In-person vs. Online Counseling
Every counselor I know believes that both in-person and online counseling can be effective, and the research bears that out as well.
There are some studies that show very small and particular differences that people can kind of nerd out about (for example one paper has shown that online clients are slightly more satisfied with treatment than in-person clients, but both groups were equally satisfied in relationship satisfaction, and success satisfaction. Another paper showed in-person was slightly more effective in addressing what they call psychological distress, and more effective in life satisfaction, but both papers found that both methods worked well overall). Again, it gets pretty granular pretty quickly, but the main takeaway for me is that both work.
Since both methods are effective, it’s really all about what you think will work best for you in your individual situation, taking into consideration your individual preferences.
Here are a few things that people consider advantages about each option that may appeal to you.
Benefits of In-person Therapy
The Energy
For some people, they just find there’s a kind of particular, difficult to describe ‘energy’ or ‘presence’ about actually being together, in person, that doesn’t happen online.
Again, it’s super hard to describe and put your finger on exactly what it is. I think part of it is that there’s something comforting about being able to see the counselor’s entire body language the whole time. I think there’s something that often feels more real about in-person because, well, it is real instead of a screen. Some people really just prefer that.
It’s not just Seniors that grew up without the internet…lots of clients of all ages just prefer the kind of particular energy of being sitting across from a person in real life. For many people COVID was the chance where we learned that we could function with zoom meetings and still get the job done…but…it was also the time that we realized that we crave and value human to human real-life interactions.
The Commute
It seems strange to say, but many people actually like having to drive to and from a counseling session.
That time in the car can be really important to help you gather your thoughts about what you want to talk about on the way to the session, and then serve as a kind of decompression time and buffer after the session when you’re driving back home or to work or wherever they’re going next.
Sometimes it can be kind of jarring if an online session ends on a particularly emotional note to then open up the bedroom or office door and immediately walking into a work meeting or a conversation with a family member.
I see my own counselor through telehealth because she lives in another city, and often have no buffer time at all from my own counseling session into a new session with a client. I have found that I often hold back emotionally from going further than I would like to in a session because I’m aware that I will have absolutely no time to process what I bring up before going into another session. A brief 10 or 20 minute drive to get ready for and process a therapy session can really be helpful.
The Privacy and Confidentiality
Not everyone has great access to their own space where they can have an online session.
Frequently during COVID when people were locked down at home with their family they would try to have virtual therapy sessions, but find difficulty accessing a space to have the virtual session where they would not be interrupted or overheard by others.
Sometimes a family member they needed to talk about in therapy was in the room next door and they didn’t know if they could hear them or not, or sometimes a child or roommate would barge in asking for something, making the whole situation difficult for the person to really share honestly and openly.
A counselor’s office in person is a safe and confidential space where you won’t have to worry about maintaining privacy, anyone overhearing you or anyone barging in unannounced.
The Office Vibe
Most counselors put a lot of intentionality into creating a space that will make you feel comfortable and safe, and believe the actual design of the space can be part of the healing that occurs during the therapy session. The lighting, the artwork, the colors, the seating, the plants, the use of religious or spiritual symbols, the use of sound or water…it all comes together to create a therapeutic atmosphere.
It may sound funny, but I remember professors in graduate school spending a pretty significant amount of time talking about and thinking through the effects of the counseling space to create an atmosphere conducive to trust, safety, and healing. It just feels good to be in the counseling office, and you may not be in a space that creates that same atmosphere if you are seeing the counselor virtually.
No Bad Connections
One of the cons of online therapy is that bad connections really can make a counseling session more difficult. Imagine opening up and sharing something that you’ve never said to anyone else in your entire life because it was so personal to you and you’re nervous how the counselor will respond to you sharing this part of yourself.
Meanwhile the counselor doesn’t hear it because there’s a bad connection and starts saying “are you there? Can you hear me? Sorry, can you repeat that?”. You take a breath, and say it again, and you get no response. Your mind starts racing…are they upset? Are they disgusted? Are they disappointed?...But then you notice that there’s just a bad connection and they’ve been frozen the whole time. They log off. In a couple minutes they’re able to log back on and the connection improves. “I’m so sorry, where were we?” the counselor asks.
A bad connection in a virtual session can really interrupt the moment.
Benefits of Online Therapy
Great for Rural Settings and Niche Therapists
If you see a therapist online, you are no longer limited by who you can drive to within 20 minutes of where you live. If you live in a rural area, or an area where there is a shortage of therapists in your community, this can give you access to mental health care professionals that wouldn’t be possible with in-person counseling.
It also can give people access to therapists with a particular specialization or niche, that, even if you live in a large city you still may not be able to find within driving distance.
A year ago, for example, I knew I wanted to find a therapist that was an expert at a particular kind of therapy that is just starting to become popular. There literally wasn’t a single person at the time in my city with almost 300,000 people who was certified in this kind of treatment and took my insurance. I was able to find a therapist who lived in a totally different city who actually trains other therapists in this method, and started my own individual therapy with her!
Access to this kind of specialization can really only happen online.
Easier to Work into Your Schedule
Seeing someone online can be much easier for some people to work into their schedules than an in-person session.
Without the commute time, a 50-minute online session can easily be taken during a lunch break if you have your own office or work from home, allowing you to not take any time off work and still take care of your mental health needs. Even if you don’t have an office or work from home, it’s not unusual for a client to just walk to their car and have the session from the car using their smartphone.
Accessibility
There are many reasons, not just time related, why someone may not be able to drive to a counseling appointment every week. Transportation, childcare, elder care, disabilities, certain anxieties, fears or phobias, or any number of other reasons can keep people from being able to leave where they are and get to a therapist in person. Online therapy can be a great option!
Less Intimidating
For some people, it just feels a little less stressful and scary to see a counselor online than to go somewhere else, enter into the counselors' space, and sit with them in real life. Some people may feel like they can open up more and share things about themselves online that they just wouldn’t feel comfortable sharing in person, and if that’s the case for you, that’s great to know about yourself.
A Hybrid Option
It’s worth mentioning that I have worked with clients who bounce between virtual and in-person sessions from week to week based on their needs at the time. I love being able to offer this flexibility to people, and it really can come in handy for certain people.
In most cases, the individual prefers in-person sessions, but as their schedule changes at work - a meeting pops up they can’t get out of, etc., rather than needing to cancel altogether, they might just switch to a virtual session for the week.
If this is something you would like, know you can always address that with your counselor.
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