online versus in person therapy

This may have been asked before apologies if I missed it but are most people here back in person or still doing virtual? How are you finding it either way?
I am still doing online and looks like it will be this way for the foreseeable future. Was in person prior to COVID. I was okay with online when it was temporary but not that it seems like it is permanent I am not really okay with it. Have people had similar things like this? How did you find it? I am considering leaving therapy because of this but I can't seem to articulate why it is that different or important.

Luckily, my T went back in person at the end of July, with a temporary break when Delta hit. For the previous year and half, we did phone sessions. Partially it was okay for me as I don't make eye contact, so found it a little easier to open up on the phone. But, I like being back in person again. There is a lot that gets missed when we just talked on the phone.

I am sorry your T doesn't seem to be going back to in person therapy. Have you talked to them about this?

I am, thankfully, back to in person therapy. I do, however, have a teletherapy appointment today because my therapist has been exposed to covid. I can barely stand teletherapy. I had to do it for 15 months and it was hardly bearable. We still have to wear masks during in-person and we have to sit 6 feet apart. I think it's all gone a bit too far, since we hug at the end of the session (and we're both fully vaxxed).

Thanks for your response. Can you tell me why in person is better for you? I know in person is better for me but just can't articulate why.

Do people find in person with masks is better than online without? I don't think mine is going to change but I want to articulate my needs and wishes in a coherent manner (especially if I decide to leave) but am having difficulty doing so.

Being in the physical, energetic, presence of someone - someone who is a support figure no less, is very different than seeing them inside a little box. You also have the totality of the visual field vs. a head and shoulders view of them. And in person, T can also get physically closer.

However, for me, T became human and relational online. I don't want to 'lose' that by being in person and be back to closed-off T. Also, on-screen, I can see micro-details of T's facial expression etc. which is very helpful. For some people, it is also easier to maintain eye contact (so to speak) online vs. in person.

In a nutshell, there is no easy answer for me to this question.

Mine went back to in-person for 3 whole weeks in late July/early August. Unfortunately, he opted to resume just as delta was beginning to spread. He was meeting in person without masks and didn't want to use masks, so he opted to go back to virtual in mid-August. I was sad, but as I told him, I was glad I got to see him in person for a few weeks (I currently go 3 times a week, so it was more than just a few sessions, but I also did a couple sessions virtually during that time due to schedule issues).

So we're back to virtual for the foreseeable future. I prefer in-person, but virtual therapy has actually worked pretty well with my T, in terms of feeling connected, communicating well, etc. There are a few things I miss though. One is what Rive mentioned, the energy of being in the same physical space with another person and being able to see all of their body language (and for him to see mine as well). Another is having a separate location for my therapy, which felt like a "safe space," rather than just meeting someplace in my house. The last one is related, but it's having the transitional time to drive to and from therapy (15-20 minutes). It gave me time to sort of get into "therapy mode" and also transition back to my regular life. I know there are ways I could theoretically do that at home, but it still doesn't feel quite the same to me.

I will say that one other advantage of virtual is being able to show my T where I live. I suppose I could have taken photos or video and shown him, but this allows me to show the actual space (my house is a split-level townhouse with lots of floors and kind of difficult to explain). Including the mess/clutter that surrounds me. Also, on a couple days that T was working at home (he often meets from his regular office), I got to see his dog and cat. It was interesting for me seeing him pet his dog for much of the session, as I hadn't seen him be affectionate to any sort of creature before (we talked about it at some point). That wouldn't have happened in his office, as he's not the type to bring a pet to work (well, aside from his now-late Fish).

Assuming at some point we'll be able to go back to in-person for good, I do like that virtual will continue to be an option. It would be good for inclement weather or if I or T wasn't feeling well but not feeling bad enough to cancel the session entirely (like he's been sick this week--negative for Covid--and I wonder if he'd have canceled both sessions had we been meeting in person without a virtual option). And it also enabled me to still have a session while I was out of town. However, I definitely wouldn't want to switch to virtual permanently, and T has said he much prefers in person, so I can't see him choosing to stop in-person entirely once things become consistently safe again (plus he's stuck in a pretty long lease on his office and rents out space to some others).

