Why the Therapy Room Still Matters
By Andrea Lahana
Teletherapy has made therapy significantly more accessible, and for many people, being able to meet with a therapist from home is exactly what they need. There is no commute, it can be easier to fit into a busy schedule, and sometimes being in your own space makes opening up feel a little easier.
But there is also something to be said for physically going somewhere for therapy.
We talk a lot about what happens in therapy, but not always about where it happens. Our brains are constantly taking in information from our environment, and research on context dependent memory suggests that the places we are in can become connected to what we experience, feel, and remember there (Smith & Vela, 2001). This doesn't mean doing therapy at home is harmful, but it does mean that our environment may play more of a role in the therapeutic process than we realize.
Your Environment Matters
Think about what it actually looks like to do therapy from home. You might sit on your couch or at your desk and spend 50 minutes talking about trauma, grief, betrayal, anxiety, your relationship, or something you have never said out loud before. Then the session ends, you close your laptop, and you are still sitting in the exact same place.
Maybe you go right back to work. Maybe your kids need something. Maybe your partner walks into the room. Maybe you start making dinner. There isn't always much space between doing really vulnerable emotional work and going right back into everyday life.
Research on context dependent memory has found that environmental cues can influence how information and experiences are remembered (Smith & Vela, 2001). While this research isn't specifically saying that therapy needs to happen in a separate room, it does help us understand why our physical surroundings can become associated with certain emotions and experiences.
Creating a Container for the Hard Stuff
For some people, having a separate physical space for therapy creates a sense of containment around the experience. You drive to the office, walk inside, sit down, do the work, and then leave.
Over time, the therapy room can become a familiar environment where your brain and body begin to recognize that this is a place where difficult things can be talked about and worked through. Research looking at telepsychology and therapeutic environments has also explored the importance of the physical therapy space in creating a sense of safety, privacy, and containment when working with difficult emotional material (Shaw et al., 2022).
This can be especially meaningful in trauma therapy. Trauma work can involve revisiting experiences that bring up intense emotions, physical sensations, memories, or nervous system responses. Having a designated space for that work can help create a clearer boundary between processing those experiences and returning to everyday life.
Home Isn't Always a Neutral Space
We tend to think of home as the place where we are most comfortable, but that isn't necessarily true for everyone.
Home might also be where you work, parent, argue with your partner, take care of everyone else, or experienced some of the very things you're processing in therapy. Even when home feels completely safe, there can still be distractions, notifications, pets, roommates, family members, chores, or that tiny voice wondering whether someone can hear what you're saying.
Privacy and environmental distractions are recognized considerations in telepsychology and can affect how comfortable someone feels speaking openly during a session (American Psychological Association, 2024).
You may technically have privacy, but if part of your attention is listening for footsteps outside the door, wondering whether your partner can hear you, or thinking about the work notification that just popped up, it can be harder to fully settle into the session.
Being in the Room With Another Person
Therapy is also relational. A lot of communication happens outside of the actual words we say.
Therapists are paying attention to posture, movement, facial expressions, breathing, changes in tone, eye contact, and the subtle ways the body responds when something difficult comes up. Those things can absolutely still be noticed virtually, but video changes what both people are able to see and experience.
Research on telepsychotherapy has noted some of these differences, particularly when it comes to nonverbal communication and the therapeutic relationship (Markowitz et al., 2023).
For therapies that incorporate mindfulness, the body, nervous system regulation, somatic work, or trauma processing, being physically present can also give both the therapist and client more room to notice what is happening beyond the conversation itself.
Don't Underestimate the Drive Home
This might be one of the simplest benefits of in person therapy, but it can also be one of the most meaningful.
When you attend therapy in person, there is usually a transition before and after the session. You drive there. You walk into the building. You have your session. And then you leave.
Maybe you sit in your car for a few minutes afterward. Maybe you listen to music on the way home. Maybe you think about what came up. Maybe you stop for coffee. Maybe you just stare out the window and let your brain do absolutely nothing for a minute.
Either way, there is some separation between therapy and whatever comes next.
When therapy happens at home, that transition can be almost nonexistent. You close the laptop and suddenly you're back at work, making dinner, answering texts, or interacting with the people you may have just spent the last hour talking about.
Sometimes having even a small amount of physical distance gives your nervous system a chance to shift gears.
So Is In Person Therapy Better?
Not necessarily.
Teletherapy is an effective and important way to access mental health care, and for some people it may actually be the better fit. Accessibility matters. Convenience matters. Feeling comfortable in your own environment matters too.
The more useful question might be: What environment helps you actually do the work?
Do you feel like you can speak freely? Do you have privacy? Can you stay present instead of thinking about everything happening around you? After a difficult session, do you have enough space to transition before jumping back into your day?
For some people, the answer will absolutely be yes at home. For others, physically coming into a therapy office provides something they didn't realize they were missing.
Sometimes it helps to have a place specifically for the hard stuff, so when you walk out the door, you don't have to carry quite as much of it back home with you.
Embrace the courage to change and contact Elliant Counseling Services to schedule a free confidential consultation today!
Learn more about Andrea Lahana.
American Psychological Association. (2024). Guidelines for the practice of telepsychology. American Psychological Association.
Markowitz, J. C., Milrod, B., Heckman, T. G., Bergman, M., Amsalem, D., Zalman, H., Ballas, T., & Neria, Y. (2023). Through the lens: Telepsychotherapy and the working alliance. American Journal of Psychotherapy, 76(2), 69–75.
Shaw, S. E., Seuren, L. M., Wherton, J., Cameron, D., A'Court, C., Vijayaraghavan, S., Morris, J., Bhattacharya, S., & Greenhalgh, T. (2022). Therapeutic holding environments and the affective atmospheres of telepsychology during the COVID 19 pandemic. Social Science & Medicine, 307, 115170.
Smith, S. M., & Vela, E. (2001). Environmental context dependent memory: A review and meta analysis. Psychonomic Bulletin & Review, 8(2), 203–220.