Why We Value In-Person Therapy at Brickel & Associates, LLC

While traditional in-person therapy has been the cornerstone of mental health care for decades, in 2020, virtual therapy became the norm as it ushered the way through the COVID-19 health crisis. Ready or not for the transition, many therapy practices, including our Alexandria, VA therapy practice, relied on virtual therapy platforms to continue serving clients. With those pandemic days (mostly) behind us, and without many health restrictions on in-person contact, many therapy hopefuls wonder which is better: in-person therapy or virtual?

At Brickel & Associates, LLC, we are committed to providing high-quality trauma-informed mental health care that meets the diverse needs of our clients. While we primarily offer in-person therapy sessions from our Old Town Alexandria therapy practice, we understand that virtual care can be a valuable option in health-related circumstances. We aim to share a balanced assessment of in-person therapy vs. virtual and share more about the policies that govern our practice. 

The Rise of Online Therapy

There’s no way around it, online therapy during the COVID-19 health pandemic was a lifesaver. 

Still today, for those with limited mobility, limited access to qualified clinicians, sickness, or a pending in-state move that makes coming to the office untenable, online therapy offers a great option for continuity of care. But what about those who have never met their therapist in person? Are they missing out or still receiving the quality care they need? 

The pros of virtual therapy

Dozens of studies published in recent years have aimed to validate online therapy as a comparable therapy delivery method, and although we experience more benefit with in-person therapy, it’s true that there are many benefits:

Convenience: Receive therapy from the comfort of your home, eliminating the need to travel to appointments.

Fewer resources required: Save time and resources associated with transportation, childcare, and unplanned appointment extensions.

Comfort: Access therapy from your familiar surroundings, allowing for greater comfort and access to coping mechanisms.

Access for rural areas: Overcome barriers to mental health care for those in remote or rural areas.

The cons of online therapy

Despite the benefits of online therapy, our personal experience at Brickel & Associates with clients online and in-person begs the question, “What is the true cost of the convenience of online sessions?”

Emotional experience: The emotional experience of online therapy differs from in-person sessions, as it can be challenging to convey and interpret nonverbal cues and feelings.

Difficulty connecting: Some clients may find it challenging to connect with their therapist online, leading to a perceived reduction in empathy. Therapists may struggle to provide the best care possible to clients when only able to see them from the neck up on a screen, especially when providing “bottom-up” or somatic-based therapy models.

Technology problems: Internet connectivity issues and device malfunctions can disrupt virtual therapy sessions.

Not a good fit for some clients: Individuals with trauma histories, struggling to trust anyone, may not benefit as much from online therapy, when clients are unable to see whether the therapist is truly fully present with them in session.

Professional boundaries: Some clients may experience a lack of professional boundaries in online therapy, such as distractions or privacy concerns.

The Benefits of In-Person Therapy

At our Alexandria therapy practice, our experience leads us to believe that in-person therapy provides a more comprehensive and nuanced approach to care, especially for trauma survivors who may benefit from the added depth of connection and sensory experience, as well as the ability to feel therapeutically held in the therapy office. Clients can engage more fully with their therapist, without the nagging trust issues that may arise in virtual care—worrying whether their therapist is paying attention to them while only on the screen, be it their eyes wandering to their email or checking their hair during an important revelation. 

Decades of evidence-based research: In-person therapy is backed by extensive research demonstrating its effectiveness for treating mental health conditions.

More thorough assessment: Therapists can conduct a more detailed assessment of clients in person, leading to more accurate treatment plans. Beyond the initial assessment, in-person therapy also allows therapists to observe a client’s body language, facial expressions, and other nonverbal cues, providing valuable information about their emotional state and helping to deepen the therapeutic work.

Safe environment: Being physically present in a therapist’s office can create a sense of safety and security for clients, which is essential for trauma survivors who may have experienced a loss of safety in the past. Returning each week to a physical therapy space allows clients to prepare and “program” their bodies for the emotional experience, creating a more conducive environment for exploring and processing challenging emotions. This embodied experience can lead to more profound insights and therapeutic breakthroughs. 

