The COVID-19 pandemic transformed the world of therapy. Video sessions became a necessity. Years later, we now have a better understanding of what works, when it works and for whom.
The short answer is: both work. The longer answer is more complex – it depends on you.
Offline Therapy (In-Person) – The Traditional Format
This is therapy conducted in person with the therapist.
What it offers
Face to face:
Being in the same room can have a powerful impact. Your therapist can observe body language, movement, pauses and breathing patterns before difficult conversations.
Less distraction:
You are in a dedicated space with fewer interruptions. This often makes it easier to open up.
Grounding during distress:
In-person sessions can help people feel more grounded in their body, especially during trauma or acute anxiety.
Ritual & commitment:
Going to an office creates structure. You’re making time, travelling to a space and fully attending the session.
What’s challenging
Logistics:
If you live far from the therapist’s office, you may travel a long distance for a 50-minute session.
System overload:
Appointment availability may be limited. Some therapists have long waiting periods.
Cost:
Some face-to-face sessions may be more expensive because therapists must maintain office space.
Being vulnerable face-to-face:
Some people initially find it harder to open up in person.
These are typical factors to consider when it comes to offline therapy.
Online Therapy – The New Way to Go!
What it offers
Easy access:
Sessions can happen from home, office or anywhere with internet access. No commute.
Accessibility:
You can access a larger number of therapists beyond your location.
Flexibility:
It fits more easily into busy schedules.
Privacy & comfort:
For some people, familiar surroundings reduce pressure.
Lower cost:
Therapists may have lower overhead expenses, making sessions more affordable.
Consistency:
People are less likely to miss sessions.
What’s challenging
Internet connection problems:
Technical issues can interrupt the session and become frustrating.
Fewer body cues:
A screen limits some non-verbal communication.
Distractions at home:
Family interruptions, notifications or pets can affect focus.
Less grounding for severe trauma:
Some individuals experiencing intense trauma may benefit more from in-person support.
These are some of the realities of online therapy.
Which is More Effective? The Research Says
Research has demonstrated that online therapy and offline therapy often have comparable results. The effectiveness depends more on the therapeutic relationship — feeling heard, respected and safe — than the medium itself.
However:
- For anxiety and depression: Both online and offline are equally effective.
- Trauma: Some studies suggest in-person sessions may feel slightly more grounding, although online therapy can still help.
- Relationship problems: Face-to-face work can sometimes feel more collaborative, depending on the couple.
- Continued support: Online sessions may improve consistency because people are less likely to stop attending.
The Real Factor – The Relationship
The most important thing is whether you trust your therapist. Do you feel heard and understood?
I’ve had people do deep emotional work through video sessions. I’ve also had clients who felt more connected sitting in the same room. The medium matters less than the relationship itself.
How to Choose – What is Right for You?
Choose offline (in-person) if:
- You are dealing with trauma and need grounding
- You like having a dedicated therapeutic space
- Your therapist is nearby and accessible
- Structure and routines help you stay committed
- You feel more comfortable speaking face-to-face
Choose online if:
- Your schedule is hectic and travel is difficult
- You live somewhere with limited therapy options
- You prefer the privacy and comfort of home
- You travel frequently
- Cost is an important factor
The Hybrid Approach
Some people use both approaches. One client I work with comes to my office during periods of acute stress because grounding helps him. Later, he shifts to online sessions for ongoing maintenance work. This isn’t a limitation of online therapy — it’s about understanding what works best for your needs.
What I’ve Learned from Both
Face-to-face sessions
I notice more subtle shifts. A change in posture while discussing a relationship. A deep breath before saying something difficult. Those moments matter.
Online sessions
Sometimes people feel more relaxed in their own environment. A person sitting comfortably at home with a pet nearby may actually open up more. Online sessions also tend to have fewer cancellations because the barriers are lower.
Key Takeaway
The “best” therapy is the one that actually happens. If online sessions help you show up consistently — do online therapy. If you need the grounding of in-person work — choose offline therapy.
The most important thing is showing up honestly and doing the work.
Mental health matters more than the format used to support it.
Follow Tanu Choksi on Instagram, LinkedIn, and Facebook for expert insights on therapy and self-understanding.
