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My Personal Experience as a Telehealth Therapist

by Julia Johnston, LPCC, LICDC

The author demonstrating telehealth.

I will never forget March 2020 when Governor DeWine signed his executive order. The community mental health agency where I worked informed us we would be working from home until further notice. Each counselor received a laptop, and we were all sent home. Our patients were informed that their appointments would be moved to telehealth, and my team began to navigate unfamiliar territory.

Before the pandemic hit, all of our patients were seen in person. Our patients did not sign up for telehealth, and neither did we! So, we were learning together and trying everything from Zoom, to Teams, to Google Voice and the trusty telephone.

We experienced some benefits of telehealth therapy.

Some patients thrived in the telehealth setting. I had patients on my caseload that shared more with me in the first few weeks of telehealth than they ever had in six years of in-person counseling. Something about telehealth made them feel more comfortable being vulnerable. And it was so beneficial for some patients that they still see me via telehealth today. There are other advantages to doing so, such as:

Accessibility: Engaging in telehealth therapy gives patients and therapists more flexibility for scheduling appointments. All you need for a telehealth therapy session is a quiet, private room. This allows patients who typically struggle to attend appointments (parents without childcare, limited access to transportation, etc.) better accessibility to therapy services.

Time: With accessibility comes a broader range of open times, as well. By eliminating barriers like transportation and driving, telehealth therapy provides more time flexibility for individuals to attend sessions. And, therapists are better able to offer early morning or late evening appointments.

Comfortability: Patients can stay in the comfort of their own homes for telehealth therapy. They can remain in their safe spaces and have access to familiar things: their own blanket, their own comfy couch, etc. Telehealth allows for more open and honest discussion because patients feel relaxed in their homes.

There are disadvantages of utilizing telehealth therapy, too.

Telehealth therapy can be a great option when appropriate. However, there can be some downsides. Very quickly after the shutdown, my team realized some vulnerable populations were inappropriate for the telehealth setting. High-risk populations, such as individuals using illicit substances or who are suicidal, are not appropriate for telehealth due to the inability of counselors to adequately address safety concerns. A few other disadvantages include:

Poor continuity of care: A provider may only be aware of some available resources or referral options (such as for a psychiatrist) in a patient’s area if they are working remotely from a different location.

Legal and ethical liabilities: Working with high-risk populations via telehealth can be risky. While working remotely, a patient must physically be at the address on file in case of an emergency so the provider knows where and how to get them help. For example, a therapist must be able to locate a patient who is suicidal if a wellness check needs to be completed.

At-risk data security: This has become a popular topic due to some big-name companies breaking privacy promises and sharing user data. Such risks put the burden on the patient to do thorough research before committing to a company/practice and may dissuade them from trying telehealth therapy in the first place.

Telehealth at Therapy for Women is different for several reasons.

If you are looking to start telehealth therapy, there are many options at your fingertips now. So…how do you choose? When I began looking to be a telehealth provider, I tried multiple agencies (including two top-rated telehealth counseling agencies who I guarantee you’ve seen in ads) before I found the right fit at Therapy for Women. Here are a few reasons I found this practice to be right for me:

Information provided:

Some telehealth agencies don’t share demographics or the address of the patient you’re working with. As I mentioned earlier, if an emergency occurs during a session or in between sessions, the therapist must be able to complete a wellness check to ensure their patient’s safety. At some big-name companies, if I had concerns, I would have to email a generic work email and would not get a timely response. But at TFW, I can access supervisors and colleagues 24/7 for resources and support.

Collaboration:

Because I have access to so many fellow providers at TFW, I’m able to reach out for feedback and engage in constant clinical discussions. TFW also has regular supervisions connecting all of the therapists on staff. These provide frequent opportunities to discuss barriers and strengths, and to learn from each other. Working with a wide range of therapists practicing such a wide range of specialties allows me to continue to become a better therapist and provide the best clinical care possible

Electronic health record:

Patients should feel safe and confident that their health information is protected when working with a therapist. TFW utilizes an Electronic Health Record to ensure patient information remains safe and private.

Psychiatrist on staff:

It can be challenging to find a psychiatrist, and wait times are sometimes lengthy. TFW has a psychiatrist on staff, which allows me to place referrals within the practice with someone I already know and trust. I don’t have to research and blindly recommend a provider without any knowledge about their quality of service. By being able to work more directly and collaboratively with a psychiatrist to meet patients’ needs, I am able to provide continuity of care.

Remember, there are a lot of available options for telehealth therapy! If you are considering taking the first step and scheduling with a provider, remember to do research and ask questions. Your mental health matters, and having a strong therapist and support system make a significant difference.


Julia is an out-of-state provider at Therapy for Women, specializing in anxiety, depression, trauma, substance use, and parenthood. To learn more about Julia or find out if she serves your state, read her bio here.

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