Therapy online or in-person; which works better?

Can't make therapy appointments in-person? Online might be the answer.

We're living in the age of busy-ness: Work, family, kids, sports, university, not to mention trying to have a social life or keeping up with our physical health. There's little time for anything extra these days unless we consciously create time and space to do the things we love and to do the things we need to do, such as exercising, cooking healthy food, and seeing our therapist. Luckily this busy digital world of ours also provides us with flexibility. Now we are able to seek out services like counselling and psychotherapy online to ensure we can fit it into our schedules. But is online therapy as beneficial as traditional face-to-face?

From this therapist's perspective, yes. The pandemic forced therapists and clients online together, and in subsequent research the findings suggest that online therapy is as effective as face-to-face sessions, with both treatment formats yielding significant improvements in quality of life and reduced depressive symptoms (1). Going back even before the Covid-19 era, early research suggested that online therapy was as beneficial as traditional in-person methods, with a 2012 study finding that 83% of participants believed their online cognitive behavioural therapy (CBT) was effective and a further 89% would recommend it as a method to others (2).

However there are a few minor limitations we face. There are of course common technical challenges such as wifi dropouts, low batteries and poor reception causing unavoidable freezes on screen. You may even experience the flow of conversation being interrupted slightly every now and then. We've all been in Zoom meetings where those in the call may not observe on screen the tiny facial muscle movements that usually indicate when one is about to speak, sparking that awkward "you go", "no sorry, you go" dance in the dialogue. If your chosen therapist offers online sessions though, they'll likely be well versed in tackling the little nuances like these that come with working on screen, and it should not impact the outcome of your therapy adversely.

This period will be a significant investment in your relationship, helping you move towards positive future outcomes as a couple.

Many people feel more comfortable working with a therapist online, especially if they are new to therapy and feel scared of embarking on the journey. For those feeling anxiety about the idea of travelling to a therapist's place of work, finding the room, waiting in the reception area and then engaging with someone unfamiliar to them in close quarters, online therapy may be a more comfortable place to begin.

Many therapists, myself included, also offer a hybrid model of working whereby you may meet your therapist in-person for the first time, before moving to online only sessions. You may alternate depending on your schedule, choosing to work with your therapist online during times when you are extremely busy or perhaps travelling interstate or overseas.

As a therapist, my preference lies in the preference of my clients. What works for you is what works for me. If a client is comfortable working online then we can stick with that and perhaps work towards meeting face-to-face, if that is the goal. For others who prefer the increased intimacy of working face-to-face, in person sessions are the way to go (with a few online hybrid sessions thrown in if needed).

Whichever format you choose, face-to-face, online or hybrid, go with what is going to be most manageable for you and your schedule. The most important part of therapy is actually making it to therapy—because if nothing changes, nothing changes.

Looking for therapy on the northern beaches or online? Book a free 15 minute phone call with me to see if working together could be helpful.

1. Alavi, N., Moghimi, E., Stephenson, C., Gutierrez, G., Jagayat, J., Kumar, A., & Omrani, M. (2023). Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial. Frontiers in Psychiatry, 14, 1113956. https://doi.org/10.3389/fpsyt.2023.1113956

2. Ruwaard J, Lange A, Schrieken B, Dolan CV, Emmelkamp P (2012) The Effectiveness of Online Cognitive Behavioral Treatment in Routine Clinical Practice. PLOS ONE 7(7): e40089. https://doi.org/10.1371/journal.pone.0040089