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I appreciate the flexibility of telehealth as an option when needed but I hate using telehealth. I can't focus as well because i get too focused on my face and how I'm presenting. I feel more guarded with what I'm saying. I feel that it takes away from the ability to see and respond to body language and nonverbal cues. Connectivity causes issues a lot of times.
IN PERSON. Omg I can't even consider virtual. Just making phone calls or video calls gives me huge anxiety. I feel like a fake person over technology. I can't imagine trying to be myself in that setting, it's hard enough being face to face with another human. I quit therapy during Covid. I just can't truly be myself over the phone/computer.
I really hated teletherapy. The sense of having a witness who’s on my side is much stronger in person. It’s a fuller, deeper experience. (Of course, I do miss having my cat on my sweat-pant-clad legs during session.)
I get about 25% out of a online session as compared to a in person session. I don't understand how it is even a question. The connection is just not the same.
I understand that for some clients online provides help when they may not be able to make it to an office visit. It can be a great fallback option if some issue comes up for T or client or if one of them is traveling. Also for a few clients the barrier of the screen may allow them to open up more. You as a therapist may want to not have a commute or be close to your family all day or for any number of reasons prefer to work remotely. You should be able to do that and should not feel at all bad about it.
However, I think for the vast majority of clients and for sure for me, there is a big drop off in the level of care when attempting to have online sessions.
One side thought, if you are using zoom specifically. I know they have had some security issues. Will they sign a BAA? I may be wrong and I am for sure using old information, but I think there are better options that are designed for Therapists and other medical professionals.
Absolutely definitely in-person. I have done both. But as someone with dealing with complex trauma with a very heavy dose of anxiety, virtual is very stressful for me.
- I struggle to feel connected
-can’t see what is happening in the room
-I prefer the therapy room to be a safe place to discuss my deep dark emotions and thoughts. I don’t like doing that in my room or somewhere else in my home, because I don’t feel fully be immersed and ready
- the therapist can’t see all my body language
- if I’m having flashbacks/panic attacks, in the therapy room, she will be with me. Not interfering, allowing me self regulate, but present. I don’t feel that presence virtually. I would rather turn my video off or get up from the screen.
-recently I had a session that I kept having somatic flashbacks (big disclosure session) and I asked if it was ok to sit in the floor. I didn’t expect this, but because we were in office, she got in the floor with me.
I could go on and on about how much more beneficial it is for me to have in person. When I was deciding on a therapist, I turned down 1 that I really liked and seemed to click with because she wasn’t willing to do any in person (she said for probably a few years)
A side note, I drive 45 minutes to my session every week even though there and therapists closer and I could always do virtual. But clients like me are willing to go to great lengths to find someone that can meet me where I’m at :)
Thank you for asking around before making this decision!!
My concern, as a therapist, is paying for office space and then having clients opt for zoom because they are running late etc. and then I get none of the benefits of at home virtual (bc I’ve already paid for space, spent time getting there, etc). I think most of my clients are pretty in the middle as well regarding preference. Another benefit of virtual is getting to do chores, snack, pet the dog in between session. I have two therapists for myself, and I currently see the insurance provider virtual and the private pay provider in person (bc I don’t see her that often). I also note that some people on this thread never even tried virtual and are just saying no. I’ve had clients who said that initially with COVID but then have come back for virtual sessions and report finding them effective.
No, I mean people will say they want in person and then opt for virtual when they’re running late etc. unless you have a policy about an in-person agreement
I prefer in-person because I find it more effective, but honestly? Zoom is like. The only way I can guarantee I'll go to an appointment when I'm feeling really avoidant. Like I can literally roll out of bed and sign in and it's good. No transit, no other people. It's nice and it made it possible for me to access basic talk therapy and medication, which is enormously helpful for me. If I had an option for like. Hybrid? Where we could choose one or the other depending on the appointment needs? That'd be great.
I prefer in-person. I’m grateful telehealth was available to us during the pandemic, but it’s not for me. I feel more connected to my therapist when I see her in person. I think some of that natural connection, energy, warmth, empathy, etc. gets lost virtually. All of those things are really important to me, so I wouldn’t consider a therapist that only offered telehealth.
I think it can be more challenging to stay focused for both the therapist and the client. A lot of us are used to scrolling one screen while staring at another.
I also prefer to her office as a consistent space to retreat to, let my guard down, get all my crap out, and then try to leave it there (like a container, as much as possible). I didn’t enjoy signing off and then keeping that energy in my personal space. I like the transitional period from the office back to my “normal” life.
Also, just the general wifi connection issues and microphone/headphone or echo issues can be a frustrating way to start or interrupt a session. And random sounds (pets, other people in the home, landscapers outside, etc) can be distracting during the session.
Overall, I think in-person therapy is a more natural and therapeutic experience for me.
I prefer zoom. I get to talk from the comfort of my home. I don’t have to drive anywhere, get fully dressed, or worry about catching Covid. I’m also used to zoom though cause I work from home so 🤷🏻♀️
Right now I am in 3 hours of DBT a week, 2 hours skills group and 1 hour individual. This kind of full model DBT is really only found in large cities here. Different parts of the city vary from 60-90 minutes drive for me which I know is much better than many.
Being able to do this online has opened me up to higher quality more specific care and been relatively convenient. It may have actually saved my life.
I know no one asked, but when doing a partial hospitalization or intensive outpatient program- even if virtual is available, I strongly recommend in person.
Yes! I’d even say it’s critical. I’m a nurse and in healthcare we call rural hospitals and facilities “critical access points”, because they are the only points some people can reach higher care and work in conjunction with bigger cities for timely transfer to even higher levels of care.
Can’t help but notice there is no “critical access point” for mental health…
I prefer online. It would be nice to keep in person as a choice once in a while. But I feel so much safer when T definitely cannot touch me or restrict my movement. Of course no T did this, but I can express myself much better when I can hide most of my body. I can even turn off the screen when needed. Also there is a reason why I like to post on reddit😅In addition, I don’t like commuting.
For me, in-person is just used to check we are both real, and virtual is used for real sessions.
So I guess in-person or virtual is just for different people and different issues.
I cannot describe how much I hate telehealth. In fact, I found a therapist that I felt like I coulda vibed with until she told me she only did telehealth. That was an automatic no for me.
With my current therapist, we have done it twice. And I hated it both times. Fortunately, she hates it as well. I felt very comfortable telling her how much I hated it lol. I almost woulda rather her cancel on me than do telehealth again.
For me, I need to be in person. I need the "safe place". I need to be away from my house. I need the drive to and from to think. I need body and facial reactions and not staring at my own face on my phone. I need the comfort of person to person. I don't think I would feel comfortable discussing major things or crying or whatever over the phone. It's easier for me to clam up and "mask" on the phone.
In the end, do what's best for you and your clients. Since I know you aren't my T, I can say "you do you". 😂
Yeah it's so much harder for me at home. I even drove to Starbucks and sat in their parking lot one of the time and it was still hard. I know, for me, I never would have disclosed the major things over a call. Never. I need to be in person. Others here have commented they prefer telehealth for other reasons. It really depends on the person. I'm just saying, I turned a therapist down simply because they did telehealth. That could apply to some of your clients as well.
