Distance therapy, unlike traditional therapy, does not have in-person interaction during treatment. It has evolved as the practice of therapy enters the digital age. Therapists may offer different forms of distance therapy to reach more people in many locations. Distance therapy is often conducted online or on the phone. Other terms for distance therapy include distance counseling, teletherapy, phone therapy, or internet therapy.

Why Choose Distance Therapy?

Distance therapists can provide services via phone, chat, video, or email. They may guide people through challenges using different types of communication technology. 

Mental health professionals might offer distance therapy as the main way to communicate with people who are seeking therapy. Some prefer this type of treatment because they can get the benefits of therapy in their own homes or while traveling.

Distance therapy may be offered as a standalone treatment. It can also be used along with the traditional therapeutic relationship. A therapist may provide treatment from an office but switch to distance therapy when a person is out of town or cannot commute to the office. 

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Distance therapy can be a good fit for people who have difficulty accessing mental health services. It can also be useful in other situations. Some people feel more comfortable communicating openly via email than in person with a therapist. Others may feel therapy is more accessible this way, since they do not know when they may need support the most.

People who are new to therapy may find it easy to participate in distance therapy sessions. The fact that treatment takes place in the home may also reduce the stigma associated with receiving mental health services.

Who Uses Distance Therapy?

Distance therapy can be a good option for people who cannot access care due to location, health, or transportation issues. It may also be appealing to people who do not wish to meet in an office. As many important aspects of life are now available online, distance therapy may be therapy’s way of keeping up with the digital world.

Many aspects of mental health can be addressed with distance therapy. Some of these include: 

Studies indicate distance therapy may be as effective as face-to-face therapy for many issues. Many popular approaches, such as cognitive behavioral therapy (CBT), may be well-suited to online therapy. However, visual feedback may not be available and depends on the technology used.

How to Tell if Distance Therapy Is Right for You

Distance therapy may be a good choice for people who live far from mental health resources. Those who have busy schedules or difficulty leaving home can also benefit from this form of mental health care. 

There are situations where distance therapy it is not recommended. For example, people with severe psychological or emotional issues may not do well with this type of treatment. People with schizophrenia, severe depression, bipolar, or suicidal thoughts may get more from traditional therapy. Individuals with these and other issues may need intensive care.

Others who may not benefit from distance therapy are those who are uncomfortable with technology. People with little privacy at home and those who wish not to share personal matters over the internet or phone may also prefer other mental health options.

Finding the Right Distance Therapy Provider

People seeking distance therapy have many options, but it is important to be cautious when searching for a therapist. Some people who offer distance therapy are not qualified or licensed. This can lead to ineffective treatment or a potentially dangerous situation. Sharing private information with the wrong person can lead to identity theft and other forms of fraud.  

When choosing an online therapist, it is important to make sure they are licensed to practice in your state. It may help to verify their full name, credentials, and license number. A trained therapist should have at least a master’s degree in a field related to mental health. Most states provide a searchable online directory of all licensed therapists for cross-checking. 

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If a therapist is offering online mental health services, they may also have a website. It is a good idea to request the website address during your initial discussion or find it online yourself. Check their website to learn more about them and their methods, experience, and philosophy. You can also search reputable websites for online reviews others may have left about the therapist’s services.

Many people are exploring the possibility of online therapy. Likewise, an increasing number of therapists are offering this form of treatment. While the therapist may be very experience in traditional face-to-face sessions, they may be unfamiliar with the equipment required for distance therapy. It is key to make sure your therapist has the technical skills to provide treatment online. 

You may clarify all details about fees and payment options in your initial meeting. While online therapy can be less expensive than traditional psychotherapy, some insurance companies do not cover online mental health services. It is best to speak with your therapist about any concerns you have regarding privacy, confidentiality, or what to expect. If the therapist is vague or unwilling to discuss these issues with you, it could be time to find another provider.

Limitations and Ethics of Distance Therapy

Distance therapy may have some downsides. Concerns you might consider before beginning treatment include:

  • Lack of nonverbal communication: Even with video conferencing, the therapist may not be able to notice signs such as dilated pupils, nervous foot-tapping, or twitching.
  • Confidentiality issues if a person’s email is hacked or a message is sent to the wrong contact
  • Delays due to issues using equipment
  • Complications when treatment is provided across state lines: This may lead to ethical and legal issues related to licensing. Counselors who offer distance therapy can treat people who live anywhere in the country. But, state licensing laws often prohibit therapists from providing care to people who live in other states.
  • Lack of skill with technology may lead to confidentiality issues if sensitive information is not properly stored or if equipment is not used correctly.
  • Delayed response to crisis situations
  • Difficulty addressing severe or complex mental health concerns
  • Financial issues due to lack of coverage from many insurance policies

History of Distance Therapy

The concept of distance therapy is not new. For instance, Sigmund Freud and other mental health professionals in the 20th century sent letters to people in their care. Through these letters, therapists were able to provide support and receive feedback from people in therapy. 

Telephones began to be used to provide mental health care in the 20th century. The popularity and effectiveness of distance therapy increased, however, as personal computers and internet use became common. At first, mental health services came in the form of self-help books and online support groups. As technology advanced, distance therapists began using web chats, instant messaging, texts, emails, video conferences, and mobile apps to provide treatment.

One of the first therapists to conduct online therapy was David Sommers. He offered mental health services on the internet for a fee. Rather than giving advice in a single session, Sommers focused on developing therapeutic relationships with the people in his care. By the time he stopped offering online therapy, he had helped more than 300 people. Other notable pioneers of internet therapy include Ed Needham and Leonard Holmes.

Now, thousands of websites offer mental health services. These services are sometimes provided by therapists who work from an office but also offer online counseling. In addition to websites, there are many online groups for people with depression, anxiety, posttraumatic stress, and other mental health issues.


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  4. Smith, K. (2016, February 24). What does new technology mean for the future of therapy? Retrieved from https://www.psychotherapynetworker.org/blog/details/745/the-rise-of-distance-therapy
  5. What you need to know before choosing online therapy. (n.d.). American Psychological Association. Retrieved from http://www.apa.org/helpcenter/online-therapy.aspx