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Online v Face-to-face therapy

Many people are wondering whether they are better off choosing face-to-face therapy over online now that things are opening up a bit more after all the lockdowns. But what are the pros and cons of each method?

Pros of online:

  • Research seems to show that for many problems CBT online can be as efficacious as it is in person, especially for anxiety and depression.

  • It is easier for clients to access, you do not have to travel

  • People often feel more comfortable in their own environment.

  • Client and therapist, have to work a little harder and engage more fully online which makes it a more collaborative experience and I think can enhance the therapy. Online does feel a bit different, because you are down to two senses, visual and hearing it can be quite intense but that does make it a very powerful form of therapy.

In my experience I really enjoy working on Zoom and find the therapeutic relationships just as strong as when I work with clients in person. We can do exercises such as breathing and relaxation exercises and behavioural experiments just as effectively online as face-to-face. For some people, being in the environment where they most experience their difficulties helps them to get to the heart of the problem and find solutions in real time. When you learn a new piece of information, it is easier to recall in the environment you learnt it in. For example if you revise for a test with a sprig of rosemary on your desk, then the smell of rosemary can help you recall the information you revised in the exam situation. This works for therapy too. if you gain a new insight in therapy in your own living room then it will be easier to remember and integrate into your life, as you will have reminders in your environment.

Pros of face to face:

  • For some people their homes are not private places and they need the privacy and space of a therapy room.

  • Others may not have the wifi connection or technical know how needed to be able to relax on line.

  • For people with more complex problems it is better to have that more natural therapeutic environment where broader body language cues can be picked up and safety can be monitored.

  • You have some thinking time travelling to and from the session which gives you space to process what you have discovered about yourself.

In my view there is no right or wrong way to access therapy, online or face-to-face seems to make no difference to the outcome. It is a matter of personal situation and preferences. What is important is the therapeutic relationship that you build with your therapist which enables you to safely look at your problems and discover ways to resolve them.

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