Pros and Cons of Telehealth, In-Office, and Walk-and-Talk Therapy: Which One is Best for Me?


You are looking for a therapist in North Carolina. You begin searching for your right fit. However, you start noticing that where providers do therapy may vary! How do you make sense of these different options?!

There are several different options when it comes to how you want to attend counseling and therapy in North Carolina.  And it can be difficult to decide which one is best for you! In this blog post, we will discuss the pros and cons of telehealth, in-office, and walk-and-talk therapy so that you can make an informed decision about which is right for you. Each type of therapy has its own unique benefits and drawbacks, so it is important to consider them all before making a decision.

Telehealth Therapy in North Carolina

Telehealth, teletherapy, or virtual counseling is a type of therapy that is conducted over a virtual platform allowing for synchronous audio-video communication. Some clinicians use Zoom, Doxy, WebEx, or Simple Practice. Most importantly, ensure that your provider using a HIPAA-compliant platform! Regular Zoom and FaceTime are not HIPAA-compliant.

Benefits of working with a telehealth provider in NC:

Telehealth, or teletherapy, can be a convenient option for people who have difficulty getting to and from an office, or who live in rural areas with limited access to mental health providers. Moreover, you can see a clinician anywhere in your state, really allowing for an ideal client-therapist match. Research shows that the therapeutic alliance, to include therapist-client “fit,” is one of the main predictors of treatment success. This is also why Be BOLD Psychology and Consulting highly encourages clients to schedule a free 20 minute consult with any of our clinicians who the client might be interested in working with to allow both client and therapist to “get a feel” for each other. 

Some other benefits of working with a telehealth therapist in North Carolina?

  • Therapy from your couch (as long as you have privacy)
  • Bring your coffee, or even a snack.
  • Shoes off? No problem
  • Got those furry, four-legged friends that can make hard talks a little easier? We love meeting them (you might meet one or two of ours as well).
  • Are you too busy for therapy? Between work, kids’ soccer practice, making dinner, and trying to squeeze in a walk – it can be hard to plan an extra hour just to get to and from your therapy session. No worries, no commute. Just log on to our HIPAA-compliant vitual platform, make sure you have a strong wifi connection, and join anywhere there is privacy. Some people join us from the office, from the parking lot of their office, from the parking lot of their kids school, from their beach house, from a friend’s house. Does not matter where as long as you have privacy, are in the state that you clinician is licensed in, and you are not operating a moving vehicle. Convenient, right?
  • Seeing a therapist in NC via telehealth may also eliminate the need to find childcare in order to attend therapy appointments, assuming you have someone who can watch your children for 45-60 minutes during your session and allow for you to have privacy!  
  • In sickness and in health! Well, If you’re sick, take care of yourself. Don’t log on, drink fluids, get some rest, and email me in the morning. BUT, if you have a cold, a light cough, runny nose, a potential COVID exposure, a PCR test you are waiting on the results of, or anything else that might keep you homebound in the name of caution, and you want to have a therapy session, you still can! 

Limitations of working with a telehealth provider in NC:

However, teletherapy can also be less private than in-person therapy, as there is often a risk of interruptions from family members, roommates, or coworkers. Wi-Fi can also be an issue at times, as a weak signal or too many people on one connection (one kiddo is playing Minecraft, spouse is streaming Schitts Creek or Game of Thrones, grandma is Zooming with her crew, and your other kiddo is doing research for their biology paper) can result in a choppy connection. Although there are several ways to intervene in the event of poor signal, it is a limitation worth noting. Moreover, some people do not have access to Wi-fi at all.

Additionally, not all insurance companies will cover or reimburse for teletherapy services.

Finally, some people don’t like to mix business with pleasure, throw off “the vibe” of their space, or “shit where they eat.” Read: Some people prefer to do their therapeutic work in a neutral space that is not where they work, sleep, eat, shop, or park. This is where going to and from your providers office can help, for some, to keep the therapeutic space separate and apart from one’s life space. And, with COVID-19 restrictions lifting, some people are simply ready to share a physical room with their provider again.

In-office Therapy in North Carolina

Benefits of working with an in-office provider in NC:

In-office therapy is the ole-fashioned, long portrayed, traditional type of therapy, where you meet with your therapist in their office. You sit on their couch, look across the room to them in their chair, and do that therapy thing! 

