I’ve experienced therapy from both sides of the room: as a clinician and as a client. I’ve done the commute, the waiting room, the first hello, and I've also clicked the zoom link from my kitchen table. Both formats could work. Both could fall flat. But when clients tell me they feel “stuck” in virtual sessions, I get it, because I’ve felt it too. The real question becomes: how do you know which is right for you?
Virtual Therapy and Its Benefits
Teletherapy marked a significant shift in the accessibility of mental health services. Virtual sessions removed barriers related to transportation, physical disability, childcare, geography, and stigma. For clients with social anxiety, chronic illness, or demanding schedules, logging in from home made therapy possible in a way it has not been before.
As a clinician, I've seen teletherapy work very well, especially for skill based interventions, structured modalities, and clients who benefit from the safety of their home. Research consistently shows that for many diagnoses, teletherapy can be as effective as in person care (Backhaus et al., 2012; Varker et al., 2019). While virtual therapy offers numerous benefits, it may unintentionally reduce the felt sense of connection that some clients rely on to feel fully seen, grounded, and emotionally engaged in the work.
When Convenience Narrows the Experience
From the client chair, I noticed how easy it became to sign onto therapy rather than arrive at it. I would close my laptop from work, open another tab, and suddenly I was in session. Same room, same posture, same state of mind. There was no transition. No walking into a different space. No physical cue to my body that something important was about to happen. Over time, I was able to articulate insights clearly, but I was not always fully feeling them in my body. The work stayed in my head.
Clinically, this makes sense. Our nervous systems rely heavily on environmental cues. Therapy is not just a conversation, it is a relational experience. When the body does not fully register safety, emotional processing can stall.
The Therapy Room
In person therapy offers something simple but meaningful: a dedicated space designed for emotional work. The consistency of the room, the chair, the lighting, and the therapist’s physical presence creates an environment that promotes emotional regulation. As a client, I felt that sharing a physical space with my therapist allowed my body to settle more easily. Silence felt less uncomfortable, and my emotions flowed more freely. From a neurobiological perspective, co-regulation is facilitated when bodies share space. Subtle cues such as breathing, shifts in posture, and non verbal signals are more easily perceived and responded to in person (Porges, 2011). As a clinician, I notice this shift when clients who primarily talk about their feelings in telehealth begin to experience them in the room.
Being Fully Present
One of the most profound differences I noticed as a client was how much harder it was to dissociate or multitask in person. There was no camera to turn off, no screen to hide behind, no checking out. Being physically present next to another human allowed me to stay fully present.
Although it could feel intimidating at first, it could also be deeply healing. Being fully seen, and staying regulated through that experience is part of the work itself.
In person sessions naturally allow for more spontaneity. Moments emerge on their own, tears surface without warning, and laughter breaks the tension. Often, it’s these unplanned moments that feel the most therapeutic.
When In-Person Therapy Is not the Right Fit
For some clients, virtual therapy provides a sense of control and safety that is necessary for engagement. Those with severe anxiety, mobility limitations, or caregiving responsibilities may experience in person sessions as more stressful than helpful. Others simply do better when they can remain in their own environment.
Even as someone who benefits from in-person work, I still value teletherapy during periods of transition, stress, or sickness. The goal is not to abandon one format for the other, it is to match the setting to the phase of work you are in.
Signs you Might Benefit from Trying In-Person Therapy
From being in both chairs, below are some patterns I’ve noticed that suggest in-person therapy might be worth exploring:
- Sessions feel repetitive or stagnant, even when you’re putting in effort and showing up consistently
- You struggle to stay present, grounded, or emotionally connected when meeting on a screen
- The therapeutic relationship feels muted or less “felt,” even though the work is meaningful
- You leave sessions with insight but little emotional shift or sense of integration
None of these mean virtual sessions have failed. They simply suggest that your nervous system may be asking for a different kind of input.
Final Remarks
Ultimately, the question is not whether in person or virtual therapy is “better,” but which environment best supports you right now. Therapy is a process, and what works during one season of life may not work in another. If you are feeling stuck or disconnected, that does not mean you are doing therapy wrong. It may simply mean the current condition you are in needs adjusting. Paying attention to how your body responds, how present you feel, and how supported you feel in the therapeutic space can offer important information about next steps. Sometimes, change doesn’t come from trying harder, but from allowing yourself to shift the setting to see what becomes possible.
References:
Backhaus, A., Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D., … Thorp, S. R. (2012). Videoconferencing psychotherapy: A systematic review. Psychological Services, 9(2), 111–131.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.