Online vs in-person therapy: which one is actually right for you?

A decade ago, the idea of doing therapy from your kitchen table would have struck most clinicians as a poor substitute for the real thing. Today, telehealth makes up a serious slice of how therapy actually happens — and the research is pretty clear that, for most concerns and most people, online work is just as effective as in-person. That doesn't mean it's identical. Each format has its own texture, its own strengths, and its own quiet trade-offs.

Where online therapy genuinely shines

• Access. Living rurally, travelling for work, on a remote site, overseas, or simply far from a sex therapist who fits — telehealth solves the geography problem completely.
• Comfort and disclosure. Many people find it easier to talk about sex and intimacy from the safety of their own home. The first time saying something out loud is often easier in your own armchair than in an unfamiliar office.
• Continuity. Travel, illness, kids home sick, daylight savings — all the small things that used to cancel sessions stop cancelling them.
• Couples in different locations. FIFO partners, long-distance couples, or partners temporarily living apart can attend the same session from two devices.

What in-person still does better

• The body in the room. Posture, breath, the small shifts that happen when something lands — these come through more clearly when you're physically present.
• Ritual and separation. Driving to a session, sitting in a waiting room, walking out afterwards — the spatial transition can help the work feel contained.
• Distress tolerance. For very acute material, having another regulated nervous system in the same physical space is genuinely calming in a way a screen isn't.
• Tech failure isn't a possibility. Sometimes the simplest reason matters most.

How to choose

Ask yourself a few honest questions. Will you actually attend in-person sessions consistently, or will the commute become a reason to cancel? Do you have a private, quiet space at home where you won't be overheard? Are you bringing material that feels easier to say out loud somewhere familiar, or somewhere clearly 'separate'? There's no single right answer — only the answer that fits your life.

A practical setup for online sessions

• Use headphones. Privacy improves dramatically and small vocal nuances come through better both ways.
• Pick a room with a door that closes. Even a parked car can work in a pinch.
• Sit somewhere that supports the body — not propped up in bed.
• Plug your device in, and have water nearby. Small comforts matter over an hour.

How I work

I see clients in person in Collingwood, Melbourne, and via secure telehealth across Australia and internationally. Many of my clients mix the two — starting in person and shifting to telehealth when life gets busy, or the other way around. The format is a tool. The work is the work.