If you’re new to online therapy, it’s normal to worry that it might not have the same benefits as in-person. Back during Covid-19, when everyone in therapy had to switch to virtual therapy, many health professionals were concerned that it would have a negative impact on outcomes, and many clients assumed they would have a less satisfying experience.
Since then, there has been significant research exploring online versus in-person therapy — and countless online therapy sessions — and the news is overwhelmingly good.
To help you understand all there is to gain from doing online therapy, we dove into the research and asked therapists to share insights on what makes seeing a therapist from home so well for so many people.
If you have a busy schedule due to work or family demands, finding time for therapy can feel impossible. Even if you can find time for an appointment, you still have to get there, and this can be another obstacle. Online therapy maximizes your time and eliminates the need for transportation.
“This a huge factor for people in rural areas, those with low-income or physical disabilities, or anyone juggling work and caregiving,” says Megan Collins, a Licensed Marriage and Family Therapist and Registered Art Therapist.
Several major studies have found that online therapy can be as effective as in-person. A 2022 systematic review and meta-analysis examined randomized controlled trials that compared online and in-person cognitive behavioral therapy (CBT) in treating depression, and a very similar 2023 systematic review and meta-analysis did the same for anxiety. Both reviews found no significant differences between online and in-person therapy in terms of outcomes and client satisfaction. Research has also found that CBT delivered via online therapy is as effective in treating post traumatic stress disorder (PTSD).
CBT isn’t the only type of therapy that can be effectively delivered via online visits, but it does tend to be the focus of most research on this topic. This is because CBT is highly-structured and has outcomes that are easier to measure — which makes it easier for researchers to crunch the data. But there is also solid evidence for the efficacy of online-delivered interpersonal psychotherapy, acceptance and commitment therapy, and psychodynamic approaches.
According to a 2021 American Medical Association survey of mental health providers who offered online therapy, 44% of respondents indicated that online therapy decreased the cost of mental health care. One reason this is true: When you broaden the number of therapists available to you from those located nearby to all therapists who are licensed in your state, it means you’re more likely to be able to find a therapist who takes your insurance, charges a cash-pay rate you can afford, or who offers payment on a sliding scale.
A 2023 study published in the journal Nature Mental Health revealed additional reasons why online therapy is so cost-effective: Researchers found that clients who opted into online CBT were able to start therapy sooner compared to in-person, which led to faster improvements in quality of life, and less money spent on other medical services.
Online therapy also empowers those with marginalized identities to connect with therapists who share their cultural identity and/or lived experiences, even if they live hundreds of miles away. For example, with Alma’s search filters, you can easily find a therapist who takes your insurance, practices in your state, and specializes in treating specific populations, including clients who are LGBTQ+, neurodivergent, or from a specific cultural or religious background.
“Working with a therapist who shares similar lived experiences can create a sense of resonance and ease,” says Melody Li, Licensed Marriage and Family Therapist, mental health justice activist, and founder of Inclusive Therapists. “It’s often a relief not to have to educate a therapist about our identities or experiences — allowing us to focus on healing rather than explaining… And having common language, cultural references, and a deeper understanding of collective struggles can help cultivate the therapeutic bond and foundation for healing work.”
People who are Indigenous, Black, Brown, Asian, trans, gender non-conforming, queer, and/or disabled also face other systemic barriers to accessing therapy. They’re more likely to have jobs that won’t allow them to take time off work and often have issues accessing transportation.
Disabled folks often face the same barriers to access at a therapist’s office as they do in other public spaces – lack of wheelchair ramps, elevators, accommodating seating, and so much more. Attending therapy sessions online removes these barriers.
If you’re able to walk into a mental health clinic without having to worry that it will put your social standing, career, or even your personal safety at risk, it can be easy to forget that this isn’t the case for everyone. For many people, fear of stigma is still a major barrier to seeking therapy.
“For those who understandably fear the stigma of seeking mental health care, attending therapy from home can feel more private,” says Janet Bayramyan, Licensed Clinical Social Worker at Road to Wellness Therapy.
Even if these concerns don’t apply to you, doing therapy in your own home can be more relaxing. “Telehealth allows people to get support without added stress — no waiting rooms, no interacting with other clients, just the ability to access care from a familiar, comfortable space,” says Collins.
Depending on your needs and goals, you may get even more benefits from online therapy, for example taking your therapist with you into challenging situations. “We can practice real-world exposures in real-time,” says Collins. “I’ve guided clients through social situations virtually, helping them regulate their emotions as they experience them.”
The therapists we talked to reported that online clients cancel appointments less often because they can attend even when they’re busy or sick. They also stick with therapy longer because the sessions are easy to access.
Research backs this up: A 2022 survey distributed to therapists and clients over the course of 16 months found that patients receiving online therapy had significantly higher rates of treatment completion than their in-person counterparts (69% vs. 44%).
Though telehealth therapy has many upsides, there are some downsides, and they can be a big deal for some.
Though online sessions make therapy more accessible for some, that doesn’t mean telehealth therapy is accessible for everyone. “Clients without reliable internet access, devices, or digital literacy may face challenges,” says Bayramyan.
Bayramyan and Collins both pointed out that some people don’t have a private space where they can attend their online therapy sessions, which may make them less comfortable sharing honestly about their experiences. It can also raise confidentiality concerns, especially if they have to access their sessions in a public setting.
Everyone we spoke to also agreed that there are some serious advantages to being in the same room as their clients. “Some clients struggle to mentally separate therapy from the rest of their day when it all happens in the same environment,” says Collins. “There’s something powerful about being in the same space with someone during an emotional moment, and that can be hard to replicate virtually.”
“The absence of shared physical space can make it harder to sense and be attuned to one another’s energy,” agrees Li. “Virtual sessions also limit access to full-body language and nonverbal cues, which can reduce the depth of communication. When therapists and participants can only see each other from the neck up, some emotional and somatic expressions may go unseen.”
Maybe! But you’re the only one who can make that decision. If you’re having trouble fitting therapy sessions into a tight schedule or you can’t make it to in-person sessions because of transportation issues, online therapy is probably a great fit for you!
It can also be a great fit if you can’t find a therapist near where you live or work, or if you can’t find a local therapist who understands the impact your identities have on your day to day life and mental health. And, of course, if you love the convenience of clicking a link to join a therapy session vs. having to change out of your soft pants and leave the house, definitely go for the online option.
That said, if you aren’t particularly tech-literate, don’t have access to reliable Internet in a relatively private space, or find that you have trouble connecting with someone over a screen, in-person therapy might be the better choice.
Alma's nationwide network includes over 21,000 licensed therapists, who are available to meet virtually and/or in-person.
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Mar 27, 2025
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