Online therapy is still relatively new. In Ontario, registered psychotherapists were not permitted to provide therapy virtually until March 2020, when emergency changes were made in response to the COVID-19 pandemic. That sudden shift understandably raised a big question for many people: Is online therapy really as effective as in-person therapy? And more personally, what might I gain or lose by meeting online instead of in a room together?

Here are my thoughts on the differences.

In-Person Therapy

There is something uniquely powerful about sharing physical space with another person. Simply being in the room together can add a kind of quiet magic to the therapeutic process. It allows the therapist to take in full body language, posture, and movement, and for many people, it deepens the sense of connection and presence.

In-person therapy also offers a physically contained space, a place where you can leave emotions, stories, or difficult material behind when the session ends. The commute to and from the clinic can matter too. That time often becomes a natural buffer, a chance to prepare beforehand and to reflect or decompress afterward. And, of course, a change of scenery alone can be supportive for mental health.

Virtual (Online) Therapy

Online therapy does miss some of the embodied elements of in-person work, but the connection between therapist and client is still very much alive. In some ways, it offers its own advantages. Seeing someone’s face up close can make micro-expressions more noticeable than they might be across a room.

Virtual therapy is also far more accessible. It removes barriers for people with disabilities, chronic illness, or mobility challenges, and it allows clients greater choice in finding a therapist who truly fits, rather than being limited by geography. Research consistently shows that the quality of the therapeutic relationship is one of the strongest predictors of successful outcomes, more so than the specific modality used (Norcross & Wampold, 2011; summarized by the Canadian Psychological Association).

I have also found online therapy to work especially well for many neurodivergent clients. Being in a familiar environment can reduce sensory overload. Clients can move around, fidget, adjust eye contact, or use comfort items without the pressure of sitting still in an unfamiliar space.

What Often Works Best

For some people, a hybrid approach is ideal, meeting your therapist in person initially and then continuing with a mix of in-person and online sessions. This can offer the grounding of shared physical space alongside the flexibility and continuity of virtual care.

I receive my own therapy online, and I have found it both deeply effective and incredibly sustaining. No matter where I live or travel, I am able to continue my work consistently with the same therapist. That continuity, being able to return to the same relationship and the same rhythm, has been invaluable.

The Bottom Line

There is no universally better option. The best choice is the one that supports your nervous system, fits your life, and allows you to build a meaningful, trusting relationship with your therapist. That relationship is what does the healing, whether it happens in a room together or through a screen.