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Humans are wired for connection and contact which makes the current pandemic situation a mental health challenge. Before COVID-19 rocked our worlds, professionals would have recommended that a client make sure to have frequent contact with family and friends when experiencing a difficult situation, and especially in a crisis. However the need to protect our health and welfare has made this primary coping strategy unavailable to many except through virtual connection. As therapists we struggle with the same preference to see people face-to-face. We have been trained  to use our intuition, education, and the flow of expressed energy in the room to help guide a client toward healing. We also understand that the most important part of therapy is the connection and trust a client feels toward their therapist.

So the big question on everyone’s mind right now is “Does video counseling (also known as telehealth) work as well as in-person therapy?” Fortunately telehealth has been gaining momentum as a viable option for people seeking counseling services even before the pandemic. Throughout the past ten years there has been a growing body of research supporting the positive experiences clients have reported when receiving video counseling using a computer or phone. In fact, most research indicates that for a majority of clients there is no difference in outcomes between in-person therapy and telehealth therapy. 

There are a variety of reasons why telehealth counseling may be used in lieu of traditional face-to-face counseling. Especially for people who live in rural areas, the cost of time and money to attend a session in-person can create a barrier to getting treatment. Unpredictable weather conditions that make driving unsafe can also add to problems attending appointments. As we are experiencing now with the COVID-19 virus pandemic, health concerns and possible exposure in public places can be a factor that prevent people from going into an office environment for counseling.

There are a variety of steps that your therapist will need to address in order to ensure a successful online therapy experience. Here are a few important things to know about telehealth counseling:


The first thing that your therapist will discuss with you is consent to engage in a telehealth session. They will talk over the pros and cons of using technology in place of face-to-face therapy sessions. Part of a successful telehealth session is preparing for any troubles that may emerge. Your therapist will want to confirm where you are located and emergency contact people in case there is a need for support during a session. They will also discuss what steps to take in case you get disconnected and alternative options to complete the session if the technology is not working properly.


It is important to have a secure place that you feel comfortable talking during your telehealth appointment without interruptions. This will allow you to focus on the issues you are discussing with your therapist and benefit from the skill building or mental exercises they will be implementing during the session. Sometimes this can be a challenge especially when there may be several family members in the home or if you work in an office environment with little to no privacy. You may need to brainstorm with your counselor creative ways to ensure a private setting such as sessions in your car, going to a different location, finding ways to keep kids occupied during your appointments, or going outside with headphones and walking in an area with little traffic. Although these settings may not be ideal, you will get much more out of a session when you are able to share your concerns without worrying about privacy.


One of the most important parts of the telehealth experience is making sure that technology does not interfere with the counseling process. Your counselor will explain how to connect and walk you through downloading any specialized software you may need. For a device you will need one of the following:

  • Desktop computer with a webcam and speakers OR
  • Laptop computer with built-in webcam and speaker OR
  • Tablet device with built-in webcam and speakers, OR
  • Smartphone with at least iOS 11 or Android 7.0

For optimal results, a reliable, high-speed internet connection with a bandwidth of at least 10 mbps will minimize connection issues and provide the best quality. Sessions can also be conducted by phone using a specialized video platform that you install onto your device, but again you will need to make sure that you have a good connection so that you can view and hear your counselor clearly. If you are unable to connect using video due to technology difficulties, you can complete a session using a normal phone call connection. Although not ideal, a phone conversation can be an effective way to monitor symptoms and get support until you are able to see a therapist in person.


Scheduling a telehealth appointment works the same as scheduling a traditional in-person session. You and your therapist will coordinate a time that works for both of your schedules and meet at that designated time. The only difference will be the actual appointment itself which will be held via a video conferencing platform rather than an office visit. One of the advantages to a telehealth appointment is that there is no need to work around drive time to and from an appointment or worry about the time it may take to find parking. This alleviates some of the stress that comes with traditional counseling and allows for more flexibility in scheduling.


There is no additional cost when attending a session using a video platform instead of an office visit. If you plan to bill insurance for telehealth, you will want to check with your insurer to verify that the specific therapist you want to see is in-network for telehealth sessions. Sometimes an insurance company will want you to use a third-party and work with a different therapist for telehealth. During the COVID-19 pandemic, the government has stated that insurance companies must allow their subscribers to connect with their therapist of choice and cannot place restrictions on who a client can see for treatment. It is always best to call your insurance company to double check and advocate to see the therapist you think will meet your specific needs. 

Right now most professionals counselors are practicing social distancing and conducting all sessions using telehealth. One positive outcome will likely be that therapists and clients will become more comfortable with this therapy option and learn how to make the most out of counseling sessions. We are working hard to help people move toward mental wellness and telehealth is an effective tool to make treatment available to even more people. If you have further questions about telehealth, you can reach out by phone or web request to find out more information and get connected with a therapist. We are here to support clients in their journey toward health and healing. 

Written by:









Sonia Combs, MS, LMHC, NCC, CMHS

*Information from this blog is not intended to treat, diagnose, or substitute as therapy. If you have concerns regarding your mental health, please seek out treatment from a trained professional.