Why the Office Still Matters: The Value of In-Person Care

Telehealth has changed the way that we deliver care, creating access to services for people who could never reach mental healthcare before. It is a valuable tool and it is here to stay. As the world has changed over the last six years, though, it can be easy to forget the value that in-person care has in our important work with clients. It is a therapeutic setting that has its own distinct strengths work keeping in our practices.

What The Room Gives Us

We communicate in complex ways, much more than just through our words. When we work with clients in the office, we are able to engage with clients on multiple levels and can read their body language in a way not possible over video. We can see changes in their posture, their movements, and their breath. Researchers have noted that many of these cues, fidgeting, trembling, even signs of self-neglect, become restricted or simply disappear on a screen. In-person work simply gives clinicians so much more to work with.

There is also value to the office itself, a distinct space where clients come to do a very specific work. The experience of coming to the office for therapy can signal that this is a held space set apart from ordinary life. It is also a neutral location away from home, reducing distractions from the obligations of life outside the room. For some clients, like children or survivors of domestic violence, the office may be the only truly effective place for them to receive therapy.

Modalities That Land Differently In Person

There are some therapeutic modalities that have a different impact when done in a shared space with a client. Somatic grounding, breathwork, biofeedback, and others all benefit from shared physical presence. When a client is learning to tolerate the physical sensations of anxiety, having the clinician in the room as a steady presence is invaluable. The clinician’s calm nervous system helps settle the client’s, and that co-regulation is part of the process.

Naming In-Person Anxiety

Something we may talk about less often is that clinicians sometimes feel real anxiety about seeing clients in person. This deserves to be named explicitly and taken seriously.  This anxiety comes in different forms. For some, it is about safety, for others it’s about the emotional intensity of being so directly engaged with a client. For some it may be about social anxiety or feelings of unworthiness around being a clinician at all.

These feelings do not make anyone less of a clinician. They are honest reactions to a very vulnerable work that we do in mental health. Since the onset of telehealth in 2020, many of us have also become accustomed to a certain way of working and change of any kind can make us anxious.

Working Through Anxiety

Just as it is with our clients, we can address this anxiety by moving toward it. Anxiety eases when it is met with structure and self-compassion. We can step toward it by scheduling just one or two days in office, giving ourselves a measured exposure to in office work. It can be helpful to set an intentional process for greeting a client in the waiting room, bringing them to the office, and conducting the session. The “ritual” of therapy can be just as helpful for us as it is for our clients.

We can also lean on our clinical peers in the office. Seek out consultation or supervision, and you’ll likely find that there are others experiencing similar feelings of vulnerability in the work. That is not a flaw, but rather a feature of the intricate work that we do as clinicians. Finally, we can remember why we chose this work in the first place: those moments of connection and healing when a client gains something deeply moving from this work. That moment can be an incredible experience when in a shared physical space.

A Balanced Practice

The strongest practices utilize all tools at their disposal. For the modern work of mental healthcare, both telehealth and in-office care have a critical role to play. We can choose the setting and method best suited to the client, the work, and our own wellbeing. Telehealth is valuable and here to stay. The office also holds its own distinct value, and for a great deal of clinical work, it remains where something irreplaceable can happen. Offering care in both settings, with eyes open to the anxiety that can come with the room, gives our clients the full range of what good therapy can be.