Online Cognitive Behavioral Therapy

There are a variety of options for your therapy. Please read below for a detailed discussion of online therapy compared to in-person therapy.

Common therapy approaches

Many therapists offer virtual services through their practice’s electronic medical record system. There are also subscription-based online platforms where licensed therapists provide services like text messaging, chat rooms, and video calls.

The main therapeutic service on these subscription platforms is typically weekly video sessions that have a set fee. However, some subscription platforms charge an additional monthly or annual fee for continued access to the service.

Telehealth vs In-Person Therapy

As with most things, there are pros and cons to each approach. We’ve compiled a list a of some common factors to consider, and the merits and drawbacks from both that can help you make an informed choice that best suits your needs.


  • Telehealth allows access to a therapist without the added travel costs. You are not solely limited to the counselors in your area but have the freedom to see someone you genuinely connect with regardless of distance.
  • Online therapy makes it easier to be consistent and avoid cancellations. Common barriers such as transportation issues or scheduling conflicts can be significantly reduced.
  • No need to deal with things such as traffic jams or extended waits in waiting rooms.
  • Everything can be accessed from the comfort of your own home and room. You can be surrounded by items that bring comfort, even items/pets that can help emotionally regulate and cope during sessions.
  • No need for additional services, such as childcare
  • In some ways confidentiality can be increased, there is no risk of someone seeing you in a waiting room or parking lot. Online services can allow access to mental health with increased privacy.
  • All information and therapy accessing services are protected by HIPAA-compliant technology.
  • No risk of COVID exposure


  • Therapist and client need to ensure access to a reliable connection and internet service. Otherwise, the session may be impacted or lost by technological issues.
  • For some, telehealth may feel more distant and hinder connection, empathy may feel different than when someone is in-person with you. There’s also the possibility of the counselor missing some body language cues that may not be visible on camera.
  • If a crisis occurs, your counselor may not have direct access to you. They can call emergency services if the need arises but would not be able to accompany you physically (which may be helpful during instances such a as panic attack).
  • Some mental health issues can make it very challenging to conduct an online session. These services may not be appropriate for people experiencing high suicidality, ADHD, schizophrenia, amongst others.
  • Things happening at their own homes may be distracting for a client or make it hard to have an uninterrupted session
  • Clients may have a harder time protecting their own confidentiality, there might be other people at home, or they may not have any private spaces to be in.

“Any therapy is better than no therapy.”


  • Being in person allows for more closeness and to some people it feels more personal; this can lead to a more meaningful connection. Furthermore, not everyone feels fully comfortable video chatting with others, in that case in-person may be the best option.
  • Non-verbal communication is more noticeable, which can be helpful to the counselor and provide valuable information that is occurring in session. A more thorough assessment is possible, which leads to a more accurate interpretation of presenting concerns and provides guidance of treatment.
  • Putting in the effort to attend in-person can give the sessions more meaning and value and provide a physical space that feels safe and reassuring.
  • Decades worth of research proving the effectiveness of in-person talk therapy.
  • More variety in terms of approaches and modalities, as some forms of treatment rely heavily on movement and senses.


  • Travel costs are something to consider when doing in-person. In comparison, telehealth might be cheaper in the long-term.
  • In-person requires a larger time commitment than just the session itself, as it occupies traveling time as well. This can create more scheduling conflicts.
  • Due to some of the stigma that still prevails around mental health, or issues related to social anxiety, some people may want to keep their attendance private, being at a clinic may risk exposing that privacy
  • Social anxiety, chronic illness, inability to take time off work, childcare expenses or physical disabilities sometimes keep people from attending in-person therapy when that is their only option.