Online vs. face-to-face therapy

Which is right for me?

I strongly believe that clients need to feel as comfortable with their therapy as much as possible. Among other things like type of therapy, therapist’s style, financial questions, ability to meet the therapist before starting, as well as whether you want to work online or on site.

Although there has been a lot said about things like Zoom fatigue, my experience with working online has mostly been positive. I believe it is all about the mode of working — unlike work calls for example, online therapy is a safe place for you to explore, feel supported and find solutions to your difficulties.

But of course, everybody is different. Here are some factors to consider when deciding if online therapy is the best option for you.

Pros of online therapy:

Flexible

Online therapy allows you to have sessions in the comfort of your own home, or wherever is easiest for you. It also removes the need to travel, and the time that takes. This means that online therapy can often fit best around, e.g., parental responsibilities and work commitments.

Easier to start

For some people, it could be that your problem is in itself a barrier to you seeking help. For example, if you are dealing with social anxiety or agoraphobia, going outside can be really difficult, especially if that entails a longer commute and public transport. While in these cases, we would work towards you feeling comfortable to do these things, for some, it could be helpful to first start from a safer place.

Your location

With online therapy, the distance between you and the therapist’s office is no longer an issue. This can make it much easier to have sessions regularly, which is really important in making progress. In some cases, this might be crucial: there might not be any therapists nearby that speak your language. You might even live in a country where mental health is not prioritised, and therapy is not readily available. In such cases online therapy can be a lifeline.

Effective

Studies show that online therapy can be as effective as in-person therapy. Thus, by making a choice to work online, you are not compromising on quality. I have been working online since 2020, so I have also had time to adapt my methods and techniques to online work, thus, by now, I don’t see any difference between applying methods live or online.

Cons of online therapy:

At the same time, I don’t believe that online therapy is suitable for everybody. Here are several important factors to consider:

(Safe) Space

Therapy can only be practiced by creating a safe space, in which the therapist and the client can explore, understand client’s circumstances, history, current difficulties and work together on them. Without this space, there is little possibility I see to reach therapeutic goals. This means you need a reasonably quiet, private space, for example a room in your house where others won’t interrupt you during the session.

That also implies protection from others — therapy is private, and this privacy is an important factor, allowing us to deeply explore our thoughts, emotions, and sensations without needing to filter them or make sure others would agree with them. It is hard to imagine an individual therapy dealing with relationship traumas while one’s partner is sitting in the same room. I am not saying we should not ever share our inner lives with our loved ones — I would argue the opposite, actually — but I would prioritize having choice of how and when that is done.

At the same time, there is flexibility in these spaces — some clients have sessions in their office after work, some sessions happen while clients have a walk in a park, some prefer to have sessions in their (parked) car. Although I would not recommend this as a long-term solution, it could provide the ability to receive help quicker, especially under difficult circumstances.

Good internet connection

Fluid communication is difficult if the screen is freezing every couple words. A session with bad internet could feel alienating and hollow, as both of us pay more attention to interruptions than to what actually is being said. Thus, it is essential that your internet allows us to have a video call without major interruptions. Thankfully, internet nowadays is often good enough, so this problem arises way rarer than one could expect (and if that happens occasionally, we could search for solutions together).

You are not feeling it

Plain and simple, if you don’t feel connected during an online session, or you still feel uncomfortable after a few sessions, it might just mean this does not work for you (at least in the current moment). I do not think people should always have elaborate reasons why they prefer one over another — you are allowed to choose things that work best for you! Thus, I always invite my clients to discuss with me if chosen format is useful for them.

Summary: what should I choose?

As with many things, there are no right or wrong answers here. Online therapy can be a life-saver for people who cannot (or do not want to) have in-person sessions. It can also be an effective alternative to in-person sessions in general. I would invite you to give it a try before deciding and see how you feel in it.

However, if you are not “feeling it” after a few sessions, that is totally normal and okay, we can discuss in-person sessions instead!