Virtual Therapy versus In-person Therapy

If you're looking for a therapist near you, you may have come across the option for virtual sessions and wondered: Does online therapy really work as well as in-person therapy? You're not alone. With the rise of telehealth over the past few years, especially during and after the pandemic, more people are choosing to meet with their therapists online. But is it just as effective?

The answer, backed by multiple large-scale studies, is yes. For most people, virtual therapy is just as effective as in-person therapy—especially for those seeking support for anxiety, depression, trauma, or wanting to build skills through DBT therapy.

Virtual vs. In-Person: What the Research Really Says

Many studies have directly compared online therapy with in-person sessions across different conditions and treatment types. A 2022 meta-analysis by Greenwood and colleagues reviewed 12 randomized controlled trials and found no meaningful difference in symptom reduction between teletherapy and face-to-face therapy across conditions like depression, PTSD, and anxiety disorders. A more recent 2023 review from Sato et al. went further, analyzing 26 trials and confirming that teletherapy was non-inferior to in-person treatment in 8 out of 10 psychiatric conditions, including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, insomnia and substance use disorders. Although, eating disorders were shown to improve more with in-person therapy.

Teletherapy showed slightly better outcomes for people seeking therapy for depression. Researchers suggested that the comfort and privacy of being at home might increase engagement and help clients open up more easily. Another study found no significant differences in how well treatment results lasted over time between virtual and in-person formats. For most clients, therapy works just as well when it's done via video—as long as it's delivered by a qualified provider and based on evidence-based approaches like DBT or EMDR.

What about Virtual Group Therapy?

It’s not just individual therapy that works online—group therapy, including programs like DBT therapy (Dialectical Behavior Therapy), can also be highly effective when done virtually.

In a 2024 systematic review comparing group therapy online vs. in person, the majority of studies found comparable clinical outcomes, with similar levels of symptom reduction and functional improvement. Only a small subset showed slightly better outcomes in face-to-face formats. In one Canadian study that focused on group CBT for anxiety, researchers found that in-person sessions were slightly more effective only for generalized anxiety disorder (GAD), while the virtual group format worked equally well for social anxiety, panic disorder, and OCD.

That said, online groups sometimes require extra attention to building group cohesion. Therapists often need to spend more time at the beginning of a group helping members feel connected, since nonverbal cues and spontaneous interactions are more limited online. But once group norms are established, participants tend to engage well, and many even report feeling safer and more open in virtual spaces. Group therapy clients who struggle with social anxiety often report preferring the online format because it gives them some emotional distance while still allowing meaningful interaction.

Why Many Clients Prefer Virtual Therapy

For many adults, virtual therapy simply fits better into their lives. Without the need to commute or take time off work, it’s easier to keep appointments consistently. Studies have shown lower no-show rates and higher treatment completion among telehealth clients compared to in-person sessions.

Virtual therapy also makes it easier to access specialized services, especially if you live in a rural area or a community with fewer providers. If you’ve ever searched “therapist near me” and felt frustrated by limited options, virtual therapy removes geographic barriers. You can now find therapists who specialize in trauma work, therapy for anxiety, or DBT therapy, even if they’re located several hours away.

Clients often say they feel more comfortable speaking from their own environment. Being at home can help reduce anxiety, and for people dealing with trauma, it may feel safer to process difficult material in a familiar space. Research confirms that therapeutic alliance—the trust and connection between therapist and client—is just as strong online as it is in person (Greenwood et al., 2022). That relationship is one of the strongest predictors of success in therapy, and it turns out it doesn’t depend on physical proximity.

When In-Person Therapy May Still Be Best

While virtual therapy is effective for most people, there are some situations where in-person sessions might be preferred or necessary. If someone is in acute crisis, has active suicidal ideation without a safety plan, or experiences severe psychosis, in-person care provides the immediacy and safety of physical support. Certain therapeutic approaches—like art therapy, somatic work, or intensive trauma processing—may also benefit from in-person interaction, though many of these are successfully adapted to online formats.

Additionally, some clients simply feel more grounded or focused in a therapy office. That sense of ritual—leaving home, entering a dedicated space—can help certain people feel more present and engaged. Fortunately, many therapists now offer hybrid models, allowing clients to choose what works best or even combine formats for maximum flexibility.

Comparing the Two: Format vs. Fit

Rather than asking which format is better overall, the real question is: Which format works best for you right now?

Both in-person and virtual therapy have their strengths. In-person therapy offers rich body language, fewer distractions, and a physically grounded experience. Virtual therapy offers convenience, comfort, accessibility, and equal clinical outcomes for most mental health needs.

Most importantly, the quality of the therapist and the therapeutic relationship matters more than the format. A skilled, attuned therapist will be effective whether you’re sitting across from them or talking on Zoom. And if you're seeking therapy for depression, trauma, or emotional regulation, it's worth knowing that both formats can help you heal and grow.

Final Thoughts

Virtual therapy is not just a temporary workaround—it’s a validated, effective option for long-term mental health care. Whether you're seeking Maryland therapy or Delaware therapy, online sessions make it easier than ever to access support without compromising on quality.

If you're looking for trauma help, struggling with anxiety, or interested in joining a structured DBT therapy group, virtual therapy offers a flexible, research-backed approach to healing.

Still unsure which direction to take? A virtual consultation can help you determine whether online, in-person, or hybrid care is best suited to your goals.

At its core, therapy is about connection, safety, and support. Thanks to today’s technology, you can access those essentials from the comfort of your own space—no matter where you are.

References

Greenwood, H., Krzyzaniak, N., Peiris, R., Scott, A. M., Cardona, M., Glasziou, P., & Del Mar, C. (2022). Telehealth versus face-to-face psychotherapy for less common mental health conditions: Systematic review and meta-analysis of equivalence. JMIR Mental Health, 9(9), e38267. https://doi.org/10.2196/38267

Sato, H., Kato, Y., Park, S. C., & Matsunaga, H. (2023). Telepsychiatry versus face-to-face treatment in psychiatry: A meta-analysis of randomized controlled trials. BJPsych Open, 9(2), e56. https://doi.org/10.1192/bjo.2023.32

Fernandez, E., Woldgabreal, Y., Day, A., Pham, T., Gleich, B., & Aboujaoude, E. (2021). Live psychotherapy by video versus in-person: A meta-analysis of efficacy and its relationship to types and targets of treatment. Clinical Psychology & Psychotherapy, 28(6), 1535–1549. https://doi.org/10.1002/cpp.2614