By: Sharon Burris-Brown, LICSW, NBC-HWC


Recently, President Trump has expanded Telehealth coverage for Medicare recipients during the COVID-19 crisis.  More and more therapists are either choosing to do teletherapy or are being mandated by their clinics to go online during this time.

Telehealth and teletherapy has picked up steam and many insurance companies are covering it.


Teletherapy offers greater access to the most ill individuals who have the most difficulty in getting to a clinic.

Telehealth and teletherapy is a boon for those who live in rural areas where doctors and therapists are scarce. In 2015, a study published in the American Journal of Preventive Medicine found that Psychiatrists, psychologists and psychiatric nurse practitioners are unequally distributed throughout the country.  65% of rural areas lacked a psychiatrist. And almost half of rural areas lacked a psychologist.

And in many areas, the technology is good enough to get a clear audio and visual connection.  Therapists use HIPAA compliant platforms to ensure confidentiality and secure connection.

Teletherapy affords the flexibility that in person sessions do not.

Increased stress and isolation for many of us right now is a huge factor.  Maintaining momentum with therapy can be an integral part of one’s self-care plan.

People who are wary of starting therapy may find teletherapy a safer alternative.  Once having had a positive experience with teletherapy, they may be more likely to switch to in-person sessions.


Individuals may feel much more comfortable seeing their therapists face-to-face.  And this is a very personal decision.  Often, clients do not have a private, separate space away from their family members to feel comfortable participating in teletherapy.

With more people at home, more are online at the same time, internet issues may be more prevalent.

Therapists are working with more limited information, because they can’t see the client’s body posture and movements.

Therapists are often not allowed to work across state boundaries unless they are licensed in the state that the client either resides or even if the client is in that state temporarily.

Types of Teletherapy

Video and audio conferencing can almost feel like you are in the room with your therapist.  But a fast-growing type of e-therapy is “asynchronous” or via chat.  Asynchronous e-therapy occurs often via secure text and e-mail where client and therapist will connect at different times.  Chat is connecting through text only in real time.

When Teletherapy May Not Be Appropriate

Teletherapy has been shown to work about as well as in-person therapy sessions for certain clients.  However, those clients who need a higher level of care—who struggle with addictions or complex trauma, for example, may not do as well with teletherapy.

Certain therapy modalities are not effective or as effective when doing teletherapy such as some trauma therapies.

Asynchronous and text-based e-therapy should not be used for suicidal clients.  Visual cues to determine deteriorating mental health are extremely important to assess these individuals.

Set Yourself Up for Teletherapy

Discuss the challenges and benefits of going to teletherapy with your therapist if you have any questions or concerns.  Your provider will let you know whether some of the therapy modalities he/she has been using with you can or would not translate to teletherapy.

Check your insurance to determine if it is covered.  Most are covering telehealth and teletherapy but some are not or may have restrictions.

Check to make sure you have a speedy connection and a private and quiet place for your teletherapy sessions.

Rest assured that your therapist has a structure and technology to maintain your confidentiality and privacy.