Teletherapy has forever changed the way we look at mental health care. A couple of years the word “therapy” may have evoked images of a cushioned chair, bookcases lined with medical textbooks, and a therapist in a white coat jotting down notes on a clipboard.
This picture feels clinical, detached, and if we’re to be honest, intimidating. When being vulnerable and talking about something as personal as our mental health, the last thing that we want is to feel like we’re being judged or analyzed.
But now, therapy has taken on a whole new look. We’ve come leaps and bounds in the last decade in decreasing the stigma of counseling. Talking about mental health and seeking professional help is starting to be perceived as normal — even, dare we say, cool.
Opening the floodgates to teletherapy over the course of the pandemic has made getting mental healthcare that much easier. Now, you can sit in the comfort of your home, sipping on some tea in your pajamas, and get mental health care and support. And you don’t need to worry about finding a babysitter, planning your commute, or struggling with the anxiety that might come with seeing a provider in person.
However, teletherapy isn’t for everyone. In this article, we’ll look at the pros and cons of both teletherapy and in-person therapy, then explore the overall benefits of hybrid counseling.
At Ellie, we offer in-person, virtual, and in-home options, so you’re sure to find an option that meets your needs. Call us to get matched with a local provider today.
The Pros of Teletherapy
Many researchers, therapists, and clients vouch for teletherapy—saying that is just as effective as in-person care. And online therapy is typically the same cost as in-person appointments and is covered by many insurances.
Since the COVID-19 pandemic pushed providers and clients to quickly adapt to virtual care, both parties have been singing the praises of teletherapy. There are many reasons why teletherapy has quickly grown in popularity and is here to stay:
Greater Access to Care
Teletherapy (whether by phone, text, or video) has ultimately made mental health care far more accessible. For people in rural areas or those with packed schedules, it removes the hassle of long commutes and makes it easier to fit sessions into their day. It’s also a a great way for parents, caregivers, or individuals with mobility challenges, to get support without the extra logistics. Plus, the flexibility of virtual sessions means fewer barriers to consistent care, which can make a big difference in overall progress.
There’s also something to be said for the privacy and comfort teletherapy offers. For those who feel uneasy walking into a clinic, connecting from home can make it easier to open up. Text-based or asynchronous options add even more flexibility, giving people a way to reach out between sessions. Ultimately, teletherapy makes care more convenient, consistent, and accessible—which is exactly what mental health support should be.
Convenience
Telehealth therapy makes mental health care more convenient by giving patients the flexibility to access support from wherever they are. With phone, text, or video sessions, there’s no need to commute, fight traffic, or sit in a waiting room. This makes it easier for people with busy schedules to fit therapy into their day, whether they’re on a lunch break, at home, or even traveling. It also cuts down on time away from work or family, making it a more realistic and sustainable option for many.
Beyond just saving time, teletherapy also offers more flexible scheduling. Evening or early morning sessions become easier to arrange and allow for asynchronous communication, letting patients reach out when it works for them. The convenience of connecting from a familiar space can also make therapy feel more comfortable, which is crucial in helping clients engage more fully in the process.
Accessibility
Therapist via telehealth offers greater accessibility by removing many of the physical and logistical barriers that can prevent people from getting care. For individuals with mobility challenges, chronic health conditions, or disabilities, virtual sessions make it possible to receive consistent support without the difficulty of traveling to a clinic. Also, as previously noted, telehealth also expands access for those in rural or underserved areas, connecting them with mental health professionals they might not otherwise be able to reach.
Comfort
Teletherapy lets people get support from the comfort of their own space, which can make the whole experience feel more relaxed and less scary (because we get it– taking that first step can feel daunting sometimes). Being at home means clients can curl up on the couch, have a pet nearby, or keep a favorite blanket or drink within reach. That familiar environment can help ease nerves and make it easier to open up. For a lot of people, it’s just more comfortable to have tough conversations in a space where they already feel safe.
Plus, being at home gives patients more control over their surroundings. They can dim the lights, play calming background music, or use noise-canceling headphones—whatever helps them feel most at ease. That added comfort can make a big difference, helping them stay present and engaged in the session.
The Cons of Teletherapy
While telehealth therapy offers tons of benefits, it’s not without its drawbacks. For some patients, the lack of in-person connection can make it harder to build rapport or feel fully understood. Technical issues, like poor internet connections or audio glitches, can also disrupt sessions and impact the flow of conversation. Additionally, privacy concerns and the challenge of finding a quiet, confidential space at home can create barriers to fully opening up. Let’s dive into some of these common issues:
Reliance on Technology
Unfortunately, poor internet access is still a major issue In the United States with about a quarter of households lacking a home internet connection. And this lack of broadband access disproportionally affects people who live in rural areas, and are in a lower income bracket. Additionally, people who are unfamiliar or uncomfortable with digital technology may struggle to use teletherapy programs.
