Online or In-person Therapy? How to Find Your Best Fit

Therapy transformed this spring. The traditional therapist’s office changed from the waiting area and the couch-with-Kleenex-therapy-room we all know, to meeting on screen at home. As therapy offices open, you have more choices to start, continue or return to therapy in-person or continue online. Both have advantages. How do you decide?
Online care isn’t for everybody. If your therapist or soon-to-be-therapist is giving you a choice, it means what you’d like to work on can be achieved in your space or theirs. There are few factors to consider. Below are some questions to help you assess whether in-person or online therapy is the best fit for you.
How comfortable are you with technology?
While online therapy doesn’t take a lot of IT skills, you may need to sign consent forms electronically and will log onto a website for your appointments. Your therapist can walk you through the process. If this seems like a hassle, traditional face to face therapy may be more your speed. If Zoom, Skype, and FaceTime are no problem at all, then online therapy will feel pretty normal.
Is your technology reliable?
Online therapy requires a computer, ideally, or phone with a camera and microphone. If your tech glitches all the time or hasn’t been updated, you’ll likely find online therapy frustrating. You’ll also need reliable internet. Are you streaming with no issues? If yes, you’ll probably have no problems.
Are you staring at a screen all day?
Likewise, if all or most of your work involves looking at a screen, you may not want to see your therapist there too. A change of environment can provide a different external view while you work on your internal view.
Are you comfortable in your space?
Having therapy in your own private comfy spot is awesome. That may be your couch at home, your office chair, or under a favorite tree. If you’re not comfortable at your place, perhaps you would prefer the therapist’s office.
Are you certain of your privacy?
Your therapy time is your time to focus on you, ideally, uninterrupted. If you’re worried about the kids, your boss, your roommate or partner coming in, or they have already popped into the room as you’re virtually visiting, you’re not relaxing. Go with the least stressful option that allows you to be fully present.

Can you be open online?
For most of us, one of three things happens when we get online.
- You become less self-conscious and say and do more than we would in public. If you struggle with opening up or have social anxiety, online therapy may be a helpful fit, at least at first.
- You clam up because the other person doesn’t seem real. Therapy works because of the connection between the therapist and the client. You want to feel like your therapist is someone who understands you. If you find it tough to connect online, in-person therapy may more useful, especially in the beginning of your work together.
- Or finally, you’re a mixture depending on the situation and the person. Your working relationship with your therapist is something to be discussed when you begin therapy and then periodically as you go along.
Your original choice to do or not to do online therapy doesn’t have to be your final choice. Even with preparation for your online sessions, you might want to have a mix of online and in-person appointment or forgo online work all together.
What are your needs?
Be honest with yourself about which choice fits better for your goals. For example, if you struggle with depression and find it easy to stay home and be alone, heading into your therapist’s office may be helpful for you. You will need to get up, get dressed, and get there. You may have some interactions along the way that help your mood. Or, if you have a super busy lifestyle and often remember where you’re supposed to be at the last minute, online therapy appointments may be easier.
How much transition time do you need?
When you drive to therapy, you get time afterwards to be alone, to think about what was said, cry, journal, breathe or laugh. Online therapy eliminates the drive time but also the alone time, unless you build it in. If you know you’ll want time after your session, consider in-person therapy or be sure to set aside time after your online visit before you head back to work or your family.
Both in-person and online therapy are effective ways to support you and your health and help you reach your goals. Considering your needs, your space and your technology can help you make the best decision.