Online or in person: which kind of therapy session is right for you?

I meet with clients both in my office and over video, and people often ask which one is better. The truthful answer is that neither one is better across the board. They are different, and the right choice depends on your life, your comfort, and what we are working on. Here is how I think about it.

What telehealth means

Telehealth is health care delivered over a distance. For therapy with me, it is always a secure video call. That means you and I talk face to face on a screen instead of in the same room. The platform I use is built for health care and protects your privacy the same way an in-office visit does. Everything about confidentiality, what we talk about, and how the session flows stays the same. The only real difference is where you are sitting.

The case for meeting online

Online sessions remove a lot of friction. There is no drive, no parking, and no waiting room. You can fit a session into a lunch break or right after work without losing an extra hour to travel. For people with busy schedules, small children at home, or a long commute, that alone can be the difference between keeping up with therapy and dropping it.

Some people also find it easier to open up from their own space. Being at home, in a familiar chair, with your pet nearby, can take the edge off the nerves that come with a new setting. If you live with a chronic illness or limited energy, staying home can make therapy possible on days when a trip out is not. I wrote more about that in my guide to therapy and chronic illness.

And video sessions travel with you. If you are out of town for work or staying with family, we can still meet, as long as you are physically in Arizona at the time, since that is where I am licensed.

The case for meeting in person

There is something about being in the same room that a screen does not fully capture. Small cues like posture, a shift in breathing, or a pause before you speak come through more clearly in person. Some people simply feel more connected face to face, and that connection is part of what makes therapy work.

The office also gives you a boundary between therapy and the rest of your life. You leave your house, you sit in a space set aside for this, and you drive home with time to think. For people whose home is loud, crowded, or not private, that separation is not a luxury. It is the only way a session can feel safe.

Finally, if home is part of what you are struggling with, it can be hard to talk about it while sitting in the middle of it. Getting out of that environment for an hour can help.

Home also comes with interruptions that an office does not. A dog who wants attention, kids who need something, a spouse walking through the room, or a knock at the door can all pull you out of a hard conversation at exactly the wrong moment. Internet connections drop, video freezes, and audio lags. None of these ruin a session, but they do add friction, and if your home has a lot of them, the office may simply be the calmer choice.

Who tends to prefer which

In my experience, people who choose online sessions most often value convenience, have a private spot at home, and already feel fairly comfortable on video. People who choose in-person sessions often want the ritual of showing up somewhere, have trouble finding privacy at home, or notice that they focus better without a screen between us.

Many people do a mix. They come to the office when they can and switch to video when life gets busy. You are not locked into one format, and you can change your mind at any point.

Can EMDR be done online?

Yes. Eye movement desensitization and reprocessing, or EMDR, is a therapy that helps the brain finish processing painful memories using back-and-forth attention, such as following a moving point with your eyes. Over video, we adapt this. You might follow a moving dot on your screen, tap alternately on your own knees or shoulders, or use audio tones through headphones. The structure of the work stays the same. If you want the full picture, I wrote a step-by-step guide to what happens in an EMDR session. For some people, the sense of safety that comes from being in the office matters more during trauma work, and that is a fair reason to choose in person. We can talk about which setting fits you.

Tips for a good video session

A little preparation goes a long way:

• Find a private space where you will not be overheard, and let the people you live with know you need the hour
• Use headphones so your side of the conversation stays yours
• Sit somewhere you can stay for the full session, ideally with your face lit from the front
• Check your internet connection and close other apps that use bandwidth
• Keep your phone nearby as a backup in case the video drops
• Give yourself a few minutes before and after so the session is not sandwiched between two other tasks

If technology fails mid-session, do not panic. We will reconnect, and if we cannot, we will finish by phone or reschedule the remaining time.

Choosing

If you are still not sure, start with whichever one feels less intimidating. You can always switch. I offer both in-person and online sessions, and the days I am available for each are listed on my about page. If you would like to talk through which option makes sense for you before you book, reach out. There is no wrong choice here, and no pressure either way.