Online Therapy vs In-Person: Which Is Right For You?
Here’s what the science, patients, and therapists have to say about online therapy.
Online Therapy vs In-Person: Which Is Right For You?
Here’s what the science, patients, and therapists have to say about online therapy.
January 01, 2024 / Christian Rigg
Online Therapy vs In-Person: Which Is Right For You?
Here’s what the science, patients, and therapists have to say about online therapy.
January 01, 2024 / Christian Rigg
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Online Therapy vs. In-Person: Which should you pick?

Both online and in-person therapy offer opportunities for healing and improved well-being, but they differ in some important ways. It’s important to understand these differences, as different people and different diagnoses may respond better to one or the other.

In this article, we’ll look at the main ways online therapy differs from in-person therapy and when one should be prioritized over the other. We’ll also see what the science says about their respective effectiveness and what professional therapists think about online therapy.

Methods of Communication

Online therapy involves speaking with your therapist remotely, via text or voice message, telephone, or video calling. For some, especially if they have grown up with this technology, it can feel safer and more familiar, making it easier to be open and honest. It also makes online therapy far more accessible, especially for those living in rural areas or who have trouble getting around. All you need is a good internet connection.

On the other hand, some people find the physical presence of their therapist comforting. A reassuring smile or hand can help promote openness and trust. In addition, therapists may be less able to read physical cues or miss out on them entirely. Posture, facial expressions, and tone of voice have all been traditionally used by therapists to aid in diagnosis and treatment.

Good therapy comes down to communication. Whichever you choose, try to be honest, accurate, and expressive with your thoughts and feelings.

Our Top 3 Online Therapy Services

Our top choice
#1
9.8
Outstanding
6305 Excellent reviews on

In a Nutshell

BetterHelp is a 100% online therapy platform, with over 30,000 licensed therapists serving clients globally. The site matches you with a therapist who can help you with issues like depression, anxiety, bereavement, and more. Its standard membership includes weekly 1-to-1, 30-minute sessions, messages, live chat, and group webinars. Prices are affordable compared to traditional therapy, and you can access BetterHelp on any device.

Features

  • 35k+ professional & credentialled therapists
  • Phone, chat, or video counseling sessions
  • Affordable therapy for your mental health
  • 20% off your first month

Pros

  • Quick matching to licensed therapists based on your needs
  • High availability of therapists
  • Caters to a wide variety of groups (LGBTQIA+, Christian, teens, etc.)
  • Change therapists easily
  • Video and phone sessions, live chat, message your therapist anytime
  • Anywhere, anytime therapy with the iOS and Android apps

Cons

  • Standard weekly video sessions are only 30-45 minutes
  • Therapists can’t diagnose illnesses or prescribe medication
  • BetterHelp can’t substitute face-to-face therapy in every case
6305 Excellent reviews on
#2
9.4
Excellent

In a Nutshell

Pride Counseling offers a solution to LGBTQ+ members looking to improve their well-being and life satisfaction. This is the case whether your personal difficulties stem from your sexual or gender identity or not. The inclusive and comprehensive questionnaire and large network usually make for a good match between individuals and therapists, and you can request a new therapist free of charge at any time. The prices are on par with competitors, which is pretty impressive given the specialized requirements of Pride Counseling’s therapists and their familiarity with (or membership of) the LGBTQ+ community. If you’re looking for therapy that takes into account your LGBTQ+ identity, this may be a good solution for you.

Features

  • Fully licensed therapists specializing in the LGBTQ+ community
  • Message anytime, plus live chat & video
  • Financial aid if you meet certain criteria
  • Comprehensive therapist matching questionnaire

Pros

  • Fully licensed therapists specializing in the LGBTQ+ community
  • Message anytime, plus live chat & video
  • Financial aid available for those who meet certain criteria
  • Dedicated iOS and Android apps (contact your therapist anywhere)
  • Comprehensive and inclusive therapist matching questionnaire

Cons

  • No choice of pricing plans or payment terms
  • No phone or chat support for technical problems
#3
9.1
Excellent

In a Nutshell

Talkspace offers online therapy solutions with an emphasis on text messaging as a primary means of engaging with your therapist. For many, this makes for a much more flexible and accessible therapy solution. The standard membership can be a more affordable alternative to traditional therapy. Extra features like a live matching session and the ability to speak with a psychiatrist (to manage medication) also help Talkspace stand out.

Features

  • Easy counselor matching
  • Start your therapy journey immediately
  • Unlimited 24/7 messaging
  • A number of different health insurance plans

Pros

  • Offers personalized matching for clients and therapists
  • Lets you choose your therapist from a list of suggested providers
  • Accepts a number of health insurance plans
  • Service is accessible through some schools and workplaces
  • Provides tutorial videos to show users how to navigate the site

Cons

  • Standard membership only includes text-based therapy
  • Live sessions can be more expensive than other online options

Licensing

Most online therapy platforms rigorously vet therapists and require them to send copies of their accreditations and licensing. However, licensing does differ by state. When choosing a therapist online , you may want to check how their state’s licensing requirements differ from those of your home state.

When Should In-person Therapy be Prioritized?

In-person therapy should be prioritized in cases of serious mental illness, especially if you’ve already been diagnosed with a serious illness like schizophrenia.

If you are experiencing thoughts of self-harm or suicide, or feel that you might hurt yourself or somebody else, online therapy is not an appropriate solution. Immediately call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255) or text the Crisis Text Line (text HELLO to 741741). Both services are free, open 24/7, and completely confidential.

If you live outside the United States, you can find a list of international suicide prevention hotlines here.

Online vs. In-person Therapy: Effectiveness

When online therapy was first introduced, many therapists were skeptical. However, more than a decade of research has shown that online and text-based therapy can be just as effective as in-person therapy. One comprehensive review of the literature found that outcomes for online therapy were on par with in-person therapy and “provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity.”

Patient experience has been found to be just as positive. One study published in the Journal of Telemedecine and Telecare found that “telepsychiatry clients felt that they could present the same information as in person (93%), were satisfied with their session (96%), and were comfortable in their ability to talk (85%); this was similar to the in-person clients”. These patients “demonstrated significant improvements on pre- and post-(intervention) mental health measures”.

There are some forms of therapy that still haven’t been fully incorporated into telemental health, like art therapy and music therapy. However, online therapy has proven to be an innovative field. If you discuss these approaches with your therapist, you may find a way to combine the two.

Bottom Line

Online therapy and in-person therapy differ in a few key regards. The former tends to be more accessible for some, more convenient and may feel more comfortable. In-person therapy is better suited to serious forms of mental illness. Both are effective at improving well-being and have similar outcomes for depression, anxiety, and other mental health problems.

Any therapy is better than no therapy. If you feel you could benefit from therapy or you just want somebody to talk to, you can start by comparing the best online therapy services using our chart and comprehensive reviews .

By Christian Rigg
Christian is a freelance writer and content manager with 6+ years' experience writing and editing content in technology and finance. In addition, he holds degrees in psychology and history, and has written extensively on social psychology, positive psychology and mental health. When he’s neither writing nor reading news or research, he can usually be found gravel biking or hiking somewhere around the French riviera, which he calls home.
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