Online Therapy vs In-Person: Advice from Therapists Who Provide Both

Karissa Fleming, MS, LCSW, highlights three significant advantages of traditional face-to-face therapy she sees in her practice:

1. Dedicated Therapeutic Space
   One major benefit to in-person therapy is the designation of space. Therapy often touches on distressing subjects. Associating that distress with your home environment can make transitioning back to everyday tasks difficult. Just as experts recommend reserving your bed strictly for sleep to promote better rest, having a dedicated therapeutic space helps your mind distinguish therapy from home life, often allowing clearer emotional boundaries and reducing feelings of being “stuck.”
2. Access to Therapeutic Tools
   Another critical advantage of in-person sessions is the access to therapists’ physical tools and resources. “Working primarily with children, my office includes miniatures, coloring materials, games, age-appropriate mental health literature, and a sand tray,” she shares. “These tools let clients explore coping strategies in real-time and address emotional needs promptly.”
3. Stronger Human Connection
   Lastly, in-person sessions enhance human connection—an essential element in therapy. While communication through screens can serve a purpose, being physically present with one another in a shared space provides a higher level of human connection. This human connection is wired into human nature and boosts oxytocin levels while also providing a real-time example of co-regulation (the concept that humans affect each other’s mood and even biology). If you are feeling anxious in your home, attending an online appointment with a calm therapist might help some, but you would still be physically alone in your home during the appointment. However, if the appointment were conducted in-person at a LifeStance office, you would likely feel the therapist’s calming presence.

While communication through screens can serve a purpose, being physically present with one another in a shared space provides a higher level of human connection.

Brianna Sneed, LCSW is a Licensed Clinical Social Worker with CADC certification specializing in addiction counseling, strongly encourages in-person visits due to significant dynamic shifts compared to online therapy.

Sneed explains, “Therapeutic rapport is important and tends to be better when we can observe subtle nonverbal cues: In person, therapists can pick up on nuanced micro-expressions, shifts in posture, and eye contact—all of which contribute to assessing a client’s emotional state.”

According to Sneed, “A client being physically present often fosters a stronger sense of emotional attunement and mutual presence. This helps create what many clinicians refer to as the ‘felt sense’ of connection, which is more difficult to replicate virtually. Entering a physical office can itself be therapeutic—a space intentionally separate from daily life that sets the tone for introspection and safety. In contrast, online sessions often take place amid domestic distractions.”

Body language plays a critical role—in person, therapists can observe nervous habits, such as fidgeting, leg shaking, or self-soothing gestures, which may be out of frame in a virtual session.

Emotional presence is another significant factor. Face-to-face sessions support emotional co-regulation through breathing, tone, and physical energy exchange, essential for individuals dealing with attachment wounds, severe anxiety, or addiction recovery. In high-emotion moments—such as grief, rage, or panic—in-person therapists can often immediately provide containment and reassurance, adjusting their tone, offering physical comforts like tissues, and modulating the therapeutic environment.

Despite the undeniable strengths of in-person therapy, experts acknowledge scenarios where online therapy may be the logical choice. Fleming points out, “For those in rural areas or facing transportation barriers, online therapy can be life-changing. It provides access to specialized mental health services that otherwise would be unreachable.”

For those in rural areas or facing transportation barriers, online therapy can be life-changing.

She specifically notes how online therapy can benefit communities with limited access to specialized care, highlighting the LGBTQ community as an example: “Online therapy can connect LGBTQ individuals with affirming therapists who may not be available nearby, potentially saving lives by breaking isolation and providing critical support.”

A recent report from Deloitte found consumers are nearly evenly divided in their preferences for virtual versus in-person mental health care, with 38 percent favoring in-person services and 35 percent preferring virtual care. LifeStance recognizes the strengths of both therapy types, offering an integrated hybrid model. Unlike platforms like TalkSpace or BetterHelp that only provide virtual care, LifeStance delivers personalized, high-quality therapy through licensed professionals, both virtually and face-to-face.