Is online therapy or tele-therapy a good idea for your practice?

L. Gordon Brewer, Jr., MEd., LMFT wrote a must read post about practicing online therapy. Gordon is currently the President of Kingsport Counseling in Kingsport, TN. He also runs the online site- The Practice of Therapy.
I remember as a kid in junior high school and us taking a field trip to see the movie “Future Shock”. Of course this would have been in the mid 1970’s (I’m showing my age here!). I remember them talking in the movie about “TV Phones”. I remember thinking, now that is just ridiculous! Why would you want to see who you are talking to? And besides that, no one could afford it. Well I guess I was wrong…

Over the past several years, the use of video conferencing in the medical field and other business has grown exponentially. With the technology we have available, besides texting the use of “Skype” or “Facetime” has become the norm for communicating rather than using a regular telephone to communicate. My guess would be that with technology growing as it is, the holograms of Star Wars and Star Trek will be a reality in the not too distant future!
The advantage of this technology of course is that you get to see facial expressions, tone and body language. And for a therapist that is huge! After all, 80% of communication is non-verbal anyway. That is of course why it seems so compelling and advantageous.

Online therapy is just as effective as face to face…
I don’t think the technology has quite reached a point where this type of therapy will replace actual person to person contact as we do in traditional therapy, but there have been studies that suggest that the efficacy of online or video therapy is just as effective. In a University of Zurich study, online therapy was found to be just as good, if not better in some instances, as regular face to face therapy.

So is this a good option for your practice? Is it a niche to capitalize on? Like most everything, it just depends. Online therapy has some drawbacks and is certainly not for everyone. In addition, as a profession we are still working through some of the legal and ethical issues with online counseling.

The first thing to consider is that to just pop onto Skype and have a session with someone presents some confidentially problems. If you log into Skype, other people can see who you might be talking to. They might not know what you are talking about, but they can see that you are online and who you might be talking to. The other dilemma is that neither Skype nor Facetime will provide you with the “Business Associate Agreement” (BAA)required to be HIPAA compliant.

Skype and Facetime not the best platform…
But there are other ways to do this. There are several other video conferencing services that are more secure and that will sign a BAA with you. The platform you choose to use can vary from something turnkey such as a service that does all the scheduling and billing for you. To something where you control all of that for yourself.

I am currently using both approaches. A service that I discovered,, is a free service. I use this for my private practice clients that I do need to meet with via video conferencing. We offer this as one the services of our practice. does require some registration and the set-up of your waiting room. But once it is set up, it is very easy to use and does not require too much tech savvy.

You can read the rest of the post at The Practice of Therapy. You can also get in touch with Gordon at

Courtney Larson

Read more posts by this author.