What the research shows
Multiple meta-analyses and randomized controlled trials now confirm that teletherapy produces outcomes equivalent to in-person therapy for depression, anxiety, PTSD, and most other common mental health conditions. The therapeutic alliance — the relationship between therapist and client — develops equally well over video, challenging early skepticism about remote therapy. For most people seeking therapy, format is a matter of preference and practical convenience rather than clinical effectiveness.
When teletherapy has advantages
Teletherapy eliminates commuting time and costs, increases access for people in rural or underserved areas, allows therapy from home during illness or mobility limitations, and removes stigma concerns (no one sees you walking into a therapist's office). For anxiety conditions — including social anxiety — access from home reduces the barrier to starting and maintaining therapy. Many therapists offer more flexible scheduling for telehealth.
When in-person therapy may be preferable
In-person therapy may be better for: people with significant dissociation or trauma where the physical presence of a therapist aids grounding; somatic therapies that involve physical exercises or movements; people without private space at home for sessions; anyone who prefers the structure of leaving home for appointments; and children and adolescents who often benefit from the focused containment of an office.
If you have limited privacy at home — due to family members, roommates, or thin walls — in-person therapy may be more appropriate. You cannot do effective therapy while worried about being overheard. Some people use their car as a private space for telehealth sessions.