Views of in-person and online remote psychotherapy across modalities: a convergent parallel mixed-method investigation

Objective: Growing use of online psychotherapy has raised questions about perceptions of delivery formats. This study examined acceptability of in-person and online remote psychotherapy, integrating quantitative and qualitative perspectives.Method: Convergent parallel mixed-methods design was used. Quantitative data were obtained from 449 adults (18–65+ years) in online survey assessing acceptability, delivery format preference, technology use, cultural influences, and treatment orientation. Qualitative data were acquired in semi-structured interviews with 34 participants (20–62 years) from diverse cultural backgrounds. Thematic analysis explored experiences and perceptions of formats.Results: In-person psychotherapy was rated significantly higher for affective attitude, perceived effectiveness, ethicality, and likelihood of recommendation, whereas remote psychotherapy was rated higher for convenience and accessibility. Ethnicity and technology self-efficacy modestly influenced preferences, while cultural influences affected in-person acceptability among specific subgroups (e.g., Arab women). Thematic analysis identified themes: (1) connection and therapeutic presence, emphasising nonverbal cues and physical co-presence for understanding (2) therapeutic space, with structured environments valued for in-person; (3) safety and privacy, emphasising importance of confidentiality and emotional security; (4) practical aspects of online therapy, and (5) perceived suitability of format. Conclusion: In-person psychotherapy was preferred by most participants, while online delivery was viewed as an acceptable and practical alternative.