Confidentiality & Privacy
While teletherapy offers convenience, it can also raise privacy concerns for some clients. Finding a private space at home can be a challenge. Clients who live with family, roommates, or children may struggle to have confidential conversations without being overheard. Even with headphones or lowered voices, the lack of true privacy can make it harder for some people to speak openly about sensitive topics.
This is especially concerning for individuals experiencing domestic violence or abuse within their home– they may feel like they can’t be completely honest about what’s happening.
Limited Scope of Therapy
While teletherapy works well for many, it may not be the best fit for clients with more serious mental health challenges. People experiencing severe depression, active suicidal thoughts, or psychosis typically require the structure and support of in-person care. In these cases, being physically present allows therapists to better assess nonverbal cues, provide immediate crisis intervention, and collaborate with other providers if necessary. While some intensive outpatient programs (IOPs) have successfully incorporated telehealth, its effectiveness largely depends on the individual. For some, the remote format may lack the level of oversight and connection they need.
Additionally, people with complex needs may benefit from a higher level of care, such as inpatient treatment or partial hospitalization, which telehealth just can’t replicate. In-person programs often offer group support, medication management, and access to multidisciplinary teams—all of which are harder to deliver virtually. While telehealth expands access, it’s not always a substitute for the hands-on, immersive care that some patients require.
The Pros of In-Person Therapy
While telehealth therapy is super convenient for many people, there’s still something special about in-person therapy. Being face-to-face can make it easier to build trust and connection, which is a big part of the healing process. Therapists can also pick up on subtle body language or nonverbal cues that might get missed over a screen. Plus, for some people, the act of going to a therapy office creates a healthy separation from daily life, making it easier to be fully present and engaged. Let’s dive into some of the unique pros of in-person therapy.
Comprehensive Assessment
In-person therapy gives therapists a fuller picture of what their clients are going through. Being face-to-face allows them to pick up on subtle body language, facial expressions, and other nonverbal cues that might be missed in virtual sessions. This can lead to more accurate assessments and deeper insights into a patient’s emotional state. In-person sessions also make it easier for therapists to create a controlled, calming environment, which can be especially helpful for grounding patients during distressing conversations or practicing certain therapeutic techniques.
As noted before, if a client is experiencing abuse or domestic violence, they might not feel like they can be completely honest when speaking to a therapist virtually at their home with their abuser present.
Therapeutic Alliance
For many people, being in the same room creates a sense of safety and presence that makes it easier to open up and feel truly seen.
The structure of in-person sessions can also help strengthen the therapeutic bond. The act of physically going to therapy—stepping away from daily life and into a dedicated space—can create a sense of intentionality and commitment. Over time, that routine can deepen the sense of trust and consistency, both of which are key to building a strong therapeutic alliance.
Intensive Support
In-person therapy offers more intensive support, especially for patients with complex or acute needs. Being physically present allows therapists to use a wider range of techniques, like guided breathing or grounding exercises, and provide immediate stabilization during distress. It also makes it easier to assess safety concerns and connect patients to additional services or higher levels of care. For many, the structured, hands-on environment of in-person therapy offers a deeper level of support that can be harder to replicate virtually.
Lack of Potential Disruptions
We’ve all been there—right in the middle of a deep conversation when the screen freezes or the audio cuts out. Or you’re finally opening up about something tough, and suddenly the dog starts barking or a family member walks in. Those kinds of interruptions can make it harder to stay focused and connected during teletherapy. In-person sessions, on the other hand, offer a steady, distraction-free space where you can be fully present without worrying about tech issues or home distractions.
The Cons of In-Person Therapy
While in-person therapy has its perks, it’s not always the most convenient option for everyone. Between commuting, dealing with traffic, and fitting sessions into a packed schedule, getting to an office can be a hassle. It can also mean limited access to specialized providers (maybe the Brainspotting therapists in your area have long waitlists). Plus with the extra time commitment, it can sometimes be harder to stick with regular sessions.
Costs
In-person therapy can lead to extra travel costs, like gas, parking, or public transportation fees. For those commuting longer distances or dealing with frequent traffic, the financial and time-related strain can become a barrier to consistent care. Additionally, bad weather or transportation issues can sometimes make it harder for patients to attend sessions reliably. (Although it’s always nice to have telehealth as an option for those snowy days!)
Lack of Local Therapists
In-person therapy can be limiting for people who live in areas with fewer mental health providers. In smaller towns or rural regions, patients may have access to only a handful of therapists—or none at all. This can make it harder to find someone who specializes in their specific needs, such as trauma-focused care, DBT, or couples therapy. It may also mean longer wait times or the need to travel significant distances just to attend sessions, making consistent care more difficult.