This option allows for a more private conversation, as well as the opportunity to use props or handouts during your session. This can be especially helpful for children or teens who may have  a harder time opening up, wherein therapeutic games and/or art-based activities can be utilized in-session, in-person. This type of arrangement also allows for one to keep their therapeutic work “separate” so-to-speak, from the rest of their life. Although clients are oftentimes working on therapeutic goals outside of session, some people find that the oftentimes deep and vulnerable processing that can occur during a therapy session happens best in a space that a person can leave, and only return to again for the specific task of doing that part of the work. Additionally, in-office therapy is most often the modality of therapy that is covered or reimbursed by insurance.

Limitations of working with an in-office provider in NC:

However, in-office therapy can be difficult to schedule around work or other obligations, and it may require you to travel a significant distance. If you are in an area with less therapists, finding a therapist you really connect with, a therapist who takes your insurance, a therapist who has openings at the time you need, or a therapist with the specialty training (EMDR, trauma-informed yoga and mindfulness, Couples/Relationship Specialist, identity-based traumatic stress) and professional or lived experience that really aligns with your needs can be tough. This may result in driving 45 minutes to an hour, one-way, to find a therapist with the expertise, availability, and overall “fit” you desire. Additionally, you may need to arrange for childcare, or pet care, to attend your weekly appointment.

Sometimes, it just doesn’t feel like there’s “time” for therapy. And maybe there isn’t. Maybe right now, in this season of life, you simply don’t have the time to drive 30 minutes to an appointment after work, be in session for 60 minutes, and drive 40 minutes home. If this sounds like you, consider telehealth!

Walk-and-Talk Therapy in Raleigh, Durham, Brier Creek, or Cary, North Carolina

Benefits of working with a walk-and-talk provider in NC:

Walk-and-talk therapy is a type of therapy that combines the best of both teletherapy and in-office therapy. With walk-and-talk therapy, you meet with your therapist in person, but instead of sitting in an office, you walk and talk together. We love walk-and-talk therapy here at Be BOLD. We have therapists in Durham, counselors in Raleigh, therapists in Brier Creek, and counselors in Cary who offer walk-and-talk sessions with clients who might benefit! Some additional benefits of walk-and-talk therapy in North Carolina:

  • Walking is a mood improving activity
  • An outdoor atmosphere can open the door for creative ways of thinking and expressing emotion
  • Opportunities to try out breathing, meditation, mindfulness, exposure, and social exercises in person and in real time
  • Great “in between” option for folks who desire in person therapy, but do not want to be confined to four walls! Likewise, this is a great option for folks who are tired of staring at a screen and are desiring to get out and about
  • Being outside creates a neutral, non-judgmental space to embark on your healing process

Limitations of working with a walk-and-talk provider in NC:

However, walk-and-talk therapy may not be an option for people with mobility challenges, trouble securing transportation, or who do not have the time to drive to and from the meeting location. Additional possible limitations relating to walk-and-talk therapy in North Carolina could be:

  • Accidental injuries from tripping or falling while walking; Physical dangers (i.e., insect stings, animal bites, exposure to heat/cold); Adverse weather conditions including heat and rain
  • Limitations to privacy. Depending upon where the walk-and-talk location is, it Is possible you and your therapist might come into contact with other people. This might even include people you or your therapist know. However, you and your walk-and-talk therapist should discuss this prior to engaging in session and come to an agreement how to handle situations such as these.
  • Perceived informality of the interaction. Although walk and talk therapy might feel more like a social interaction rather than a therapeutic interaction, it is a therapeutic activity. Despite the relative informality of the interaction, the relationship between client and therapist continues to be entirely professional, and not a social, relationship. This can sometimes feel confusing for clients. That being said, this can also be addressed and discussed with your walk-and-talk therapist.

The best therapy, and therapist, for you

Ultimately, the best type of therapy for you is the one that you will attend and feel your best and safest participating. If teletherapy is more convenient for you, but you are worried about privacy, try scheduling sessions during times when you know you will be home alone. If in-office therapy is difficult to schedule, try meeting with your therapist before or after work, or on your lunch break. And if walk-and-talk therapy sounds appealing but you are worried about mobility privacy issues, talk to your therapist about meeting somewhere with ample seating alongside a trail or with some benches off in a more private space. No matter what type of therapy you choose, the most important thing is that you make the decision that is going to be best for you!

Be BOLD Psychology and Consulting has Walk-and-Talk Therapists in Raleigh, Durham, Cary, and Brier Creek, and offers trauma-informed teletherapy in North Carolina!

Still not sure what way to do therapy is best for you? No worries! Our talented team of therapists, counselors, and psychologists in North Carolina can work with you to decide what might be the best fit! Self-schedule your free 20-minute consult here or learn more about our LGBTQIA-affirming, trauma-informed therapists in North Carolina here. We can’t wait to meet you!

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