In an era where mental health care is increasingly accessible through digital platforms, many individuals still wonder whether online therapy can truly match the depth of in-person treatment. Amy Markuson, founder of Wonder and Grow Therapy, recently shared her insights on this topic in an email interview with Peekwire. Her responses offer a grounded, practical perspective for anyone considering virtual therapy for anxiety, depression, or OCD.
Online vs. In-Person: What’s Different?
Markuson emphasizes that both formats have distinct advantages. "Many clients appreciate the comfort and flexibility of online therapy because it allows them to connect from a location where they feel most at ease," she explains. Telehealth can be a lifeline for those whose anxiety makes leaving home difficult, or for individuals with limited access to specialists. However, she notes that in-person therapy provides a dedicated environment free from home distractions, which some find easier to focus in. The key, she says, is that "the most effective treatment is the one that best fits your individual needs." During a consult, therapist and client can determine which format best supports their goals.
Breaking Free from Overthinking
Rumination often masquerades as problem-solving but leaves people feeling stuck. Markuson describes how she helps clients recognize when they have shifted into unhelpful patterns. "Rather than trying to ignore or eliminate difficult thoughts, the goal is to acknowledge and validate the emotions and information those thoughts may be signaling," she says. Using evidence-based approaches like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), clients learn to challenge cognitive distortions and tolerate uncertainty. The ultimate aim is to help people recognize that *"they are the driver of their lives—not a passenger to their thoughts."
What to Expect in Early Sessions
For those new to therapy, the first few sessions are intentionally unhurried. "Our first sessions are not about 'fixing' you," Markuson clarifies. Instead, they focus on understanding the client's story, strengths, and the patterns that have kept them stuck. She introduces practical tools from CBT, Exposure and Response Prevention (ERP), and DBT that clients can use between sessions. "We'll move at a pace that feels right for you while gently encouraging growth," she adds, emphasizing that therapy is a collaborative process where the client is the expert on their own life.
When Anxiety and Depression Co-Occur
It is more common for anxiety and depression to occur together than alone. Markuson explains that CBT is effective for both because it targets the connection between thoughts, emotions, and behaviors. For anxiety, treatment may involve challenging catastrophic predictions and reducing avoidance. For depression, it includes behavioral activation and reconnecting with meaningful activities. "By addressing both the thoughts that keep clients feeling stuck and the behaviors that reinforce those feelings, therapy helps clients regain a sense of control," she says.
Recognizing OCD: Subtle Signs
Many people with OCD hesitate to seek help because of shame or uncertainty. Markuson points to key indicators: when symptoms interfere with daily life, when the world begins to feel smaller due to avoidance or rituals, or when someone thinks, "I know this may not make sense, but I can't stop." She notes that OCD often targets what a person values most, creating fear and doubt. OCD-focused therapy helps individuals understand this cycle and learn that *"they can experience uncertainty without needing to engage in compulsions or avoidance." The goal is not to eliminate every unwanted thought, but to help individuals regain freedom and reconnect with what matters.
For those considering therapy, Markuson’s approach at Wonder and Grow Therapy offers a compassionate, evidence-based path forward—whether online or in person.