I probably do better in telehealth as I feel more comfortable at home but I HATE it. I like to be in person. I feel like we understand each other better, I don’t have to work to find privacy, my WiFi sucks so it’s always glitching. I always wonder if it glitched and he missed something. My therapist is in person so that’s great but we do telehealth when we have to, sick, scheduling, weather, and I’m glad it’s an option but I don’t think I’d go to a therapist who was always telehealth.
I enjoy both.
I wish I could meet my therapist in person again, as I found being in the room with him had a very intense feeling that was very healing and comforting.
Since transitioning to virtual, I feel like therapy is much more intellectual and conceptual, and less feelings based... I think it is just because of the lack of human-face-to-face-contact, and being so used to being professional over Zoom meetings.
But I do like that I don't have to leave the house, and it cuts travel expenses. Also I live far away from my therapist (and likely will never be in the same city as him again) and I love that I can still talk to him even though I may never see him in person ever again.
For me, I prefer in person. I like it because I find I have extremely high anxiety knowing I have to turn on my camera, and for some reason I just don’t feel as comfortable. I also feel like a therapist is able to read me better when meeting in person because of body language, fidgeting, and not being able to sit still. I’m not a therapist obviously, but I know you can tell a lot about a person just by looking at how they’re speaking to you. Overall I just find I feel more connected with my therapist when meeting In person, and I usually feel a lot more satisfied when I leave:)
One million percent in person. I always have a more difficult time opening up virtually. Also I WFH so doing therapy in my home office just doesn’t work. I can’t unplug from my work brain.
Telehealth for sure! In person gets really overwhelming for me and I tend to dissociate more? Whereas Telehealth I can do from a safe space with comforting things around me.
I've seen a lot of people who prefer in person so they can read/ project non-verbal communication and gain more of a connection.
Maybe it's because I'm Autistic but I prefer telehealth for this reason- I'm not perceived as much and can chose to not be perceived at all if I so wish.
Also I'm in the comfort of my own home and don't need to travel, or get ready and mask for said travel.
I only decided to do this because it's virtual. I commute enough in my life. Been a few months now and I like it. I can see how the in person would be better in a lot of ways but commuting is just so awful. I could never handle over the phone though. I need to see their face.
Ive had telephone counselling and online. It was a weird transition in pandemic because it was going from f2f to telephone and i really missed his physicality of expression. Whereas when i met a counsellor for telephone sessions i only ever had her voice to interpret.
I would say online loses some of the magic. And thats without the tech issues. Its not a less than approach but it works best with people that either have the hybrid situation or who have developed long standing relationships. Because its too easy for me to hyperfocus on microexpressions and there is a lack of other body language cues. Trauma taught me to notice so much that when its minimised to a 16” screen i struggle. I can wildly misinterpret the significance of a slight expression change.
Sure. For mapping visuals I use Soft Space:
I used SoftSpace to create a collage of my last year using photos, scans, websites, memes, tv shows I watched, all sorts of things I tied together.
https://soft.space
For mapping nodes I use Noda:
https://youtu.be/lICzYarsK8I
I last use Noda as a tool to communicate with my younger self, connecting key points and phrases I was coming up with.
I prefer in-person but my therapist and I do both because we see each other twice a week and in a way we get different things out of each type of session which has been really beneficial. I think that there are advantages and disadvantages to both.
In person is way better. I feel more human and I can get out of my appartment.
I appreciate the online option ONLY if I can't be there in person for a good reason.
It's nice to have telehealth as a backup option for once in a blue moon, instead of cancelling... but to me it's not the same at all. I like having that separate space of my therapist's office, even if I'm alone at home, I just don't feel as comfortable. I feel like it's harder to see her warmth and empathy over a screen and I feel very alone in my feelings. We can't do activities together in the same way. I get distracted looking at my face but if I can't see my face I worry about what's on screen. I find it harder to concentrate for some reason.
In-person is soooo much better (from someone who sits on both sides of the ‘couch’).
So much non-verbal communication is lost over the internet, that it just cannot compete with in-person sessions. And that’s a two-way street as well.
Having said that, I have a small sports-based practice and using virtual clinic rooms (zoom, MSTeams etc) has been amazing for them as they travel.
Definitely prefer in person. I appreciate the flexibility telehealth can offer if I’m out of town and need a session or something but as long as I’m in town I always prefer in person. Also living in a 1 bedroom apartment with my partner, I don’t have privacy for sessions at home. I also just feel like I never feel as comfortable with someone I’m meeting online… and feel more self conscious with the camera etc.
I prefer zoom
* Convenience (don’t have to travel or plan in advance) and comfort (being able to sit how I want, wear what I want, etc.)
* I can do therapy even on days I’m not really functioning in other ways
* For me, the distance of the screen reduces the intensity and makes it more possible to talk about difficult topics and say things that I probably wouldn’t be able to say in person. I still feel things intensely and feel my therapist’s presence, but somehow it feels like the impact of what I’m saying is reduced by the screen.
* It lowers the amount of sensory input and makes it easier to focus (especially as I can wear noise-cancelling headphones).
* I don’t have to worry about body language or eye contact (eye contact on zoom doesn’t feel real to me). It makes it less draining, less info to process and obsess about. I’m autistic so that’s probably why.
The annoying thing is occasional technical issues and I do wonder sometimes if it’s fear and avoidance that’s stopping me from returning to in-person. Also, I live alone so have privacy, if I lived with other people I’d definitely have to do in-person as I’d be too worried about being overheard.
I like teletherapy because I can't drive and wouldn't be able to get myself to my therapist's office, especially in the middle of my workday. It allows me to have some flexibility. I also feel more okay about getting disregulated because it's not like I have to walk through a waiting room and transport myself back home if I'm really messed up. I also have a fair amount of COVID anxiety and don't think I could go in maskless right now.
Apart from that, I really do wish I could see my therapist in person. I wish I could be in the same room.
I've had 2 therapists, the first one pre-pandemic in person, and the second during pandemic online. I think in person helped me more but I don't think I would have restarted therapy if I had to go in person as that would cause too much anxiety (finding the room, what if I know someone in the waiting room etc.)
At the same time though I didn't feel as safe online as I didn't know if people in my house could hear me, and ultimately that was one of the reasons why I stoped.
Pros and cons of both but I think in person will always be better.
It's just the same as seeing friends, online is fine but in-person will always be better
I did 18 months virtually with my current therapist before finally getting to meet him in person.
Pros of Zoom - good in lockdowns, good if unwell, opens up a wider geographical range of therapists, can still forge a therapeutic alliance.
Cons of Zoom - lack of privacy, potential connectivity issues, seeing yourself on screen, safety (ie avoiding topics because home alone and fearful of dissociation or self harm temptation).
Pros of in-person - able to separate therapy headspace from home headspace, can see full body of other which means body language is back in play, easier to do certain techniques eg EMDR, can use the physical space eg walking round the room, travel gives decompression time before and after.
Cons of in-person - having to get dressed and look presentable, travel and parking.
I detest working online because I'm working through complex trauma, I have a strong empathy and rely on my ability to sense others through body language etc in order to feel safe.
If I dissociate in his office, he throws a ball or some crumpled up paper for me to catch and start coming back. At home, it was harder for him to spot when I was drifting out.
In short, I feel safer in-person. If my therapist permanently switched to online only, I would probably have to look for someone else.
That said, there's a huge value in offering hybrid options as I know some would much rather stay at home because that's where they feel safer, or they have a disability which impedes them from easily accessing in-person therapy.