Just curious LT, and please feel free to disregard: did you / were you able to feel as connected to T in-person? I mean, was he as 'open' or relatable in-person, if that makes sense?

That is a worry I have re my T, so just wondering how it was for you?

Virtual sessions were always impossible for me. Last year at the beginning of covid me and T had arranged to do appointments on zoom, and I completely broke down in that week. I knew the pandemic would go on for years and that meant not seeing him for years, possibly.

I regret not having any experience with zoom now, as I just had a baby and it would be really useful to talk to him somehow right now, without leaving the house.

The only way I can explain how seeing him in person is better than online, is the same as if I was to talk to someone I love. On the phone or internet it's too far, they are there but not there. I long to see them in real life and feel them physically close to me.

While we were doing zoom at the beginning unbeknownst to me she moved more than two hours away. When were able to go back to in person she told me she moved but we could continue to do zoom. I could have chosen to see someone in person but I had been seeing her for 5 years so it would have been difficult to leave.
I don’t mind the zoom , I think I actually talk more, but I wish I could do in person every once in a while.

I'm trying to think of how to answer this. So, I did see him in person for a session once outside at a table at the coffeeshop downstairs from his office in June. And that felt both nice and strange, in part because it felt more like two people meeting for coffee, so more friend-like (which I think also made it kind of nice).

With that, it felt like I was talking to a different person. This may seem like a minor thing, but on Zoom, he wears reading glasses, but in person, he doesn't wear glasses. So I had to sort of adapt to that. Plus his being in 3 dimensions. And he was wearing shorts, which I hadn't seen him in before (he'd warned me about that, but it was hot out, so it didn't matter). I think he could tell that at first I had trouble connecting/recognizing it as the same person I'd been talking to on the computer, as he said, "Hello there!" a few times in the first 10 minutes.

I think the fact that I had seen him in person that time made it easier to transition and recognize it as him when I returned briefly to his office in late July. That was complicated a bit though by his returning after 10 days away, his first actual vacation since the pandemic started. So it was like I had to reconnect due to that, plus to in person.

But I feel that happened pretty quickly, and I felt connected and comfortable talking about different issues. I think being in his office made it easier for my brain to make the connection that it was the same person I'd been talking to (he often does Zoom sessions from his office). And I was even able to talk about something really personal tied to the therapeutic relationship by the third week.

The one difficult thing was him having us sit 6 feet apart, so I wasn't in my usual seat, plus he seemed much further away than he did on the computer. And he did his best to keep his distance (difficult due to office layout) when I was leaving, which felt a bit rejecting (we used to shake hands), even though I knew while he was doing it.

So I would say that yes, I ultimately felt pretty much the same connection, though it was a bit different. I would say if/when you try going back in person to just give it a few sessions to adapt before making a decision about whether it works for you.

The first time I did Zoom with him, I *hated* it and didn't feel like I could continue (thinking maybe phone would be better or stopping until we could be back in person--little did I know at the time, how long that would be...). But I gave it another try, and after a few sessions, basically adapted (I think there was also an element of comprehending that it was the same person). So I think the same could apply to returning in person.

TL;DR: Yes, it did feel connected in person, though felt a bit strange at first and took a session or two to feel the same level of connection and comfort.

Thank you very much, LT!

Yep, seems to be a learning curve i will have to adapt to.

I’ve been back to in person since May 18th after 14 months of virtual. I find in person to be more productive mainly because of privacy issues. I haven’t heard anything about them going back to virtual. I’ve heard that other offices have. I can very well see it happening to me. I may have to do virtual by choice in a few weeks for a session.

I moved away from my old therapist while still being remote. Saying goodbye to her through a screen was heartbreaking and messed with my mental health for several months straight. My current T says I never had closure with her.

