What to consider if you want to expand into virtual practice?

By Kristie Overstreet on June 26, 2019

Many people who are ready to start therapy would like the option of talking to a therapist online. Virtual therapy is also known as telehealth, video counseling, or online counseling.

Telehealth is a booming business that is evident from the many commercials offering people the ability to connect with a therapist through an app. Some insurance companies are allowing providers to use virtual therapy versus in-office sessions.

There are many considerations in creating and expanding a virtual practice. Here are important points to review before jumping into online work.

Virtual Practice Benefits

There are many benefits of virtual work for clients. They can avoid traffic, not have to get a sitter for their kids, and the convenience of having a session around their schedule. Attending a therapy session from their home removes many barriers that would surface if they wanted to participate in an in-office session.

As a clinician, you can enjoy the benefits of working from home, flexibility to work from anywhere, and possibly offer more appointment options. You can enjoy the freedom of not being tied to your office and provide different appointment times that work for your schedule.

Virtual Practice Privacy and Confidentiality

Your client’s privacy and confidentiality are at the top of the list as a priority when considering expanding into virtual work. You will need to identify what processes will be different from this type of counseling.

Make sure your new client forms include privacy and confidentiality in virtual work. You can’t ensure this due to it being online, but there are many steps you can take to protect your client.

Consider your options for a video platform that ensures privacy. There are many options so compare them to see which is best for your practice. Wear earphones during your session to provide an extra layer of privacy in your office.

Virtual Practice Note Taking and Records

You may have to review your note-taking and storage system. Will you be able to integrate your current practice system into virtual work? If you are using an online practice management system, you have the option of sending the forms through a portal to your new clients.

If you don’t have an online practice system, you will have to decide how you will send the forms and ensure receiving them back. You wouldn’t start a new session without having all the forms completed, and with virtual work, that doesn’t change.

Virtual Payments

Another big difference in virtual versus in-office appointments is the process of fees for sessions. Begin to think about how you will accept payments for virtual clients. Will you use the same card processing system you currently use? Identify any problems or barriers that may surface with a collection of payments since you won’t see your client in-person.

You have to decide if you will charge the same or different rate for a virtual session as you do for an in-office appointment. Many payment systems will allow you to send an invoice to the client. Be sure you have a system in place to track and ensure payment of all sessions.

You will need to receive payment for a first appointment before the session. The goal is to ensure the client doesn’t disappear without payment after the first session by collecting it ahead of time.

Up Your Therapy Game

Be prepared to up your therapy game due to meeting virtually you need to be even more focused on being present. You may find yourself working twice as hard at times to keep the rapport and energy for a virtual session.

Don’t be a lazy clinician who uses virtual sessions to work less. Your goal is to make a difference in your client’s life. Make it an experience that is helpful and effective for the client.

Keep your clinical skills sharp especially, with attention to nonverbal communication that you see during the session. These can easily be missed on video so be present.

These are just a few of the many considerations when you consider expanding into private practice. Always practice within your scope of expertise and don’t try to work with every client virtually because it may not be a good fit. Seek supervision and coaching to help you work through any concerns you have about adapting your virtual practice. Technology is allowing more people to access therapy, which helps you to serve them better.



Dr. Kristie Overstreet is a clinical sexologist, certified sex therapist, licensed professional clinical counselor, author, speaker, and consultant. She holds a Ph.D. in Clinical Sexology, Master of Arts in Professional Counseling, and a Bachelor of Science in Biology. She is a licensed counselor in California, Florida, Georgia, and Louisiana. She is also a Certified Sex Therapist and Certified Addiction Professional. She has over 12 years of clinical experience specializing in sex therapy, transgender healthcare, relationships, and helping counselors build their private practice. She is president of Therapy Department, a private practice that provides counseling, training, speaking, and consulting services across the United States.  For more information about Dr. Kristie's work visit www.KristieOverstreet.com.


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