For decades, the only way to give and receive mental health therapy was in person at the therapist’s office. While this model works for most people, it’s not right for everyone. People who live in rural areas or don’t have reliable transportation may not be able to reach a therapist’s office easily, if at all. And for those with inflexible schedules, making time for mental health care isn’t always possible.
Though some therapists offered virtual services alongside in-person therapy, the pandemic forced therapy services to shift online. As the pandemic faded and things reopened, some people realized they liked virtual appointments better than in-person therapy. It was easier to schedule and attend, and they were able to connect with therapists they would never be able to see in person.
While having more access to therapeutic support for mental health is incredibly important, online therapy comes with risks. However, those risks may outweigh the benefits of in-person care. So, what should you look out for? And how do you know if online vs. in-person therapy is right for you?
What Is In-Person Therapy?
When you think of traditional therapy, you probably think of in-person therapy. You meet with your therapist in their office or at a local mental health clinic. Individual therapy is when you meet one-on-one with your therapist, while group therapy is when you and a group of people with the same or a similar mental health condition or concern meet with one or two mental health professionals at the same time.
Outside of individual and group therapy, there are several traditional, in-person therapy modalities you can use, including:
- Talk therapy
- EMDR therapy
- Cognitive-behavior therapy (CBT)
- Couples counseling or therapy
- Family therapy
Pros of In-Person Therapy
In-person therapy is the dominant model of mental health treatment in part because it’s been around for a long time. Outside of the longevity, in-person therapy has several pros that make it appealing.
- Neutral. Being in a neutral location for in-person sessions, like your therapist’s office, helps create a “safe space” for you to open up and share your concerns. It’s away from your home and work locations, giving you the privacy you may need to feel comfortable talking about yourself.
- Non-verbal cues. Unlike virtual therapy, traditional in-person therapy sessions allow you and the therapist to see all of each other in a physical setting, giving them and you the opportunity to communicate non-verbally. An experienced mental health services professional can pick up on the things you may not realize you’re saying with your body language or facial expressions.
- Multiple modalities. While some treatment modalities are appropriate for in-person and virtual therapy, not all are. Art therapy, music therapy, or EMDR therapy require an experienced professional to guide you through the session and help you process your emotions. While it’s theoretically possible to do this in virtual therapy, a screen share of your artwork isn’t quite the same as sculpting during an in-person session.
- Proven track record. Online therapy is a recent development. While that’s a matter of technology catching up with modern life, there are decades of evidence-based research and results that demonstrate the effectiveness of in-person therapy.
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Cons of In-Person Therapy
Though in-person therapy is the dominant model of mental health care, that doesn’t mean it’s right for everyone. In-person therapy has some cons that make it a less desirable treatment modality for some.
- Lack of qualified professionals. Choosing in-person therapy means working with the mental health professionals in your area. If you live somewhere with limited mental health professionals or have a long commute to work with a therapist you’re comfortable with, in-person therapy may feel more like a burden than a help. Someone with a severe mental health condition that requires intensive treatment or who wants a therapist who specializes in a certain mental illness may not have any in-person options.
- Accessibility issues. Living somewhere with an abundance of mental health care resources and professionals doesn’t guarantee in-person therapy will work for you. If you have limited public transportation options and don’t have a car, it may be difficult to attend in-person therapy sessions. Likewise, if you have dependents or an inflexible and unpredictable work schedule, making time for regular in-person therapy appointments can be challenging.
- Wait times. In-person therapists are often booked far in advance, making it difficult for you to access mental health resources when you need them. You may have to wait weeks (or longer) just to have your first in-person session.
- Cost. In-person therapy can be more expensive than online therapy, though that’s not always the case. Group therapy is often less expensive than one-on-one therapy, but it can still be more expensive than virtual therapy.
What Is Online Therapy?
Online therapy, also called virtual therapy or distance-based therapy, is when you meet with your mental health therapist online. You may connect in a Zoom meeting or private meeting room you access through a mental health platform.
As a rule, online therapy services and sessions are similar to traditional therapy in that you meet with your therapist regularly and for the same amount of time (60 or so minutes). The main difference is you need internet access for every virtual therapy session.
Pros of Online Therapy
For some people, the pros of online therapy outweigh the pros of in-person therapy.
- Price. Virtual therapy can cost less than in-person therapy, particularly if you use an online therapy platform to connect with your treatment provider. Local therapists may also charge less for online therapy sessions than in-person ones.
