Video-based therapy moved, in a short span of years, from a niche option to a mainstream one. With that shift came a fair question: does it actually work as well as sitting in a room with someone? The honest answer, supported by a growing body of research, is that for most presentations it works well, and that it is not identical to in-person work. Knowing the difference helps you decide whether it fits and, if it does, how to get the most from it.
What the research supports
For common concerns such as anxiety, depression, and stress, studies have generally found telehealth therapy to be comparably helpful to in-person therapy, with clients forming strong working relationships with their clinicians over video. The therapeutic alliance, the sense of trust and collaboration that does much of the work in therapy, turns out to translate to a screen better than many people expect. For a wide range of people and problems, the format is a genuine option rather than a lesser substitute.
Where it shines
Telehealth removes the commute, which is no small thing if you live outside the city, have a demanding schedule, or face mobility or health barriers. It widens access to clinicians who might otherwise be out of reach geographically. Many people also find it easier to speak openly from the comfort of their own space, and the continuity it allows, keeping sessions even while travelling or unwell, can be valuable in itself.
Where in-person may serve better
Telehealth is not the ideal channel for everything. Certain kinds of work with young children, who engage through play and movement, are better in person. Parts of psychological assessment require in-person standardized testing. And for some people, a private space at home is genuinely hard to find, which undermines the openness therapy depends on. Acute crisis is not suited to telehealth either; in a crisis, emergency services are the right call, not a scheduled session.
How to get the most from a video session
A few practical things make a real difference. Find a private space where you will not be overheard or interrupted, and let the people you live with know you need the time. Use a reliable connection and a device with a decent camera, positioned at eye level so it feels more like a conversation. Close other tabs and silence notifications, since the temptation to multitask is the main thing that erodes a video session. And treat the session with the same seriousness you would an in-person appointment: arrive a few minutes early, settle in, and give it your attention.
Deciding what fits
For many people the best answer is not all-or-nothing. Plenty of clients mix in-person and video sessions depending on the week and the work. If you are unsure which suits your situation, an intake team can give you an honest read rather than a default recommendation, and you can adjust as you go.
You can read more on our telehealth page, or talk to our care team about whether video sessions would suit you.