How to choose between online and in-person therapy

The COVID-19 pandemic brought about a massive increase in demand for telehealth services like online therapy. As of 2021, about 38% of Americans were using telehealth services to meet with a medical or mental health professional. 

This convenient option has expanded access to critical supports at a time when many people are experiencing mental health challenges. But while teletherapy has been proven to be just as effective as in-person care in many cases, it isn’t necessarily right for everyone. In the following guide, we’ll explore some questions that can help you decide which treatment approach is best for you. 

What type of connection do you seek with a provider?

You can still build a strong, trusting relationship with your provider if you meet remotely. But it’s OK if you prefer to see your therapist in person. Some people may find that it’s a little easier to connect with their provider when they’re in the same room, and there’s nothing wrong with that. 

You can also request occasional in-person visits if most of your sessions are virtual. Depending on your provider’s location and availability, that may be a helpful option.

Do you have scheduling or transportation constraints?

One of the added benefits of teletherapy is its flexibility. For example, some teletherapy providers may offer evening or weekend appointments. If you have a tight schedule, work odd hours, or don’t have access to transportation, it may be more convenient for you to attend therapy online. 

Teletherapy can also expand your provider search. If you’re not limited to seeing a therapist in your immediate area, it might be easier to find a good fit.

How comfortable are you with technology?

Teletherapy providers use HIPAA-compliant video conferencing software to meet with their clients. If you’re not familiar with this technology, it can be a little intimidating. Rest assured, your provider can help you prepare for remote sessions. This may include downloading an app, testing your camera and speakers, and ensuring that you have a strong Wi-Fi connection. 

But if learning a new technology feels like a barrier or makes you uncomfortable, it’s OK to choose in-person care instead. 

Do you have a private space to attend remote sessions?

In traditional therapy, you usually meet with your provider in a private office or other professional treatment setting. These spaces are designed for confidential conversations. But if you attend your therapy sessions remotely, you may not have the same guarantee of privacy. And that can make it harder to open up. 

For example, if you don’t have your own room or you have roommates who might interrupt your appointments, you may be more comfortable seeing your therapist in their office. On the other hand, if you’re interested in couples or family support, teletherapy can make it easier for people who may not live or work in the same location to attend sessions together.

Are providers in your area accepting new clients?

The U.S. is facing a nationwide mental health professional shortage. This means that many people in rural or other underserved areas can’t access mental health support in their community. The shortage is also causing long wait times. So even if you can get an appointment with a local therapist or psychiatrist, it may be months away. 

If you’re facing any of these challenges, teletherapy can help you connect with a therapist outside of your immediate geographic area. You just need to verify that the provider is licensed to work with clients in your location.

What are your symptoms?

Common mental health concerns like depression and anxiety are frequently treated via teletherapy. But there’s limited evidence of telehealth’s effectiveness on less prevalent conditions like bipolar disorder or schizophrenia. In addition, sometimes safety issues can be harder to detect and address remotely. 

So if you’re in crisis or experiencing severe mental health symptoms (like suicidal thoughts*, self-harm, or other unsafe behaviors), it’s usually better to see your provider in person. 

*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. Any of these resources will ensure that the person in crisis receives support right away. For more information on getting help, go to 988lifeline.org

If experiencing a life-threatening emergency or you need immediate help, please call 911. 

What type of therapy are you interested in?

Some types of therapy are more experience-based than others. For example, somatic methods are designed to enhance the mind-body connection, and creative approaches (like art or music therapy) usually involve some form of guidance from the provider. These therapies can be effectively used in teletherapy. 

But depending on your preference and your provider’s recommendations, you may wish to engage in experience-based therapies in person.

Clinician's take

One factor people often overlook when deciding between online and in-person therapy is how much their physical environment affects their ability to open up. Some people feel more at ease talking from home, while others need the separation of a therapist’s office to help them shift into therapy mode.

Ashley Ayala, LMFT

Clinical reviewer

Find care with Rula

Some people might prefer the convenience of teletherapy — especially if they’ve had trouble finding a therapist in their area. Others might prefer to connect with their providers in person or to use a combination of both options. But when it comes to choosing between online and in-person therapy, what matters most is finding the format that works for you. 

If you’re unsure which option might be best, consider the pros and cons of each approach and remember, you don’t have to make this decision alone. You and your provider can discuss your needs and preferences, and they can help you select the treatment style that’s right for you. 

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.