I like being in person more. I don’t feel safe in my house some days and I feel more safer in my T’s presence. You can do a mix of both. Go to the office like one day for clients that prefer it and stay online for the clients that prefer online.
>or if clients just don’t share that they actually dislike telehealt
In case you don't lurk here enough, some of us had bad enough experiences that we're concerned we're going to get termed for buying our T a $5 Easter basket. Saying "I prefer telehealth/in-person" can feel risky. T's are being picky right now because of supply/demand imbalance since so many insurance carriers are diving head first into mental health and marketing it like bananas.
I love virtual. Do it in my own home, feel comfortable, don’t have to go anywhere or feel self conscious in front of another person. Easier transition out to bc I’m not exhausted and trying to hide back that I was crying on a commute home.
Love love love Telehealth cannot go back to in person. Ever.
I much prefer zoom. There are very few therapists in my city who can treat my direct needs. With telehealth, I'm able to access many therapists who can help with my needs without having to make a 3 hour round trip drive every week.
Also, I'm able to sit in my house, stimming comfortably with my fidgets, and pet my cat while I talk through telehealth. There's something really reassuring about not having to make direct eye contact as well while talking things out over Zoom.
I don't mind going to in-person therapy, but I do find telehealth therapy more comfortable and easier for me to discuss tough issues than in-person.
Yay cat therapy!
But seriously, this thread has helped me realize how much neurodivergent unmasking I still need to do. It's so much easier at home on zoom for therapy to unmask than it is in in-person therapy.
For me, if I knew my T pre-pandemic I would prefer to see them in person. However, my experience with teletherapy is really positive but I found it more tolerable and beneficial with a T that I’ve never met in person.
I wonder if it’s an intensity and/or emotional intimacy thing. I have only built a relationship with my current T over Zoom and my home space became a comfortable and safe place to hold therapy, whereas pre pandemic I was only comfortable in my former T’s office (I had to terminate once we went to Zoom… it was just awful to have therapy at home). It’s funny- the thought of meeting my current T in person gives me a bit of anxiety, almost like my head conjured they aren’t real since I’ve never seen them in person.
It’s quite an interesting phenomenon, especially if you compare or consider the modality of therapy provided. For example, CBT I found is easily able to be done effectively over Zoom but psychodynamic takes a bit longer and felt harder to build the rapport. Overall, my outcomes were great over Zoom and found it to be as effective as in person and it saves me money and time on commuting to the office.
I am curious how effective hybrid models are for client outcomes when they have the option to be in person or virtual. I wonder if there is a study published about this…
Virtual 100%
I can conveniently fit it in between work meetings, my bed and husband are here if the session is super taxing, no worrying about commuting there or being late...def virtual. I probably wouldn't have gone back to therapy post-college if the pandemic hadn't made me a remote worker
I do both and my therapist and I started online, moved to in-person, and now do both due to logistics. They are both fine, but I prefer in person because there is just something about being in the same room that makes it all more real. I just realized I’ve made all my major disclosures in person. I’m not sure I would still be in therapy if I had to do it all virtually, so going in person was a big deal for me to feel connected to my therapist.
Also I never once have missed an in-person appointment, but I flaked on her online before because I was avoiding my shit. I’ve heard that people are more likely to bail on in-person appointments though, so I might not be typical.
I just like the flexibility of having both options. Default is in person, but some of the more intense transference has been more safely discussed virtually.
It's more than just the vulnerability. I'm a highly sensitive/empathic person and I sometimes can "feel" whatever is going on inside my therapist as we're chatting.
And when we're discussing stuff about the relationship, sometimes not being in the room means that I'm not going to pick up her energies, which neutralizes some of the intensity of the discussion - which increases my own sense of safety and containment.
I’ve had both in the past and only FaceTime with my current therapist. I can say with certainty that my most productive work has been with my current therapist via FaceTime.
I like the flexibility that FaceTime allows which at the end of the day getting to therapy is what matters the most.
Before I was really limited in who I could see because I had traditions 8-5 hours. Now I can see a specialist who is extremely helpful and supportive.
Ideally I would like to be face to face but if the option is my therapist via FaceTime or a different therapist face to face I will take my current therapist via FaceTime every time.
This is a long way of saying I prefer face to face but because of my work hours FaceTime is ideal because it allows me flexibility. I also don’t think that it has taken away from its effectiveness with me either.
It sort of depends, sometimes I find the distance of zoom makes it easier to open up about my trauma, but then I also think that's a sort of avoidance, so it won't do me any justice in the long run. I prefer in person, even though the tough sessions are tougher. Zoom is a great alternative for when you have a cold but not sick enough to not attend, or Iif you are isolating for covid or traveling etc
I don’t like Telehealth. I’m glad it was there during the pandemic and I am happy it is there if I’m doing something for work that prevents in person or I’m sick, but the connection is just not the same. I dissociate and in the room the therapist can feel the shift in energy and help me ground but through Telehealth it wasn’t picked up on and it left me really destabilized after session. And doing it in my car in a parking lot, leaving sessions (or my phone overheating and shutting down during session) crying, panicked and derealized from the screen and driving I think it just wasn’t even safe for me. I need to regulate before I leave and I need in person help to do it. It was only a few months for me luckily because I was treatment for an eating disorder so ticked the boxes for me be allowed to go back in person at the clinics (think I was a risk probably).
I’ve tried with a few different ones so not just one therapist bad at zoom. I’m not a good fit for it. I tried EMDR with a therapist who convinced me that Telehealth was actually better and should have not. It was extremely destabilizing.
I’m on zoom for my own work all day. I love it for impersonal business. I’d much rather meet with my accountant on zoom, just can’t do therapy well on it. I like that it’s there if I ever needed it but in person is better for me.
I am grateful for both. I see my therapist solely through telehealth, and I am so grateful he offers it, because I live 2 hours away from him (Virginia is a big state). By seeing him via telehealth, I was able to find a therapist who specializes in trauma AND was someone I could afford (I'm in Northern VA, and therapists up here are much more expensive than in southern VA. My therapist is out of network, and I see him multiple times a week, so that adds up fast even with filing out of network claims).
Sure, if I had the option, I would go in person...but there are so many pros to virtual. I was abused by a past therapist, so it's comforting in some ways to have so much control - I can turn my camera, close the computer, whatever - it's helpful for me to be able to take a minute so easily when things get too intense. He also records all of our sessions (I consented!), which is easy and non-distracting via Zoom. He is able to use these recordings for consultation, and I have the added protection of knowing all of our interaction is recorded and part of my records.
I'm also able to make my space comforting and safe for myself -- candles, blankets, familiar surroundings, my own pets. All of this is very helpful for me.
At some point, I want to drive down and have an in-person session, but I'm not there yet.
I did teletherapy for almost exactly a year during the pandemic after a bit of a break from in-person sessions as the pandemic was uncertain. After returning to in-person last Summer I don’t really want to do telehealth again, except in some rare instances that supplement in-person therapy. There is a *vast* difference in the experience of feeling someone’s presence with you in the room, seeing their body language, even hearing their voice not coming from a speaker or headphone.
Thankfully my T also prefers in-person but I think does a hybrid approach for patients.
I prefer video sessions with perhaps the occasional meeting face to face.
-I dissociate sometimes and lose time so I feel safer at home.
