Technology has changed the world. We all know it influences every part of our lives and relationships. So it’s no surprise that technology is changing how you can meet with your therapist. You may hear it referred to as online therapy, telemedicine, telemental health, online counseling, virtual therapy, or e-therapy.  Regardless of what it’s called, it’s all about giving you more options.

So what is online counseling?

Online therapy is exactly how it sounds. Counseling involves meeting with your therapist over a HIPAA-compliant video platform using your computer, phone, or tablet. It’s kind of like Skype or FaceTime but easier and more secure. Just like in-person therapy, you still have a scheduled appointment time, find a private space to talk, and have similar conversations. 

I love talking about online therapy and how it allows us to help more people than we ever could in our offices. I truly believe the future of counseling is to have a combination of in-person and online therapy options available for everyone. The convenience and flexibility of online counseling allows you to really fit therapy into your life by just opening an app or clicking a link. Your therapist is right there with you, wherever you are. Seriously, it’s really that simple.

Several research studies are beginning to suggest that online therapy is just as effective as in-person therapy for helping you meet your goals. And, in my experience working with couples and families online, I’ve noticed swift improvements in relationships (although there is no current research about the effectiveness with couples and families - but hopefully there will be soon!).


Like anything in life, there are benefits and also potential drawbacks.


  • Convenience - Participating in online therapy means you can meet with your therapist at a location of your convenience (work, home, etc.) and fit it into your already busy schedule. There’s no commute, no parking struggle, no waiting room, or any of the other time and expense associated with traveling to your therapist's office.

  • Flexibility - Some people meet with their therapist in-person and occasionally do online therapy when it works out better for their schedule. Other people meet exclusively with their therapist online. The benefit is that you can choose what works best for your lifestyle. So, when there is bad weather, kids are home from school, or you have a cold you don’t want to share (thank you!), you can still meet with your therapist.

  • Quality - One of the greatest advantages of online therapy is the ability to choose the therapist that’s right for you, without being limited to the providers located within a few miles of you. Having a skilled therapist that you connect with is crucial, and with online therapy in the U.S., you can see any provider who is licensed to work in your state. So for example, since I’m licensed in three states, I’m able to provide therapy to you if you’re located anywhere within those states. That means even though my office is in the Milwaukee area, I can see clients who are located in Illinois, Indiana, or anywhere else in Wisconsin.

  • Comfort - Since online therapy involves technology, many people assume it could be uncomfortable to meet a therapist that way. There often seems to be an assumption that it’ll be less meaningful or impactful if a client and therapist are not physically in the same room - that somehow you won’t have the same connection. To be fair, I thought that too. However, what I’ve experienced with my clients is different. The relationship can be just as powerful and meaningful as in-person therapy. I’ve been surprised at how meaningful moments still happen and how close people can feel while online. Sometimes, I think it’s a safer, more comfortable way to open up, because you can be in your space. Sitting on your couch, in your office, or with your pets can make therapy even more powerful and effective.

  • Confidentiality - Some may argue that online therapy provides an extra layer of confidentiality, since you won’t be bumping into a colleague in the waiting room or be seen walking into a building with “counseling” over the door. While we’re all for breaking down the stigmas associated with therapy, the reality is that some of that stigma still exists. Not everyone is comfortable with that kind of visibility, and online counseling allows you to be as open or private as you want about being in therapy.

Potential drawbacks:

  • Some providers may be risky - Unfortunately, there are a number of providers who are practicing naively or unethically. I’d love to believe that these providers simply don’t understand what they’re doing wrong and that they can and will learn to change. Sadly, I’m afraid some may be doing it intentionally to get more business. Some of these providers are not complying with HIPAA regulations. Some are practicing unethically or illegally by not following other government or professional regulations and standards. Some are not holding appropriate boundaries to protect your confidentiality. And some aren’t learning how to adapt their clinical skills for online counseling. All of these issues can be harmful to you as the client, and can provide a poor experience and/or little progress toward your goals. In the best case scenario, these unprofessional actions can be annoying or ineffective, and you’ll look for a new therapist. However, in many situations, these actions can result in serious breaches of confidentiality and trust, emotional distress for you, or in the worst cases, psychological harm.

  • Not for every issue - While online counseling is appropriate for most issues, there are some situations when online therapy is not suitable. For example, if you have active thoughts of hurting yourself or other people, it may be best for you to see a therapist in person. When you first “interview” online therapists to find out who is the best fit for you (see below for more about that), the therapist will likely be asking a few questions to find out if online therapy is appropriate for your situation. Determining if it’s the best option for you is certainly a topic we suggest clients discuss with therapists in advance, and is one of the reasons we offer a free consultation prior to beginning therapy.

  • Basic technology requirements - When considering online therapy, it’s important to consider the technology requirements. The video platforms most therapists’ use require a strong internet connection, so you’ll need reliable internet and computer/tablet/smartphone access. And, since you’re not going to a therapist’s office, you will be responsible for making sure that your end of the connection is as private and confidential as possible. That means finding a space where you can talk privately without interruptions.



When you’re considering a therapist, it’s perfectly acceptable for you to expect answers to your questions, so you can decide who is the best therapist for you. 

  • Are you licensed in my state?

    • If the therapist is not licensed in your state, then (in most U.S. states) it would be against state regulations for them to provide therapy for you. This is the therapist's responsibility to know and should also be listed on their website.

  • Do you use HIPAA-compliant technology and follow current legal and ethical guidelines?

    • To protect your confidentiality as much as possible, it’s important that your therapist is up-to-date on everything from the technology, to the guidelines, and best practices in the field.

  • What’s your education and/or experience with online therapy?

    • Even if the therapist is new to providing online therapy, there are many ways for therapists to learn about it. This helps them provide better quality care for you.

  • Are we a good match?

    • It’s important that you feel comfortable with the therapist’s style and personality, so that you can achieve the greatest results.

You have the ability to change your life and situations, and a skilled therapist can help make that happen. 

If you have questions about online therapy, or therapy in general, please let us know! We’d love to help you figure out what the best fit is for you. Whether it’s online, in-person, with one of us, or with someone else - we’re here to help. 

I’m here if you want to talk. Take care!  
- Shelly