Is Online Therapy as Effective as In-Person Sessions for Depression?
If you're struggling with depression but finding it hard to get to an office—maybe the drive from Blue Springs feels impossible, or leaving your house feels like climbing a mountain—you might wonder if online therapy is actually worth it. Or maybe you're simply weighing your options and want to know what works best.
Here's the short answer: for many people, online therapy for depression works just as well as in-person sessions. But there's nuance here, and it's worth understanding what the research says—and what actually matters most for your healing.
Does online therapy really work for depression?
Yes, it does. Multiple research studies from 2023 and 2024 found that online therapy delivers similar results to in-person treatment for depression. Whether the therapy happened through video calls or face-to-face, people improved at similar rates. The connection you build with your therapist and the work you do together matter more than where you're sitting when you do it.
This isn't surprising to those of us who've been providing therapy for years. What I've seen in my practice is that depression improves when people show up consistently, feel safe enough to be honest, and work with approaches that actually target depression symptoms—like behavioral activation, cognitive work, and mindfulness.
The method of delivery? It's less important than people often assume.
What does the research actually say?
A 2024 meta-analysis published in The Cognitive Behaviour Therapist compared video-based CBT to in-person CBT for depression and anxiety. The researchers found essentially no meaningful difference between the two formats. Both worked.
Another 2023 systematic review in JMIR Mental Health examined psychiatric treatment via telemedicine versus in-person care. Again, the results showed comparable outcomes for depression. Clients reported similar satisfaction, similar working relationships with their therapists, and similar rates of sticking with treatment.
Here's what this means for you: if you're wondering whether online therapy is a "lesser" option, the evidence suggests it's not. For most people with depression, what you do in therapy matters far more than how you access it.
What actually matters for depression treatment?
The format—online versus in-person—is less important than several other factors. Depression responds best to treatment when a few key ingredients are present.
Consistency. Depression wants you to cancel. It wants you to stay in bed, isolate, and convince yourself that nothing will help. Showing up—whether that means driving to our Lee's Summit office or logging in from your couch in Columbia—interrupts that pattern. In fact, some research found that people in online therapy actually completed more sessions than in-person clients. That matters.
An evidence-based approach. At Aspire Counseling, our therapists use approaches like CBT, ACT, behavioral activation and IFS that actually target depression. We use behavioral activation—which sounds clinical, but really means helping you take small steps toward doing things again, even when you don't feel like it. We help you examine your thoughts without getting stuck in them. We don't just ask "how was your week?" and call it therapy.
The relationship. Research shows that the therapeutic alliance—your connection with your therapist—is one of the strongest predictors of good outcomes. At Aspire Counseling, our therapists consistently score high on measures of therapeutic alliance with clients. That bond happens just as naturally over video as it does in person when you're working with someone who genuinely gets it.
A way to track progress. Depression can feel so heavy that it's hard to notice when things are actually improving. That's why we use measurement-based care—simple assessments like the PHQ-9 to track your symptoms over time. When you're in the fog, it helps to have data showing that the fog is actually lifting.
When might online therapy be a great fit?
Online therapy may be ideal for treating your depression if:
Getting to an office feels like too much right now. (Depression makes everything harder. Meeting yourself where you are isn't weakness—it's strategy.)
You live in a rural area of Missouri where there aren't many specialized therapists nearby.
Your schedule makes regular in-person appointments difficult.
You feel more comfortable in your own space.
You already know you can be present and focused in a video call environment.
For many people in the Kansas City area, MId Missouri area or across Missouri, online therapy removes the barriers that keep them from starting—or continuing—treatment.
When might in-person sessions be better?
In-person therapy may be a better fit for treating your depression if:
You don't have a private, quiet space at home where you can talk openly.
You find it hard to focus or stay present during video calls.
Being physically in an office helps you "switch modes" into therapy mode.
Your depression symptoms are severe and you may benefit from the additional support of being physically present with someone.
Some of my clients choose in-person sessions at our Lee's Summit office because leaving the house becomes part of their behavioral activation—a small but meaningful way of breaking out of the pattern depression creates. Others prefer online sessions because just getting dressed and driving somewhere feels impossible right now. Both choices are valid.
How do I decide what's right for me?
Here's what I tell people who ask me this question: the best format is the one you can actually show up for—and feel safe enough to be real in.
If online therapy means you'll actually attend regularly instead of canceling when your depression flares, that's worth considering. If in-person feels more grounding for you, that's worth knowing too.
You don't have to get this decision perfect. Many people try one format and adjust as they learn what works. Our therapists are flexible and can often meet you both ways—some clients come to our Columbia or Lee's Summit office when they can and switch to video sessions when they can't.
Starting Depression Treatment in Missouri
Depression makes it hard to take the first step. I know that. But you don't have to have everything figured out before you reach out.
At Aspire Counseling, we offer both in-person sessions at our Lee's Summit and Columbia offices, and online therapy throughout Missouri. Our therapists specialize in evidence-based treatment for depression and anxiety, and we'll help you figure out what format works best for your life right now.
Reach out to schedule a consultation. You can call our team at (816) 287-1116 or fill out our online contact form. We'll talk through your options and find a therapist who fits what you're looking for.
About the Author
Jessica Oliver, LCSW, is the founder and Clinical Director of Aspire Counseling, a trauma- and anxiety-focused therapy practice with offices in Lee's Summit and Columbia, Missouri. With extensive training in evidence-based approaches including EMDR, CPT, and CBT, she has helped hundreds of clients navigate depression, trauma, and anxiety. Jessica is passionate about making effective mental health care accessible—whether in-person or online.
