Online Therapy vs. In-Person Therapy

With the emergence of social-distancing guidelines due to COVID-19, telehealth and online therapy platforms have gained popularity in the recent months. Just like there are different types of theories that help different clients, a preference for either online or face to face therapy depends on the needs of the client. Each method has its benefits and disadvantages.

Let us talk about some of the benefits of online therapy. Online therapy can help clients that live in remote areas that would otherwise not have access to treatment. For clients where the nearest counselor is potentially hours away and/or for clients with transportation issues, online counseling can be a way for individuals to receive the help they need. Additionally, online therapy is helpful for people with disabilities and mobility issues; depending on their disabilities, it can be difficult for individuals to travel. Having the ability to attend counseling from the comfort of their own home can relieve some of the stress that the trip adds. Lastly, online therapy is extremely convenient. For some individuals, the benefits of online counseling include no time in traffic, no expenditures for gas, and decreased waiting times. Clients may also feel more comfortable and able to share more when they are in their own environment. Another benefit of online therapy is safety; with the emergence of COVID-19, individuals have had to adjust to safety measures and protocols. Online counseling has allowed counselors to continue providing services to their clients while keeping themselves and their clients safe.

Although there are many advantages to online therapy, there are some disadvantages. Some health insurance companies do not cover online counseling; without insurance coverage, therapy can be expensive, depending on the counselor’s fee and the number of sessions you receive each month. Second, technology can be unreliable. There can be a poor connection, technical difficulties can be very frustrating, due to issues with audio or video. In addition, although online therapy platforms are HIPPA-compliant and secure, there is always a risk of a security breach when working online. Another disadvantage of online counseling is that if a client is in crisis, it can be more difficult for the counselor to intervene and get emergency resources to the client. Online therapy is also limited to individuals with relatively minor mental health concerns; clients with severe psychological disorders who may need a higher level of care would not be a good fit for online therapy. Lastly, some counselors believe that with online counseling, you lose valuable information that you can obtain from body language and facial expressions that may not translate well across a screen.

In-person counseling has its benefits as well. In-person counseling is usually covered by health insurance; therefore, clients usually end up just paying a copay, which is generally less expensive than the full-session fees. In addition, in-person therapy allows the clinician to better observe body language and facial expressions that can be of importance to the session. Crisis management is also more easily navigated with in-person counseling; the counselor is better equipped to help the client and obtain the best crisis care needed. Finally, in-person counseling allows the client to utilize a variety of techniques that can only be used while face to face. Sand tables, art, music, and cards to incorporate different therapy modalities are more easily accessed with in-person sessions.

The disadvantages of face to face counseling include the inconvenience of having to travel, as well as the increased concerns for safety during the COVID-19 pandemic. There are advantages and disadvantages to each type of therapy. However, in terms of effectiveness, studies have shown that the client-client alliance remains the same with either one of the modalities (Cook & Doyle, 2002). It all comes down to preference and what the client and the counselor think is the best route to take that would best benefit the client. 

Cook, J. E., & Doyle, C. (2002). Working Alliance in Online Therapy as Compared to Face-to-Face Therapy: Preliminary Results. CyberPsychology & Behavior, 5(2), 95-105. doi:10.1089/109493102753770480

Written by Elihennette Carreron, M.S.