What is Online Counseling?

​​Online counseling – also referred to as telemental health, e-therapy, video therapy or virtual therapy – is not as new as many believe.  As early as the 1950s the medical profession began providing telemedicine over the telephone.  What is new is the technology to transmit and view each other in ways that closely simulate being in the same room together. Today telemental health includes work done by video, text, email and telephone via a HIPAA secure platform.   Video therapy sessions are my most favored method of online counseling but text, email and phone all can be appropriate in certain situations. 

Advantages to online counseling include convenience, affordability, flexible scheduling, and accessibility for those with physical limitations or who live in remote or rural areas.  If there is a blizzard or your car has a flat tire we can still meet.  If you’d prefer to meet by phone occasionally we can do that, as well.

Research has repeatedly shown that online counseling using cognitive behavioral therapy (CBT) for depression, anxiety, panic, stress and social anxiety is just as effective as in-office therapy.  The outcomes are similar and some studies show the results are even longer lasting with online therapy.   The verdict is still out on using telemental health with bipolar disorders, schizophrenia, PTSD and those who have thoughts of self harm.

Texting certainly has its place in some types of counseling such as when the client wants to a quick behavior prompt or to let the therapist know of progress.  Let’s say you are particularly proud of your effort to have a difficult conversation with someone you love and you want to let your therapist know how well you did.  That’s a great time to send a secure text and you will probably receive a congratulatory text in return. Quick and done.  However, you should always have a conversation with your therapist at the beginning of your therapy to see whether the therapist wants “to be on call” in that manner.  Personally, I’m thrilled to hear about your successes and will usually send a brief response. Don’t expect to engage in a volley of back and forth however.

Therapy by email is ONLY appropriate if it is done using HIPAA secure and encrypted means.  I do not routinely do therapy via email.

Simple Practice is my electronic practice management system on which you register prior to your first visit.  On your private page you will see a conversation bubble on the top right hand side which is messaging that you can use like email.   We can converse securely and it is easy to use. 

If you are submitting a claim to your insurance it is important to know that only synchronous or live video therapy sessions will be covered.  Text, messaging, and email are not considered live so will not be covered. Phone therapy is also not covered.


  1.  Nordgren LB, Hedman E, Etienne J, et al. Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: a randomized controlled trial. Behav Res Ther. 2014;59:1-11. doi:10.1016/j.brat.2014.05.007

  2. Wagner B, Horn AB, Maercker A. Internet-based versus face-to-face cognitive-behavioral intervention for depression: a randomized controlled non-inferiority trial. J Affect Disord. 2014;152-154:113-121. doi:10.1016/j.jad.2013.06.032

  3. Andrews G, Basu A, Cuijpers P, et al. Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: an updated meta-analysis. J Anxiety Disord. 2018;55:70-78. doi:10.1016/j.janxdis.2018.01.001