How Does Teletherapy Work: What Mental Health Professionals Should Know in 2025

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

Share

What is teletherapy in mental healthcare?

Teletherapy is a form of mental health care that entails holding therapy sessions through digital platforms. This method enables individuals to receive therapeutic support without the need for in-person appointments.

Similar to an in-person therapist, a teletherapist conducts assessments, provides therapy, and guides clients through coping strategies or behavioral changes. Teletherapy sessions are conducted in real-time via secure, compliant platforms. 

Much like traditional in-person therapy, a teletherapist conducts mental health assessments, develops treatment plans, and provides counseling, coping strategies, and behavioral interventions tailored to the client’s needs. Sessions are typically conducted in real-time on platforms that are compliant with privacy and healthcare regulations, ensuring confidentiality and client safety.

For professionals training in fields like school counseling, including those enrolled in accelerated online school counseling master's programs, learning about teletherapy is especially valuable since many students and families now rely on virtual access to support services.

Teletherapy has become increasingly popular due to its flexibility, accessibility, and ability to reach underserved populations, making professional mental health care more inclusive and adaptable to modern lifestyles.

Benefits of Teletherapy

One of the main advantages of teletherapy is accessibility—clients can receive care regardless of their location, which is especially valuable for individuals in rural or remote areas. It also offers convenience and flexibility, allowing sessions to fit into busy schedules without the need to commute. For some clients, meeting virtually can reduce anxiety about seeking help and make it easier to open up in a familiar environment.

Limitations of Teletherapy

Despite its advantages, teletherapy may not be suitable for everyone. Clients without reliable internet access, private space, or comfort with technology may face challenges in engaging fully with virtual care. Additionally, certain mental health conditions or crisis situations may require more intensive, in-person support. Teletherapy is most effective when it complements, rather than completely replaces, traditional face-to-face mental health services.

How does teletherapy work compared to in-person therapy?

Teletherapy has the same structure and goals as in-person therapy, but the key difference lies in the medium through which sessions are conducted.

Teletherapy vs. In-person therapy

In in-person therapy, clients meet their therapist face-to-face in a physical location, such as a therapist's office. This direct interaction allows for the use of body language, non-verbal cues, and a more immersive environment.

On the other hand, teletherapy takes place remotely. It utilizes digital platforms, including video calls, phone sessions, and messaging. 

For future school counselors considering teletherapy, it’s important to understand how this format fits into their role. A school counselor job description often includes responsibilities like providing emotional support, academic guidance, and crisis intervention—many of which can be delivered effectively through virtual platforms. 

What it means for therapists

While the core therapeutic techniques, such as cognitive-behavioral therapy (CBT), mindfulness, and talk therapy, remain the same in both formats, teletherapy requires therapists to adapt to the challenges of virtual communication. Therapists need to focus more on verbal communication and actively manage technical issues that may arise.

Research proves the effectiveness of teletherapy for many conditions. Nonetheless, some clients may still prefer in-person sessions due to the direct personal connection and environment they provide.

Recent data, found in the chart below, highlights what Americans believe clinicians should be permitted to do through telehealth channels, reflecting shifting attitudes toward digital healthcare. 

What conditions can teletherapy effectively treat?

Teletherapy provides an option for individuals seeking treatment for various disorders, particularly for those who face barriers to in-person care. Below are some conditions that can be treated through teletherapy:

• Anxiety Disorders: Teletherapy can treat generalized anxiety, social anxiety, and panic disorders. Online therapy can help clients learn coping strategies and cognitive restructuring techniques that reduce anxiety symptoms.
• Depression: Many studies show that teletherapy, especially CBT, is successful in alleviating depression. Virtual sessions allow therapists to provide ongoing support, monitor symptoms, and offer intervention strategies.
• Post-Traumatic Stress Disorder (PTSD): Teletherapy can also treat individuals with PTSD, using trauma-focused therapies like CBT and EMDR. Remote sessions offer a safe, private space for clients to process traumatic memories and learn grounding techniques.
• Obsessive-Compulsive Disorder (OCD): Exposure and Response Prevention (ERP), a form of CBT, can be delivered through teletherapy to treat OCD. Online therapy allows clients to gradually confront their fears in a controlled environment while receiving professional guidance.
• Eating Disorders: Teletherapy can be used to treat conditions like anorexia, bulimia, and binge eating disorder. Therapists can offer counseling and behavioral strategies to help clients address the psychological aspects of their eating habits.
• Substance Use Disorders: Teletherapy can be used as a platform for clients struggling with substance use to receive counseling and support. It can be combined with other treatment methods like support groups or medication management to create a comprehensive recovery plan.
• Relationship and Family Issues: Teletherapy can help couples and families dealing with conflict, communication breakdowns, or relationship distress. Mental health professionals interested in this niche can compare a master of social work degree vs marriage and family therapy to get additional insights.

