Prior to Covid 19 I conducted therapy in a traditional face-to-face format for over a decade. When the pandemic started I was nervous to start offering online therapy; Would I be able to read people’s body language and shifting emotions? Would I be able to create the same sense of connection and safety? Would clients be as engaged? After having a year and a half of experience offering online couples therapy, here are some of the pros and cons I have found:
Perhaps the biggest advantage of online therapy is convenience. Previously, in order to see a therapist, an appointment had to be booked weeks or perhaps months in advance, depending on one’s schedule. Plus, there was the issue of getting to the office. This might not be an easy task for people that don’t have reliable transportation or must rely on taking multiple forms of transportation. With online therapy, you don’t have to leave your home. All you need is a device to engage with the therapist and internet connection.This also allows for more flexibility with scheduling. Some clients are able to take a lunch break and fit in an online therapy session. Meanwhile, therapists are able to offer more session availability thanks to not having to include travel time to and from the office.
Couples with children may be able to avoid the need for a sitter by being present in their home with the children or (hopefully) by finding times when kids are in school.
Couples may meet with their therapist even when geographically separated due to work-related travel or other circumstances.
Reduced Privacy Concerns
For those in smaller communities or those concerned about being seen coming or going from a therapist's office due to fear of stigma, online sessions provide greater privacy.
Traffic-Related Stress and Travel Time
Many couples sessions tend to be scheduled for after typical work-day hours, resulting in heavier traffic and more stress just getting to a therapist's office. Sometimes the hassle of getting to a therapist’s office can feel as though it outweighs the benefit of therapy.
For Disabled Persons having to navigate issues such as chronic pain, wheelchair accessibility, visual or hearing impairments, getting to an office can be a tiresome task. A pro for technology is that it provides more accessibility for people with different limitations.
Online Therapy can also help bridge the rural-urban divide when it comes to mental health. People who live in small towns or very rural areas may not have a therapist where they live. Or the nearest professional might be several hours away. With online therapy, these people have the opportunity to access treatment that they might not otherwise receive. This also translates into saving both the time and money that they would have otherwise spent getting to a therapist.
(Dis)Comfort Level with Technology and Technological Glitches
Of course, there are downsides—perhaps the most obvious being technological glitches such as problems with the video chat platform or inconsistency in internet connection strength. As to be expected, frozen screens, echoing, low-resolution video feeds, and dropped calls are not conducive to the therapeutic experience.
How comfortable someone is with technology can also be a determining factor when weighing the pros and cons of online vs. offline therapy. Younger generations are often more comfortable interfacing with technical devices. Hence, chatting with a therapist online could be less stressful for young people when engaging with the therapeutic process. Whereas older generations may generally be more comfortable talking with a therapist face-to-face.
Therapy is not just a place to process emotions, it’s a place to form a connection, to practice communication, and to be in the presence of another human being. For some people video conferencing can feel less intimate and cannot replace the experience of talking to someone face to face.
In cases of domestic violence or severe crises online therapy may not be the right fit. It may be difficult for someone experiencing abuse to talk apart from their partner or to find a safe place in their home to have individual therapy. It can be more challenging to read body language on the part of the therapist, or to see other signs of abuse that may be more clear when in person.
Less Information for the Therapist's Assessment
During a live video couples’ session, it is usually just 2 faces that can be seen on the screen. The therapist cannot see the partner’s nonverbal reaction to the person in distress. When one is clearly upset, does the other reach out with some gesture of affection or compassion? This type of information provides a clue to their general responsiveness to each other.
Accessibility and Privilege
Many communities that are in dire need of support do not have the financial means for phones (or phones with video capacity and unlimited minutes) or pricey internet packages. Some people do not have the luxury of private space to talk in their homes, or even homes at all for that matter. Those with young children that are not in school and not ready to be independent for an hour can’t always afford childcare. While online therapy is more accessible for some, it is less accessible for others.
As you can see, online therapy, like traditional therapy, is imperfect. Is it better or worse than in-person therapy? I’d say that depends on perception. Does it have limitations? Sure. But most importantly, the integrity of the therapeutic relationship is not reduced in any way because we are connecting through a screen. Rather, people often tell me that their online experience has been more pleasurable than their previous in-person therapy.
The experience of online therapy is apparently a reinforcing one; otherwise, it wouldn’t be a rapidly expanding means of providing and receiving therapy. However, I leave it to you to decide if teletherapy is the right fit for you. There is certainly more to say about this emerging field, but the parts I’ve shared are the ones that have influenced me the most.