As friends and families have embraced new technologies for keeping in touch, so have many therapists and their clients. Online therapy—also called e-therapy, online counseling, teletherapy, and distance counseling, among other names—is such a widely used medium that it is now specifically managed by many state regulatory agencies.

Online therapy refers to psychotherapy or counseling services conducted over the Internet. Therapist-client interactions might happen via email, chat, phone, or video. They can be live and interactive, or they can be asynchronous, in which one party at a time sends a communication and then checks back later for a response.

How Does Online Therapy Work?

It is critical that your therapist is thoroughly prepared to offer ethical online services. There is more to this than having a counseling degree and knowing how to use Skype. Therapists must research allowed practices in their area. They must also determine which technology platforms best deliver their services while preserving client privacy, as outlined by the federal government.

First, a therapist will demonstrate her compliance with The Health Insurance Portability and Accountability Act (HIPAA), by sharing a Notice of Privacy Practices, and discussing ways in which your protected health information may be legally used or shared for your treatment, and ways in which it must be kept private. The therapist will also disclose other risks involved with the digital transmission of your health care information. You will need to consent to this process and these risks if you wish to continue with online therapy.

Next, your therapist will outline her particular method of conducting therapy over the internet. Your therapist may introduce you to secure video conferencing tools or messaging services. You will discuss equipment and internet requirements (such as reliable, high speed internet access or a laptop with a web camera). Your therapist will describe how she will contact you for your first appointment, and what to do in case of a power or internet outage.

Additionally, your therapist will screen you to make sure you are a good candidate for online therapy. Distance counseling is contraindicated for clients who are suicidal, and may not be appropriate for clients in major or multiple crises.

What are the Benefits of Online Therapy?

In addition to the general established benefits of psychotherapy, e-therapy has the added features of

• increased access to high quality care providers
• reduced transportation time and money spent on accessing services
• fewer barriers for clients with physical limitations
• enhanced access for clients with anxiety conditions which make it difficult to travel or meet new people

Because licensure and legislature are done state-by-state, clients have access to an entire state of potential providers instead of just those who happen to be located nearby. This is an especially helpful resource for counselors who would like to be therapy clients outside of their own professional communities. This also gives clients more options when looking for a provider with suitable experience, temperament, and approach.

Are there Drawbacks to Online Therapy?

Teletherapy is not the right fit for all clients. It is not advised for clients who are suicidal, highly dissociative, or have other severe mental illnesses. This is the case, in part, because it can be resourcing simply to be in the same room as someone in a trusted role, such as a counselor.

Online counseling relationships require a bit more paperwork and set up on the front end. Your therapist will need to walk you through their process for sessions and their electronic communications consent forms, and not all clients wish to invest this energy into a relationship before they are sure it will pay off.

Finally, some clients may feel that too much is lost from a full in-person interaction, especially when working without video, and will prefer working face-to-face.

Though the setup may feel unusual at first, many clients report that the acclimation process to working online is a surprisingly easy one, and that the benefit of working with the therapist of your choice outweighs the discomfort of adjusting to online work.

If you are a California resident and interested in learning more about online therapy or experiencing it for yourself, please contact me today.