Why BetterHelp May Not be Better
Attending neurodiversity affirming therapy in person may be more helpful than Talkspace, Cerebral, or Talkiatry
At Better Together Family Therapy we do offer both in person and online therapy. Attending therapy in person has clear benefits, but there are times when online therapy makes sense. Before we get into them, let’s define what we’re talking about.
What is in Person Therapy?
When we say “in person therapy,” we mean going to a therapist’s office to meet with the therapist one on one. In person therapy usually happens once per week for 45-60 minutes. This 45-60 minute visit is called a therapy session. Sessions may be longer than 60 min. in couple and family therapy (though they usually are not at Better Together Family Therapy). Sessions may be scheduled more than once a week during times of intense stress.
Is In Person Therapy Better Than Online?
In some ways, yes. If attending therapy online is your only option, we’ll explain below how to make the best of it. But there are some elements of in person therapy that can’t be replicated on a telephone or computer screen.
The Pros and Cons of Virtual Therapy
Let’s start with a few benefits of virtual or online therapy.
Note: we are not talking about therapy provided by AI or bots. When we say virtual therapy, we mean meeting with a licensed therapist via video chat or phone.
Online therapy is convenient
You can squeeze it in between your work meetings or meet with a therapist who is far from your home. You don’t have to allow time to get to the therapist’s office, which can be especially helpful if you struggle with time management. You might even be able to continue meeting with your therapist while you are on vacation. (This is possible under specific circumstances. Providing virtual therapy across state lines is still illegal in many cases.)
Online therapy may be cheaper
Large companies that provide online therapy are funded by venture capitalists. Their goal is to have a high number of clients and maximize profit. They are paying their therapists less per session and are not paying for office space, so the cost to you is less.
Online therapy can minimize sensory stressors
Being in the comfort of home may feel better for those who are sensitive to sounds and smells they can’t control. Or who have difficulty navigating to new places.
Online therapy may feel safer for those with social anxiety
Some online therapy services offer asynchronous or text communication, which can be less stressful for people with social anxiety. This can actually be both a pro and a con. If reducing your social anxiety is one of your therapy goals, meeting in person with a therapist you trust can be an important step toward achieving your goal. Still, starting with asynchronous communication (text, for example) may feel safer at first.
Benefits of In Person Therapy
Stronger Therapeutic Relationship
This sounds minor, but actually the relationship between client and therapist is extremely important. Research has shown repeatedly that client-therapist relationship is the most important factor in determining the success of therapy.
When you are in a room together, you and your therapist can observe each other’s body language. Your therapist can move closer to or further from you as needed, can lean in or sit back, or can use his/her/their breathing to help regulate your nervous system.
Coregulation
Coregulation is the process by which anxiety or calm becomes contagious. Your therapist’s ability to self regulate actually can make you feel more secure during your therapy session, allowing you to take brave steps toward your goals.
It’s Safer to Open Up
Physically stepping into a dedicated therapeutic space signals a commitment to self-care and creates a mental boundary between therapy and other parts of life. This makes it easier to be more vulnerable during this time, and allows you to put your defenses back up if needed when you leave. For more about this, see How a Therapist’s Office Helps You Heal (below).
Minimized Distractions (On Both Sides)
A therapist's office should be a quiet environment designed to help you focus on your thoughts, feelings, and physical sensations without interruption. Being fully in the room with you also minimizes distractions for your therapist. He/she/they won’t be answering a text under the table, or opening another window on their computer screen during your time together.
Wider Range of Available Techniques (Art Therapy, Play Therapy, etc.)
Some of the interventions we use like somatic therapy, EMDR (eye movement desensitization and reprocessing), art therapy, family systems therapy, and play therapy can be more effective in person.
Accountability for Self Care
Attending therapy in person can encourage you to set aside time for yourself every week, and to practice being on time. Doing this consistently improves your chances of reaching your goals. (This is why we have a weekly attendance requirement for therapy.) Attending consistently can also be a therapeutic goal for people with ADHD or other executive function challenges.
Immediate Crisis Support
Therapists are better equipped to provide real-time assistance in emergencies or moments of acute emotional distress when physically present. See below for how to handle these in online therapy.
Is In Person Therapy Better for Neurodivergent People?
Almost always, yes. As expert neurodiversity affirming therapists, we are focused on supporting neurospicy adults, children, teens, and families in living their best life. In most cases, we’d expect attending therapy in person to work better for you.
Why You Should Attend Neurodiversity Affirming Therapy in Person
It’s fun!
We love our office, and our clients do too. We’re not really a sit still and talk kind of place.
Multisensory Intervention
We’ve designed our space to support you in learning with both body and mind. Our office has plenty of physical tools like balance balls, spinning chairs, fidgets, sensory items, weighted lap pads, and art supplies so you can move and engage your whole body.
Fewer Distractions
Nobody will interrupt you here. This time belongs to YOU.
A Safe Place to be Yourself
Neurodiversity affirming therapy is a place where you can be who you are. Most neurospicy people don’t have enough of those places! We won’t ask you to stop doing the things that make you feel safe. We won’t force you to make eye contact. Or try the things you hate. We WILL encourage you to stretch a little to reach the goals you set for yourself. And we’ll do that with compassion and care.
How a Neurodiversity Affirming Therapist's Office Helps You Heal
A therapy office is what we call a “container.” It is a space that you enter for a specific length of time, with a specific purpose in mind. There are lots of examples of containers in your life. When you go to the dentist’s office, you are ready for someone to poke around inside your mouth. But you wouldn’t be so ready if that happened to you at the gym.
