In 2020, Covid happened. The global pandemic not only reshaped daily life but also drastically affected mental health across the world. People were in more need of connection than ever, but access to traditional, in-person therapy was severely limited.

This shift led to a rapid rise in online therapy, particularly cognitive behavioral therapy (CBT). Following the pandemic, the percentage of online therapy sessions jumped from 29% to over half of all sessions. With this shift came a lot of research evaluating the effectiveness of online therapies, and studies have found that online, in-person, and group therapy formats are effective in improving mental health outcomes.

Now, in 2024, while the pandemic has subsided, the importance of mental health is as essential as ever. CBT is considered one of the most effective therapeutic strategies for helping individuals overcome mental health challenges, whether it’s conducted online or in person. The choice between formats largely depends on your personal needs and preferences regarding therapy.

Understanding Cognitive Behavioral Therapy and Its Formats

Cognitive behavioral therapy, in essence, is a problem-solving therapy. It focuses on identifying how an individual’s thoughts influence their emotions and behaviors, which in turn impact mental health. CBT is time-limited and goal-oriented, meaning that session duration is shorter than in other therapy times. The primary focus is working directly on an individual’s current issues with goals to address them.

One of the key strengths of CBT is its adaptability. Research has found it to be effective in treating several conditions, including depression, anxiety, substance use, and trauma. It’s highly personalized, with treatment tailored to your condition and unique needs.

Whether delivered online, in person, or in group therapy formats, CBT offers practical techniques to help individuals reframe negative thoughts and develop healthier behavior patterns. Each format uses the same evidence-based strategies, such as cognitive restructuring and behavioral activation, and is effective in helping people reach their mental health goals. The choice of therapy format largely depends on your needs and which option is best for you.

In-Person Individual CBT

In an in-person CBT session, you meet face-to-face with a therapist in an office setting. Sessions involve discussing specific challenges you’re facing, identifying negative thought patterns, and working through exercises designed to reframe these patterns. Additionally, a significant portion is dedicated to building strengths and personal interests to reinforce confidence and self-esteem.

The therapist provides immediate feedback, guides you through role-play scenarios, or offers practice worksheets to work on skills at home. Homework and reinforcement of skills outside of therapy are critical aspects of CBT that help dial in individuals’ behavioral changes.

Pros of In-Person Individual CBT

• Direct, personal interaction with the therapist
• For some people it may allow for a stronger therapeutic alliance
• Nuanced communication through body language and facial expressions can provide more information for the therapist. (Compared to phone sessions, online video sessions provide some nonverbal feedback for therapists).
• Allows for more treatment modalities, such as movement-based therapy.
• Is recommended for more severe mental health issues.

Cons of In-Person CBT When Compared to Online CBT

• Fewer available therapist options
• Less accessible for individuals who live far away
• Can feel more intimidating for some individuals

In-Person Group CBT

In-person group CBT involves a therapist leading a small group who shares similar mental health challenges. Sessions are usually longer than in individual therapy, up to 1.5-2 hours. Typically, sessions involve group discussions, role-playing exercises, and collaborative problem-solving activities. Group therapy can be incredibly helpful because participants benefit from the therapist’s guidance and the support and shared experiences of others in the group.

While less researched than individual or online CBT, studies indicate it’s an effective option for individuals who benefit from social interaction and peer support. For some individuals, it may be intimidating to share personal experiences in a group setting with people you may not know. For others, not having the pressure of engaging in therapy alone can make the process much more comfortable.

Pros of Group CBT

• Reduces feelings of isolation and provides peer support
• Allows for the practice of social skills in a shared environment
• Increases accountability
• Allows for vicarious learning by listening to others’ experiences of similar issues
• Particularly effective for depression and substance use disorders

Cons of Group CBT When Compared to In-Person CBT

• Less individualized attention from the therapist
• Some people may feel uncomfortable sharing in a group setting
• Group formats may move too quickly or slowly for some member’s individual progress

Online CBT

Online CBT involves participating in therapy sessions via video or phone calls. Just like in in-person therapy, these sessions focus on identifying negative thoughts and working toward changing behaviors. The only difference is the mode of communication, which allows individuals to engage in therapy from wherever they have an internet connection.

Pros of Online CBT

• Greater accessibility, especially for those in remote areas
• More flexibility in scheduling
• Provides a more comfortable and private environment for some individuals

Cons of Online CBT When Compared to In-Person CBT

• Lack of face-to-face interaction can reduce a sense of connection for some individuals
• Potential technical difficulties, such as internet connection problems
• Not suitable for all conditions, particularly for severe mental illness or high-risk individuals

Which CBT Option is Right for You?

When choosing a CBT format, it’s important to remember that all options–whether online, in-person, or group CBT–are effective. However, finding the best format for you can significantly impact your experience and outcomes. Here’s a short guide to help you decide which option fits you best.

Accessibility and Flexibility

If your schedule is unpredictable, or you live in an area with limited access to in-person therapy, online CBT may be the best option. Online therapy allows you to participate from home, offers more flexible scheduling, and eliminates the need for travel.

Personal Connection and Comfort

If face-to-face interaction is crucial for you, in-person CBT may be most effective. Some people find that in-person therapy allows for a deeper sense of connection and collaboration with their therapist, which can help build trust.

Social Interaction and Peer Support

For those who prefer interacting with a group and sharing experiences, group CBT is a good option. Group therapy provides a supportive environment where you can learn from and support others who face similar challenges.

Privacy and Comfort

If you’re concerned about privacy, consider where you feel most comfortable. Online CBT allows you to participate in a private space of your choosing. However, others prefer to engage in therapy in an office, where the space is neutral and conducive to the therapeutic process.

Begin Your CBT Journey with Start My Wellness

Cognitive behavioral therapy offers a range of options, including online, in-person, and group therapy formats, all of which are effective in addressing mental health concerns and promoting long-term self-esteem.

At Start My Wellness, we understand that finding the right therapy for you is essential for achieving your mental health goals. Our team of experienced therapists is trained in providing high-quality CBT across all formats–online, in-person, and group sessions. We’re ready to help you navigate your options and find the best fit for your needs, ensuring you receive the support you deserve.

If you’re ready to start your journey with CBT, contact us today at (248)-514-4955 or schedule an appointment to learn more about our CBT services and how we can help you get started.

Sources

1. Psychiatry Online: Telepsychiatry Use in U.S. Mental Health Facilities, 2010–2017
2. USA Today: Americans are getting more therapy than ever — and spending more. Here’s why.
3. Start My Wellness: Cognitive Behavioral Therapy
4. Start My Wellness: Top 5 Benefits of CBT for Anxiety and Depression
5. Start My Wellness: Understanding CBT for Adults: What to Expect in Your First Session
6. JAMA Psychiatry: Effectiveness and Acceptability of Cognitive Behavior Therapy Delivery Formats in Adults With Depression