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Telehealth Vs. In Person Therapy: How Do I Choose?
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Feb 6, 2025
Welcome to Adaptable | Behavior Explained! In this video, we are going to explore the pros and cons of telehealth versus in-person therapy. As mental health services become more accessible online, many are wondering which option is best for their needs. I'll dive into the benefits and challenges of both approaches, covering aspects like convenience, effectiveness, personal connection, and privacy. Whether you're considering starting therapy or just curious about the differences, this video will help you make an informed decision. I'm Kelly O'Horo, Attachment based EMDR Therapist, EMDRIA Consultant, and Advanced Trainer. I'm a mom of 5, Nonna of 5, wife, and a healer. I have the honor of spending my workdays walking along side people while they brave their healing journeys. I try to live with the generous assumption that we're all doing the best we can with what we know. Therapists are teachers for the "life stuff" and "emotional vocabulary" that may not have been learned due to gaps in our care givers capabilities. In the last 15 years I've learned that people are freaking amazing, resilient, and inspiring. Most importantly, we are hardwired for connection and for healing! I hope to bring an authentic, compassionate, and unpolished approach while we explore a variety of topics such as parenting, marriage, relationships, dating, trauma, attachment, adoption, depression, addiction, anxiety, and love! There's a why for all behaviors and an explanation that makes perfect sense as emotion is at the root of it all. -- Links -- https://linktr.ee/kellyohorolpc https://youtu.be/rLnARKekvgo https://www.emdria.org/find-an-emdr-therapist/
View Video Transcript
0:06
hi everyone I'm Kell ooro and this is
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adaptable Behavior explained hi
0:12
everybody thank you so much for tuning
0:14
in today to adaptable I'm Kelly ooro and
0:17
I'm glad to have you here I wanted to
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talk with you today about the topic of
0:22
uh te theapy or tella Health versus
0:24
in-person therapy a lot of people are
0:27
struggling to decide what approach they
0:29
want to take
0:30
and they're um torn because there's pros
0:33
and cons to both so we're just going to
0:34
dig into that a little bit today and
0:36
talk about some of those pros and cons
0:38
before covid we were really an in-person
0:41
modality and in-person experience most
0:44
people didn't go outside of the box to
0:45
do online therapy and um with with covid
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we kind of had no choice we all had to
0:52
separate of course as you all know and
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we had to adapt and we had to become
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flexible and so with that we learned a
0:58
whole bunch about uh about online
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therapy as an option there's so many
1:04
positive attributes related to this
1:06
evolution in our field because we have
1:09
more choices and with with more choices
1:11
always things can improve so let's talk
1:14
first about how do we even decide what
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it is that we want to do do I want to go
1:18
through one of those apps and find an
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online person or do I want to look in my
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community and find an in-person
1:23
therapist so let's talk first about
1:25
Effectiveness research does show that
1:28
online therapy can be just as effective
1:29
Ive as inperson therapy especially when
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you use an Evidence Place uh based
1:34
approach like cognitive behavioral
1:36
therapy or EMDR therapy uh eye movement
1:39
desensitization and reprocessing which
1:41
is a really uh well researched bottomup
1:43
trauma informed therapy um but let's
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break it down a little bit further so
1:48
cognitive behavioral therapy uh there's
1:50
been many programs that have been
1:52
successful in treating anxiety
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depression and other mental health
1:55
conditions for example there's apps like
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wobot um that use CB principles to guide
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people through self-help exercises and
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coping strategies like I've mentioned in
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many other episodes we want to make sure
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we recognize those strategies as a state
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change activity um as opposed to a trait
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change activity if we want to get to the
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root of the matter we have to do
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bottomup therapies and the good news is
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that even online we can do bottomup
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therapies such as EMDR EMDR I've got a
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whole episode or actually two episodes
2:26
on how EMDR works that's the specialty
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that I have um and I've been doing for
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many years and it involves bilateral
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stimulation like with eye movements or
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tapping and it's been adapted for online
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sessions uh I love a company called
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bilateral iOS if you're a therapist
2:43
tuning in they are my favorite these uh
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gentlemen from Holland got so Innovative
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they were motivated for the right
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reasons to create this application for
2:52
us therapists during covid because they
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were former clients and they had an IT
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specialty and they they saw a gap and
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they bridged it during Co and they
3:00
offered this app to us for free for so
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long while they were developing it and
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it was a game Cher so I have to tell you
3:07
that there are some really cool apps
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that help us as therapists and as the
3:11
client um working through these things
3:13
together uh with apps that make us
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something that we didn't think could be
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done by not being in person really super
3:20
effective on in an online setting so
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with EMDR therapy and the applications
3:25
that have been invented we can
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absolutely use um these strategies to
3:30
work on on unresolved things that people
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come to therapy for the modality does
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matter because there's there one we have
3:38
to have research that supports uh
3:40
therapeutic modalities and Effectiveness
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so that we're making sure that we are
3:44
effective and that our outcomes can be
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counted on and so there is a lot of um
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research for virtual versus face-to-face
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sessions uh specifically with uh CBT
3:56
therapy and now EMDR therapy talk any
3:59
talk therapy or video call works well
4:02
because people can talk about uh
4:04
themselves how they feel their feelings
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and they can have support and connection
4:08
and validation the relationship is the
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basis for outcomes that are strong and
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so that can absolutely be achieved in an
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online setting and so if we're lonely if
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we're disconnected we're able to have an
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online uh experience in a therapeutic
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setting we don't have to wait till an
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in-person option happens I will caution
4:28
you that certain experience cial
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therapies would probably not be as
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effective like um art or dance therapy
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where there's probably something that's
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lost in the digital realm so there are
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certain things that uh are better in
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person another factor that has to be
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considered when it comes to con thinking
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about online versus in-person therapy is
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the client Readiness so your Readiness
4:50
for change plays a significant role some
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people thrive in a virtual therapy
4:55
setting they appreciate convenience
4:58
privacy time constraints that don't have
5:00
to be considered by going into an office
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but others might struggle with the
5:04
format missing those tangible uh
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presence of the therapist uh and the
5:10
physical connection that we get so I'll
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share a little bit about my personal
