When telehealth therapy expanded rapidly in 2020, many people assumed it was a temporary workaround
a stopgap until things returned to normal. What happened instead was that millions of people discovered that therapy delivered over video was not just adequate. For many of them, it was genuinely better. That does not mean telehealth is right for everyone. But it does mean the question is worth taking seriously — not as a compromise, but as a legitimate option with its own distinct advantages and limitations.
IS TELEHEALTH THERAPY AS EFFECTIVE AS IN-PERSON?
The short answer is yes — for most people and most presentations. A substantial body of research, including multiple meta-analyses and randomized controlled trials, has found that telehealth therapy produces outcomes comparable to in-person therapy for anxiety, depression, PTSD, and a range of other mental health concerns. The American Psychological Association, SAMHSA, and the Department of Veterans Affairs have all recognized telehealth as an evidence-based delivery format. The therapeutic relationship — which research consistently identifies as one of the strongest predictors of positive outcomes — can be built effectively over video.
WHO IS TELEHEALTH THERAPY RIGHT FOR?
Telehealth is a strong fit for most adults seeking therapy for anxiety and depression, trauma and PTSD, life transitions, burnout and chronic stress, and ongoing therapy maintenance. It is particularly valuable for people who live in rural areas with limited access to mental health providers, have physical disabilities or mobility limitations, have demanding work schedules or caregiving responsibilities, experience significant anxiety about leaving home or being in clinical settings, or are in a state where their preferred therapist is also licensed but live at a distance.
WHO SHOULD CONSIDER IN-PERSON CARE INSTEAD?
Telehealth is not appropriate for everyone. In-person care is generally preferable for people who are actively suicidal or in acute psychiatric crisis, have severe and chronic mental illness that requires close clinical monitoring, struggle significantly with dissociation, do not have access to a private stable internet connection, or find the video format itself activating or distressing in a way that interferes with the work. If you are unsure which format is right for you, that is a good question to bring to an initial consultation.
WHAT DOES A TELEHEALTH SESSION ACTUALLY LOOK LIKE?
You will connect via a secure, HIPAA-compliant video platform at your scheduled time. Most sessions are 50 to 55 minutes. You will need a private space where you will not be overheard — a bedroom with the door closed, a parked car, a quiet office. Headphones can help with both privacy and audio quality. The conversation itself is the same as in-person therapy. The modalities used in in-person therapy — Cognitive Behavioral Therapy, trauma-informed approaches, EMDR, mindfulness-based interventions — can all be delivered effectively via telehealth.
TELEHEALTH AND LICENSURE: WHAT YOU NEED TO KNOW
A therapist can only provide telehealth services to clients who are physically located in a state where the therapist is licensed. This means that if you live in Iowa but travel to Illinois for work, your Iowa-based therapist cannot legally see you during that trip. You need to find a therapist who is licensed in your state — not just any therapist who offers video sessions. I am currently licensed in Iowa, Minnesota, Colorado, and Florida. I can see clients via telehealth in any of those states, as long as you are physically located there at the time of our session.
DOES INSURANCE COVER TELEHEALTH THERAPY?
Coverage varies by plan and state, but telehealth parity laws have expanded significantly in recent years. Most major insurance plans now cover telehealth therapy. The best way to confirm your coverage is to call the member services number on the back of your insurance card and ask specifically about outpatient mental health telehealth benefits. If you are uninsured or your plan does not cover telehealth, sliding scale fees may be available. I offer an anti-oppressive sliding scale ranging from $50 to $175 per session, based on income and financial circumstances.
If you are considering telehealth therapy and want to talk through whether it might be a good fit, I offer consultations for prospective clients. We can take the time to discuss what you are looking for, answer any questions you have, and figure out together whether telehealth — and whether working with me specifically — makes sense for where you are right now. Telehealth sessions available for clients in Iowa, Minnesota, Colorado, and Florida. In-person sessions available in Iowa City, Iowa.