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  • Charleen Gonzalez

Why Online Mental Health Care Versus In-Person?

By: Charleen Gonzalez LMFT


Due to the pandemic in 2020, virtual everything has become the norm. From working, to school, to even medical visits, there doesn't seem to be that many activities that can't be done via webcam. We're also starting to use teleconferencing in our daily vernacular, i.e. "I have a zoom meeting later", or "we're having a zoom get together". During early 2020 insurance companies and licensing boards made it a lot easier to receive mental health care via teletherapy due to the pandemic. A great majority of therapists began offering their services 100% online in order to keep their clients safe. Now that 63% of Americans (as of 6/3/2021) have received at least one vaccine, many providers are offering to begin in person appointments. But do we want to go back to in person? Plenty of individuals are refusing to go back to work in person. According to one poll, about 39% of responders would consider quiting a job if their employers did not allow for work from home flexibility. It begs the question if we are unwilling to work in person, if we're likely to want to continue health and wellness visits in person either?


So what are the pros of online mental health care? Let's lay them out here:

  • Convenience would be likely be the most obvious answer. Driving 30-45 minutes in traffic after work to get a therapist appointment, finding parking, baring your soul, then driving another 30-45 minutes home to finally unload after a long day sounds like a no go for many. Also, for disabled individuals where getting around can become an even bigger ordeal, online therapy provides an easy answer. Saving money on gas is another bonus.

  • Access is another big one. Ability to see providers with certain expertise from within the entire state of residence. In certain areas finding a provider is a near impossible task. Now with telehealth, you can see a provider 100 miles away with no problem.

  • Comfort is another pro. Those with anxiety disorders can feel a little more at ease with going to therapy as they don't even have to leave their home. Meeting with people in person can feel exceedingly nerve wracking for several with social anxiety, and although this may also be the case for meeting via zoom, for many teletherapy provides them with a buffer that is more comfortable since they are in their own homes/safety zone.

  • Ease of scheduling is a pro not often thought about. Let's say the only feasible time you have in the week to see a therapist is from your lunch break. This is a reality for several who work multiple jobs, have kids, and also live far from work. Now you can pop into your car and have an online session whenever you have the time. Or let's say you only have time at 8:00pm for sessions, but need to be able to stay home either due to safety reasons or not having a nanny. There are many personal reasons why online therapy makes sense.

Let's also consider the cons:

  • Privacy. This is a big one for many, as not everyone has a private space in order to conduct therapy. I have had clients that talk to me from their car because that is the only private space they have away from their partners or other family member. This works for those clients, but it may not work for everyone.

  • Not having a strong internet connection. This is a reality many have to face. Having high speed internet is not a luxury everyone can afford. This restricts access.

  • Feeling a connection to your therapist. This is a case by case situation. I have had clients that I have continued to see me since the start of the pandemic last year via online counseling. Some love it, and some are not into it (therefore do not make an appointment). It's truly up to the person, but any competent therapist can build rapport with a client no matter the medium of therapy.

  • Worries about technical safe guards. Any ethical therapist will use a HIPPA compliant website for therapy sessions. These are websites that sign a BAA with the therapist and ensure safe guards are set up to secure privacy. Websites like Doxy.me, VSee, Psychology Today, Simplepractice, professional version of Zoom, and others have been vetted and are trusted within the medical/mental health community.

  • Online counseling is not indicated/advisable for high risk clients. Several mental health licensing boards have made it clear that high risk clients (suicidal/homicidal) clients should only be engaged in person treatment. This is for the client's safety. This does not include passive suicidal ideation, which is very common for individuals with depression. But rather for those have current suicidal intent, or have indicated a current plan to end their lives.

So the conclusion here is to take some time to consider the pros and cons of online therapy, and what works best for you. For some, online therapy has been truly life changing. So many of my clients had never tried therapy before the pandemic, and have loved the ease of engaging in online counseling. Many therapists are either planning on a hybrid model, where they do some sessions in person and some online. Or are giving up their offices entirely and dedicating their services via solely online. Teletherapy truly seems like the future of mental health care.

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