Five years after the world shifted almost overnight to screens for mental health care, something unexpected is happening. Virtual therapy, once heralded as the convenient future of the field, has not fully replaced the experience of meeting face-to-face. Many therapists now run hybrid practices or have returned to the office entirely, and a growing number of clients seem to prefer it that way. This raises a compelling question: What draws people back to the therapy room when virtual sessions are easier, cheaper, and just as effective on paper?

From Rare to Routine—and Back Again

Before 2020, virtual therapy was an uncommon exception. While secure platforms existed, most therapists viewed remote work skeptically, often citing concerns about its clinical effectiveness. Early research already suggested outcomes were comparable to in-person care, yet the default professional standard remained firmly face-to-face. Then the pandemic forced a complete, immediate switch. Nearly every therapist moved online, and the field adapted with remarkable speed. What began as a necessity soon revealed clear benefits: no office rent, no commuting, and the ability to reach clients across wide geographic areas, including remote regions where specialists are scarce.

By late 2021, over half of therapists worked exclusively online, with another quarter offering hybrid options. Yet by 2024, the balance had shifted slightly—around 55% of mental health appointments remained virtual, meaning 45% were now in person. The change is gradual, but it signals that while virtual care is here to stay, it may not become the sole standard for treatment.

The Clear Advantages of Virtual Therapy

Virtual sessions offer undeniable strengths that continue to drive its popularity. Therapists save significantly on overhead as full-time office space is no longer a strict requirement. Clients gain unparalleled flexibility: they can attend sessions from work (provided they have privacy), home, or even remote locations where local options are limited. For those with mobility challenges, transportation barriers, or packed schedules, online care removes real obstacles to access.

Furthermore, research consistently shows that, overall, virtual therapy produces results comparable to in-person treatment for many conditions. The combination of accessibility, reduced costs, and convenience makes a strong case for keeping telehealth central to the mental health landscape.

What Draws People Back to the Room

Despite those benefits, many therapists and clients feel that something essential shifts when therapy happens in person. Therapists often describe a deeper connection within the shared physical space. The availability of full body language, subtle non-verbal cues, and the absence of technical glitches create a distinctly different atmosphere. Some clinicians note it is easier to “contain” intense emotions or co-regulate with clients, especially during deep trauma work. Others simply find all-virtual days draining—too much focused screen time can feel exhausting and less clinically authentic.

Clients, too, sometimes prefer the office environment. Surveys show that while insurance coverage ranks highest in choosing a provider, the availability of in-person sessions comes in second for a significant portion of seekers—ranking far ahead of those who say online options are unimportant. Certain populations, such as children, teens, and couples, may benefit significantly more from the interactive possibilities of being physically together in the room.

The Research: Effective, Yet Not Identical

Large reviews and meta-analyses find no meaningful differences in symptom reduction, client satisfaction, or overall improvement between virtual and in-person therapy. Outcomes appear equivalent across many diagnoses and standardized measures. Yet some studies highlight a vital nuance: the therapeutic alliance—the sense of trust and collaboration between therapist and client—tends to form more strongly face-to-face.

Since the alliance is one of the strongest predictors of therapeutic success, this finding raises thoughtful questions. If results are similar overall, but the felt connection differs, what does that mean for the human experience of healing? Effectiveness clearly depends on context: the client’s specific needs, the therapist’s style, the type of intervention, and even practical factors like privacy at home. There is no universal “better” format—only the one that fits the unique circumstances.

Looking Ahead

Virtual therapy expanded access in ways that should never be rolled back. It remains a powerful tool, especially for underserved areas and busy lives. At the same time, the quiet return to in-person sessions reminds us that human connection often carries an irreplaceable quality—something harder to replicate through a screen. The coming years will likely settle into a balanced hybrid landscape, where both formats coexist and complement each other. What matters most is staying attuned to what truly serves healing, whether that happens across a room or across a secure video link.

References

• Cataldo, F., et al. (2022). Therapeutic alliance in online and face-to-face psychological treatment: Comparative study. JMIR Mental Health, 9(5), e36775.
  This study compared therapeutic alliance scores and found significantly higher ratings in face-to-face treatments compared to online, suggesting professionals may need specific training to achieve comparable alliance remotely.
• Greenwood, H., et al. (2022). Telehealth versus face-to-face psychotherapy for less common mental health conditions: Systematic review and meta-analysis of randomized controlled trials. JMIR Mental Health, 9(3), e31780.
  The review found no significant differences in symptom reduction, working alliance, or client satisfaction between telehealth and in-person psychotherapy across various outcomes and follow-up points.
• American Psychological Association. (2024). Telehealth and telepsychology practice trends. Retrieved from https://www.apa.org/practice/telehealth-telepsychology
  Recent survey data indicate that in 2024, 19% of psychologists practiced fully remotely, 69% used a hybrid model, and the remainder were primarily or exclusively in person, reflecting a stable but mixed adoption of telehealth post-pandemic.