Teletherapy Best Practices

What Is Teletherapy?

Teletherapy (also called telehealth or online therapy) involves providing therapy services remotely through video conferencing, phone calls, or secure messaging. It has become a standard part of modern therapy practice.

Setting Up for Success

Technology

• Use a HIPAA-compliant video platform with a signed BAA
• Ensure a stable internet connection (wired is more reliable than Wi-Fi)
• Test your setup before sessions: camera, microphone, lighting
• Have a backup plan (phone call) for technical failures

Environment

• Use a private, soundproofed space
• Ensure a neutral, professional background
• Maintain consistent lighting (face the light source)
• Minimise distractions

Clinical Considerations

Building Rapport

• Make deliberate eye contact (look at the camera, not the screen)
• Use more verbal check-ins than you would in person
• Be explicit about emotional observations since non-verbal cues are harder to read
• Allow for natural pauses — video lag can make conversations feel rushed

Risk Management

• Establish the client’s physical location at the start of each session
• Have emergency contact information readily available
• Know the crisis resources for the client’s location
• Document teletherapy-specific consent in your informed consent form

Documentation

• Note that the session was conducted via teletherapy
• Record the platform used
• Document any technical issues that affected the session

Legal and Ethical Requirements

• Verify you are licensed to practice in the client’s state or jurisdiction
• Follow your licensing board’s teletherapy guidelines
• Use only HIPAA-compliant platforms
• Obtain specific informed consent for teletherapy services
• Maintain the same documentation standards as in-person sessions