The Differences Between Online and In-Person Therapy

(Note: The words “therapist” and “counselor” are used interchangeably, as well as “therapy” and “counseling”)

If you were thinking of trying therapy for the first time and wanted to know if in-person or online therapy will suit you, this is it. If I could sweeten the deal, I want you to know I am a therapist and have been on the receiving end of both methods.

You might think with our wealth of knowledge in treating mental illness we’d be able to therapy ourselves out of our ruts. But alas, we, like many others, sometimes need a helping hand too.

I began in-person therapy at the start of 2016 while studying for my bachelor’s in psychology, and after two years of therapy sessions, I mutually agreed with my counselor I was well-equipped enough to continue life without her help.

After completing my Master’s degree in Mental Health Counseling in May of 2019, I went through some life experiences in March of 2020 that led me to seek out therapy once more. However, because of the pandemic, I enrolled myself in online therapy through an app called BetterHelp.

From both experiences, I got the help I needed. Whether you read this out of sheer interest or for better insight, I hope my academic background and personal experience can bring you a heightened understanding of the major differences between these two mediums of therapy.

Let’s begin.

1. Pacing

In-Person: Typically once-a-week, in-person therapy is routinely executed so you’re not constantly relying on your therapist. This isn’t to say you cannot contact them between weekly sessions, but a week is an ample amount of time to make your progress and for new events to arise. I enjoyed this, though there have been moments where I wish I could have gone to therapy twice a week. This is the usual pace for in-person therapy, though every person’s needs may vary.

Online: Depending on which therapist you are assigned, many will mention their schedule to you before starting. The therapist I had did not work on Wednesdays or Saturdays. On all other days, I could expect them to respond in a timely fashion.

In a way, online therapy feels like it’s happening almost every day. I ask my questions, they ask me questions, and we essentially text each other back and forth. Other therapists may also include a 30 to 45-minute video or phone session weekly, which helps add to that feeling that therapy is frequent online.

If you like the idea of knowing your therapist could respond to you almost every day, online therapy is ideal. Those who like giving it their all once a week and having the other days to themselves should see in-person therapy as the best option.

2. Convenience

In-Person: Maybe it was the therapist I had, but I could only reach my therapist via e-mail and during our weekly sessions. The boundary was made clear from the beginning. I need to make the effort to use the skills I was taught from therapy in the real world. If I had problems with it, I would write it down in a journal, then bring it up in my next session. For the most part, seeing my therapist happened when I physically saw them.

Every therapist does their work differently. Some may allow you to text them, and others would prefer you call. What is certain, however, is your next session with them. The therapist you see in-person will keep you in-the-know about if they will be seeing you next week, or if there is a schedule change. They also tend to be flexible if your schedule changes, too.

Online: I’ll be up-front: online therapy is absurdly convenient. I can reach out to my therapist at any time. As long as it’s not their day off, they will respond in a timely fashion. What’s more, is I don’t have to worry if I’m bothering my therapist! Sure, I may not be able to video-call them frequently, but I sure can reach out at any time.

If an issue arises and I am unsure of how to handle or cope, I can reach out. If I experienced something and want to go over it, I can tell them. If I went to let my therapist know I feel like I’m making progress, I’m more than welcome.

Online therapy is easily the most convenient form of therapy there is.

3. Emotional Depth

In-Person: I have had the luxury of being able to cry during my in-person sessions with my therapist. Done correctly, crying can be a good thing in therapy. It can be even better if it’s happening in-person.

In-person therapy allows you and your therapist to see each other face-to-face in (duh). While this sounds obvious, being physically there is a key element of therapy. Everything happens in real-time. Your therapist will be able to see your every fidget, every look away, and every move you make. And because of this, your therapist can better understand you as a person.

It’s impossible to have 100% accuracy when it comes to knowing the tone behind exchanged text messages with your therapist. Some of us use periods at the ends of our sentences when we’re being serious. Other times we simply break all grammatical rules. If you have an in-depth conversation over text with your therapist, it is possible one of you may misunderstand each other.

In-person therapy will negate this possibility.

Online: Amid my palpable anxiousness, online therapy had the least effect. I will occasionally struggle with chest pains which terrify me, leading me to think I’m having an impending heart attack. In reality, I’m overly stressed over something, dehydrated, and not sleeping well. What helps me best is if someone tells me I’m going to be okay, or a gentle rub on the back.

If you see yourself being able to self-soothe and cope with strong emotions on your own, online therapy will be able to handle the rest. At the heights of anxiety and depression, the most I have been able to do to evoke a response from my therapist is to tick off the “Urgent” checkbox in my next message. For others who experience suicidal thoughts, many platforms will recommend you reaching out for help immediately instead of waiting for your therapist to respond.

While online therapy may have its convenience factor, it lacks in the ability to reach the emotional depth that in-person therapy excels best.

4. Affordability

In-Person: Therapy can be absurdly expensive. However, it can also be very affordable. I have heard stories of colleagues and friends who attend therapy, and sessions being as low as $20 each. On Quora, I’ve read stories of sessions being as low as a dollar. Others can cost hundreds — thousands, even — which can make therapy seem like a luxury. It doesn’t have to be.

When searching for in-person therapy, you can ask therapists over the phone if they function on what’s called a “sliding scale.” This means therapists will assess your current financial circumstances, and then provide you an estimate of what your sessions may cost per week. You could also see if your therapist accepts insurance, too.

Online: When I first did online therapy, I noticed you could input your current status (student, unemployed, part-time, full-time, etc.), which helps the app decide what you will pay. I was paying somewhere around $35 a week. It was difficult, but not impossible.

With that price in mind, I made sure I was getting the most out of what I was paying for, which meant:

1. Asking the right questions for myself
2. Rigorously applying the skills and suggestions given by my therapist
3. Responding to my therapist whenever possible

After some month’s time, I was able to correct the habits contributing to my anxiety. I also continue to work on making peace with my current circumstances than to devote energy fussing over them. Many people are struggling mentally during these times, which affects their emotions and their physical well-being. Both avenues have their means of making themselves more affordable. Therapy doesn’t have to cost so much — and it shouldn’t.

If you’re considering therapy, let this be one more article in favor of you doing it. Anything is better than nothing.