Can Online Therapy Replace In-Person Therapy?


Over the past decade, the world has become more aware of the need for mental health solutions. In response, we have seen the rise of tech startups offering online therapy or virtual counseling. This is touted as an alternative to traditional in-person therapy. It has also been met with skepticism by some mental health experts.

The online therapy space was already blooming, but the pandemic led to an even bigger boom. During the pandemic, people could no longer see therapists in person. At the same time, more people needed therapy than ever before to manage the collective trauma.

Now, with life having returned to a semblance of normality, online therapy has retained much of its popularity. Is this sustainable? If so, should we be concerned about it potentially replacing in-person therapy?

How does online therapy work?

Online or virtual therapy can refer to a number of things. In a broad sense, it encompasses any therapy that occurs via an online medium. In other words, if you have been seeing a therapist in person for a few years and start seeing them via video call when coming into the office is inconvenient, that is online therapy. However, that is not what we are going to focus on.

Instead, when we speak of online therapy, we’re referring to the many websites and online platforms that offer voice or video therapy as a primary mental healthcare solution. These websites are not marketed as substitutes for in-person therapy. Rather, virtual guidance is presented as an ideal approach to therapy.

When we look at what online therapy offers, this starts to make sense. Online therapy is not just a glorified version of Zoom. It actually provides a process to onboard new clients and pair them with the best possible therapists.

The Online Therapy Process

Online counseling platforms begin the process with a simple online sign-up. You enter your personal details, expectations, the concerns you hope to deal with, your experience with therapy, and other relevant information. You can also provide details of your insurance so the platform can confirm that they accept it.

Once your profile is set up, the therapy website provides you with a list of recommended therapists. They will be matched as closely to your preferences as possible. You can choose the therapist you think you will connect with best. However, your decision does not need to be final. If you find that the therapist does not meet your needs, you can switch to another therapist.

This is actually a major advantage to online therapy. In the past, many people have stuck with therapists who were not the right fit because of the financial and time costs of finding someone new. With online therapy, you have no reason to stick with the wrong therapist just because you have done a session or two with them.

Potential Benefits of Online Therapy

But we would be remiss if we only mentioned the administrative side of online therapy. Proponents of virtual therapy do not simply recommend it because it is convenient and accessible. Rather, they claim that it might actually be better than in-person therapy.

There are a number of reasons for this. For some people, seeing a therapist in person is more inhibiting. While the therapist has the advantage of observing the person’s body language, that in itself can lead the person to draw inwards and exert greater control over their body. When there is a screen between therapist and client, they feel more at ease and can share more freely.

Online therapists have also expressed the benefit of having clients describe what is happening in their own bodies rather than the therapist observing it. The online setting requires clients to look inside and connect with themselves for this reason.

Finally, many people unintentionally use the time getting to their therapist’s office and waiting in the waiting room to ‘prepare’ for therapy. They think about what they are going to say and how they are going to say it, instead of expressing whatever comes to mind. People generally come to online therapy when the session starts, not giving themselves the opportunity to curate their thoughts.

On paper, the above all sounds great. However, there are naysayers, and their concerns should be addressed.

What are the downsides of online therapy?

No matter how a therapist and client approach online therapy, there are certain aspects in which it will differ from in-person therapy. As we mentioned before, it is more difficult for the therapist to observe body language. While this may improve the experience for some clients, it can be a barrier for people who struggle to get in touch with their bodies.

The lack of in-person contact can also impact the outcomes for certain people. Someone struggling with social anxiety can benefit from meeting their therapist in person, as it provides a kind of practice for real-world social scenarios. The online setting can provide a way for people with social anxiety to avoid facing their anxiety head-on.

Some mental health experts also cannot get behind the idea that meeting someone online can ever be as potent an experience as meeting them in person. They see great value in connecting with people in the real world – value that cannot be replicated in online sessions.

These concerns are all valid. But do they outweigh the benefits mentioned? Are they reasons to disregard online therapy as a primary treatment?

Does online therapy stand up to scrutiny?

The good news is that we don’t have to rely solely on speculation. A fair amount of research has been done into online therapy, both pre- and post-pandemic. Most of the research supports the validity of online therapy as a primary treatment approach, finding it as effective as in-person therapy.

There are some caveats. One study found that distractedness was more of an issue reported by therapists when therapy was carried out online. That same study found indications that a therapist’s negative attitudes towards online therapy could negatively impact the efficacy of online therapy. There can also be a learning curve for therapists new to online therapy which can lead to them being less effective during their first few months.

So, online therapy is as effective as in-person therapy in most cases. Does this mean it will replace in-person therapy?

Will online therapy replace in-person therapy?

For now, there is no reason to believe that online therapy will replace in-person therapy. There are still many therapists and clients who simply prefer to see each other in person. In other words, online therapy theoretically can replace in-person therapy, but it is unlikely to do so.

However, the evolution of the internet could change that. It is widely thought that we are on the verge of the widespread adoption of Augmented Reality (AR) and Virtual Reality (VR). AR and VR could effectively replicate the experience of the therapist’s office in future. At that point, online therapy may resemble in-person therapy enough for it not to matter at all.

That said, we are still a long way from full-dive AR and VR. For the foreseeable future, online therapy and in-person therapy will co-exist.

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