It’s a silly example, but when you enter a space that has a set purpose, your body and mind are ready to engage in that activity. This is one of the reasons online therapy can be harder. Chances are you were doing something else in the same space just moments before.
Your therapist’s office has been designed with its purpose in mind. For neurodiversity affirming therapy that means having multisensory tools available and paying careful attention to lighting, smells, and sounds. If you don’t like the feel of the office, that therapist might not be the right fit for you.
Attending neurodiversity affirming therapy in the office provides
A Calming Environment
The space should be fairly quiet, with comfortable furniture and soft lighting.
Boundaries and Rituals
The act of traveling to the office, entering the space, and leaving after the session reinforces the therapeutic process as distinct and important.
Facilitation of Vulnerability
The space should be very private, so that you can say things without fear of being overheard and participate in your session without being interrupted.
Tools to Help You Reach Your Goals
The therapist has used their expertise to choose items that help you to feel comfortable, open up, and challenge yourself. In our office those tools are multisensory and selected to promote emotional regulation in children, teens, and adults.
Personal Power and Control
The therapist’s office isn’t where you work, go to school, or do anything else. You get to choose what you share and what thoughts, feelings, and experiences you bring into the space with you.
Why is in person therapy so hard to find?
There are many reasons for this, but let’s start with the very practical ones. In person therapists are usually working independently or in small groups. They don’t typically have an advertising budget, so you won’t encounter ads from them on your social media feed. You will have to look for them when you need them.
As therapists, we actually think that’s a good thing. We want you to find us when you are feeling ready to work toward your goals. Therapy is a commitment to yourself, and searching for the right therapist is the first step.
Why are so many therapists online only?
You’re right. It is harder to find in person therapy now than it used to be. That is because many therapists are now working online only. This saves them the costs of renting and furnishing an office, and of commuting to work. Post-pandemic, our cultural comfort with Zoom meetings has made it possible for therapists to work without leaving home. Attending therapy in person offers several benefits, however, and a therapist's office can play a crucial role in fostering healing. To us, it’s well worth the extra cost. Read about the services available in our office here.
Is in person therapy more effective than online?
In most cases, yes. That is why we choose to do most of our work in person. However, if online therapy is what you need, we’ll help you make the most of it.
How to Get the Best Results from Online Therapy (Do’s and Don’ts in Online Therapy Sessions)
DO Choose a Private, Comfortable Space
Privacy will help you open up without fear of being overheard or interrupted. Choose a quiet place where you feel safe. If it is a shared space, choose a time when you can have it to yourself.
DO Set the Scene
Try not to use a space that you also use for work or other tasks. If you have to use the same space, make subtle changes when it’s therapy time. Turn your chair in a different direction. Add an essential oil diffuser, a plant, or a comfy throw to your chair.
DO Reduce Distractions
When it’s time for your session
Let others know not to interrupt you.
Put your phone on do not disturb.
Use headphones to enhance privacy and focus.
Close other tabs and windows on your device.
Put away paperwork or other projects that are in your therapy space.
Make a commitment not to multitask.
DO Test Your Technology
Choose a space with a good internet connection. Charge your device and headphones. And test out the online therapy platform (such as Zoom) so you know how to connect.
DO Set Your Intention for Each Session
Online therapy can feel a lot like calling a friend. You may find yourself talking about anything and everything, and before you know it you’re out of time! Consider what you’d like to focus on for each session, and tell your therapist at the start of the session. He/she/they can help you stay on task.
DO Consider Sitting Where Your Therapist Can See You Best
Scoot back from the camera a little so that your therapist can see you from the waist up. He/she/they will notice subtle shifts in your body and breathing that help them understand how you feel. This distance can also help therapy feel less intimidating, especially if you don’t love eye contact.
DO Communicate Your Needs
This is true for all forms of therapy. Your therapist wants to know what does and doesn’t work for you, even in the moment. It is GREAT to say “I don’t want to do that” or “can we work on ________ instead?”
DO Prepare for Emergencies
During online therapy you are alone in your own personal space. If you experience a medical emergency or other crisis, your therapist is limited in their ability to help. These steps will enable the therapist to do what they can.
Talk about how to reconnect if technology fails and you are disconnected.
Tell your therapist the address where you are located during an online session.
Provide contact information in advance for 2 people who could get to you in an emergency.
Let your therapist know ahead of time if you will be connecting to your session in a different city or state. This allows them to look up contact information for emergency services in that area, or to let you know if they are not authorized to provide services in that location.
DON’T Avoid the Tough Stuff
It’s harder to be vulnerable in an online session, especially if you are in a space you live in every day. Resist the temptation to play it cool.
DON’T Get Too Comfortable
You might be tempted to curl up in your bed for your session, or attend in your pajamas (or less). Don’t do it. Therapy is a time to focus on yourself, and focusing is tough when you’re too relaxed.
DON’T Keep Your Camera Off
Engaging with your therapist visually helps build connection, and holds you accountable for not multitasking.
DON’T Expect Instant Results
Online therapy can be scheduled and started quickly, but that doesn’t mean faster results. Therapy of all kinds has 3 stages: building rapport (connecting and getting comfortable), active engagement (working toward your goals), and termination (making plans to continue growing without the therapist’s help). Talk with your therapist regularly about where you are in the process, and end therapy when your goals feel complete.
By being proactive, engaged, and communicative, you can maximize the effectiveness of your online therapy.
When you’re ready to feel less stress and more hope, schedule an appointment for neurodiversity affirming therapy in our Kensington, MD office or online.
Click the links in the text to read more about our neurodiversity affirming and LGBTQIA+ affirming therapy services. We support adults, children, teens, and families.
