How is online therapy better if there is no personal and face to face connection.

Dear PeanutButterandJelly,

Online therapy is not necessarily advertised as being always better than or a replacement for face-to-face therapy overall, but for many it is a much more desirable option and I will explain some of the instances in which that is the case.

The important part is the word "option."

Prior to the advent of or easy availability of online therapy, people had to do all the often complicated or uncomfortable things leading up to seeing a therapist at all.  These consist of finding one in a particular insurance network or otherwise affordable self-pay rate, as well as someone located in the realistic travel distance from where the client lived or worked, and with hours that fit the individual's schedule. Many people who desire or are in need of therapeutic intervention often have difficulty making the decision to actually reach out for help, and are also often concerned about having others find out about the decision or see them entering or exiting an office building, or with whom they might be sitting in a waiting room. From my personal experience as a therapist for both in-person in my primary job, and online situations with BetterHelp, persons with anxiety disorders or for whom the main struggles they have are with anxiety and panic, introducing someone into their lives to deal with very personal issues is in itself a very anxiety-provoking situation, and there are frequent no-shows, call-offs and appointments rescheduled multiple times as the person tries to muster up the courage to actually start and then continue the process.

All this being said, the availability of starting and working through the therapeutic process for any type of issue resolution often feels more comfortable in one's familiar surroundings where there is a feeling of more control of the situation. My experience is that yes, while there are signals and mannerisms that cannot always be observed or identified via video as well as they would in person, they are still noticeable in most cases if the therapist is maintaining an awareness of all the things she or he is taught to look for. I have also noted patterns of people starting out with live chat or phone sessions gradually moving to the next highest level of observation (i.e. moving from chat to actually speaking via phone, or moving from phone to video) as the trust level matures and more in-depth work has been done and more goals reached. Others may move back and forth depending upon their mood at the time of the session and events since the last contact between therapist and client. If only face-to-face were offered, it seems more likely then, in those situations, many people would merely cancel or no-show until they felt they were more able to physically get ready to leave the house and attend the therapy session. So continuity of care is often enhanced by a person being able to go to another room in their home or other surroundings in which they have control of their privacy, and have a phone session in which they do not have to worry about their appearance, being tearful or otherwise working through sensitive self-disclosures.

Hopefully even though therapy can be, yes, exhausting, the client can come to view it and experience it as more akin to talking to someone whom they trust and can share and unload information that has become a burden and is hampering healthy pursuits, than that of one more endless work-related zoom in an already stressful day. And on an online platform if a client feels the therapist assigned is not the best fit, another assignment can take place with a quicker turnaround and much less hassle than having to do that by juggling all the requirements listed above as to setting up counseling with a new therapy practice.