Telehealth vs in-person therapy: how to decide
Choose telehealth if travel, scheduling or distance would keep you from attending, and you have a private space and a reliable connection. Choose in-person therapy if home is not private, technology frustrates you, or you focus more easily in a room with someone. Many people switch between the two as life changes.
Key points
Telehealth saves travel time and can reach people far from an office.
In-person visits offer a private room and no technology to manage.
Privacy at home and a steady internet connection are the main telehealth hurdles.
Whether telehealth is available depends on where you are located during the session.
Check that your insurance plan covers the format you choose.
What is telehealth therapy?
Telehealth therapy is a session with a licensed clinician over a secure video or phone connection instead of in the same room. The National Institute of Mental Health describes this kind of care as mental health support delivered virtually, and notes it is often called telehealth or telemedicine.
The conversation itself is much the same. You still meet with the same therapist at a set time, talk about what is going on, and work toward goals you set together. What changes is the setting, and that matters more for some people than others.
What are the benefits of telehealth therapy?
The National Institute of Mental Health lists four main advantages of meeting with a provider virtually.
Convenience: virtual visits do not require travel.
Flexibility: appointments can often be scheduled with less notice and at more flexible hours than in-person care.
Access: virtual visits may reach people who cannot easily get to in-person care, such as people who cannot drive or who live in remote areas.
Comfort: connecting with a provider online may feel less intimidating than walking into an office.
What are the downsides of telehealth therapy?
The same source is direct about the drawbacks. You need an internet connection and a device such as a smartphone or computer. A weak connection or a device that misbehaves can interrupt a session, and learning a new app can be confusing.
Privacy is the bigger issue for many households. A virtual visit may feel less private if people nearby can see or overhear it. Some people are also uncomfortable using a camera at home, where a provider can see their surroundings.
Think honestly about your space. A parked car, a bedroom with the door closed, or an empty office at lunch can work. A kitchen table with family walking through usually does not.
When is in-person therapy a better choice?
An office gives you a room that exists only for this purpose. Nobody is on the other side of the wall, nothing needs charging, and the drive there and back can give you time to shift gears.
In-person sessions may suit people who share a small home, who find screens tiring, or who feel more at ease talking with a person face to face. If the appointment is for a young child, ask the therapist which format they recommend for your child's age.
Distance is the usual trade-off. On Maryland's Eastern Shore, an office visit can mean a long drive, and that cost in time is real. If the drive would make you cancel often, the format you can keep attending is the better one.
How do you decide between telehealth and in-person therapy?
Work through these questions in order. If you answer no to the first two, start in person.
Do you have a private place to talk?. You need somewhere you will not be overheard or interrupted for the full session, every week.
Is your technology reliable?. Check that your device, camera, microphone and connection hold up on a video call before your first visit.
Where will you be during sessions?. The licensing rules a clinician must follow depend on where the client is physically located during the session. Tell the office where you will be, including when you travel.
Does your plan cover it?. Check with your insurance provider or the practice's billing office to confirm that your plan covers telehealth. Our guide to checking your mental health benefits lists the questions to ask.
Which setting helps you open up?. Some people speak more freely from their own couch. Others need to leave the house to focus. Neither is wrong.
Can you mix formats?. Ask whether you can begin in person and move to video later, or switch when your schedule changes.
Telehealth is not for emergencies
A scheduled video visit is not crisis care. If you are in crisis, call or text 988 or call 911. Our office does not provide emergency services.
How Balanced Life can help
Balanced Life Counseling Services offers both formats. In-person and telehealth appointments are available through our Salisbury office and our Bethesda office, for children, teens, adults, couples and families.
Whether telehealth therapy is an option for you depends on where you are located during the session, so please ask when you call. You can read how individual counseling works, review how we protect your information on our patient privacy page, or contact us to set up a first visit.
Frequently asked questions
Is telehealth therapy private?
It can be, if both sides do their part. Look for a provider who uses a secure platform that protects your privacy and verifies your identity. On your end, choose a room where you cannot be overheard, use headphones, and close other apps. If privacy at home is not possible, in-person visits may be the better fit.
Does insurance cover telehealth therapy?
Coverage varies. The National Institute of Mental Health advises checking with your insurance provider, or with your health care provider's billing department, to confirm that your plan covers telehealth, because policies vary from state to state. Ask whether video and phone sessions are covered the same way as office visits.
Can I do telehealth therapy while I am traveling out of state?
Maybe. Licensing rules are tied to where the client is physically located during the session. Maryland's social work board, for example, tells its licensees to check with the board in the place where the client is located. Tell your therapist about travel plans ahead of time so they can confirm what is allowed.
Can I switch from telehealth to in-person therapy later?
Ask your therapist. Our practice offers both in-person and telehealth appointments, and changing formats is a reasonable thing to raise when your schedule, your living situation or your comfort changes. Please give at least 24 hours' notice if a change means canceling a visit, or a missed appointment fee may apply.
Sources
If you are in crisis or thinking about suicide, call or text 988 (Suicide and Crisis Lifeline). In an emergency, call 911.