A more visceral experience: In-person sessions allow for a deeper emotional connection between therapist and client. Face-to-face interactions help build trust and a sense of connection between the therapist and client, and immediate feedback helps clients feel heard and validated in real time.

Co-regulation: In-person therapy allows for the therapist and client to co-regulate each other’s emotions, which is particularly important for clients who have experienced trauma and may struggle with emotional regulation. Therapists can help their clients learn to regulate using techniques such as grounding exercises, flashback halting protocols, and deep breathing.

Body-oriented therapies: As we provide trauma-informed care using somatic-based therapies—including Sensorimotor Psychotherapy or EMDR—these approaches involve working with the body’s sensations and movements, which are more effectively done in person.

Criticisms of in-person therapy may focus on the discomfort and hassle involved in showing up each week for sessions, citing traffic, busy schedules, and a greater time investment. We believe that this is vital to the work of therapy. The act of physically going to therapy creates a dedicated space and time for healing and introspection. It signals a commitment to oneself and the therapeutic process, setting the stage for meaningful progress. 

There is also an added benefit in the personal time you gain while traveling to and from sessions. Beforehand, you can prepare yourself for the work of therapy, and after, you can take the time to process and sort through your emotions in a more meaningful manner, as well as find time for more grounding back to the present, by not jumping right back into home or work life.  In this way, the effort required to attend sessions can be seen as a reflection of the client’s investment in their own well-being, reinforcing the value and importance of the work being done in therapy.

Meaningful, actionable therapy At Brickel & Associates, LLC

We believe that in-person therapy offers unique benefits that enhance the therapeutic experience. Our in-person sessions allow for a deeper connection between therapist and client, fostering a more empathetic and trauma-informed environment. We value the live interactions and personal connections that are central to our therapeutic approach. However, we do still offer online sessions in some cases.

When We Use Virtual Care

  • Illness-Related Issues: If a client is ill or physically impaired and unable to attend an in-person session, virtual care may be used to ensure continuity of care, as long as the client is physically located in an area where their therapist is licensed to provide care.
  • Weather-Related Issues: In cases of inclement weather, such as snowstorms, virtual care may be used if it is unsafe for clients or therapists to travel to the office, again,  as long as the client is physically located in an area where their therapist is licensed to provide care.

If you need to switch to a virtual care appointment for health-related reasons, please reach out to your therapist at least 3 hours prior to your scheduled session. This allows your therapist time to review your request, connect with you, and make the necessary arrangements.

Teletherapy Participation Requirements

Participating in teletherapy services requires clients to have access to certain technology and to follow specific guidelines to ensure the effectiveness of the sessions. Please review the following requirements:

  • Computer, tablet, or phone with a webcam and microphone
  • High-speed internet connection
  • Latest version of Google Chrome, Safari, or Mozilla Firefox
  • Private, confidential space for sessions
  • Minimum noise and distractions during sessions
  • Well-lit, stationary area for sessions – We cannot provide virtual care while you are in a moving vehicle
  • Appropriate attire and attitude during sessions

Licensure Laws and Location Requirements

It is important to note that therapists are required to be licensed in the state or jurisdiction where the client is located at the time of any virtual care sessions. This means that clients must be physically located in a state or jurisdiction where their therapist is licensed to provide virtual care. 

Can I use text with my therapist for care?

It should be noted that, while many therapists may use text messaging to confirm appointment details and facilitate communication for scheduling and billing purposes, there are a host of ethical concerns and boundary issues that prevent this from being a realistic therapy delivery format. Brickel and Associated does not use texting for any communication. The most effective virtual therapy sessions aim to replicate the in-person therapy experience as closely as possible, which in our office, means video sessions for the most effective virtual route for meaningful interactions between therapist and client.

Begin counseling in Alexandria, VA today!

If you have any questions about our approach to in-person and virtual therapy, please don’t hesitate to contact us.

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