Thanks for sharing LT. Question out of curiosity if he said tomorrow he was going to be online for the foreseeable future and would not ever be resuming in person would this effect you? This is what is happening for me. Virtual was okay whilst it was okay and temporary but now that is permanent it doesn't feel okay anymore.

It would definitely affect me. I'd feel really sad about it and probably have doubts over whether to continue with him, even though virtual generally works well for us. I think part of what kept me going through it before was the thought that we'd eventually resume meeting in person again. And I'm feeling the same way now.


I'm very sorry you're dealing with that. Do you think you want to stay with this T, knowing now that the virtual is permanent?

Good question..I am trying to figure out the answer. Right now I don't think I want to stay with them if it's going to be online forever. I'm trying to figure out why though and put it in to words and having difficulty. I don't want it be based on an unconscious temper tantrum because I'm not getting what I want and that I later regret doing. It does feel very much like it has changed something though and if I do end therapy I want it to be a conscious choice because I feel it's the best choice for me and not a reaction to something that has happened.

My T and I did virtual sessions for 11 months last year. During that time, I was extremely anxious about the change, felt like the experience wasn’t as rich and even when sessions went well and I felt connected to him, I’d be reminded that we were far apart by bad internet connection, pixelated screens and the chat freezing. As the weeks turned into months, I convinced myself that he would never go back to in person and constantly felt like I was about to lose something extremely important. The whole thing also accentuated the limitations of our relationship. When lockdown restrictions eased, he could meet friends and family outdoors, but we still did virtual sessions. It was a painful reminder that I was just his job, that if we wouldn’t meet in person again, it wouldn’t matter that much to him.

Fast forward to February of this year. We were still in lockdown here in the UK but seemingly overnight, T decided to allow in person sessions at his own private practice. He had made the space “covid secure” but we weren’t required to wear face masks. I’ve now been back to face to face since then and couldn’t really be happier. To me, it makes a massive difference to be be able to see all of him, to sit in the same room as him. The energy in the room transforms the sessions for me, makes me feel heard and seen in ways I didn’t feel over video.

That being said, I was thinking about virtual sessions recently and realised that there is something I sort of miss about them. We had quite a few breakthroughs over zoom, some really memorable sessions. Video provided a different sort of intimacy that is not there in person. I don’t mean that it was more intimate than in person, just that it was different and had its own quality. I sometimes miss that. While I wouldn’t willingly go back to virtual sessions, I don’t think they were as bad as I thought at the time and now I look back to that time in my therapy with a certain degree of nostalgia.

I did it online once a week from March shutdown until the end of the year (quit because I had to downgrade my insurance to a ppo and that T didn’t take it).

I guess I am the outlier here - I thought it was great, other than the occasional technical difficulties with teleconferencing. Didn’t have to drive to an office in heavy traffic, or in all kinds of weather, or find a parking spot, or wait for a crowded elevator or in an overcrowded waiting room.

Personally I hope telemedicine is here to stay for anything that doesn’t literally require the provider to be “hands on” the patient. Saves time, gas and frustration.

I think it's good to have teletherapy as an option, but also (once the pandemic recedes) to have in-person as an option, too. I think teletherapy could be really useful for bad weather, therapist or client feeling a bit ill (but not bad enough to cancel), car trouble, child care trouble, work issues, or just not wanting to make a long drive for someone who lives far from their therapist. Actually, it could also increase availablility for people who live in more remote/rural areas as well.

But I also want in-person to stay, because I think that has many advantages as well.

I hope telemedicine continues to exist for medical doctors, too. If it's just, say, following up on test results, it doesn't seem necessary to go into the office.

My new one only does telehealth. I want to get away from my current one as soon as possible so part of me is saying whatever I have to do. The other part is still thinking telehealth sucks majorly.

L now uses telehealth when she's out of town or when I was sick. Before we would just miss sessions. I, personally, still hate telehealth. However, it's better than nothing. L and I do phone sessions and then the last 5 mins switch to telehealth so we can see each other when we say goodbye. I don't like being on video. It makes me insecure and self conscious. So that's why we do both.