Online counseling, also called teletherapy or virtual therapy, is a type of formal psychotherapy that offers services using electronic technology or the telephone.

Phone therapy, counseling via chat or apps, and videoconferencing with a therapist are all forms of online counseling.

Teletherapy typically follows some of the most important agreements and rules of psychotherapy, in general. But, is it as effective as in-person counseling?

Yes, it is, says Robert Cuyler, PhD, a psychologist in Houston and expert on telemedicine and technology innovations for behavioral health. According to him, research indicates that treatment outcomes and patient satisfaction are equivalent for both.

Online counseling works as in-person therapy, except that you’re not in the same room as your therapist.

Teletherapy sessions can be individual or in group and typically last 50 minutes.

Phone therapy works by connecting with a licensed professional via your landline or cellular phone and usually talking for 50 minutes about your challenges. This type of teletherapy may be ideal for people who live with social anxiety or don’t feel comfortable seeing or being seen by their therapist.

Video therapy will use a videoconference platform such as Skype or Zoom where you and your therapist will have your camera on for 50 minutes while talking about your goals and challenges.

In some cases, teletherapy will also include communication via chat, app, or a website. This may work for people who need support from their therapists in between sessions.

Each state and profession has different licensing and practice requirements for teletherapy. What is common across the nation is that your therapist must hold a license in the state in which you reside.

Also, your personal and health information is protected through the Health Insurance Portability and Accountability Act (HIPAA).

Does teletherapy work for formal diagnoses?

Teletherapy can be helpful for addressing a variety of everyday challenges and also mental health conditions, including those that require formal treatments like anxiety, depression, or personality disorders.

There may be some exceptions. If you require medical treatment as part of your intervention, you may attend psychotherapy sessions virtually but would also need to see your health professional in person. For example, if you need medication or inpatient support for substance use disorder.

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Sense of safety

Teletherapy can help reduce the effects of mental health stigma sometimes associated with therapy, says Natalie Bernstein, PsyD, a psychologist in Pittsburgh, who works primarily online with individuals, families, and couples.

“The idea that others are judging you for attending therapy or seeing you enter and leave a therapist’s office is not a factor online,” she explains.

Convenience and flexibility

For many clients, teletherapy is a more flexible, convenient, and cost-effective alternative to in-person therapy. You may be able to skip babysitter, parking, and driving expenses, for example. You may also save some time since you don’t have to commute back and forth to see your therapist.

“Many of my clients say they wouldn’t be able to participate in therapy if it wasn’t online due to time constraints like work, family, and traffic,” says Bernstein.

Greater accessibility

Teletherapy allows greater access to care for people in rural areas and or who may experience challenges leaving home due to physical limitations or anxiety disorders.

More energy for therapy

Online therapy can reduce the amount of time and effort an in-person session requires. This can help people with depression, for example, with factors like motivation and energy, says Bernstein.

“These clients tend to feel safer in their own homes, and that can come through during online sessions,” she says.


Depending on where you’re connecting from, teletherapy may involve dealing with some distractions. For example, traffic, pets and children, other people working or being in the same place, or deliveries.

You may not always have the chance to connect from a quiet place.

Technology problems

You may not always have access to adequate broadband or a laptop or tablet to conduct an online session. Internet service interruptions, power outages, and website problems can also get in the way.

Lack of privacy

Finding a private space for therapy may be a challenge, says Bernstein. “I’ve had sessions where individuals are in their closet or parked car in order to maintain privacy,” she says.

Limited information

Therapists may lack additional information they would get in person, says Cuyler, such as body language, posture, or even hygiene. “They also don’t have the same capacity to deal with emergencies that can occur in the course of care,” he notes.

Teletherapy refers to online counseling or virtual psychotherapy. It may involve phone therapy, videoconferencing, chatting online, or using an app to receive mental health support.

Benefits include reduced chance of feeling stigmatized, convenience, flexibility, and greater accessibility. Limitations may involve technology problems, distractions, lack of privacy, and limited information about clients for therapists.

Each state has its own requirements for teletherapy. You may want to discuss the rules and goals of online counseling during your first therapy session or consultation.