In-Person vs Virtual Therapy: Which Is Right for You?
The pandemic has influenced the way we live, work and interact with the world. We’ve all been forced to make a variety of unwanted, albeit necessary changes.
Even therapists, whose work with patients demands a strong, interpersonal connection, turned to remote treatment. At first, both patients and therapists alike were doubtful that therapy could be as effective virtually. However, as the pandemic raged on, and therapy remained digital, we realized that our worries about the change were mostly unfounded.
Fast-forwarding to the present, the pandemic has quieted down (for now) and while a few patients have come back to in-person sessions, a good number remain virtual. A few patients have asked me, “Should I come back to in-person therapy, or is it okay to continue with virtual sessions?”
I don’t think there is a one size fits all answer, but the question deserves discussion. Both modes of therapy are valid and healing, but they provide different benefits and potential considerations.
First, let’s talk about the benefits of virtual therapy.
Home, Sweet Home: Just like we learned with the transition to WFH, being home is pretty great. We have access to all of our most comforting belongings, and we also feel most relaxed at home. For some patients, being at home during therapy is a win-win. They can explore their distress with the guidance of a therapist, but also feel reassured they are safe and secure in their home base.
Time Saver: Without the commute to the therapy office, patients are definitely saving time in their days for other activities such as self-care, errands and finishing work tasks. In turn, this can lessen anxiety at the end of the day. This benefit is more compelling for those who have longer drives to get to the therapy office than those who live a couple of minutes away.
Germ-Free Zone: While it seems the pandemic has been lessening, we know based on previous patterns that spikes in COVID tend to pop up quickly and intensely. Any lull in new cases may not last. Therefore, with virtual therapy, there is no worry of germ transference at all. You can even show up to a virtual session under the weather, without being concerned about passing it on. Besides, COVID is not the only virus that circulates through the population. Colds and flus still exist and are NOT fun to catch either! Understandably, this may be one of the biggest factors influencing many patients’ decisions to remain virtual.
Considerations for returning to in-person therapy sessions:
What Are You Working On? It is important to consider the type of work you are doing in therapy. If a patient is working through trauma, for example, there are many benefits to working in person with the therapist. With trauma work, a healing component of the therapeutic process is a mechanism called interpersonal neurobiology. Basically, a patient's mirror neurons see and mimic the calm and collected manner of the therapist, which helps integrate trauma and teach the trauma brain that it is not in danger. While research shows that this happens when two people are together in the same room, there isn’t research data yet on if this effect can still happen through a virtual space. Trauma work can also be better as in-person work because the therapist is better able to read the patient’s body language, see if the patient is being triggered by the content of the conversations and help ground them again. That being said, trauma work can absolutely be done virtually, it just requires more frequent check-ins with the patient and verbal communication from the patient when she recognizes herself being triggered or dissociating.
Screen Time: For most of us, screen time has definitely increased since the pandemic began. For some, another hour of screen-time chatting with your therapist is no big deal, but for others, therapy provides some much-needed social interaction free of technology.
Play Therapy: As a therapist who works with children, I have to say one of the only times I would recommend only doing in-person sessions is if the patient is a young child. The younger the child, the more important it is that they participate in person. At the height of the pandemic, even older children struggled, to pay attention for a full hour during virtual therapy. Understandably! Children work through problems by playing, and it is really hard to find activities online that properly help them express their emotions to the therapist. In addition, the activities that children can do with the therapist during virtual sessions is finite. A child can only play virtual Uno so many times before getting bored to tears of it. (Related: Play Therapy: More Than Fun and Games)
Therapy Office as a Container: With the pandemic, our homes have become more than just a place of rest. They have become our workplaces, schools and therapy offices by necessity. But boundaries can be a good thing. It can be unhealthy to unload our stress and trauma in the same room we fall asleep in. By returning in person to therapy, a patient can recreate a symbolic and tangible space where it is okay to let their problems out and keep them there without fear it will follow them home.
No matter the modality, therapy is an important tool to have at the ready. Above all else, if you are in need of therapy, you should choose the format that makes it easiest to attend regular sessions.
When in doubt, talk it out! If you’re in a position where you can choose between modalities, talking through the options with your therapist can help you make a decision that’s right for you.
It’s time to live the life you deserve.
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