I've been in therapy for two years now, and I still can't figure out whether online therapy sessions are as effective as meeting face-to-face. My therapist moved to a different city last year, so we switched to video calls, and I notice I hold back more—maybe because I'm aware of my own face on the screen or because the physical distance makes it easier to avoid hard topics. Yet I've read studies suggesting no significant difference in outcomes for common issues like anxiety or depression, but those studies rarely account for the nuanced quality of the therapeutic alliance. For someone who's considering starting therapy, would you choose a local in-person therapist, even if it means a longer wait or higher cost, or is a convenient online option good enough for you?