Pros and Cons of Telehealth

What is Telehealth and why should I try it?  There are many advantages to seeing your therapist online, and they begin with convenience.  Seeing your therapist online means being able to have your session in the privacy of your home or office.  It means not having to drive in inclement weather, or when you're just too tired from the day to make the drive.  It means relaxing in your own home or office at the end of the day, and not having to rush through traffic to get dinner on the table, only to have to rush out again for your therapy appointment. It means privacy - not worrying whether someone you know will see you entering or leaving a therapist's office.  It means not having to pay a late-cancel fee when you, you partner or child, etc, gets sick and you have to stay home to care for them.  You may not need to take a break from therapy when you're recovering from illness or injury, experiencing temporary (or permanent) mobility issues, or acting as primary caregiver for someone who is housebound.  Maybe telehealth means you get up in the morning and grab your cup of tea or coffee and have your therapy session in your PJs, before heading off to work, feeling uplifted and encouraged. 


Of course, there are disadvantages, also.  For the therapist, the main disadvantage is that by not being in the same room with the client, we miss body-language and other cues that are indicators to us of how clients are doing. We try to address this by asking additional questions about physical state, eg, foot tapping, eating habits, hand wringing, hygiene, fidgeting. For the client, disadvantages might include missing out on being in the same room as the therapist, the inability to pay by cash or check, or even, lacking a quiet, private space to have your telehealth session.  On the other hand, advantages for client include more flexible scheduling, not having to commute to therapist’s office, no parking issues, and being able to see any therapist who is licensed in your state. 

There are some factors to consider to determine if online therapy is a good fit for you. For example, do you have access to a quiet, private space where you can be undisturbed during your session? Do you have good wifi? Are you at risk for suicide, overdose, or self-injurious behaviors? Are there physical mannerisms or tics that the therapist will miss because of only seeing your upper body? These are important to consider in evaluating whether online therapy is right for you.

If the thought of being able to see a therapist online is appealing to you, contact me for a free, initial consultation.


Have more questions about telehealth?  Call me at (609) 248-0536 or send a message to

Pros and Cons of Self-pay

Advantages of using insurance to pay for therapy are obvious:  the insurance company pays some or all of your fees for seeing a therapist.  Disadvantages of using insurance are not as obvious, but there are several.  First and foremost: privacy.  When you pay for therapy using insurance, the insurance company requires your therapist to report your diagnosis, and they have access to your therapist’s records, including your treatment plan and in some instances, the therapist’s notes. 


Insurance companies will not provide coverage for all conditions, so if your therapist does not diagnose you with a “covered condition” your insurance company doesn’t have to pay.  Depending on your policy, you may be restricted in the number of sessions you can have in a calendar year.  Also, as an insurance client, you are limited to therapists in your insurance network, and you may have to satisfy a deductible and co-insurance before insurance will pay any of your fees.


So, what about self-pay?  The obvious disadvantage to self-pay is that you pay out of pocket for your visits to a therapist.  Your therapist may be willing to provide a Super Bill, which you can submit to your insurance company and, depending on your policy, you may get some money back.  The downside is that your therapist will need to include a diagnosis on your Super Bill or the insurance company will not pay.  


Your therapist’s fees may actually be lower if they are not working with insurance companies.  Running a practice with insurance billing requires many hours per week managing claims, with no certainty that the insurance company will pay, or the amount they will pay.  A therapist has to take this into consideration when setting their fees.


Working with insurance companies, therapists are required to provide a diagnosis and treatment plan following the initial session, when client and therapist are just getting to know one another.  This diagnosis becomes part of your medical record.  With self-pay, therapists can get to know the client first, and develop a diagnosis and treatment plan after getting to know the client better, and do not have to report the diagnosis to anyone.


Thus, a main advantage to self-pay is that your privacy is protected.  Your therapist does not have to provide any information about your treatmenty to your insurer, or to anyone else (with a few legal exceptions [feel free to ask me about these]).  Also, clients who pay out of pocket tend to be more motivated to see results sooner and often invest themselves (no pun intended!) more fully in their therapy.


Have more questions about self-pay?  Call me at (609) 248-0536 or send a message to