General anxiety is the most common mental health diagnosis addressed through telehealth.

What types of teletherapy platforms do mental health professionals use?

These platforms are designed to serve as a seamless communication channel between therapists and clients while adhering to industry regulations. Some popular teletherapy platforms in the mental health field are:

• Zoom for Healthcare: Zoom’s healthcare version offers a video conferencing tool for teletherapy sessions. It boasts high-quality video calls, screen sharing, and session recording, along with the necessary security features for ensuring privacy protection.
• Doxy.me: Doxy.me is a user-friendly telehealth platform that does not require any downloads or installations. It can be used for secure video calls, with features like virtual waiting rooms and the ability to integrate with other practice management tools.
• TheraNest: TheraNest is a comprehensive teletherapy platform that combines video conferencing with scheduling and billing tools. It allows mental health professionals to conduct therapy sessions, manage client records, and track treatment progress all in one place.
• SimplePractice: SimplePractice is another teletherapy platform that offers secure video conferencing as part of its practice management software. It also includes appointment scheduling, billing, and document management features.
• VSee: VSee is known for its high-security standards and ease of use. It's often preferred for its stability and clarity during remote sessions, particularly in rural or underserved areas.

The wide adoption of these tools reflects how teletherapy has become as legitimate as other remote learning or work platforms, similar to how online colleges that accept low GPA have expanded access to education for nontraditional students.

How do therapists measure progress in teletherapy sessions?

Therapists measure progress in teletherapy sessions using a combination of qualitative and quantitative methods to assess the effectiveness of treatment.

Client self-reporting

One of the most common ways to measure progress is through client self-reporting. Here, the client shares their thoughts, feelings, and experiences during the session. This can involve discussing changes in symptoms, as well as exploring the client’s self-perception of their progress.

Therapists often use standardized assessment tools and questionnaires to track symptom severity over time. It allows both the therapist and the client to visualize progress objectively.

For instance, if you’ve ever wondered what does a licensed marriage and family therapist do, part of their role involves guiding clients through these reflective practices to assess and encourage meaningful growth.

Therapeutic techniques

Therapists in teletherapy often rely on therapeutic techniques like goal-setting and action plans. At the beginning of treatment, therapists work with clients to set specific, measurable, achievable, relevant, and time-bound (SMART) goals that can serve as benchmarks for progress.

These goals might focus on symptom reduction, improved coping strategies, or behavior changes. Therapists periodically revisit these goals, evaluating whether they have been met and adjusting the treatment plan as needed to ensure continued progress.

Observation and feedback

Therapists observe how clients respond to different therapeutic interventions and note improvements in emotional regulation or coping skills. Regular feedback from clients about how they are applying the skills learned in therapy to real-life situations also plays a huge role.

For example, a client may report using relaxation techniques to manage stress or successfully applying new communication strategies in a relationship, which would indicate progress toward achieving therapeutic goals.

What ethical challenges do therapists face in teletherapy?

Teletherapy presents a unique set of ethical challenges for therapists, as it involves delivering care through digital platforms rather than traditional face-to-face interactions. These challenges range from client confidentiality to managing technological issues that may impact the quality of therapy. 

Confidentiality and Privacy

Protecting client privacy is a top concern in teletherapy, as digital platforms may be vulnerable to security breaches. Therapists must use compliant platforms and guarantee that clients are in private, secure spaces during sessions. 

Informed Consent

Therapists must clearly explain the technology being used, the potential risks, and the limitations of virtual therapy. Clients should understand the differences between in-person and remote care, including the possibility of technological interruptions.

Licensing and Jurisdiction

Providing teletherapy across state or national borders can raise legal issues regarding licensing. Therapists need to be aware of the licensing requirements for each state or country in which their clients reside.

Emergency Situations

Handling emergencies during teletherapy can be challenging, especially if the therapist is unable to physically assess the situation. Therapists must have protocols in place for managing crises, including knowing the client’s location and local emergency services contact information. You can take fast-track emergency management masters degree online to gain more skills in this area.

Technology Issues

Technical difficulties, such as poor internet connections or platform malfunctions, can disrupt therapy sessions and impact the quality of care. Therapists must be prepared with contingency plans in case of technical problems.

Therapeutic Boundaries

Maintaining professional boundaries can be more difficult in the virtual space, where clients may feel more comfortable or disconnected from the traditional therapy environment. Therapists must establish clear boundaries, including guidelines for communication outside of scheduled sessions.

For aspiring professionals, such as those exploring the fastest online master's programs in marriage and family counseling, understanding these ethical considerations is essential preparation for modern clinical practice.

What legal risks should mental health professionals be aware of in teletherapy?

