they make it easier to fit therapy into a busy week. Video psychotherapy has shown outcomes broadly comparable to in-person therapy⁶.

Consider therapy if a negative view of yourself:

• has been present for a long time and does not shift;
• stops you from trying new things or pursuing what you want;
• affects your relationships, work or study;
• comes with low mood, anxiety or thoughts that you would be better off not here.

If you feel hopeless or have thoughts of harming yourself, please seek help promptly; see the urgent help information below.