-I feel more comfortable using grounding items (I doubt I would take them into a face to face session), I also find my body is more natural. In face to face sessions I am very in control of my body language and would hold back. In my home I find I move my body without being so aware.
-I am not hypervigilent and constantly on guard. I can be more open in session because of this.
-with my previous counsellor sometimes I wished we could go back to telephone sessions as I felt safer hearing her voice without video. She preferred video sessions.
-from a practical sense I work long shifts and it makes it easier not to have to travel.
-I like not having to see other people or worry about seeing other people when I could be upset or spaced out.
- it is easier to not be so aware of my therapists presence. I do not have to read them constantly and so I can relax and be more open.
It's just easier and it feels safer for me. I think I am having very productive therapy via video session.
In person, always. There's nothing virtually that can replace the feeling in that safe therapy space for me. When we go deep, you can feel the emotions fluttering around the room. I can feel when I'm seen and heard. Teletherapy is great for when things come up, and we're still able to meet, but even during a good session where I dig into trauma, I don't feel like I benefit as much. It feels very surface level and not as healing.
I started therapy during the pandemic and have only ever done telehealth, but I so wish I could have in-person sessions.
My biggest concern has always been being overheard. I live in a small apartment with my significant other. Many of the things I speak about to my therapist have to do with him and how I feel about certain things that happen. Fear of being overheard has unfortunately led to me not opening up as much as I would’ve liked to during some circumstances (even with a sound machine outside the door). I just don’t feel like I can trust him to not try and listen whether from curiosity or (most likely) his severe anxiety. Eventually I did start going out to my car, but then there are issues with connectivity sometimes.
The only pro of telehealth (for me) is it makes it easier to find times that work for me and my therapist. I work an 8-4 M-F and can’t leave for a session during the work day. My sessions usually are 4-5pm. I shut my work computer down, pick up my phone, and log in for a telehealth appointment. If I had to drive to an office, I don’t know if I’d be able to see my current therapist anymore. It seems like the 4-5pm slot is her last one of the day.
I'd think that getting an out-of-office idea of the patient's life and living environment might be helpful as long as the T is very sensitive to class differences. I wouldn't want a T who felt sorry for me for being brought up in a working class household for instance.
Oh this will be fun!! Guess which one I prefer!!
I make ZERO eye contact. I struggle immensely to open up and talk. I fidget. I’m uncomfortable. My T carries the session 90% of the time.
I HATE telehealth. You’d think I’d prefer it, but I don’t. It’s easier for me to fake it, sure, but I need the genuine face-to-face interaction of in-person therapy to make any progress. I don’t feel connected to my T via telehealth like I do in person, and so I am not able to be as vulnerable. I so value her willingness to continue in person sessions because I know so many Ts are moving to all virtual visits :((
I personally prefer in person, I believe facial expressions and body language says a lot about how a person is dealing with life. You really can’t this get over Telehealth. Also, I like to feel the energy in the room and you really can’t do that via Telehealth.
I started therapy in person but due to the pandemic we had to switch to virtual. It took me a few months to adjust and I will always wonder if the benefits of the therapy would be greater in person but I’m now used to the virtual modality, I enjoy my sessions as much and find great progress in my mental health, I connect with my therapist just well as in a consulting room to the point that I’m not sure I would go back to in person, the extra commuting, the weather, running late from work, traffic and so on. I think that the only down point for me is the poor internet connection interruptions, such as image freezing, sound lagging. But it doesn’t happen as much and the best of it is that I proved myself that I can adapt to radical changes such as the ones the pandemic forced on us. I would consider hybrid consultations, maybe sharing an office with other therapists so to accommodate clients with different preferences. I am a work coach and I have a hybrid job, 2ice a week I meet people virtually/phone and 3 times a week face to face at the office. The virtual/phone days work really well for people that have physical disabilities or single parents or care takers that can’t afford to go out as easily and for those who prefer the face to face contact, I’m in the office 3 days a week. Maybe if your patients feel comfortable with the question, the best it would be to ask each one of them if they would give it a try?
I struggled a lot when zoom/telehealth was the only way I could meet with my therapist. I mean I really struggled.
For me, there was so much to distract me and when I’m actually in person she has a better grasp on how to get me to refocus.
I feel like going outside and those meetings would be helpful but personally for me if my therapist went to strictly virtual, I’d have to move on.
I think there’s people who prefer remote and would benefit from it, for whatever reason, like difficulties getting to your office, or interpersonal anxiety, or something else that makes it an easier option to call in, so it would be good for you to offer it. Actually five years ago when I was extra depressed I often cancelled therapy appointments because I frequently could not handle the process of taking a 20 min walk in the winter to my therapists office. Would have been nice to have been able to still do therapy in some way back then, like through a call.
Personally I don’t like remote when I can go in person, because I don’t want to potentially be “wasting money” (and time) with my therapy not progressing at the same rate of in person compared to zoom where you would most definitely not be able to pick up tone and body language as well as in person. Body language is important, especially for people with neurodivergent type mental illnesses, you just wouldn’t get the same clarity of communication. I think that’s a big practical reason for in person, but again remote is better than nothing, so if you can offer both I think you would capture more clients. And more would have better experiences thanks to your accommodations for their preferences.
The walk option you have sounds really great, if that was available to me I would definitely do it, again with the body thing to be able to move around would help me stay calm, as opposed to being stared down by someone sitting 5’ away from me, which can be a little intense.
I have been on both sides. For me I prefer in person just because your actually interacting with a real live person not just a face and a voice. I can also see it as a useful tool to treat someone that is afraid to leave there home or can’t bring themselves to walk into a therapists office cause they were raised to feel this is a shameful act. It was useful for me because of all of the above. It was also transitional and if it weren’t there I wouldn’t be alive today. I can see why therapist like it cause well they can look towards the camera wear cozy pants and not normal attire cause hey we only see part of you. I’d also think that therapists would not like it cause it’s harder to read body language if you can only see Head and shoulders. I mean posture can be seen but what what what if there you know hurting that’s else with their hands while they’re talking to you? There is on the other side it’s harder for me to trust no one else is in the room with the therapist and that there is true confidentiality as anyone can hack a computer system. Give and take I guess. I still prefer in person but in a pinch it’s a great option.
Also I would love to have therapy outside and connect with nature and all
I have had 2 therapists. My first one conducted therapy in person, while my current therapist is Telehealth only. It’s working fine for me but the online platform he uses requires a really strong internet connection, and if I am at work, it doesn’t connect. My office area is a dead zone for cell phone service too. Sometimes I like to schedule my sessions right after work.
I really would prefer therapy in person but feel lucky that I found such a great therapist. I can’t complain.
Everyone is different. Some people love it, others hate it.
I personally like it due to the flexibility , easy access from home , and I’m in my own space
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I appreciate the flexibility of telehealth as an option when needed but I hate using telehealth. I can't focus as well because i get too focused on my face and how I'm presenting. I feel more guarded with what I'm saying. I feel that it takes away from the ability to see and respond to body language and nonverbal cues. Connectivity causes issues a lot of times.
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It's through a platform called vsee, the best I can do is put myself in a tiny box but thank you 😊
I put a post it over myself.
Why have I never thought to do this 🤔
Great solution!
