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This comes up a lot, usually from people who assume there's a meaningful gap between video therapy and in-person therapy, and want to know if they're settling for something lesser by choosing the more convenient option.

The Research

Across a large body of outcome studies, teletherapy has consistently shown comparable effectiveness to in-person therapy for most common concerns, including anxiety, depression, and relationship or attachment-focused work. The therapeutic relationship, which is one of the strongest predictors of outcome in therapy generally, forms just as reliably over video for the large majority of clients.

Comparing Formats

Fit with the therapist, consistency of attending sessions, and whether the approach matches what you're working on tend to predict outcomes far more than whether you're in the same room. A well-matched therapist over video will generally outperform a poorly matched one in person.

There are some exceptions. Certain modalities that rely heavily on physical presence, or clients in active crisis who need more immediate, in-person support structures, are situations where telehealth may not be the right primary format. For most individual talk therapy, though, the format gap is much smaller than people expect going in.

A Common Observation From Clients

Some clients find they're more comfortable and more themselves from their own space than they were in an unfamiliar office, which can make it easier, not harder, to be honest early on.

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