Even in more populated cities, finding the right fit can still be a challenge. Certain specialties or therapists with no waitlist may be hard to find locally, forcing patients to either settle for less specialized care or travel farther for the right support. This lack of accessibility can create a barrier to receiving effective, tailored treatment.
Stigma and Lack of Privacy
For some people, the thought of sitting in a waiting room for therapy can be pretty uncomfortable. Running into someone you know can add an extra layer of anxiety. In smaller communities, where familiar faces are more common, this can make people hesitant to seek help in the first place.
There’s also the privacy factor. Even in bigger practices, some folks feel self-conscious about being seen walking into or out of a therapy office. That lack of anonymity can make it harder to feel comfortable, especially for those who are already a bit unsure about reaching out for support.
Inconvenience
In-person therapy can come with some hassles, especially when it comes to scheduling. Trying to find a time that works for both you and your therapist isn’t always easy—especially if you’re juggling work, kids, or a packed calendar. Plus, when you factor in commute time, fitting sessions into your day can feel even trickier. For some, this might mean having to miss work or rearrange plans just to make it to therapy.
Travel can also be a challenge. If you don’t have reliable transportation or live far from your provider, getting to sessions regularly can be tough. Bad weather, traffic, or last-minute conflicts can throw off your schedule and make it harder to stay consistent. Over time, those little inconveniences can add up and make in-person therapy feel less doable.
The Benefits of Hybrid Counseling
Teletherapy and in-person therapy both have many benefits on their own, but when offered together, they provide accessible, effective care for most people.
Some folks might prefer the convenience of virtual sessions for regular check-ins but feel more comfortable diving into deeper topics in person. Others might stick with in-person therapy most of the time but appreciate the option to go virtual when life gets hectic (or the weather turns unpredictable). Having both options makes mental health care more accessible and adaptable, giving people the freedom to choose what works best for their schedule, comfort level, and needs.
Integrating Community-Based Care
When a mental health practice has a physical location, it has the potential to do more than just help individuals. Even a small practice caters to its entire local community by providing care to people close to home, and therapists can more easily communicate and work alongside other local health providers and mental health providers if necessary. Additionally, mental health clinics can choose to take a more active role in their community by offering rehabilitative services, training, outreach, and advocacy.
When a mental health practice is rooted in the local community, it can even enhance the quality of care for clients seeking teletherapy as well. Therapists who are familiar with local resources, support groups, and healthcare providers can offer more personalized referrals and recommendations, even to their virtual clients. Plus, when therapists are actively involved in local outreach and advocacy, they stay more in tune with the specific challenges their community faces. That insight helps them bring greater empathy and relevance to their online sessions, strengthening the therapeutic alliance by making care feel more personalized and connected—even from a distance.
Removing Barriers to Access
Both in-person counseling and teletherapy come with their own set of barriers. As we mentioned earlier, people may live outside city limits or have limitations that make commuting to a physical location difficult. On the other hand, teletherapy often takes place over video chat. This requires people to be digitally savvy and have access to reliable internet service.
That’s why offering both in-person counseling and teletherapy is so important— because no single approach works for everyone. Some people may struggle with transportation or live too far from a therapist, making virtual care the best option. Others may not have reliable internet or feel more comfortable talking face-to-face in a private setting. By providing multiple ways to access therapy, mental health practices ensure that more people can get the support they need in a way that fits their lifestyle, abilities, and comfort level.
Offering Care Away From Home
While some people love doing therapy from home, some people get the best results in a fresh, neutral space outside their house. Additionally, some people may struggle to find a quiet, private space in their homes where they feel comfortable being vulnerable. And, of course, not everyone’s home is a safe space. Having the option to seek help away from their living space allows people to seek care without disclosing that information with a spouse, parents, or other household members.
Get Started With Hybrid Counseling in Your Location
When it comes to providing you with mental health care services, we believe that choice matters. We want to give you the option to talk with us virtually if that’s what is most comfortable and convenient for you, but we also know the value that in-person care provides. By offering a hybrid of in-person therapy and teletherapy at each location, we strive to produce better health outcomes and establish the best relationship possible with everyone who comes to us for care.
Whether you want to meet with us online or in person is up to you — and we promise we won’t judge you if you want to come into our clinic in your pajamas. Our clinics are designed to feel cozy, safe, and familiar.
And our amazing providers aren’t the peer-over-the-clipboard, silently judging types. We’re here to get to know the real you and help you live a life you love. No matter your background, your style, or your feelings about therapy, we promise to accept you as you are and provide you with the compassionate care you deserve.
Speak with an Ellie specialist to choose your preferred method of care and get matched with a provider in your area.
