Confessions of a Teletherapist: What You Need to Know about Virtual Therapy


For years, I have been saying that psychology is technologically behind. With the advances of technology in business (apps like Wealthfront to track wealth planning), food (drones to optimize agriculture and 3D printing candy), and entertainment (instagram influencers), psychology has been lacking to catch up.

In recent years, psychology has been adapted to online formats, including virtual therapy, self-help tools through online websites, and texting apps as an adjunct to in-person therapy. Virtual therapy had not taken off to the point where people were really choosing to do virtual therapy over in-person therapy, especially not for children. However, teletherapy does a great job of increasing access, since transportation is one of the largest barriers to accessing mental health treatment (Neil & Christensen, 2009). To be honest, I never saw myself going virtual as I am a therapist in Los Angeles, where therapy is more accessible than in rural counties.

However, due to the pandemic and stay-at-home orders, I have seen my entire caseload online via Zoom and Vsee for teenagers, adults, and parents since March 19th.



Here are my main takeaways from being a full-time tele-health therapist over the past 3 months:


  1. Research shows internet-based Cognitive Behavioral Therapy (CBT) has the same effectiveness as in-person CBT for anxiety and depression.

  2. Building a connection can actually be easier and occur more quickly.

    • To be honest, I have been conducting my teletherapy sessions from my bedroom. Therefore, my patients gain access to some personal aspects about my life, like the fact that I have a plant wall and a dog (yes, they can hear Derby the dog barking from time to time). I also get to learn more about my patients, based on the personal details of their space, like the artwork on their walls. I have actually found it easier to build connections via telehealth.

  3. Therapists can see the patient where they struggle the most.

    • If there is a patient struggling with substance use, the therapist can walk them through making the substance less accessible. The therapist and patient can work more collaboratively in terms of keeping the patient safe.

    • Another example- if your child seems “fine” in. the therapy room but really struggles in school, the therapist can actually join school Zoom calls, or coach the child through the difficult interaction, in the moment!

  4. It can be frustrating, at times.

    • I hate the video lag. It can be awkward when both my patient and I are trying to talk at the same time and neither of us can hear each other because Zoom mutes the other person. This is not how conversing works in real life and it can definitely be frustrating!

    • For kids with attention deficit difficulties, getting their attention over video can be a lot more difficult. This can require a lot of creativity!

  5. The alternative is going in-person- with a mask

    • I personally do not know any therapists who are seeing patients back in the office. However, if therapists were seeing patients in the office, both of them would have to wear a mask. I honestly cannot imagine doing therapy while wearing a mask, as facial and micro-expressions provide a lot of data- for both parties.

    • My personal opinion: I can imagine that looking at your therapist as you tell them something that makes you feel sad would feel disheartening as you are met with lack of facial expressions of warmth from your therapist.

  6. The main takeaway

    • I have found virtual therapy to be just as effective virtually and in-person for most people. There will always be exceptions but your therapist can work with you or your child to make virtual therapy as effective as possible.