The pros and cons of virtual therapy vs. in-person therapy

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Medically reviewed by Neal Swartz

Large bodies of evidence-based literature have demonstrated the effectiveness of in-person therapy in treating mental illness for many decades. Virtual therapy is an emerging approach that leverages cutting-edge technology to enable therapeutic services that follow the same principles of in-person therapy except that the therapist and client meet online rather than in the same physical location.

No matter if mental health services are received over the internet or via in-person sessions, working with a highly qualified therapist who can determine which format will best meet your needs is vital for achieving long term mental health.

What Is Online Therapy?

Clients receiving therapy online typically have multiple formats to choose from. Many therapists extend virtual services via the electronic medical record systems for their practice. Additionally, there are online subscription platforms used by licensed therapists which allow clients to receive therapeutic services via texting, chat rooms, and video calls. While online subscription services typically use weekly video call sessions as their core therapeutic service with corresponding fees, these subscription models sometimes have an added fee in order to maintain access to the subscription.

Mental health care providers offer services virtually that are quite similar to what clients receive via therapy in the provider’s office. In particular, when online video conferencing is used, a standard 50-minute therapy session can offer just about the same experience for many clients as an in-person session would because the provider and client can see each other’s facial expressions in addition to audio.

The Pros of Virtual Therapy

Virtual therapy provides many benefits for clients to consider. This therapy format allows clients to receive services from therapists with minimal effort when it comes to being present for appointments and available for more frequent engagements.

Let’s take a closer look at the pros of virtual therapy:

Convenience

By receiving services online, clients are able to meet with their therapist without leaving their own home. Powering up your laptop or iPad to meet with a therapist is much easier than driving through rush hour traffic, waiting in the waiting room, and then fighting more traffic to get back home after the appointment.

Multiple Meeting Methods

With virtual therapy services, clients have multiple methods for receiving therapy. These methods include messaging services, chatrooms, telephone calls, and video conferencing. As long as your provider has the proper infrastructure in place for HIPAA compliance, the more communication options your provider can make available to you.

Fewer Resources Required

Virtual therapy lessens additional burdens for clients when it comes to transportation, childcare services, or unplanned appointment extensions. Online therapy removes many of these obstacles that would be present with in-person therapy.

Comfort

With virtual therapy, clients can meet with their therapist from the comfort of their own homes. When meeting with your provider from within your own familiar surroundings you can access items such as a pet or blanket that may allow you to better cope in the midst of painful conversations. Having access to these coping items may help you be more comfortable with sharing difficult information.

Access for Rural Areas

People who live in remote places or rural settings can have a hard time accessing high quality mental health care. Virtual therapy enables these clients who wouldn’t otherwise have access to great therapists with many different subspecialties to receive highly tailored treatment plans for their health.

Confidentiality

In-person therapy is highly confidential with extremely limited reasons for breaching confidentiality such as protection of a vulnerable person. Nonetheless, when accessing care in person, clients could see other people in the office waiting room or parking lot. With virtual therapy, the client accesses treatment without these persons being present.

The Cons of Online Therapy

There’s no denying that online therapy has many significant benefits. However, there are some very important factors to take into consideration for some clients who may not benefit as much as others. If you’re considering online therapy, it’s important to understand some of the potential downsides to this format.

Some potential cons of online therapy include:

Harder to Experience Empathy

One of the downsides to virtual therapy is a perceived reduction of connection between client and therapist. Since they are not in the same room together, some clients may have a harder time receiving empathy from their provider like they would if they were sitting across from one another at the practice.

Technology Problems

Let’s face it, our devices don’t always function when we need them to. When trying to connect for online therapy, the client and the therapist are each dependent on their internet connections, software programs, and devices working properly. As a result of this, there will inevitably be times where appointments have to be rescheduled because the virtual technology wasn’t functioning.

Difficulty Assessing Therapist Quality

When it comes to online-based therapists, all that glitters is not gold. Some therapists could have amazing websites, but in reality are only minimally skilled and lack adequate experience. Additionally, it can be difficult to assess the reputation of a therapist you’ve met online, especially if they don’t provide verified references and reviews.

Not a Good Fit for Some Clients

Some clients are not able to be cared for well using online therapy. People with more severe mental health conditions including intellectual disabilities, schizophrenia, or are at a higher risk of suicide need be seen in person.

