In-Person Therapy vs. Online Therapy (I’ve Provided Both) – Here’s What I’ve Learned
I’ve been a therapist since 1995, and over the years I’ve seen the field change in remarkable ways. When I first started, therapy meant sitting together in an office—two chairs, a box of tissues, and a quiet space to talk. Fast forward to today, and many of my sessions happen online.
Having worked with thousands of individuals and couples in both formats, I can tell you that each has its own unique strengths. The best choice really depends on your personality, lifestyle, and what kind of connection helps you feel most supported.
Here’s what I’ve learned from three decades of experience offering both in-person and online therapy.
1. Connection and Presence
In-person therapy offers a certain kind of closeness that comes from sharing physical space. There’s something powerful about sitting across from someone, noticing subtle cues like non-verbal communication and physical closeness. Many people find that this in-person energy helps them feel grounded and safe.
But I’ve also witnessed how deeply connected people can feel online. Once the session starts, the screen almost disappears. I’ve had clients tear up, laugh, and experience major breakthroughs over telehealth. Research confirms what I’ve seen firsthand: the quality of the therapeutic relationship—the most important factor in successful therapy—is just as strong online as it is in person.
2. Convenience and Accessibility
Online therapy has opened doors for so many people who otherwise might not have been able to attend sessions. There’s no commute, no parking, no need to take a full morning or afternoon off work. For couples balancing busy schedules, or parents trying to coordinate childcare, the flexibility can make a big difference.
In-person therapy, on the other hand, carries a certain ritual that some clients really value. Leaving the house, walking into an office, and entering a calm, private space can create a mental separation that helps you focus and be fully present. Simply sitting in a waiting room can help you gently transition from the outside world into a space of self-growth.
Overall, online therapy offers more convenience, while in person counseling offers a change in environment.
3. Comfort and Privacy
Privacy looks different in each format. Our offices are designed to feel safe and comfortable, but some people feel self-conscious about being seen in a waiting room. When I first started doing therapy in the mid nineties, we had a separate door to enter and exit so that people were less likely to be seen. Over the years there is less and less stigma connected to seeking help, but for many it is still a consideration.
Online therapy allows you to stay in the privacy of your own home—which can be wonderful if you have a quiet, comfortable space. If you share your home with others, though, you may need to plan ahead to make sure you won’t be overheard. (Many clients use white noise, cars, or even a parked space outside their home to create a little private “therapy corner.”)
Overall, it has been my observation that tele-medicine provides a less confidential environment. It isn’t uncommon for a family member to accidentally interrupt a session. This can be extremely jolting during a moment of vulnerability or deep insight.
4. Technology and Environment
When therapy moved online in 2020, I quickly learned that technology can be both a gift and a frustration. A strong internet connection and good lighting go a long way—but I’ve also had sessions where a frozen screen led to shared laughter and a quick reboot. Most of the time, it’s smooth and seamless.
For clients who suffer from depression or anxiety, it can be easier to keep an appointment with a therapist as it can be challenging to get out of the house. For some individuals, online therapy opens a door that might not otherwise be available.
Many of my clients feel like they spend a large amount of their days in front of screens, and they complain of eye-strain, sitting all day, and in some cases they feel addicted to their phones.
In-person sessions remove those variables. My office is intentionally designed to be a calming space—with soft lighting, cozy chairs, and no distractions. It’s a tech-free zone where people can take a breath and just be.
5. Location and Licensing
One important factor that often gets overlooked is location. Therapists are licensed by state boards, depending on our discipline, some of us can only provide online therapy to clients who are physically located in the state(s) where we’re licensed at the time of the session.
For me, that means my license is active in Pennsylvania. I’m able to provide telehealth sessions for clients located anywhere within the state.
If you live in New Jersey, Delaware, or Maryland, I unfortunately can’t see you online unless you’re physically in Pennsylvania during the session—but many clients from nearby states choose to drive in for in-person therapy or schedule intensive sessions that make the trip worthwhile.
It’s always worth checking your therapist’s licensure status before beginning online work, since laws vary from state to state.
6. Effectiveness
After seeing hundreds of clients in both settings, I can confidently say that online therapy works. Study after study supports this, and my own experience matches the data. Whether online or in person, when there’s trust, empathy, and commitment to the process, meaningful change happens.
That said, there are some situations where being physically together is ideal—particularly when we’re doing body-based grounding, deep emotional processing, or work that involves noticing subtle physical cues between partners.
My Takeaway After 30 Years
Both formats have incredible potential for healing. What matters most isn’t whether therapy happens in a room or on a screen—it’s the relationship we build and the courage you bring to the process.
Some of my clients even blend the two: meeting in person for deeper sessions and switching to online when life gets busy. That kind of flexibility can keep therapy consistent and effective over the long haul.
That said, I’ve found that most of us tend to have a personal preference. Many of my clients prefer online therapy due to the flexibility it provides and decreased commute time. I am quick to say that I am old school and prefer to work face to face. I like knowing that we have telehealth as an alternative for clients with accessibility challenges, car trouble, or sick children, but I like to be in the room sitting next to my clients. I have wheels on my chair, which is also an added bonus 🙂
If you’re wondering which format might be best for you, we’d love to help you decide.
At Main Line Counseling Partners, we offer both in-person and online sessions for clients across Pennsylvania. After nearly 30 years in this field, I’ve seen therapy work beautifully in both formats—and I’d be honored to help you find the one that fits your life best.
👉 Schedule a free consultation to get started.
Takeaway
Both online therapy and in-person therapy offer unique strengths—online therapy offers convenience and accessibility, while in-person sessions provide powerful presence and focus. The best choice depends on your comfort, location, and what helps you feel most supported in your growth.