Considering offering virtual therapy? You may want to rethink that

shutterstock_820953341It would seem that everything is going digital, and digital therapy or “distance therapy” is the future of the counseling profession.  Why is it?  Well, there are many valid reasons.  We know, for instance, that inconvenience is the #1 thing keeping people from seeing a therapist.  This may be very surprising to those that always heard that the stigma of seeing a therapist was what kept people away.  But actually, stigma and cost fall very far on the list in recent surveys.  So if the inconvenience of having to get in your car and drive to your therapist’s office is what’s keeping people away, what better solution than to just have the session via skype from the convenience of your own home?

Of course, one of the immediate issues that surfaces for clients is that insurance will not cover any service that doesn’t happen face-to-face.  Despite this, it would seem that plenty of people are willing to pay extra for the convenience of in-home sessions.  It also means less cancellations, as illness and transportation are less of an issue when everything’s online.  Therapists are also happy to not have to deal with the insurance companies or cancellations.

Another plus for therapists is that we are no longer limited by the pool of clients in our area.  We can see clients all over the country, perhaps even the world.  Another advantage is that due to time-zones, it means we can offer evening appointments without having it actually be the evening.  In theory, therapists could work 9-5, while still being able to work with their client’s schedules.

Sounds pretty good, right?  Well you might have noticed that I don’t offer distance therapy.  There’s a few reasons why.  One is the technical issues.  At any moment one of you could lose your internet or the software could fail.  A few times of this happening and virtual therapy is no longer convenient for your client.  I could see people getting frustrated and dropping out.  Another issue, and more importantly, is what do you do if your client is experiencing an emergency or you are mandated to report?  Mandated Reporter laws vary state to state.  So do emergency lines.  From a liability standpoint, this could be very bad.

Another issue is that when clients are paying-out-of-pocket, they don’t feel any need to give you their information.  There’s been a few times when I’ve found that private pay clients weren’t using their real name.  People are even less likely to use their real information if when it comes to online interactions.  Understandably, people want privacy, and if they don’t have to give their information to their therapist, they wont.  This makes it even harder if something were to go wrong in the course of therapy.

These are my reasons for not offering distance therapy.  Of course I also recognize that I probably wont be able to avoid forever.  It’s hard to imagine 20 years from now that I will still be seeing clients in my office.

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My name is Marina Williams and I am a licensed mental health counselor with a private practice in Jamaica Plain, MA. This website is my professional website devoted to my activities as a therapist. If you are interested in finding out more about my private practice, please visit my other website


Do you want to make an appointment for counseling or supervision? Interested in having me speak at your event? Have any questions or concerns? Feel free to contact me at 774-240-5550 or