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Why Virtual Therapy Isn’t Always Enough

More young people than ever before are struggling with their mental health right now—and the majority of them aren’t getting the help they need. According to Mental Health America’s 2021 rankings, 60 percent of youth with major depression don’t receive any mental healthcare at all. Even among the states with the best youth treatment statistics, more than one in three young people are still not receiving mental health services.

Boosted exponentially by the pandemic, online therapy is attempting to meet this need, providing a convenient and accessible way for teens and young adults to receive depression, anxiety, and grief counseling. A weekly telepsych session—with a local therapist or one from an online service such as Better Help or Talkspace—can help clients gain the skills and understanding to address mental health challenges and work toward greater flourishing.

But for many young people, online therapy isn’t enough. As important as telepsych is in providing greater access to care, it is not sufficient for the growing number of teens and young adults who are suffering with acute diagnoses or in crisis. The nature of online therapy makes it difficult if not impossible to address the underlying causes of a client’s symptoms in order to create sustainable healing.

10 Signs That a Client Needs In-Person Therapy

When does a teen or young adult need more than virtual therapy? If they are getting worse rather than better, have experienced recent trauma, or are recovering from or at risk of a mental health crisis, a higher level of care may be essential, particularly face-to-face therapy.

“Knowing how to read in between the lines can provide much-needed information,” says Heather Hagen, MA, LMFT, Newport’s Director of Clinical Program Development. The assessment process can also include industry-approved tools measuring clients’ levels of depression, anxiety, self-harm, disordered eating, and suicidal ideation.

Here are the top 10 signs that a teen or young adult needs in-person therapy rather than virtual therapy:

  • A breakdown in school performance
  • Lack of interest in activities and friends they previously enjoyed
  • Family discord
  • Difficulty sleeping
  • Trouble with law enforcement
  • Increased use of drugs or alcohol
  • Disordered eating patterns
  • Anger issues
  • Talking about feeling hopeless or suicidal
  • Withdrawal from everyday interactions


As important as telepsych is in providing greater access to care, it is not sufficient when clients are suffering with acute diagnoses or in crisis.

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Online Therapy vs. Traditional Therapy

Is virtual therapy better or in-person therapy? Particularly for adolescents—who tend to build trust and connection through action and activity as much as conversation—there are significant benefits to face-to-face therapy.  When considering online therapy versus traditional therapy, it’s important to consider that any adolescents do not respond well to online therapy options like Better Help or Talkspace. Teens often find it easier to process emotions through somatic and experiential modalities—such as art, music, Adventure Therapy, and EMDR—rather than words.

For these young people, the most effective therapy might take place on a surfboard, in a yoga class, on a hike, or during an impromptu chat. That’s why at both Newport Academy, our teen treatment program, and Newport Institute for young adults, our clinical model includes a variety of evidence-based experiential modalities in addition to clinical therapies like DBT, CBT, and Attachment-Based Family Therapy.

“Some of the most powerful interactions that a client has in residential treatment may occur outside of the therapist’s office,” says Heather. “Experiential therapies such as equine, art, and yoga can be extremely supportive and enlightening. And therapists can cover so much ground in a short amount of time, because they see clients every day—not only during individual therapy sessions but also in group sessions and at lunch. Two or three months’ time in residential treatment is like a year’s worth of weekly 50-minute sessions.”

Establishing Connection and Community Through In-person Therapy

There are several benefits to face-to-face therapy. For example, during in-person therapy sessions, Heather can establish rapport with young people through little things like appreciating each other’s fashion sense, talking about the pet whose picture is on her desk, or discussing a book a client notices on her shelves. And she can read body language signs that in online therapy sessions would occur outside the frame of the screen, like a client’s fidgeting hands or anxious leg bouncing.

In addition, the peer community developed within the treatment milieu—whether residential or outpatient—is enormously impactful for young people. “The support of peers who are struggling with similar feelings can normalize a client’s experience,” Heather says. “It provides a sense of community that many of our clients have never experienced. It’s not uncommon for these strong connections to translate into long-standing friendships between clients.”

Residential or outpatient treatment programs may also connect clients and families to an alumni network of support groups, and give them access to a like-minded community. At Newport, our Alumni program supports clients and staff to stay in touch through ongoing alumni events, and many of our clinicians stay in contact with young people and families years after they leave treatment. This level of bonding and connection is another great benefit of face-to-face therapy.

“Teletherapy is no doubt an excellent response for emergencies such as the COVID-19 pandemic. It has also served in the efforts of increasing access to psychotherapy in places with limitations to local mental health resources. Nevertheless it should not always replace the face-to-face therapeutic encounter. Using teletherapy beyond these contexts could pose the risk of eliminating the social activity and physical, embodied closeness that often facilitates healing.”

— Journal of Humanistic Psychology

Determining What Care You Need

We encourage families who are struggling with the question, “Is therapy better in-person or online?” to reach out to us for more information and resources. Newport’s Admissions and Clinical Outreach experts work with families and referring professionals to ensure a seamless admissions process for teens and young adults who need face-to-face therapy and a higher level of care.

Contact us today to learn more about our outpatient and residential locations across the country, providing the highest-quality and most effective mental health treatment for teens and young adults. Our mission is to help young people get the support they need at this pivotal stage of development, so they can move forward into a thriving life.