Before the COVID pandemic, very few people received online therapy. The technology was relatively new and therapists had concerns about privacy and effectiveness. Little did we know that the coronavirus would soon instill fear of public places and the demand for online services would spike, including psychotherapy. Currently, the tide seems to have shifted. The majority of therapy is now performed virtually and it appears unlikely to change. Does that mean traditional therapy is dead and buried? Should you dismiss it without another thought? Despite its waning popularity, in-person therapy still has its advantages and may be a better fit for your needs. Let’s examine the key differences so you can determine which is best for you.

Comparing Traditional Therapy and Teletherapy

Teletherapy is the use of technology to gain access to mental health services. You can receive teletherapy through phone, text, video, and e-mail. Currently, when people talk about teletherapy, they most often refer to online counseling provided through video conferencing.

Traditional therapy takes place face-to-face in an office setting. Meetings often take place weekly in 45-60 minute sessions.

Pros and Cons

The following are the advantages and disadvantages of in-person therapy and teletherapy:

Convenience/Flexibility

The primary benefits of teletherapy are convenience and flexibility. As long as you have a computer or smartphone, you can access help from wherever it is most comfortable for you. This saves you time and money (and childcare) in traveling to a therapist’s office. In addition, you can avoid the stigma and confidentiality issues that occur by having to go to a place where you might see people you know. 

Access

Some communities do not have access to therapists. Teletherapy gives people in rural areas counseling options that they never had before. Additionally, people may have problems that need specialized assistance that they can’t find locally. Fortunately, teletherapy can help those people find someone who specializes in their issues online. Further, people with disabilities may have difficulty physically getting to a therapist’s office.

Increased Contact

In conventional psychotherapy, your interaction with a therapist is limited to your in-person therapy session. You might be able to talk to your therapist on the phone if needed, but that is an exception, not the rule. Depending on your therapist, teletherapy may allow you more regular contact than one weekly appointment. Certain platforms enable you to communicate through text message, chat room, e-mail, or video conferencing at times when you need to seek assistance outside your regular therapy session.

Effectiveness

One question you may have is whether or not online counseling works as well as in-person therapy. Although research into teletherapy is still in the early stages, the evidence appears to indicate it can be as effective as conventional therapy for most problems. One area of concern frequently cited by therapists is the inability to see a client’s body language. The therapist does not have access to physical cues (e.g., leg bouncing) that may inform their assessment.

Cost

It is difficult to give a blanket answer as to which type of therapy costs more. It is complicated. Traditional therapy is usually charged per office session. Any interaction outside the session may incur additional costs. Teletherapy, however, may be offered per session or as a package. For example, a company like Talkspace offers packages that include different types of therapist interaction, including texting and live video sessions. The more live sessions, the higher the cost. Therapists in private practice who offer both in-person and teletherapy may charge the same amount for each type of session. However, a therapist who does not have an office may charge less because they don’t have all the associated costs of a renting a physical office space.

Insurance Coverage

Insurance companies almost always cover in-person therapy, although they may limit the number of sessions depending on your plan. They will also usually cover live virtual sessions in the same way. However, if you receive therapeutic services from an online company, such as BetterHelp, that may not be covered. Although you can still pay out of pocket, that can be expensive, especially on an ongoing basis. Still, if your therapist doesn’t take insurance, online therapy may be a cheaper alternative.

Therapist-Client Relationship

For some people, an online relationship with a therapist just does not feel the same as seeing someone in person. Certain people may have difficulty emotionally connecting with their therapist through phone or video. It feels less intimate. Because the therapeutic relationship is so integral to the success of therapy, it is an important consideration.

Distraction

In a related vein, it is much easier to get distracted during online therapy. Are you going to be able to concentrate for a full session when your phone, TV, and family members may be nearby? Also, you may wonder if your therapist is paying close attention when you can’t be sure what they are doing off camera.

Teletherapy May Not Be Right For Certain Problems

If you are having serious difficulties (e.g., suicidal thoughts) teletherapy may not be right for you. It can be much more difficult for a therapist to assess a person accurately if they are not in the same room. Additionally, if a crisis arises, counselors will frequently want to be able to deal with those situations in person. Further, certain types of therapy may not be conducive to online counseling. For example, if you need exposure therapy, that is more difficult to administer remotely.

Traditional or Online Therapy?

When choosing whether to pursue in-person or online therapy, there are a lot of moving parts. What is good for one person may be a poor choice for another. If you value convenience, online therapy is for you. If you want a more intimate environment, free of distraction, in-person therapy is the better option. Whatever your decision, you can rest assured that both types of therapy are effective. The important part is that you are seeking help and trying to better yourself. You can never go wrong with improving your health and well-being.