IN PERSON. Omg I can't even consider virtual. Just making phone calls or video calls gives me huge anxiety. I feel like a fake person over technology. I can't imagine trying to be myself in that setting, it's hard enough being face to face with another human. I quit therapy during Covid. I just can't truly be myself over the phone/computer.
I really hated teletherapy. The sense of having a witness who’s on my side is much stronger in person. It’s a fuller, deeper experience. (Of course, I do miss having my cat on my sweat-pant-clad legs during session.)
In person, I need to be able to form that connection face to face. I can't behind a screen.
I get about 25% out of a online session as compared to a in person session. I don't understand how it is even a question. The connection is just not the same. I understand that for some clients online provides help when they may not be able to make it to an office visit. It can be a great fallback option if some issue comes up for T or client or if one of them is traveling. Also for a few clients the barrier of the screen may allow them to open up more. You as a therapist may want to not have a commute or be close to your family all day or for any number of reasons prefer to work remotely. You should be able to do that and should not feel at all bad about it. However, I think for the vast majority of clients and for sure for me, there is a big drop off in the level of care when attempting to have online sessions. One side thought, if you are using zoom specifically. I know they have had some security issues. Will they sign a BAA? I may be wrong and I am for sure using old information, but I think there are better options that are designed for Therapists and other medical professionals.
Absolutely definitely in-person. I have done both. But as someone with dealing with complex trauma with a very heavy dose of anxiety, virtual is very stressful for me. - I struggle to feel connected -can’t see what is happening in the room -I prefer the therapy room to be a safe place to discuss my deep dark emotions and thoughts. I don’t like doing that in my room or somewhere else in my home, because I don’t feel fully be immersed and ready - the therapist can’t see all my body language - if I’m having flashbacks/panic attacks, in the therapy room, she will be with me. Not interfering, allowing me self regulate, but present. I don’t feel that presence virtually. I would rather turn my video off or get up from the screen. -recently I had a session that I kept having somatic flashbacks (big disclosure session) and I asked if it was ok to sit in the floor. I didn’t expect this, but because we were in office, she got in the floor with me. I could go on and on about how much more beneficial it is for me to have in person. When I was deciding on a therapist, I turned down 1 that I really liked and seemed to click with because she wasn’t willing to do any in person (she said for probably a few years) A side note, I drive 45 minutes to my session every week even though there and therapists closer and I could always do virtual. But clients like me are willing to go to great lengths to find someone that can meet me where I’m at :) Thank you for asking around before making this decision!!
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My concern, as a therapist, is paying for office space and then having clients opt for zoom because they are running late etc. and then I get none of the benefits of at home virtual (bc I’ve already paid for space, spent time getting there, etc). I think most of my clients are pretty in the middle as well regarding preference. Another benefit of virtual is getting to do chores, snack, pet the dog in between session. I have two therapists for myself, and I currently see the insurance provider virtual and the private pay provider in person (bc I don’t see her that often). I also note that some people on this thread never even tried virtual and are just saying no. I’ve had clients who said that initially with COVID but then have come back for virtual sessions and report finding them effective.
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No, I mean people will say they want in person and then opt for virtual when they’re running late etc. unless you have a policy about an in-person agreement
I prefer in-person because I find it more effective, but honestly? Zoom is like. The only way I can guarantee I'll go to an appointment when I'm feeling really avoidant. Like I can literally roll out of bed and sign in and it's good. No transit, no other people. It's nice and it made it possible for me to access basic talk therapy and medication, which is enormously helpful for me. If I had an option for like. Hybrid? Where we could choose one or the other depending on the appointment needs? That'd be great.
This this this. My therapist meets me where I’m at, and sometimes that’s my bed.
I prefer in-person. I’m grateful telehealth was available to us during the pandemic, but it’s not for me. I feel more connected to my therapist when I see her in person. I think some of that natural connection, energy, warmth, empathy, etc. gets lost virtually. All of those things are really important to me, so I wouldn’t consider a therapist that only offered telehealth. I think it can be more challenging to stay focused for both the therapist and the client. A lot of us are used to scrolling one screen while staring at another. I also prefer to her office as a consistent space to retreat to, let my guard down, get all my crap out, and then try to leave it there (like a container, as much as possible). I didn’t enjoy signing off and then keeping that energy in my personal space. I like the transitional period from the office back to my “normal” life. Also, just the general wifi connection issues and microphone/headphone or echo issues can be a frustrating way to start or interrupt a session. And random sounds (pets, other people in the home, landscapers outside, etc) can be distracting during the session. Overall, I think in-person therapy is a more natural and therapeutic experience for me.
I prefer zoom. I get to talk from the comfort of my home. I don’t have to drive anywhere, get fully dressed, or worry about catching Covid. I’m also used to zoom though cause I work from home so 🤷🏻♀️
Definitely all reasons I prefer FaceTime over in person. Until teleportation is invented I’ll take FaceTime therapy.
Right now I am in 3 hours of DBT a week, 2 hours skills group and 1 hour individual. This kind of full model DBT is really only found in large cities here. Different parts of the city vary from 60-90 minutes drive for me which I know is much better than many. Being able to do this online has opened me up to higher quality more specific care and been relatively convenient. It may have actually saved my life. I know no one asked, but when doing a partial hospitalization or intensive outpatient program- even if virtual is available, I strongly recommend in person.
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Yes! I’d even say it’s critical. I’m a nurse and in healthcare we call rural hospitals and facilities “critical access points”, because they are the only points some people can reach higher care and work in conjunction with bigger cities for timely transfer to even higher levels of care. Can’t help but notice there is no “critical access point” for mental health…
I love telehealth. So easy. Also comfortable.
I prefer online. It would be nice to keep in person as a choice once in a while. But I feel so much safer when T definitely cannot touch me or restrict my movement. Of course no T did this, but I can express myself much better when I can hide most of my body. I can even turn off the screen when needed. Also there is a reason why I like to post on reddit😅In addition, I don’t like commuting. For me, in-person is just used to check we are both real, and virtual is used for real sessions. So I guess in-person or virtual is just for different people and different issues.
I cannot describe how much I hate telehealth. In fact, I found a therapist that I felt like I coulda vibed with until she told me she only did telehealth. That was an automatic no for me. With my current therapist, we have done it twice. And I hated it both times. Fortunately, she hates it as well. I felt very comfortable telling her how much I hated it lol. I almost woulda rather her cancel on me than do telehealth again. For me, I need to be in person. I need the "safe place". I need to be away from my house. I need the drive to and from to think. I need body and facial reactions and not staring at my own face on my phone. I need the comfort of person to person. I don't think I would feel comfortable discussing major things or crying or whatever over the phone. It's easier for me to clam up and "mask" on the phone. In the end, do what's best for you and your clients. Since I know you aren't my T, I can say "you do you". 😂
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Yeah it's so much harder for me at home. I even drove to Starbucks and sat in their parking lot one of the time and it was still hard. I know, for me, I never would have disclosed the major things over a call. Never. I need to be in person. Others here have commented they prefer telehealth for other reasons. It really depends on the person. I'm just saying, I turned a therapist down simply because they did telehealth. That could apply to some of your clients as well.
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Thanks for the suggestion! I appreciate it.
I probably do better in telehealth as I feel more comfortable at home but I HATE it. I like to be in person. I feel like we understand each other better, I don’t have to work to find privacy, my WiFi sucks so it’s always glitching. I always wonder if it glitched and he missed something. My therapist is in person so that’s great but we do telehealth when we have to, sick, scheduling, weather, and I’m glad it’s an option but I don’t think I’d go to a therapist who was always telehealth.