The Pros of In-Person Therapy

As the traditional mode of therapy, in-person therapy is well-established as an effective format and many clients have a basic idea for what they might expect during therapy. While online therapy is being increasingly adopted by providers and clients, it’s important to not lose sight of the many benefits of in-person therapy.

Some of the most notable pros of in-person therapy are:

Forming the Therapeutic Alliance

There’s no doubt that sharing hard stories from your life in a shared space with a therapist can be difficult. The good news is that licensed, professional therapists are highly trained to build therapeutic alliances with their clients. These alliances help to ensure client well-being and positive clinical results. For most therapists practicing today, most of the training they received was centered around engaging with clients in-person rather than online. As a result, some therapists may have a harder time connecting with their clients online versus in person.

Decades of Evidence-Based Research

To no fault of virtual therapy, the reality is in-person therapy for the treatment of many mental health conditions is backed by decades of empirical evidence. While many more high-quality studies assessing the effectiveness of online therapy are sure to come, there is simply much more evidence in existence today that backs in-person therapy.

Enablement of More Treatment Modalities

In-person psychotherapy enables the use of more treatment modalities compared to online therapy. With in-person services, clients can experience therapy through additional senses, and therapists may be more effective with certain interventions such as EMDR, psychodrama, and movement-based therapy.

More Thorough Assessment

Therapists are able to conduct a more thorough assessment of their clients in-person. By being present together during the appointment, therapists are able to gain a more accurate and detailed understanding of the client’s health status by noticing finer details that couldn’t be seen or heard in virtual therapy.

The Cons of In-Person Therapy

Traditional in-person therapy brings many valuable benefits to clients and their health. However, some clients have substantial difficulties when it comes to going to in-person therapy. Even though these difficulties may seem trivial to some clients, they are felt in a very real sense by those impacted by certain conditions.

Let’s take a closer look at some of the cons of in-person therapy:

Social Stigma

Many clients experience a social stigma when it comes to going to in-person therapy. Arriving at the therapist’s practice and sitting in the waiting room with other clients can trigger feelings of vulnerability especially for clients with social anxiety.

Inconvenience

For many clients, getting to in-person appointments can be rather difficult. It’s not always easy to find a provider who has flexibility in their schedule such as when a client needs therapy outside of normal business hours because of their job. For other clients, it can be hard to drive and make it to their appointment on time.

Hard to Find High Quality In-Person Therapy in Rural Settings

Clients living in cities or areas with large populations have the benefit of choosing between multiple different therapists for in-person therapy. In contrast, clients who live in rural areas can have a much harder time finding high quality providers for in-person services. This scarcity is particularly felt if a client in a rural area needs highly specialized psychotherapy services.

Some Mental Health Conditions Make Access Difficult

Many clients have an extremely difficult time attending in-person appointments due to their mental health condition. For example, conditions such as social anxiety and agoraphobia prevents some clients from making it in for potentially life-changing therapy services.

In-Person vs. Virtual Therapy is Not One-Size-Fits-All

The effectiveness of in-person versus online therapy depends on the type of therapy (cognitive behavioral therapy, interpersonal therapy, psychodynamic psychotherapy, etc.), as well as the condition being treated (general anxiety disorder, depression, obsessive-compulsive disorder, etc.). Therefore, it’s imperative that clients find highly qualified therapists that they trust who can give them guidance on whether virtual or in-person therapy would be better for their specific condition.

For clients whose therapists feel that online therapy would be effective for their condition, they should feel free to try out virtual therapy and assess their own comfort level with the service. Additionally, as virtual therapy technology continues to evolve, the online platforms supporting the technology will continue to improve in terms of features and reliability.

High quality mental health services can prove to be life changing for many people who work with competent therapists that they trust. With the increased adoption of virtual therapy by providers, clients have more options than ever before for receiving these incredibly valuable health services.

Additionally, the increase is online therapy services has resulted in an increased awareness of mental health treatment options by the general public due to the mass advertising of these virtual services. One of the hopes is that this increased awareness will result in a reduction of the stigma of mental health in society.

At REACH Behavioral Health, we are passionate about caring for the mental health of individuals and families through a variety of therapies and formats. Our goal when it comes to deciding between virtual therapy and in-person therapy is to help our clients determine which format will be most effective for them based on their unique situation.

For more information on virtual or in-person therapy, reach out to us today!

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