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Bringing It Back Home: Home-Based Therapy

When you think about the option of having a therapist come to your home, what comes to mind? Are you shaking your head ‘no’ at the thought or are you glad that you wouldn’t have to drive anywhere? You may even be going back and forth about why it is or isn’t a good fit for you. Either of those reactions are completely understandable.

When is Home-Based Therapy an Option?

A therapist may offer home-based therapy because they recognize how tough it can be to get to an office. If you have ever faced obstacles with childcare, illness, disability, financial strain, or transportation then you may know how life was impacted from missing appointments, family events, and even work. On the other hand, a therapist may offer this option if they see it as a beneficial form of treatment regardless if access to care is a concern. Also, a therapist may not offer in-office sessions simply out of their personal preference and experiences. Depending on the therapist, home-based therapy can be offered only under specific circumstances (i.e.: difficulty moving around after a surgery) or it can be the only option they offer. So, let’s look at reasons why home-based therapy may be a good idea for you.

It’s Convenient

Instead of thinking about transportation, getting in traffic, and worrying about being late, you can stay at home while the therapist deals with those things. Offering home-based therapy allows the therapist to meet with clients who may have transportation issues, trouble getting out of bed due to depression, or physical limitations that make commuting more difficult.

More Privacy

Since the therapist comes to your home, you miss the opportunity of seeing familiar faces while waiting for your appointment. That may be appealing to you if you’d prefer that other people did not know you were in therapy. Though seeking help is nothing to feel shame or be embarrassed about, privacy is something that many people value. On the other hand, it is possible that someone recognizes the therapist visiting your home and know that you are in therapy.

The Setting is Telling

A skilled therapist will apply a whole-person approach to therapy and treatment. This means that they want to understand where you come from, the environment that you live in, and situations you may be subject to because of your neighborhood and home. All of this gives the therapist insight to who you are and what your struggles may be. The therapist will also get a better idea of other needs you may have and refer you to additional resources. This is all information that is not readily available when therapy takes place is an office. For some clients and therapists, this may fall under the list of cons for home-based therapy. As a client, you may not want the therapist to see your home environment and the therapist may also feel a level of discomfort.

Your Home Becomes Part of the Process

One thing a therapist does is help you create interventions that meet your needs. When therapy occurs in the home, you and the therapist can work together to include your immediate surroundings in your treatment plan. This can mean determining an area in or around the house that is therapeutic to you or finding one. From creating a quiet room, going for a walk at a nearby park, gardening, to working in the garage it is easier for you and the therapist to come up with coping strategies when everything is in your face, as opposed of trying to recall them while in an office. The depth in which therapy can be personalized is increased due to being in the environment and observing how people use their space.

Relationship Information

The therapist will have front row seats to how the family operates and even talk to, with your permission of course, with family members and other people in your life. This is especially helpful and convenient if other people have not been able or willing to go to an office for a session with you. With all this input, you and the therapist have more information to address your situation. Looking at the family and relationship patterns are important when developing a treatment plan because many people in our lives contribute, in some way, to a problem or a solution.

We are a Family, in Therapy

Building on the previous section, when the therapist comes to the home, there are more opportunities for other people to be involved. During couples, family, or some other type of relationship therapy, the therapist obtains more insight and clarity to how everyone interacts with one another in their natural settings. Being at home may put everyone more at ease as well, which allows for deeper and committed work.

To the Home and Beyond

Home-based therapy does not have to be limited to the kitchen table and living room, despite its name. You and the therapist can make the decision to hold some sessions in the home, sit in the park, or even discuss treatment while going for a walk.

A Home-Based Approach May Not Be for You If...

  • You do not feel safe or comfortable in your home.

  • You do not live alone and do not feel you will have enough privacy to speak openly during therapy.

  • You have pets that cannot be contained, small children who need your attention, or other distractions and both you and the therapist may have difficulties staying focus during the session.

  • You are concerned that the therapist may witness unsafe or illegal activities while in the home. Remember that therapists are mandated reporters which means they are legally required to ensure a report is made when abuse is observed or suspected.

Any therapist offering home-based therapy as an option will share their boundaries, roles, and other expectations with you. This is helpful in maintaining a professional relationship that remains therapeutic and not confusing for you, the therapist, and those around you.

So, is home-based therapy right for you? Well, I am one of those therapists who offer this option! Contact me with additional questions or information on how to proceed. UPDATE: Healing Exchange LLC is no longer offering home-based therapy but may incorporate sessions outside of the office as appropriate.


Rafaella Smith-Fiallo is a Licensed Clinical Social Worker and owns Healing Exchange LLC. She specializes in supporting healing after sexual violence, building self-esteem and confidence, and teaching healthy sexuality to individuals, those in relationships, and within supportive group settings. She also cofounded Afrosexology, a sex-positive, pleasure based sexuality education platform.

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