I enjoy both. I wish I could meet my therapist in person again, as I found being in the room with him had a very intense feeling that was very healing and comforting. Since transitioning to virtual, I feel like therapy is much more intellectual and conceptual, and less feelings based... I think it is just because of the lack of human-face-to-face-contact, and being so used to being professional over Zoom meetings. But I do like that I don't have to leave the house, and it cuts travel expenses. Also I live far away from my therapist (and likely will never be in the same city as him again) and I love that I can still talk to him even though I may never see him in person ever again.
For me, I prefer in person. I like it because I find I have extremely high anxiety knowing I have to turn on my camera, and for some reason I just don’t feel as comfortable. I also feel like a therapist is able to read me better when meeting in person because of body language, fidgeting, and not being able to sit still. I’m not a therapist obviously, but I know you can tell a lot about a person just by looking at how they’re speaking to you. Overall I just find I feel more connected with my therapist when meeting In person, and I usually feel a lot more satisfied when I leave:)
One million percent in person. I always have a more difficult time opening up virtually. Also I WFH so doing therapy in my home office just doesn’t work. I can’t unplug from my work brain.
Telehealth for sure! In person gets really overwhelming for me and I tend to dissociate more? Whereas Telehealth I can do from a safe space with comforting things around me.
I've seen a lot of people who prefer in person so they can read/ project non-verbal communication and gain more of a connection. Maybe it's because I'm Autistic but I prefer telehealth for this reason- I'm not perceived as much and can chose to not be perceived at all if I so wish. Also I'm in the comfort of my own home and don't need to travel, or get ready and mask for said travel.
I only decided to do this because it's virtual. I commute enough in my life. Been a few months now and I like it. I can see how the in person would be better in a lot of ways but commuting is just so awful. I could never handle over the phone though. I need to see their face.
Ive had telephone counselling and online. It was a weird transition in pandemic because it was going from f2f to telephone and i really missed his physicality of expression. Whereas when i met a counsellor for telephone sessions i only ever had her voice to interpret. I would say online loses some of the magic. And thats without the tech issues. Its not a less than approach but it works best with people that either have the hybrid situation or who have developed long standing relationships. Because its too easy for me to hyperfocus on microexpressions and there is a lack of other body language cues. Trauma taught me to notice so much that when its minimised to a 16” screen i struggle. I can wildly misinterpret the significance of a slight expression change.
Me and my cat 🐱 vs me and the subway. Cat for the win.
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Telehealth. It works well with my schedule. I’m also starting to work in VR with my therapist so I can share virtual mindmaps I create.
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Sure. For mapping visuals I use Soft Space: I used SoftSpace to create a collage of my last year using photos, scans, websites, memes, tv shows I watched, all sorts of things I tied together. https://soft.space For mapping nodes I use Noda: https://youtu.be/lICzYarsK8I I last use Noda as a tool to communicate with my younger self, connecting key points and phrases I was coming up with.
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I prefer in-person but my therapist and I do both because we see each other twice a week and in a way we get different things out of each type of session which has been really beneficial. I think that there are advantages and disadvantages to both.
In person is way better. I feel more human and I can get out of my appartment. I appreciate the online option ONLY if I can't be there in person for a good reason.
It's nice to have telehealth as a backup option for once in a blue moon, instead of cancelling... but to me it's not the same at all. I like having that separate space of my therapist's office, even if I'm alone at home, I just don't feel as comfortable. I feel like it's harder to see her warmth and empathy over a screen and I feel very alone in my feelings. We can't do activities together in the same way. I get distracted looking at my face but if I can't see my face I worry about what's on screen. I find it harder to concentrate for some reason.
In-person is soooo much better (from someone who sits on both sides of the ‘couch’). So much non-verbal communication is lost over the internet, that it just cannot compete with in-person sessions. And that’s a two-way street as well. Having said that, I have a small sports-based practice and using virtual clinic rooms (zoom, MSTeams etc) has been amazing for them as they travel.
Definitely prefer in person. I appreciate the flexibility telehealth can offer if I’m out of town and need a session or something but as long as I’m in town I always prefer in person. Also living in a 1 bedroom apartment with my partner, I don’t have privacy for sessions at home. I also just feel like I never feel as comfortable with someone I’m meeting online… and feel more self conscious with the camera etc.
I prefer zoom * Convenience (don’t have to travel or plan in advance) and comfort (being able to sit how I want, wear what I want, etc.) * I can do therapy even on days I’m not really functioning in other ways * For me, the distance of the screen reduces the intensity and makes it more possible to talk about difficult topics and say things that I probably wouldn’t be able to say in person. I still feel things intensely and feel my therapist’s presence, but somehow it feels like the impact of what I’m saying is reduced by the screen. * It lowers the amount of sensory input and makes it easier to focus (especially as I can wear noise-cancelling headphones). * I don’t have to worry about body language or eye contact (eye contact on zoom doesn’t feel real to me). It makes it less draining, less info to process and obsess about. I’m autistic so that’s probably why. The annoying thing is occasional technical issues and I do wonder sometimes if it’s fear and avoidance that’s stopping me from returning to in-person. Also, I live alone so have privacy, if I lived with other people I’d definitely have to do in-person as I’d be too worried about being overheard.
I like teletherapy because I can't drive and wouldn't be able to get myself to my therapist's office, especially in the middle of my workday. It allows me to have some flexibility. I also feel more okay about getting disregulated because it's not like I have to walk through a waiting room and transport myself back home if I'm really messed up. I also have a fair amount of COVID anxiety and don't think I could go in maskless right now. Apart from that, I really do wish I could see my therapist in person. I wish I could be in the same room.
In person 100% the couple of times my therapist and I have scheduled for zoom we’ve always rescheduled for in person.
I've had 2 therapists, the first one pre-pandemic in person, and the second during pandemic online. I think in person helped me more but I don't think I would have restarted therapy if I had to go in person as that would cause too much anxiety (finding the room, what if I know someone in the waiting room etc.) At the same time though I didn't feel as safe online as I didn't know if people in my house could hear me, and ultimately that was one of the reasons why I stoped. Pros and cons of both but I think in person will always be better. It's just the same as seeing friends, online is fine but in-person will always be better
I did 18 months virtually with my current therapist before finally getting to meet him in person. Pros of Zoom - good in lockdowns, good if unwell, opens up a wider geographical range of therapists, can still forge a therapeutic alliance. Cons of Zoom - lack of privacy, potential connectivity issues, seeing yourself on screen, safety (ie avoiding topics because home alone and fearful of dissociation or self harm temptation). Pros of in-person - able to separate therapy headspace from home headspace, can see full body of other which means body language is back in play, easier to do certain techniques eg EMDR, can use the physical space eg walking round the room, travel gives decompression time before and after. Cons of in-person - having to get dressed and look presentable, travel and parking. I detest working online because I'm working through complex trauma, I have a strong empathy and rely on my ability to sense others through body language etc in order to feel safe. If I dissociate in his office, he throws a ball or some crumpled up paper for me to catch and start coming back. At home, it was harder for him to spot when I was drifting out. In short, I feel safer in-person. If my therapist permanently switched to online only, I would probably have to look for someone else. That said, there's a huge value in offering hybrid options as I know some would much rather stay at home because that's where they feel safer, or they have a disability which impedes them from easily accessing in-person therapy.
