Telehealth: Brilliant Innovation or Recipe for Disaster?

How to Actually Know if Telehealth Is Right for Your Clients (And Avoid a Clinical Train Wreck)

Telehealth sounds amazing.

No commute. Sweatpants. Seeing clients while sipping coffee from your couch like a therapy wizard.

That’s the dream, right?

For a lot of therapists, telehealth has been a game-changer. It’s expanded access, made therapy more flexible, and allowed clinicians to ditch the office overhead while maintaining full caseloads.

But then reality sets in.

Your client’s WiFi is terrible and they freeze mid-sentence, leaving you guessing about the rest of their trauma disclosure. Another client won’t stop walking around their house while on session, giving you a nausea-inducing tour of their cluttered kitchen. And then there’s the nightmare scenario: You’re pretty sure your client isn’t alone… but they won’t confirm it.

This isn’t just annoying. This is clinically and ethically risky.

Therapists jumped into telehealth out of necessity when the world shut down. But now, as we settle into a post-pandemic practice, the conversation needs to shift. Not every client should be doing virtual therapy. And if you’re just assuming that telehealth is always a good option, you might be making serious mistakes.

The Hard Truth: Not Every Client is a Good Fit for Telehealth

When you log into a telehealth session, you’re entering your client’s environment. Unlike your office—a controlled, confidential, and intentionally therapeutic space—their setting might be the complete opposite.

Have you ever had a client:

• Whisper through an entire session because someone else is in the house?
• Mute themselves repeatedly to yell at their kids, dog, or random delivery guy?
• Log in from their car, bathroom, or even their workplace breakroom?

At what point does this stop being therapy and start being a logistical nightmare?

More importantly, how do you know when to say, “This isn’t working”—and actually stand firm in that decision?

Because let’s be real: some clients are not clinically appropriate for telehealth. Their setting isn’t private. Their engagement is inconsistent. Their safety might even be in question.

Yet, a lot of therapists continue to offer virtual sessions because they don’t want to upset their clients, lose business, or feel like they’re being rigid.

Telehealth Isn’t Just a Preference—It’s an Ethical Decision

Here’s what many clinicians fail to recognize: offering telehealth isn’t just about convenience. It’s an ethical decision that has real consequences for client care.

Imagine this:

A client insists on telehealth because they “prefer it.” You agree. Weeks go by, and something feels off, but you can’t quite put your finger on it. Then one day, they casually mention that their partner is usually in the next room during sessions.

Suddenly, everything clicks. The guarded body language. The hesitations before answering personal questions. The vague responses. This client has not had a single fully private session with you.

What do you do?

This is where a lot of therapists freeze. We weren’t trained to assess whether telehealth is actually the right choice for a client—we were just told to offer it.

And that’s dangerous.

How to Ethically Assess Telehealth Suitability

This is why we created the Telehealth Suitability & Best Practices course. Because guessing isn’t good enough.

This course walks you through:

• How to properly assess whether telehealth is appropriate for your client (before they even book a session).
• How to handle tricky ethical situations—like when a client isn’t alone but won’t disclose it.
• How to confidently set boundaries with clients who push for telehealth when it’s not clinically beneficial.

We break down the key factors you need to evaluate before agreeing to telehealth, including:

• Privacy & safety: Is this client in a confidential, distraction-free space?
• Engagement & participation: Are they able to fully engage in therapy, or are they distracted and disengaged?
• Technology barriers: Do they have reliable internet, or are they spending half the session buffering?
• Crisis management: What’s your plan if they experience distress or suicidality while on a telehealth session?

Because telehealth should not be an automatic default. It should be a thoughtful, clinically sound choice—and you need to know how to make that call.

This Isn’t Just About Telehealth—It’s About Being a Better Clinician

This is where you have to decide what kind of therapist you want to be.

Do you want to be the kind of clinician who blindly follows client preferences because it’s easier than having a hard conversation?

Or do you want to be the kind of therapist who says, “I’m making this decision based on what’s actually best for your care”?

Because here’s the truth: Your clients trust you to make professional, ethical decisions about their treatment. And sometimes, that means saying no to telehealth—even when it’s inconvenient.

You Have a Responsibility Here

You don’t get to just hope telehealth is working for your clients. You have to know.

Because one day, a client is going to log on from a space where they aren’t actually safe.

Or a session is going to fall apart because you didn’t realize that the client in front of you needed more structure, more presence, more engagement than a screen can provide.

And in that moment, you will wish you had known what to do.

Learn it now!

👉 Enroll in Telehealth or In-Person Therapy: Who Decides What’s Best today!

Telehealth #TherapistLife #EthicalTherapy #MentalHealth #TheCounselorEdge