Distance Therapy: Phone Therapy and Internet Therapy

Distance therapy, also known as phone therapy or Internet therapy, has evolved over the years as the therapeutic world has embraced the digital age. Some therapists offer different forms of distance therapy in an effort to reach a wider range of people in various locations and across distances. As the names imply, phone therapy and online therapy do not use in-person, face-to-face communication as the primary mode of therapy.

Why Choose Distance Therapy?

Internet and phone therapy can be employed as a part of a traditional therapeutic relationship. A therapist might, for example, conduct online or phone sessions with a patient during a time of crisis or when the patient is out of town. But online and phone therapy can also serve as stand-alone forms of therapy.

Distance therapists guide clients through challenges, detect distorted thinking, and provide assignments via voice or text over the phone and via chat, video, or email online. Some therapists offer distance therapy as the primary venue for the therapist and client to “meet,” and many people prefer phone or Internet therapy because it means that they can conduct therapy sessions with the therapist from the comfort of their own homes or even at times when they are traveling.

What Issues Are Addressed in Distance Therapy?

Any number of concerns, from anxiety to eating and food issues, may be addressed with distance therapy, although concerns of a particularly sensitive nature may be better suited to traditional talk therapy. In addition, there are many therapeutic modalities that are well suited to distance therapy and many that are not. Whatever modality is used, it will need to be able to be done without the “visual” feedback from a face-to-face session.

Distance therapy may be contraindicated for people who are working through very challenging and upsetting experiences or experiencing multiple crises. Suicidal clients, for example, may need more intensive interventions, but the inability to see body language on the phone or hear inflection online can make it challenging for a therapist to assess a client's mental state. Therapists may need to take additional measures to ensure they're accurately assessing their clients, meeting ethical requirements, and providing high-quality counseling. A distance therapist is wise to have specific plans in place in case of client emergencies. 

Ethical Considerations for Distance Therapy

There are some concerns about distance therapy in the field of psychotherapy, not just because of potential dangers and misuse, but also about its efficacy. Some opponents of distance therapy believe that because humans are hurt in relationship to others, that one must heal in relationship, face-to-face. Distance therapy, they say, can skip over the most fundamental and important aspect of healing: the relationship. But generally proponents of distance therapy agree that the relationship is of primary importance and believe that they are indeed able to establish a trusting therapeutic relationship via phone, webcam, or email. Other distance therapy proponents ignore the issue altogether and focus on helping people with surface issues, essentially providing distance coaching or counseling.

Rules and Regulations for Distance Therapy

As with in-person therapy, only a licensed professional can administer distance therapy. Therapists traditionally have to be licensed in the state in which they practice, but distance therapy poses a challenge, as some states may require that therapists be licensed in the state in which the client is located, for example. So far, only a few states have passed laws specifically designed to regulate distance counseling. 

In addition, some types of distance-based consultation are not therapy at all, but could easily be mistaken for it. For example, some suicide hotlines offer online and phone crisis counseling, and some life coaches offer phone and online consultations. These services, however, cannot market themselves as therapy or try to administer therapy. 

Last Update: 01-26-2014

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