Written by Sierra Sands, M.S., LLP

Therapy is not one size fits all. The rise of telehealth has made mental health services more accessible than ever. However, many people wonder whether virtual therapy or in-person therapy is the better choice. Different factors such as schedules, privacy concerns, and transportation may influence someone’s preferences on whether in-person or virtual therapy is right for them. The bottom line is that both options can be effective, and the best fit for someone depends on their individual needs, preferences, and circumstances.

What Is Virtual Therapy?

Virtual therapy is conducted through a secure video platform (at MFS, we use Zoom), phone calls, or other telehealth technology.

Common Benefits

• Convenience and flexibility: You can join from many secure locations at any time within your provider’s availability. This also offers greater accessibility for individuals with transportation, mobility, or health concerns.
• No commute or travel time: No travel time gives people the opportunity to fit therapy into their schedule when they otherwise might not have the time. This makes scheduling easier for busy professionals, parents, and students
• Access to specialists who may not be available locally: You may be able to see a provider in a different part of the state, or a different state altogether depending on their licensure. *If you are in another state, be sure that your provider is licensed in that state, or that state/therapist is part of PSYPACT (see below for details).

Potential Challenges

• Requires reliable internet and technology: Therapy may not be as productive if your video keeps freezing or you are dealing with dropped calls.
• Limited privacy in some home environments: Some individuals may worry about their therapy sessions staying private if they are in their home while others are present.
• Potential distractions at home: Being at home could increase distractions through other people in the home, neighbors, or even being distracted by other tabs and notifications on the device you are joining your appointment from.
• May feel less personal for some individuals: Some folks may feel less connected to their therapist online rather than in person.

What is PSYPACT?

PSYPACT (the Psychology Interjurisdictional Compact) is an agreement among participating U.S. states that allows licensed psychologists who have obtained PSYPACT authorization to provide teletherapy across state lines. This means that eligible clients can continue working with their psychologist even if they are temporarily or permanently located in another participating PSYPACT state.

Whether you’re away at college, traveling for work, spending part of the year in another state, or relocating, PSYPACT can help ensure continuity of care without interrupting your therapeutic relationship. It expands access to high-quality psychological services while maintaining the same professional licensing and ethical standards required for in-person care.

At McCaskill Family Services, several of our psychologists are PSYPACT-authorized, allowing us to provide teletherapy to clients in participating PSYPACT states. If you’re unsure whether your location qualifies, we’re happy to help you determine your eligibility.

What Is In-Person Therapy?

In-person therapy is traditional face-to-face therapy where sessions are going to be held in an office setting.

Common Benefits

• Dedicated therapeutic environment free from home distractions: Having a specific place separate from your home to talk about your concerns can make people feel more engaged. It is also helpful for those who prefer structured routines and separation between therapy and home life
• Strong sense of personal connection for some clients: Attending in-person therapy appointments can help some clients feel more comfortable and connected to their clinician.
• Easier observation of nonverbal communication: Since you are in person, a clinician is better able to read nonverbal communication as they can see all of you, rather than a portrait on a screen.

Potential Challenges

• Travel time and transportation costs: It may take someone longer to commute to a therapy office, which also requires transportation. This could also be an accessibility barrier for some individuals who have health challenges, lack of reliable transportation, or mobility concerns.
• Scheduling limitations: You may be able to schedule a virtual appointment for your lunch break or right after work if you want to attend virtually, but that could be more challenging if you must commute to an office, depending on the drive time and the therapist’s schedule.
• Geographic restrictions on provider options: There may be a specialist in another city or state that you want to work with, and traveling may not be a reasonable option.

How Effective Is Virtual Therapy Compared to In-Person Therapy?

Studies show that teletherapy is effective for many common concerns, such as:

• Anxiety
• Depression
• Stress management
• Relationship challenges
• Many forms of trauma treatment

Overall, the quality of the therapeutic relationship is often more important than the format of the treatment and both formats of therapy can lead to meaningful progress.

How Do I Decide?

Virtual Therapy May Be a Good Fit If You:

• Have a busy schedule
• Travel frequently
• Live in a rural or underserved area
• Have transportation challenges
• Feel more comfortable opening up in your own environment
• Need access to a specific specialty provider

In-Person Therapy May Be a Good Fit If You:

• Prefer face-to-face interactions
• Find it easier to focus outside of your home
• Value having a dedicated therapeutic space
• Have limited privacy at home
• Feel more connected through in-person conversations

Special Considerations for Children and Teens

Virtual therapy may work well for older children and teens who are more comfortable with technology.  Whereas in-person therapy may be beneficial for younger children, especially if the therapist is engaging them through play-based activities. The age, developmental level, attention span, and treatment goals will all influence what the best option is.

Can You Switch Between Formats?

At McCaskill Family Services, we offer both virtual and in-person options for whatever fits your needs best. Some clients may start with in-person appointments and later switch to telehealth. Others will use a hybrid approach based on scheduling needs. We can be flexible as your needs change over time.

Conclusion

There is no “better” option, only the option that works best for you. Both types of therapy can provide effective support, growth and healing and help you meet your goals. If you are feeling unsure what would be best for you, talk to your clinician about your goals, preferences and circumstances and they can help you decide what is the best option.

Interested in starting therapy but unsure which format is right for you? Our team offers both virtual and in-person services and would be happy to help you explore the option that best meets your needs.