Mental health professionals working on teletherapy face several legal risks due to the digital nature of their services. Recognizing and preventing these legal risks maintains ethical practice and avoids legal repercussions. 

• Licensing and Jurisdiction: Therapists must be licensed in the state or country where the client is located, as providing teletherapy across state or national borders without proper licensing can lead to legal issues. Some regions have specific telehealth regulations, and therapists need to stay informed about these requirements to avoid violations.
• Confidentiality and Data Security: Keeping client information confidential is a legal obligation. Any breach of confidentiality due to insecure platforms or improper handling of client data can result in legal consequences.
• Malpractice Claims: Teletherapy could expose therapists to malpractice claims if the therapy provided is deemed ineffective or negligent due to the limitations of remote care. Therapists should document sessions thoroughly and follow best practices.
• Scope of Practice: Providing teletherapy outside of a therapist’s area of expertise or training could lead to legal and ethical issues. Therapists should be cautious not to offer services or treatments that fall outside of their licensure or professional qualifications.
• Insurance Coverage: Not all insurance policies cover teletherapy, and therapists must be aware of the policies that may limit or deny reimbursement for remote sessions. Therapists should verify whether teletherapy is covered under their clients’ insurance plans and have transparent discussions about payment terms.

Navigating these risks requires awareness of policy shifts and professional growth strategies, much like understanding what are the benefits of a graduate certificate, which can expand a therapist’s qualifications and credibility.

How do therapists ensure patient confidentiality in teletherapy?

Therapists must use secure telehealth services to protect the privacy of their clients. These platforms use encryption to safeguard video, audio, and written communication between the therapist and the client. They should also carry out sessions in a quiet space, free from interruptions.

Beyond platform security, therapists should be proactive in explaining the limits of confidentiality, such as when there is a legal obligation to disclose information. Therapists should also guide clients in using secure internet connections to prevent unauthorized access. They should remind clients that any communication through unsecured networks or devices could potentially compromise confidentiality.

Therapists must maintain careful documentation of all sessions, storing notes in encrypted systems and updating security measures regularly. These practices echo the importance of professional standards in education—similar to psychology program accreditation, which assures students and employers that training meets rigorous ethical and academic benchmarks.

What are HIPAA requirements for teletherapy security?

HIPAA sets strict guidelines for maintaining the confidentiality and security of patient information. Here are the key requirements for teletherapy security:

• HIPAA-Compliant Platforms: Teletherapy platforms must be compliant with HIPAA standards to protect patient information. Platforms should offer end-to-end encryption for video, audio, and written communications to ensure confidentiality.
• Business Associate Agreements (BAAs): Therapists must sign a BAA with any third-party service providers (such as teletherapy platform providers). This agreement outlines the responsibilities and security measures the third party must follow for compliance.
• Protected Health Information (PHI) Protection: Any electronic communication involving PHI must be encrypted and secure. Therapists should avoid using platforms that do not offer encryption or fail to meet HIPAA standards for PHI protection.
• Access Control and Authentication: Teletherapy platforms must include secure login systems, such as multi-factor authentication, to prevent unauthorized access to patient information. Only authorized individuals should be able to access client records and session data.
• Session Privacy and Environment: Therapists must conduct sessions in a private, secure location to prevent unauthorized individuals from overhearing. Clients should also be advised to have a safe space for their sessions to prevent accidental breaches of confidentiality.
• Data Storage and Disposal: All patient records and session data should be securely stored in encrypted systems and should be appropriately disposed of when no longer needed. Therapists must adhere to HIPAA's retention and disposal guidelines to protect patient data even after therapy sessions have ended.
• Regular Security Updates and Audits: To stay HIPAA-compliant, teletherapy platforms and therapy practices must regularly update their software and security protocols. Routine security audits help identify vulnerabilities and continuously adhere to HIPAA standards.

How do clients typically feel about teletherapy sessions?

Many clients appreciate the convenience and flexibility that teletherapy offers. For clients with busy schedules, those in rural or underserved areas, or individuals with mobility challenges, teletherapy can be a practical solution. The ability to attend therapy remotely can increase accessibility and lessen the stigma some people feel about seeking mental health care.

Meanwhile, some clients may experience discomfort or dissatisfaction with teletherapy due to technical issues or the lack of an in-person connection. Technical difficulties can interfere with the quality of sessions and frustrate clients. Some individuals may also feel less engaged or disconnected from their therapist during virtual sessions. 

Still, many clients report comfort with teletherapy once they adapt to the format. Interestingly, teletherapy has also inspired some practitioners to consider alternative careers for MSW, where social work graduates expand into digital therapy, policy advocacy, or health technology roles.

What training do mental health professionals need for teletherapy?

