Beyond the Screen: The Case for In-Person Therapy in Canada

Canada’s mental-health scene now invites us to choose between in-person and virtual therapy. Both formats have found their place: virtual for its reach, in-person for its presence. Studies often point to equivalent effectiveness, particularly in cognitive behavioural therapies. Yet many Canadians, therapists included, feel something deeper remains tethered to physical presence. What follows is an exploration of how the two differ, when in-person may matter more, and why offering both is not just pragmatic but essential.

Scientific Grounding: Virtual Holds Its Own, But with a Caveat

At McMaster University, researchers sifted through 51 randomized controlled trials involving 5,384 participants. They found that therapist-guided remote cognitive behavioural therapy (CBT) often matches in-person CBT for treating anxiety, depression, chronic pain, insomnia and more. The Canadian Medical Association Journal labelled the evidence "moderate-certainty," confirming the therapy formats are comparably effective across diagnoses, session types and follow-up durations .

Ontario Shores Research added nuance, noting that virtual therapy often works comparably when technology is not a barrier, but that disruptions and digital inequality still derail the experience for too many . At Queen’s and the University of Toronto, researchers investigated e-CBT programs versus in-person CBT for major depressive disorder. Treatment results were virtually indistinguishable. Both approaches led to meaningful reductions in depression and quality-of-life improvements, and the study noted higher completion rates among virtual participants .

These findings suggest that, when judged by outcomes, virtual therapy stands as a viable and convenient sibling to in-person care.

The Experience Difference: In-Person Still Holds a Quiet Power

Evidence says results are similar. Experience says something else. Meeting face to face offers a nuanced communion. In person, therapists see subtleties such as posture shifts, fidgeting, and micro-gestures that often vanish behind a screen. Eye contact is not framed by glass, and silences carry weight. That kind of presence can deepen connection in ways quantitative studies do not always capture.

Then there is the unspoken ritual of the office: the commute, waiting room, and closing the door. Those actions signal that this moment is set apart. You arrive not just physically, but mentally. That arrival can sharpen focus, prime reflection, and mark emotional ground more firmly than logging into a video link.

Certain approaches also lean heavily on presence: EMDR, somatic work, art therapy, and play-based interventions. They often rely on textures and movement that virtual platforms struggle to replicate. The physical space, the tools, even the stretch of a therapy couch matter, especially when exploring trauma or embodied responses.

What People Say: When Screens Feel Thin

The sentiment emerges in forums and testimonials.

• One person wrote: "Virtual will never be my format. It undercuts so much of the therapeutic depth I get in person."
• Another noted: "Virtual is better than nothing when one of us is unwell or travelling, but the connection over video does not feel close."
• A third insisted simply: "Seeing body language matters."

The phrasing is not about data. It is about feeling held.

Some Need In-Person More than Others

Canadian surveys spotlight where in-person therapy matters most. A study of youth and parents caring for family members with severe mental illness found that while virtual is accessible, the preference for in-person remains strong. Roughly two-thirds of youth (66.6%) and nearly half of parents (48%) chose in-person, citing privacy concerns among other reasons . Sometimes your home is not safe enough, and logging in from a shared space feels exposing rather than freeing.

Virtual Therapy’s Gifts And Its Limits

It bears saying: virtual therapy has renewed access for many Canadians. Those in rural or remote areas, people with mobility limitations, and anyone juggling busy schedules benefit from having their therapist reach them wherever they are. The University of Regina’s Online Therapy Unit has demonstrated how email-based and internet CBT can support meaningful therapeutic connection. Clients say writing their thoughts, having a written record, and pacing the conversation at their own rhythm offer notable advantages. Others have found such therapy cost-effective, flexible, and expedient.

Yet technology remains brittle. Calls freeze. Screens glitch. Bonds fray when cameras fail. Pets, roommates, or thin walls can leave little room for private expression.

Licensing and regulation also shape access. In Canada, regulation is provincial. In most cases practitioners must be registered in the jurisdiction where the client is physically located. Some provinces permit temporary or limited telepractice registration, and rules vary by profession and province .

Even more subtle is the boundary challenge. When your therapy session happens in the same room you eat or work in, it becomes harder to pause, and harder to leave the hard stuff at the door.

A Realistic Middle Path: Hybrid as Practice Norm

Across Canada, many therapists now offer hybrid options. They rotate between in-person when depth matters and virtual when logistics make sense. Life is complex; energy and access vary. Sometimes in-person is essential; other times, the convenience of virtual is enough.

Therapy by itself does not solve everything, but having the choice between formats is powerful. It allows trust to grow, flexibility to flow, and presence to recalibrate when needed.

Final Thought for Theralist Readers

In-person therapy is not inherently superior. But it does offer a quietly dense presence, layered communication, and an environment that primes emotional safety. For certain groups—youth, caregivers, rural clients, and those with trauma complexity—it is not just preferable, it is essential.

Virtual therapy is not lesser. It is proven effective, often more accessible, and in many cases more affordable. It tears down geographic barriers and makes mental-health care possible for people who would otherwise go without.

The real win lies in platforms like Theralist embracing both. Helping people find the modality that fits their moment, their needs, and their comfort level is not just good service. It is respect for nuance.

Frequently Asked Questions

Is in-person therapy more effective than virtual therapy?
Not necessarily. Research in Canada shows both formats can be equally effective, particularly for CBT. However, many clients find in-person therapy feels more connected and helps establish a stronger therapeutic relationship.

Why do some Canadians prefer in-person sessions?
Privacy is a big factor. Not everyone has a private space at home. Others find the ritual of going to a therapist’s office helps them focus and separate therapy from everyday life.

Can all types of therapy be done virtually?
Not all. Some modalities such as EMDR, art therapy, or play-based therapy rely on tools, physical space, or body-based techniques that are best suited to in-person care.

What are the main benefits of virtual therapy?
Accessibility, especially for rural and remote communities. Flexibility, reduced travel, and sometimes lower cost also make it appealing.

How does Theralist help?
Theralist allows Canadians to search for licensed therapists across the country and filter by format, whether you want in-person, virtual, or a hybrid approach.

Sources

• McMaster University Health Sciences: "Is Remote Therapy Effective?"
• Brighter World (McMaster): "Remote Therapy as Good as In-Person"
• Ontario Shores Research: "e-CBT Effective Alternative to In-Person Care"
• Queen’s University / University of Toronto: "Randomized Trial of e-CBT vs In-Person CBT" (Frontiers in Psychiatry, 2023)
• Canadian youth and parent preferences: PubMed & PMC studies on severe mental illness care
• University of Regina, Online Therapy Unit: Internet-based CBT research
• Global News Canada: Reporting on Canadian remote therapy studies
• Canadian Psychological Association & provincial colleges: Telepsychology and interjurisdictional practice guidance
• Theralist Blog: "Online Therapy vs In-Person Therapy in Canada"

Ready to Find the Right Fit?

Therapy is never one-size-fits-all. Whether you are looking for the grounded presence of in-person sessions or the flexibility of virtual care, Theralist makes it easy to find a Canadian therapist who meets your needs.

Visit Theralist.ca today and explore your options.