Video-delivered CBT for anxiety has been studied extensively, including well before 2020, and the finding has been stable: outcomes are broadly equivalent to face-to-face treatment across panic, generalised anxiety and social anxiety, with similar effect sizes and similar durability.
Internet-delivered CBT with therapist guidance also has a substantial evidence base, particularly from Swedish and Australian research groups, and performs well for mild to moderate presentations at a fraction of the cost.
Where remote is better
Agoraphobia and panic with avoidance. The obvious point: someone who can’t leave the house can’t attend an in-person appointment. Remote treatment reaches them where an office can’t, and the exposures can then be built outward from home in the actual environment.
Anything where the trigger is at home. Health anxiety with body checking, driving anxiety that starts on your own driveway, phobias attached to your own environment. A clinician on video can be present for the real thing rather than a clinic approximation.
Access. Clinicians trained in specific anxiety protocols are unevenly distributed. Since therapy is regulated where you sit rather than where they sit, everyone licensed in your state is reachable — which for people outside a metro is the difference between protocol-driven treatment and whatever is nearby.
Where in-person still wins
Social anxiety, arguably. This is the honest exception. The feared situation is being in a room with a person and being evaluated. On video you can angle away, watch your own face, and control your exposure — all of which are subtle safety behaviours, and the treatment is meant to remove those.
The evidence still shows remote CBT for social anxiety working well, so this is a preference rather than a contraindication. But if it’s available, in-person — and especially group treatment, which supplies the feared situation directly — is worth choosing.
Some in vivo exposures. A crowded train, a lift, a specific bridge. A good remote clinician sends you to do these as homework and debriefs, sometimes with a call from the location, which works — it’s simply more effortful than walking there together.
The thing to check instead of format
Training. A remote clinician who runs proper exposure hierarchies will outperform an in-person one who does supportive listening, every time. Ask the four questions and let the answers, not the delivery method, decide.
Also confirm they’re licensed in your state, and — if panic is your issue — that they use interoceptive exposure, which transfers to video without any loss at all.