- Convenient. Meeting with an online therapist is generally more convenient than meeting with an in-person therapist. You don’t have to take as much time away from your job or other responsibilities to commute to and from an office or treatment center and can, instead, log into your virtual therapy session just a few minutes before it starts. What’s more, many online therapy platforms offer text and email support, giving you access to therapeutic support outside of your scheduled sessions.
- Access. Virtual therapy eliminates most accessibility issues. While you’ll need a reliable and stable internet connection for your sessions, you’re not limited to only the therapists you can reach by car or public transportation. Individuals with mobility issues can address their mental health needs without worrying about how and if they can get to the office. And you may be better able to fit your therapy sessions into an odd or demanding personal schedule.
- Confidential. In some respects, online and virtual therapy are more confidential than in-person therapy. You don’t run the risk of being seen going in or out of your therapist’s office, which, for some people, is a significant concern that prevents them from seeking therapy in the first place.
Cons of Online Therapy
Just like in-person therapy, online therapy has its share of cons, which may outweigh the benefits.
- Tech dependent. Without the right hardware, software, or internet connection, you may still face accessibility issues and be unable to use online therapy.
- Not for everyone. Treating severe mental health conditions in online therapy may not be appropriate.
- Lack of nonverbal communication. While communicating in virtual therapy can happen via an online session or through text and chat, your therapist may miss your nonverbal cues. When your provider can only see you from the shoulders up, they may not see you tapping your foot or bouncing your knee, which could speak volumes about what you’re feeling.
- Hacking and breaches. While the possibility of a hack or breach is low, it is possible, which could mean someone has access to your confidential mental health information. Even if that never happens, texting with your therapist while at work could expose personal information you’d rather keep quiet.
Finally, one con of online or virtual therapy — particularly national online mental health therapy platforms — is that not all of them verify a therapist’s credentials before adding them to the database, meaning it may be up to you to verify the provider is licensed to practice in your state.
While you always have the option of checking a therapist’s license whenever you want, if you’re using virtual therapy, this becomes a critical step. If you need to file a complaint against a therapist who isn’t licensed in your state, you may have difficulty getting the help you need. What’s more, the therapist you see may be breaking the law in your state by practicing somewhere they aren’t licensed.
What to Check Before Starting Therapy
Whether you choose online therapy or in-person therapy, what ultimately matters is your personal preference, specifically finding a therapist you connect with and feel comfortable working with. You may need to meet with several therapists before finding “the one” and embarking on your healing journey. But no matter where you find your therapist or how you connect with them, it’s crucial to check them out before you start working with them.
Check Their Licensing
As mentioned above, it’s generally up to you to verify your therapist is licensed in your state. While this is especially true for online therapy platforms, it’s also a good step to take with an in-person therapist. The best place to start is with your state’s licensing body. You can verify if a particular provider is a licensed therapist in your state, what license they have, and if they’re in good standing. You may also be able to see if there were any complaints against the therapist and what the resolution was.
Discuss Payment Options
Some therapists accept health insurance, and some don’t. This is true for in-person and online therapists, so confirm with the therapist that they take your insurance before starting care. And, if they do, verify with your insurance company the number of sessions they’ll pay for in a year. Some health insurance providers limit the number of therapy sessions they’ll pay for
If you really like the therapist but they don’t take your insurance, or the insurance company caps the number of sessions you can attend, most therapists accept out-of-pocket payments. But make sure you have a clear understanding of what the therapist will charge you for each session, what types of payment they’ll accept, and when payment is due.
Online or In-Person Therapy for You?
The differences between online and in-person therapy may be too small to impact your decision, or it could be quite significant. If you live where in-person therapeutic support is limited or even nonexistent, online therapy might be the best option for you, even if you’re not a fan. But a spotty or slow internet connection might outweigh the distance or inconvenience of traveling to a licensed therapist to address your mental health needs.
Similarly, if you live somewhere with many licensed therapists, but none accept your insurance, or you haven’t found the right fit yet, online therapy may be the better option for you — if the therapist you connect with is licensed to practice in your state.
If you live in the Seattle metro area, Anchor Light Couples and Family Therapy offers in-person appointments and therapy sessions for anyone struggling with a range of mental health conditions. Contact us today to schedule your free consultation and start your healing journey.