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experience both as the client and as the
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therapist uh that we learned about
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during the pandemic so of course my
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therapist switched to online therapy
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when we were in the covid uh times and
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at first I was like this is kind of
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weird I'm not so sure about it but uh it
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really felt liberating to have sessions
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uh from my home I didn't have to travel
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up to Scottdale where my therapist was
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but I did miss some of the things about
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the ambience of being in the therapist's
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office and feeling that sense of
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connection and of course there's that
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energetic share of having that
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transference energy of being in presence
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with somebody and also the space that
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had been established for me in her
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office you know I lost that so now I
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have associations with with you know my
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home office or a bedroom or some of
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these other places that I did therapy
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from and that's not necessarily the most
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ideal situation but it definitely worked
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now in my case my therapist opted not to
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return to an in-person setting so I have
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remained online and I get really
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effective work done in my online therapy
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setting now I will say that as a
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therapist I experienced absolute change
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for my clients I was able to still
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create uh the connection and
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uh the safety and people were able to do
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really really good work myself as the
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therapist and treating people online but
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I have to say something I didn't expect
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to have happen as the therapist is the
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energetic connection that I felt that
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was that was about what I got from being
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a Helper and being in a helping position
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that was gone in the same way that it
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wasn't the same as it was when I was in
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person and I noticed that I was more
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physically tired
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I'm an extrovert and I gain energy from
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being with others and so for me that I
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noticed was a real change in my energy
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level being online but I have to say
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that there were several clients that I
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worked with where there was a shift that
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helped people move past stuck stuff when
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they went online so some of my clients
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which I didn't even know had become a
7:22
little overly Reliant or dependent on me
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during our in-person sessions and so
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when they were forced to go online and
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they had to become more autonomous um
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which I didn't realize was happening uh
7:35
they became more autonomous they became
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more independent they became more
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self-reliant and whatever part of them
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was falling into a dependent strategy in
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our relationship that was sort of
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removed and people were able to heal in
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ways that we weren't achieving in the
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same kind of cadence uh in person so
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some things came out of it that I didn't
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expect to see and I found it really
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fascinating another concern that you
8:01
have to think about when choosing tella
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Health versus in person are privacy
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concerns online therapy requires a
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private space you have to set some
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boundaries with the people in your life
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and in your family uh Whispering from a
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closet is not ideal for deep therapeutic
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work although I have to say that during
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Co I did work with a couple people who
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found themselves in their closet with
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the do shut and we had clothes behind
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them because that was how they could get
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the most privacy and you know Sound
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Reduction so have to consider your
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surroundings and ensure that you have
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quiet confidential space uh for your
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sessions so that you can get the most
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out of your experience because when we
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have those distractions in our personal
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lives it interrupts your sanctity of
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your healing space so you have to
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definitely be comfortable enough to set
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boundaries otherwise you're going to get
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interrupted then there's some advantages
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too like maybe you have an animal that
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can lay by you during your session and
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um offer some emotional support where
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before you uh wouldn't have had that and
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so we've learned a lot about the pros
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and cons of being in some of those uh
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alternate spaces rather than being in
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the office specifically now as a
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therapist something I noticed is the
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non-verbal communication is a bit harder
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to see as the therapist um and my client
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is online uh because we really are
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responsible for following direct access
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for things like body language facial
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expressions and even energy I can feel
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energy when someone comes in before they
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say a single word and I'm like what's
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going on so these cues can enhance our
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therapeutic relationship and they can't
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fully be replicated online and so that
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um you know let's say I'm working with
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someone and they slouch in their chair
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but I can't really tell online so I
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can't tell they're falling into a bit of
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a low or shame posture or maybe
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everything from the waist up looks great
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but their foot is profoundly moving and
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they have a really strong fidget