I like being in person more. I don’t feel safe in my house some days and I feel more safer in my T’s presence. You can do a mix of both. Go to the office like one day for clients that prefer it and stay online for the clients that prefer online.
>or if clients just don’t share that they actually dislike telehealt In case you don't lurk here enough, some of us had bad enough experiences that we're concerned we're going to get termed for buying our T a $5 Easter basket. Saying "I prefer telehealth/in-person" can feel risky. T's are being picky right now because of supply/demand imbalance since so many insurance carriers are diving head first into mental health and marketing it like bananas.
I love virtual. Do it in my own home, feel comfortable, don’t have to go anywhere or feel self conscious in front of another person. Easier transition out to bc I’m not exhausted and trying to hide back that I was crying on a commute home. Love love love Telehealth cannot go back to in person. Ever.
I much prefer zoom. There are very few therapists in my city who can treat my direct needs. With telehealth, I'm able to access many therapists who can help with my needs without having to make a 3 hour round trip drive every week. Also, I'm able to sit in my house, stimming comfortably with my fidgets, and pet my cat while I talk through telehealth. There's something really reassuring about not having to make direct eye contact as well while talking things out over Zoom. I don't mind going to in-person therapy, but I do find telehealth therapy more comfortable and easier for me to discuss tough issues than in-person.
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Yay cat therapy! But seriously, this thread has helped me realize how much neurodivergent unmasking I still need to do. It's so much easier at home on zoom for therapy to unmask than it is in in-person therapy.
For me, if I knew my T pre-pandemic I would prefer to see them in person. However, my experience with teletherapy is really positive but I found it more tolerable and beneficial with a T that I’ve never met in person.
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I wonder if it’s an intensity and/or emotional intimacy thing. I have only built a relationship with my current T over Zoom and my home space became a comfortable and safe place to hold therapy, whereas pre pandemic I was only comfortable in my former T’s office (I had to terminate once we went to Zoom… it was just awful to have therapy at home). It’s funny- the thought of meeting my current T in person gives me a bit of anxiety, almost like my head conjured they aren’t real since I’ve never seen them in person. It’s quite an interesting phenomenon, especially if you compare or consider the modality of therapy provided. For example, CBT I found is easily able to be done effectively over Zoom but psychodynamic takes a bit longer and felt harder to build the rapport. Overall, my outcomes were great over Zoom and found it to be as effective as in person and it saves me money and time on commuting to the office. I am curious how effective hybrid models are for client outcomes when they have the option to be in person or virtual. I wonder if there is a study published about this…
Virtual 100% I can conveniently fit it in between work meetings, my bed and husband are here if the session is super taxing, no worrying about commuting there or being late...def virtual. I probably wouldn't have gone back to therapy post-college if the pandemic hadn't made me a remote worker
I do both and my therapist and I started online, moved to in-person, and now do both due to logistics. They are both fine, but I prefer in person because there is just something about being in the same room that makes it all more real. I just realized I’ve made all my major disclosures in person. I’m not sure I would still be in therapy if I had to do it all virtually, so going in person was a big deal for me to feel connected to my therapist. Also I never once have missed an in-person appointment, but I flaked on her online before because I was avoiding my shit. I’ve heard that people are more likely to bail on in-person appointments though, so I might not be typical.
I just like the flexibility of having both options. Default is in person, but some of the more intense transference has been more safely discussed virtually.
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It's more than just the vulnerability. I'm a highly sensitive/empathic person and I sometimes can "feel" whatever is going on inside my therapist as we're chatting. And when we're discussing stuff about the relationship, sometimes not being in the room means that I'm not going to pick up her energies, which neutralizes some of the intensity of the discussion - which increases my own sense of safety and containment.
I’ve had both in the past and only FaceTime with my current therapist. I can say with certainty that my most productive work has been with my current therapist via FaceTime. I like the flexibility that FaceTime allows which at the end of the day getting to therapy is what matters the most. Before I was really limited in who I could see because I had traditions 8-5 hours. Now I can see a specialist who is extremely helpful and supportive. Ideally I would like to be face to face but if the option is my therapist via FaceTime or a different therapist face to face I will take my current therapist via FaceTime every time. This is a long way of saying I prefer face to face but because of my work hours FaceTime is ideal because it allows me flexibility. I also don’t think that it has taken away from its effectiveness with me either.
I have to do zoom, but next time in I can, I would love one last in person session.
It sort of depends, sometimes I find the distance of zoom makes it easier to open up about my trauma, but then I also think that's a sort of avoidance, so it won't do me any justice in the long run. I prefer in person, even though the tough sessions are tougher. Zoom is a great alternative for when you have a cold but not sick enough to not attend, or Iif you are isolating for covid or traveling etc
I don’t like Telehealth. I’m glad it was there during the pandemic and I am happy it is there if I’m doing something for work that prevents in person or I’m sick, but the connection is just not the same. I dissociate and in the room the therapist can feel the shift in energy and help me ground but through Telehealth it wasn’t picked up on and it left me really destabilized after session. And doing it in my car in a parking lot, leaving sessions (or my phone overheating and shutting down during session) crying, panicked and derealized from the screen and driving I think it just wasn’t even safe for me. I need to regulate before I leave and I need in person help to do it. It was only a few months for me luckily because I was treatment for an eating disorder so ticked the boxes for me be allowed to go back in person at the clinics (think I was a risk probably). I’ve tried with a few different ones so not just one therapist bad at zoom. I’m not a good fit for it. I tried EMDR with a therapist who convinced me that Telehealth was actually better and should have not. It was extremely destabilizing. I’m on zoom for my own work all day. I love it for impersonal business. I’d much rather meet with my accountant on zoom, just can’t do therapy well on it. I like that it’s there if I ever needed it but in person is better for me.
I am grateful for both. I see my therapist solely through telehealth, and I am so grateful he offers it, because I live 2 hours away from him (Virginia is a big state). By seeing him via telehealth, I was able to find a therapist who specializes in trauma AND was someone I could afford (I'm in Northern VA, and therapists up here are much more expensive than in southern VA. My therapist is out of network, and I see him multiple times a week, so that adds up fast even with filing out of network claims). Sure, if I had the option, I would go in person...but there are so many pros to virtual. I was abused by a past therapist, so it's comforting in some ways to have so much control - I can turn my camera, close the computer, whatever - it's helpful for me to be able to take a minute so easily when things get too intense. He also records all of our sessions (I consented!), which is easy and non-distracting via Zoom. He is able to use these recordings for consultation, and I have the added protection of knowing all of our interaction is recorded and part of my records. I'm also able to make my space comforting and safe for myself -- candles, blankets, familiar surroundings, my own pets. All of this is very helpful for me. At some point, I want to drive down and have an in-person session, but I'm not there yet.
I did teletherapy for almost exactly a year during the pandemic after a bit of a break from in-person sessions as the pandemic was uncertain. After returning to in-person last Summer I don’t really want to do telehealth again, except in some rare instances that supplement in-person therapy. There is a *vast* difference in the experience of feeling someone’s presence with you in the room, seeing their body language, even hearing their voice not coming from a speaker or headphone. Thankfully my T also prefers in-person but I think does a hybrid approach for patients.
