Is Telephone Counseling/Therapy Appropriate?

By Sarah Fader

Updated March 11, 2020

Reviewer Patricia Corlew , LMFT, LPC,

Technology is getting more and more advanced and it has managed to make many things much easier and more efficient, including counseling and therapy. However, some people are still not sure that telephone counseling is appropriate. There are those who believe that for counseling or therapy to be effective that you have to do it the old-fashioned way - in person. While this may be true for certain circumstances, in most cases, telephone counseling is perfect. In fact, phone counseling literally saves lives, in the form of suicide prevention and addiction treatment hotlines.

These services, typically staffed by volunteers and rely on donations to function, are some of the most valuable public mental health initiatives around today. That having been said, the same treatment approach which is highly effective in one set of circumstances may be far less useful in a different setting. With the rise of several online counseling sites, which offer telephone counseling, we need to ask ourselves if therapy by phone can be effective.


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Distance Therapy

Using technology, therapists can now work with clients in any location, from prisons to overseas to remote areas. Obviously, this requires some differences in approach compared to the traditional in-person fifty-minute hour. Talk therapy has certainly shown itself to be an effective therapeutic tool; but how much is lost when a therapist is unable to rely on visual cues?

The short answer must be that this depends on the individual therapist and his or her therapeutic approach. In terms of cognitive behavioral therapy (CBT) the content of what is being said may be much more significant than how it is expressed. Other types of psychotherapy may require greater insights into the patient's emotional responses, including observing body language.

However, in most cases, telephone therapy or counseling is not only appropriate but is actually more effective than traditional face to face therapy or counseling. There are so many people who need help and cannot or will not get it because they either cannot or will not go see a therapist or counselor.

For example, those with severe anxiety issues such as social anxiety disorder or post-traumatic stress disorder have a difficult time going out in public or talking to strangers. In addition, patients who suffer from depression have a hard time getting out of bed sometimes, let alone going to see a counselor or therapist. For these individuals, telephone therapy can be a lifesaver.

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A Route to Affordable Counseling

Regardless of the nature of their problems, many potential patients simply cannot afford traditional face to face talk therapy. This is not only a matter of not being able to afford the rates charged but also a systemic issue in the health insurance industry. For instance, many health insurance policies do not cover mental health conditions. In other cases, those who do have insurance that covers their mental health care do not want to get treatment because they do not want their employer to know about it. They may fear discrimination or feel that it may affect their future with the company.

Telephone counseling can save individuals thousands of dollars over just a few months of therapy because the cost is more reasonable. Telephone counseling or therapy with BetterHelp.com is only about $40 to $70 per week(billed monthly) rather than the $250 to $500 per hour that some traditional therapists charge. Why is it so much more affordable?

Because the therapist does not have as many expenses as the traditional therapist. They do not have to pay for rent or leasing of an office, the employees to run that office, utilities and other expenses for the office like office supplies, and transportation costs. Since they are saving money, they pass these savings on to their patients so they can benefit as well.


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Convenient and Easy

Additionally, with most counseling practices keeping normal business hours, work obligations can make it very difficult for many people to pursue traditional modes of therapy. Phone counseling can be accessed from very nearly anywhere and be available 24 hours per day, seven days per week in case an emotional emergency arises. While it may have its limitations (no psychiatrist is going to write a prescription for a patient he or she has never seen in person) phone counseling is a major benefit to many people who would otherwise remain untreated.

In addition to not being able to prescribe medication, there are a few other circumstances in which phone counseling simply is not appropriate. Over the telephone, a therapist may encourage a client who is facing mental health issues, may make suggestions about dealing with problems, warn of distorted thinking and offer general encouragement as well as a sympathetic ear.

However, a distance counselor cannot provide a comforting and secure environment, nor provide the reassurance of a physical presence when particularly sensitive or traumatic issues are being discussed. Although the patient does have the option of speaking to their counselor or therapist face to face on a video chat platform such as Facetime or Skype.

In fact, telephone counseling or therapy is just like having a casual conversation with a friend though so it can be a big help in many ways, especially to those who have a hard time getting around. For example, those who are physically impaired or unable to get transportation would benefit greatly from telephone therapy. Especially those who live out in rural areas where there is no public transportation to rely on. It is also a great choice for those who do not have a babysitter or cannot afford to make that trip back and forth to the office.

Who Should Not Use Telephone Therapy or Counseling?

Anyone who is having suicidal thoughts or has had these thoughts in the past are not recommended to use phone therapy.Also, people who are working through extremely difficult issues and/or suffering from a severe mental health condition may find traditional in-person therapy much more conducive to their healing. However, with video chat, the patient can certainly get intensive and personal treatment where the therapist can see those visual cues that they need.

The decision is really up to the individual patient and their therapist or counselor because everyone's situation is different and not all therapies are appropriate for everyone. If you just want to talk to someone about your thoughts and feelings, have concerns about your mental or emotional health, or just need a little advice, telephone counseling can be an amazing healing tool.

However, if you are having thoughts of suicide or think you may need medication, traditional therapy is better for you. Still, phone counseling remains a valuable tool, whether used in conjunction with more conventional sessions, or simply by itself.

Frequently Asked Questions (FAQs)

Is online therapy covered by insurance?

In some instances, therapy can be covered by insurance under the federal Mental Health Parity Act. The federal Parity Act requires large insurance providers to offer equal coverage for medical and mental health disorders. Check with your insurance provider to find out if your behavioral health plan includes therapy.

Can you do therapy online?

There are therapy options available online for people who suffer from non-severe mental illness. Examples of conditions considered to be non-severe are depression, anxiety, and substance abuse disorders.

How much does online therapy cost?

Online therapy is normally less expensive than traditional in-office therapy. The national average cost of therapy in the United States is $65.00 - $200.00 for a one-hour therapy session. Online therapy with leading therapy platforms like BetterHelp starts at just $40.00 - $70.00 per week for unlimited messaging therapy sessions with licensed providers.

Does online therapy really work?

Yes! Online therapy has proven to be just as effective as in-office therapy sessions for non-severe mental health and substance abuse related conditions. Experts state that talk therapy is one of the most effective forms of treatment for dealing with non-severe mental health issues.

How often should you see your therapist?

You should see your therapist as often as your treatment plan recommends. During your initial therapy sessions, your licensed provider will ask you a series of questions. These questions will help determine how many therapy sessions your provider deems necessary for improvement.

Is online therapy confidential?

Yes. Getting therapy online is a confidential process. When you get therapy online, you're entitled to the same level of confidentiality that you have during in-office therapy sessions and medical appointments with your licensed provider. Information shared between you, your therapist, and other participating parties in therapy is strictly confidential.

How long should you be in therapy?

The length of time spent in therapy is determined by your treatment plan. People with less severe mental health issues may require fewer sessions. Therapists and counselors who treat substance abuse disorders may only spend a few weeks with therapy clients. Those with more complex or severe issues may be required to take part in therapy for a lifetime.

What do you do in therapy?

Therapy is designed to be a safe space where you can seek real-life guidance, support, and referrals for related services. During sessions with your therapist, you will learn how to uncover the negative behavior patterns in yourself and others around you that are contributing to undesirable outcomes in your life. Sessions with your therapist will teach you new strategies for communication, coping, dealing with grief, loss, or addiction. Licensed therapists are trained to provide professional support and advice. The goal of therapy is to improve the quality of your mental health and produce more desirable outcomes in your life.


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