Mental health professionals offering teletherapy must undergo specific training to be able to deliver ethical and legally compliant care. This training covers not only the technical aspects of using telehealth tools but also the distinct issues associated with providing therapy remotely. 

• Familiarity with Telehealth Platforms: Therapists need to be trained in using telehealth platforms. Mastering the technical features, such as video/audio settings and client data security, helps maintain confidentiality and session quality.
• Ethical and Legal Considerations: Mental health professionals must be educated on the legal and ethical guidelines surrounding teletherapy. Knowledge of regional telehealth regulations and the limits of virtual therapy helps avoid legal issues.
• Crisis Management in Virtual Settings: Training should include protocols for handling emergencies in teletherapy. This includes understanding how to assess risk remotely and how to contact local emergency services if necessary.
• Adapting Therapeutic Techniques for Remote Care: Therapists should receive training on how to adapt traditional therapeutic techniques for the virtual environment. This means adjusting communication strategies, resolving technical disruptions, and keeping therapeutic rapport through a screen.
• Cultural Competency in Teletherapy: Since teletherapy allows therapists to work with clients from diverse backgrounds and locations, training should emphasize cultural competence. Professionals must understand how cultural differences can influence the virtual therapy process and modify their approaches accordingly.
• Understanding Technology Limitations: Therapists must be aware of the potential technological limitations that can affect the therapy experience. Training should include troubleshooting tips and alternative communication methods in case of technical issues.
• Ongoing Professional Development: This includes staying updated on the latest technology, research, and best practices in virtual care to provide high-quality, effective teletherapy. For those who wish to upskill, getting an online PsyD program can be advantageous.

What new technologies are shaping the future of online therapy?

Innovations in AI, VR, and other digital systems bring about more personalized, engaging, and interactive treatment experiences. These advancements are poised to address some of the limitations of traditional teletherapy and refine the overall therapeutic process.

• AI and Chatbots: AI-powered chatbots can assist therapists by providing preliminary assessments, monitoring client progress, and offering support between sessions. They can also help spot patterns in clients' behaviors or moods.
• VR Therapy: VR allows therapists to create immersive environments that can simulate real-life situations for clients to work through specific phobias, anxiety, or PTSD. VR can foster a more interactive and engaging therapeutic experience, letting clients confront and process difficult emotions.
• Wearable Devices and Biofeedback: Wearable devices can track physiological responses like heart rate and sleep patterns, giving therapists valuable insights into a client's physical and emotional state. Biofeedback systems help clients become more aware of their bodily responses.
• Teletherapy Platforms with Integrated Tools: Mood trackers, journaling features, and therapeutic games help enhance virtual sessions. These integrated tools allow for continuous support and facilitate deeper engagement between the therapist and client outside of scheduled sessions.
• AR in Therapy: AR is being explored as a way to create virtual environments for exposure therapy. By layering digital elements on top of the physical world, AR can simulate real-world experiences while allowing for a controlled and safe environment.

Here’s What Mental Health Professionals Have to Say About Teletherapy

Other Things You Should Know About Teletherapy for Mental Health Professionals

Is teletherapy evidence-based and supported by research?

Yes, teletherapy is evidence-based and supported by a growing body of research showing its effectiveness in treating a variety of mental health conditions. Studies have demonstrated that teletherapy can be as effective as in-person therapy, with many clients reporting high satisfaction with the convenience and accessibility it offers.

Research also highlights that teletherapy provides a viable option for individuals who face barriers to in-person therapy, such as geographic isolation or mobility issues.

Why is therapeutic self-awareness important to the mental health professional?

Therapeutic self-awareness allows them to recognize and manage their own emotional responses, biases, and triggers during therapy. This self-awareness helps ensure that therapists maintain a clear, nonjudgmental space for clients and remain fully present in the therapeutic process.

By understanding their own thoughts, feelings, and behaviors, therapists can better empathize with clients, set appropriate boundaries, and avoid projecting personal issues onto the client.

What is the difference between telehealth and telepsychiatry?

Telehealth is a broad term that encompasses a wide spectrum of healthcare services provided remotely, including general medical consultations, mental health therapy, and other health-related services through digital platforms. Telepsychiatry is a specialized subset of telehealth that specifically focuses on delivering psychiatric services remotely.

While telehealth can include a variety of health services, telepsychiatry is primarily concerned with the diagnosis, treatment, and management of mental health disorders.

What are the disadvantages of telepsychiatry?

Telepsychiatry's disadvantages include potential technical issues such as poor internet connectivity or audio/video disruptions. The lack of in-person interaction may also hinder the ability to fully decode body language. Some clients may feel less comfortable or disconnected in a virtual setting as well. Furthermore, telepsychiatry may not be suitable for individuals in crises who require immediate, in-person intervention.