Online psychiatry is proven effective, but the emotional experience is very different from in-person sessions.

In-person benefits include access to nonverbal communication and a more intimate personal relationship.

Online psychiatry limits access to unspoken feelings, visual cues, and tactile experiences. 

​If viewing people or events on screens were truly the same emotional experience as live and in-person, there would be no reason to go to concerts, sports games, dance performances, or lectures; we could shut down theaters, museums, galleries, and schools, and switch entirely to screens.

A New York Times article (“Should You Resume In-Person Therapy?”) reports that many mental health providers find online sessions fatiguing and have difficulty staying focused. Some patients express frustration that they can’t tell if their online provider is listening or distracted. Some even wonder if their provider is scrolling through their cell phone or the Internet during the session.

Professional boundaries also tend to become lax in online therapy. Recently, a teenager reported that her therapist was in her pajamas doing her session. Another couple was surprised to see their therapist in bed with her dog. Many have noticed their therapist eating, adjusting their clothes, or fixing their hair during the session, which caused them to wonder, Is my therapist looking at me or themselves during sessions?

When a providers and client come into contact, feelings flow between them. A well-trained provider studies these feelings and harvests them for meaning. These feelings may result from transference, projection, or emotional induction. Understanding these unspoken feelings aids providers in understanding their clients’ inner emotional life. A screen makes it difficult for therapists to pick up on these subtle communications and grasp a client’s core emotional issues.