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response that I can't see online and
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that's really important information as a
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therapist so it's a little harder to
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pick up on some of those subtle cues in
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an online setting um but you know with
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good Attunement which you can do as a
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therapist online we can uh we can
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achieve a pretty good understanding
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about what's happening in those
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non-verbal cues now we want to talk
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about convenience and accessibility
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there are people that live in really
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remote areas and they don't have access
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to good therapists or geographical
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barriers and so being able to just get
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online and have have access like let's
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say I live in the outskirts of somewhere
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in New York and I can have access to all
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the therapists in New York City my
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possibilities of getting good competent
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quality help have drastically improved
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so that's one really positive uh aspect
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people that were formerly not able to
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see someone because of those
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geographical constraints now have that
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opportunity uh flexibility is not uh
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something we can ignore as well I have
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clients that you know even though we
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moved back into in person they will
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still opt for online settings depending
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on their work schedule or their travel
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time or their uh other uh things that
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are in their calendar that they need to
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manage and modify they're able to go can
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I just do online today or I have a child
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care issue and I can't leave the kiddo
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at home but I don't want to cancel my
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session so I'm going to jump online so
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that convenience can really be a
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positive thing for people in our busy
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lives comfort's something you want to
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think about too do I want to be in an
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office or do I feel anxious or over
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overwhelmed when I have to drive or when
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I have to be in a space with more people
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or if I have to wait in a waiting room
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for a long time if I can just stay in my
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own office and I have the Privacy that I
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can offer myself for the situation and I
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don't have to worry about uh discussing
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sensitive to topics uh in my environment
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that is really comfortable but there's
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you know the disadvantage of if there's
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an emergency or a crisis if you're
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online we need to be able to have
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someone that we can call to help help
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you cope with something because
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ultimately we can't physically be in
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your presence one of the considerations
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that I have found to be most frustrating
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for some of my clients uh and for them
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to find frustrating is the technological
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requirements so if if someone doesn't
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have good internet or they don't have um
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they live in a rural area and they don't
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have uh consistent uh Power internet
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issues online therapy can create a
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little bit of difficulty uh while at the
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same time the pro of that is I don't
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have to do a long Comm if I'm in a rural
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setting and that can be a a positive so
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you have to look at both pros and cons
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something that I've noticed but not all
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too much is that costs can be different
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so in a space we have a lot more
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overhead whereas if I'm a therapist that
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just works at home I don't have to
12:45
necessarily pay rent and so I might be
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able to offer therapy at a lesser cost
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and uh we don't have to add travel
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expenses and all the other additional
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expenses involved with running an office
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so remember that whether you choose
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online or inperson therapy what matters
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most is finding a supportive space where
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you can heal and grow you still want to
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interview the therapist you still want
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to make sure a fit is part of it and I
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would say the best case scenario if you
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can find this is an in-person therapist
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that you can go online if you choose to
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or an online therapist where you can
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come in and do intensive work for a
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couple hours at a time every couple
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three months just to get both
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experiences that's the ideal sweet spot
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if possible but ultimately getting help
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is better than not getting help so um
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make sure that you uh reach out if you
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want help there's lots of good U places
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to find help online and in person and if
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you're looking for an inperson therapist
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that does EMDR therapy check out
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mrea.org where you can filter on your
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ZIP code uh you can also look at
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Psychology today and filter on your ZIP
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code your insurance uh people who do
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teleah health or not and you can find
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people in that way thank you so much for
13:58
tuning in I hope this helps you
14:00
determine whether or not you decide to
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find an online or an in-person therapist
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and what we want is that you get the
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help you deserve because everyone uh
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deserves freedom and peace and healing
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and until next time I hope that you move
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forward leading with love because it'll
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never steer you wrong
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[Music]
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oh
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[Music]
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