What Works Best: Online or In-Person Therapy?

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An increasing number of therapy sessions are being offered online, a trend that was accelerated by the COVID-19 pandemic. In this new world of virtual therapy, what are the limitations? What are the benefits? Should patients go back to seeing their therapist in person?

Therapy is most effective when there is a strong “therapeutic alliance” (the relationship between you and your therapist), when you consistently attend sessions, and when the therapist uses an approach that fits your needs. If these three key components are met, outcomes should be similar regardless of delivery method. Research largely supports that teletherapy produces comparable outcomes to in-person care for many common conditions.

However, this does not mean that format doesn’t matter for everyone. The better option depends on your situation, your preferences, and what kind of support you need right now.

Advantages of online therapy

Online therapy can make getting help much easier. For many people, it removes the biggest barriers that get in the way of starting or sticking with therapy. Some key advantages to teletherapy include:

Accessibility

Online Therapy allows clients to connect with therapists they might not be able to get to in person; for individuals with mobility limitations or transportation challenges, virtual therapy allows them to still get the care they need. While online therapy is not usually less expensive than in-person therapy, seeing a therapist remotely may help reduce other costs associated with therapy, such as travel costs.

Convenience

You do not have to commute, find parking, or set aside extra time in your day for virtual therapy. This convenience can make it easier to stay consistent with sessions, which is one of the most important parts of effective therapy.

Access to specialist care

When you are not limited to therapists in your immediate area, you have more options. You can look for someone who specializes in exactly what you are going through or who shares your background or identity.

Comfort

Talking from your own space can feel more natural. Some people find it easier to open up when they are at home rather than sitting in an unfamiliar office.

Advantages of in-person therapy

In-person therapy offers something different: a shared physical space that can feel more focused, more personal, and sometimes more supportive. Some advantages to in-person therapy include:

Non-verbal cues

When you are in the same room, your therapist can pick up on small things like your posture, facial expressions, or shifts in mood. These details can help them understand you more fully.

High-acuity conditions

For patients in crisis or with severe conditions, in-person therapy provides a human connection that might be absent over a screen.

Fewer distractions

A therapist’s office is designed to be a quiet, private space. At home, it is easier to get interrupted by other people. Also, in-person therapy reduces the risk of internet or other technology disruptions that may be relevant during online therapy.

Better support for certain therapy types

Some types of therapy work better in person. For example, child therapy or exposure therapy that involves practicing real-world situations can be easier face-to-face.

Finding a good fit

The most important thing is not whether you choose online or in-person therapy. It is whether you feel comfortable with your therapist and are able to build trust over time. Some patients may also benefit from a hybrid approach, coming into the office when needed and staying home for more routine check-ins.

If you are deciding what format is best for you, it can help to think about:

• What kind of support do you need right now?
• What does your schedule look like?
• Where will you feel most comfortable opening up?