When COVID started, I started seeing my therapist over telehealth. Using my laptop's built-in camera, they weren't able to see me below my shoulders, so they couldn't get any sense of body language. That improved when I switched to a separate webcam and was able to put my whole top half on camera.

Although I spend my whole day standing up at my computer, I'm sitting down during therapy so I can relax.

When I tried connecting over VPN, the video call was choppy and had a maybe 3-second delay, so I stopped using VPN. Rarely, the video call has an 8ish-second delay, and my therapist's internet is not great in general (a couple times, they emailed me beforehand, saying their internet was out and they couldn't do a video call, but we could do a phone call if I wanted. I've always said no to the phone call).

In-person was probably more effective for me, but I wouldn't be willing to go in-person unmasked (which would be necessary for the therapist to see facial expressions) because COVID, and my therapist does nothing in-person anymore except assessments anyway, also because of COVID.