Expat therapy online, in EnglishFar from home, not on your own.

Most people who move abroad expect the practical challenges, such as paperwork, housing and a new job. What tends to catch them off guard is the emotional side, which usually unfolds in stages and rarely in a straight line. The first months can be busy and exciting, and the strain often arrives later, when the novelty has worn off and the reality of building a life from scratch sets in.

Loneliness and the loss of a social network

Loneliness is common everywhere, not only among people who have moved: the World Health Organization's Commission on Social Connection estimates that about one in six people worldwide is affected by it, and links it to serious consequences for health (WHO, 2025). After a move, however, it can take a particular shape. You may have plenty of acquaintances through work or an expat community and still have nobody to call at eleven at night when something goes wrong, while friendships back home slowly thin out across time zones and missed calls.

Culture shock and adjustment

Culture shock is less about dramatic misunderstandings and more about the slow fatigue of living where nothing is automatic. Unspoken rules about time, directness, family and work can differ in ways that leave you second-guessing yourself, and constantly operating in a second language can be draining even when you speak it well. Many people describe feeling less like themselves, less funny, less quick and less confident, and that change in self-image can be surprisingly painful.

Distance from family

Being far away from parents, siblings and old friends becomes hardest at the moments that matter: a parent's illness, a birth you miss, a funeral you cannot reach in time. Guilt about not being there, and worry about what might happen, can sit in the background for years and come to the surface suddenly.

Relationships under pressure

Couples who move together often do so because of one partner's job, and the partner who follows may lose a career, an income and a social circle all at once. Relationships across cultures bring their own richness and their own friction, from expectations about extended family to how conflict is handled, and raising children between two cultures adds another layer. These pressures do not mean a relationship is failing, but they do benefit from being talked about openly — see couples therapy and relationship counselling.

Identity, belonging and going home

Over time, many people find that they no longer feel fully at home either in their new country or in the one they left, and questions about where they belong, and whether to stay, move again or return, can feel heavy. Returning home can be its own adjustment, because both you and the place have changed in the meantime.

When you are dealing with something painful, finding words for it is hard enough without having to translate. Talking in the language you think and feel in lets you say what you actually mean, including the half-formed, contradictory things that matter most in therapy. Seeing a therapist online also means you can keep working with the same person if you move again, travel for work or spend the summer elsewhere, which is valuable for people whose lives do not stay in one place for long.

There is good evidence that this can work well. A meta-analysis of randomised trials found that treatment delivered by video was comparable with in-person treatment for depression, anxiety and post-traumatic stress in effectiveness, satisfaction and drop-out (Shaker et al., 2023), and research on the therapeutic relationship has found that its link with good outcomes holds in internet-based therapy just as it does face to face (Flückiger et al., 2018).

Some people also value talking to a therapist who sits outside their expat circle. In smaller international communities, where colleagues, neighbours and the parents at school all know one another, it can be a relief to speak to someone who has no connection to any of them.

Therapy is most useful when it connects with the rest of your week, and there are some modest steps that many people living abroad find helpful while they are working on things. Keeping a regular routine, including a fixed time to get up and some daily movement or daylight, gives the days a shape when work or social life does not. Setting up one or two predictable points of contact, such as a weekly call with a friend at home or a class or club where you see the same faces, tends to do more for loneliness than occasional large events. It also helps to treat language and cultural fatigue as real tiredness rather than a personal shortcoming, and to plan some rest in your own language. None of this replaces therapy, but it gives the work something to build on.

If you have moved to Greece, our sessions are available to you wherever you are, from Athens and Thessaloniki to Crete and Patras. Our English guide to mental health services in Greece explains how the public system, private care and the national helplines work, and why the European Health Insurance Card, which covers necessary state-provided healthcare during temporary stays, does not cover private care (European Commission).