Get on Board or Be Left Behind: Teletherapy is the Future Norm

By Kathy Lynn Gray, Associate Editor
March 4, 2018

teletherapyTeletherapy will be part of normal practice for psychologists in a decade, predicts leading on-line therapy educator Marlene Maheu, Ph.D. Psychologists must embrace the change or be left behind, warns Sherry Benton, Ph.D, ABPP, founder of the teletherapy company TAO Connect.

“We in the behavioral world are the last holdouts for technological change in health care,” said Maheu, executive director and founder of the Telebehavioral Health Institute. “Technology is evolving, and I firmly believe we will be connecting with one another in many new ways in the future.” Maheu oversees telebehavioral health training at the institute and has been involved with teletherapy as a clinical psychologist herself since 1994.

Benton, a psychologist and former director of a large university mental-health clinic, became convinced a few years ago that adding teletherapy to psychology practices could help millions of people living in areas underserved by mental health specialists. After testing the concept with college students in 2014, she launched TAO Connect to provide teletherapy to college and university counseling centers.

Both Maheu and Benton believe that psychologists who want to provide counseling via video conferencing, e-mail or telephone need to educate themselves first about the practice. Maheu’s institute offers classes, as does the American Psychological Association and other organizations and companies.

“It’s critical to get training,” Benton said. “There are so many things you might not think about.”

That includes having a license to practice in the state where the patient is, having a crisis management plan for online patients, knowing how to keep consultations with a patient private and knowing how to rewrite consent-to-treat forms for patients you may never see in person, she said.

Equally important, Maheu said, is figuring out what population you want to serve online and identifying a way to get paid for your online work. If you work with at-risk youth and want to serve that community online, figure out what agency might pay you for the online work. Or if you want to work online with senior citizens in nursing homes, there are online employers who will hire you to do that, she said.

Similarly, if you are in private practice and want to add online work, health insurance could be your payer, she said. “This is not about reinventing yourself, but doing what you’re already good at with technology,” Maheu said.

Numerous online therapy companies have popped up in recent years, including TalkSpace, BreakThrough, BetterHelp and iCouch, and many enlist a variety of therapists, including psychologists, to work full or part time as outside contractors.

Each company is different and any psychologist who wants to associate with one should investigate the firm carefully, Benton said. “You want to look at how they work, what your reimbursement rate is, what’s expected of you – basically what’s their deal and does it fit with the way you want to work,” she said.

TalkSpace is one of the largest and mainly provides counseling sessions through texting. BreakThrough and BetterHelp both offer videoconferencing with therapists and BetterHelp also offers messaging, live messaging chats and telephone sessions with therapists.

iCouch, while it offers therapist referrals, concentrates on providing services for therapists who want to practice online. Those include videoconferencing, therapy marketing, scheduling and billing services.

Benton’s company is similar, offering private practitioners a suite of tools they can use for their own online services. They include HIPPA-compliant video conferencing, education modules for patients, administrative tools and secure messaging.

“We just license our materials; we don’t actually hire psychologists,” Benton said. “But our tools allow psychologists to help more patients and to help their income.”

Psychologists can offer patients shorter therapy sessions, such as 20 minutes, and augment that with patient education sessions from TAO, she said. “Even after a psychologist pays for TAO they really can increase their income,” she said.

One of the newest entries into the market is LARKR, a video therapy app that launched in October through the Apple App Store. LARKR links therapists with patients for 50-minute sessions on mobile devices. The site, at, is seeking 10,000 certified mental health therapists to join its ranks, according to its press information.

Plenty of information is available online for psychologists who are considering trying online therapy.

iCouch has several blogs that suggest ways to get started: (Add “online therapy available” to your business cards and website; ask current clients if they’d be interested in trying a session online; try online therapy several times so you become comfortable with the technology).

The APA has a 19-page Guidelines for the Practice of Telepsychology on its website that encourages psychologists to get specific training and includes information about confidentiality, informed consent and interjuridictional practice.

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