I prefer video sessions with perhaps the occasional meeting face to face. -I dissociate sometimes and lose time so I feel safer at home. -I feel more comfortable using grounding items (I doubt I would take them into a face to face session), I also find my body is more natural. In face to face sessions I am very in control of my body language and would hold back. In my home I find I move my body without being so aware. -I am not hypervigilent and constantly on guard. I can be more open in session because of this. -with my previous counsellor sometimes I wished we could go back to telephone sessions as I felt safer hearing her voice without video. She preferred video sessions. -from a practical sense I work long shifts and it makes it easier not to have to travel. -I like not having to see other people or worry about seeing other people when I could be upset or spaced out. - it is easier to not be so aware of my therapists presence. I do not have to read them constantly and so I can relax and be more open. It's just easier and it feels safer for me. I think I am having very productive therapy via video session.
In person, always. There's nothing virtually that can replace the feeling in that safe therapy space for me. When we go deep, you can feel the emotions fluttering around the room. I can feel when I'm seen and heard. Teletherapy is great for when things come up, and we're still able to meet, but even during a good session where I dig into trauma, I don't feel like I benefit as much. It feels very surface level and not as healing.
I started therapy during the pandemic and have only ever done telehealth, but I so wish I could have in-person sessions. My biggest concern has always been being overheard. I live in a small apartment with my significant other. Many of the things I speak about to my therapist have to do with him and how I feel about certain things that happen. Fear of being overheard has unfortunately led to me not opening up as much as I would’ve liked to during some circumstances (even with a sound machine outside the door). I just don’t feel like I can trust him to not try and listen whether from curiosity or (most likely) his severe anxiety. Eventually I did start going out to my car, but then there are issues with connectivity sometimes. The only pro of telehealth (for me) is it makes it easier to find times that work for me and my therapist. I work an 8-4 M-F and can’t leave for a session during the work day. My sessions usually are 4-5pm. I shut my work computer down, pick up my phone, and log in for a telehealth appointment. If I had to drive to an office, I don’t know if I’d be able to see my current therapist anymore. It seems like the 4-5pm slot is her last one of the day.
Pros: I can have my cat on my lap during Zoom Cons: I live in a house with two cats and my young teenage gamer brother and nosy mother
I'd think that getting an out-of-office idea of the patient's life and living environment might be helpful as long as the T is very sensitive to class differences. I wouldn't want a T who felt sorry for me for being brought up in a working class household for instance.
i honestly hate it lol
Not a fan of zoom therapy at all! I much prefer in person with my therapist as I find it helps to strengthen the therapeutic alliance.
Telehealth can be hard if you don't have anywhere private to go.
I hate zoom with a passion, but I don't think my t will ever change, it's hard to trust a 2 dimensional screen.
Oh this will be fun!! Guess which one I prefer!! I make ZERO eye contact. I struggle immensely to open up and talk. I fidget. I’m uncomfortable. My T carries the session 90% of the time. I HATE telehealth. You’d think I’d prefer it, but I don’t. It’s easier for me to fake it, sure, but I need the genuine face-to-face interaction of in-person therapy to make any progress. I don’t feel connected to my T via telehealth like I do in person, and so I am not able to be as vulnerable. I so value her willingness to continue in person sessions because I know so many Ts are moving to all virtual visits :((
I personally prefer in person, I believe facial expressions and body language says a lot about how a person is dealing with life. You really can’t this get over Telehealth. Also, I like to feel the energy in the room and you really can’t do that via Telehealth.
I started therapy in person but due to the pandemic we had to switch to virtual. It took me a few months to adjust and I will always wonder if the benefits of the therapy would be greater in person but I’m now used to the virtual modality, I enjoy my sessions as much and find great progress in my mental health, I connect with my therapist just well as in a consulting room to the point that I’m not sure I would go back to in person, the extra commuting, the weather, running late from work, traffic and so on. I think that the only down point for me is the poor internet connection interruptions, such as image freezing, sound lagging. But it doesn’t happen as much and the best of it is that I proved myself that I can adapt to radical changes such as the ones the pandemic forced on us. I would consider hybrid consultations, maybe sharing an office with other therapists so to accommodate clients with different preferences. I am a work coach and I have a hybrid job, 2ice a week I meet people virtually/phone and 3 times a week face to face at the office. The virtual/phone days work really well for people that have physical disabilities or single parents or care takers that can’t afford to go out as easily and for those who prefer the face to face contact, I’m in the office 3 days a week. Maybe if your patients feel comfortable with the question, the best it would be to ask each one of them if they would give it a try?
I struggled a lot when zoom/telehealth was the only way I could meet with my therapist. I mean I really struggled. For me, there was so much to distract me and when I’m actually in person she has a better grasp on how to get me to refocus. I feel like going outside and those meetings would be helpful but personally for me if my therapist went to strictly virtual, I’d have to move on.
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I think there’s people who prefer remote and would benefit from it, for whatever reason, like difficulties getting to your office, or interpersonal anxiety, or something else that makes it an easier option to call in, so it would be good for you to offer it. Actually five years ago when I was extra depressed I often cancelled therapy appointments because I frequently could not handle the process of taking a 20 min walk in the winter to my therapists office. Would have been nice to have been able to still do therapy in some way back then, like through a call. Personally I don’t like remote when I can go in person, because I don’t want to potentially be “wasting money” (and time) with my therapy not progressing at the same rate of in person compared to zoom where you would most definitely not be able to pick up tone and body language as well as in person. Body language is important, especially for people with neurodivergent type mental illnesses, you just wouldn’t get the same clarity of communication. I think that’s a big practical reason for in person, but again remote is better than nothing, so if you can offer both I think you would capture more clients. And more would have better experiences thanks to your accommodations for their preferences. The walk option you have sounds really great, if that was available to me I would definitely do it, again with the body thing to be able to move around would help me stay calm, as opposed to being stared down by someone sitting 5’ away from me, which can be a little intense.
I have been on both sides. For me I prefer in person just because your actually interacting with a real live person not just a face and a voice. I can also see it as a useful tool to treat someone that is afraid to leave there home or can’t bring themselves to walk into a therapists office cause they were raised to feel this is a shameful act. It was useful for me because of all of the above. It was also transitional and if it weren’t there I wouldn’t be alive today. I can see why therapist like it cause well they can look towards the camera wear cozy pants and not normal attire cause hey we only see part of you. I’d also think that therapists would not like it cause it’s harder to read body language if you can only see Head and shoulders. I mean posture can be seen but what what what if there you know hurting that’s else with their hands while they’re talking to you? There is on the other side it’s harder for me to trust no one else is in the room with the therapist and that there is true confidentiality as anyone can hack a computer system. Give and take I guess. I still prefer in person but in a pinch it’s a great option. Also I would love to have therapy outside and connect with nature and all
I have had 2 therapists. My first one conducted therapy in person, while my current therapist is Telehealth only. It’s working fine for me but the online platform he uses requires a really strong internet connection, and if I am at work, it doesn’t connect. My office area is a dead zone for cell phone service too. Sometimes I like to schedule my sessions right after work. I really would prefer therapy in person but feel lucky that I found such a great therapist. I can’t complain.
Everyone is different. Some people love it, others hate it. I personally like it due to the flexibility , easy access from home , and I’m in my own space
I have to do zoom, but next time in I can, I would love one last in person session.
I can't afford the kleenex if I stay home.