Evolve Your Therapy Practice for a Dynamic Future

(by Kirsten Keach, LMFT) I closed the doors on my face-to-face therapy office. I will be 100% online for the foreseeable future. This was a big but necessary decision to make. One that I know many therapists are struggling with as we all try and adjust to unpredictable circumstances.

Going to my office, even to do video sessions, made me feel normal— it was a tether to the ease of my pre-COVID life. But that time period is over now. We can’t go back to the way things were before. It is prudent to create a practice and lifestyle that allows flexibility within the unknown.

Many of you reading this article were thrust into practicing online as a result of the closures and may have considered it a temporary adjustment and structured your practices as such, with the intention of going back to your office. Depending on your circumstances and location, going back to the office may be a long time off for you. I wrote this blog to help you shift your temporary online practice into something more long-term, engaging, fun, and creative. Even when you can see clients in person, an online practice can be a powerful addition for you.

This article will help you see the benefits and options available to you as a therapist working online AND how to craft an online lifestyle that works for you for the long-term.

I started dabbling in online therapy in 2016 when a very entrepreneurial friend explained to me that ALL non-emergency medical services would eventually be online only and that many major hospitals were already planning that transition. Foreshadowing?? I took his advice and decided to get ahead of the game. I quickly found that providing online therapy was very different than providing face-to-face therapy.

Being a successful online therapist requires you to adjust your lifestyle and your practice in order to accommodate the type of energy it requires. With this comes the opportunity to design your lifestyle AND you get to be creative with how you practice – even more so than when you are working in a face-to-face practice.

To get you started in re-imagining your practice, let’s begin by talking about all of the great benefits that come with working online.

Benefits of Working Online

  • It is location flexible – for both you and your clients
  • Lower overhead – you can cut costs by not having office space if you choose. 
  • Easier scheduling – It is easier for clients to schedule because it removes travel time. 
  • No longer have to work evenings – I find most people can take a lunch break during the day, so I don’t have to see people after normal business hours. 
  • Better client fit – Because you are less limited by geography, you can access a larger pool of people who may be perfect for you to work with. 
  • Makes returning from maternity leave easier – You can work from home and have the ability to see your baby or breastfeed between sessions. This is critical in a field that is approximately 73% female.
  • You can provide in-home family therapy without having to physically go to the client’s home, allowing you access to the entire family system. 
  • You get to have your emotional support animal with you all day 😉
  • You have more options for the way you deliver therapy.

Types of Online Therapy

Let’s talk about the different types of online therapy out there. When most people think of online therapy they think of video sessions. But a successful online practice can involve more than just replacing your in-person sessions with video sessions. Working online gives you permission to explore a variety of mediums for your client’s personal growth. Below are some of the options.

  • Video Sessions – delivered online via a secure video software. 
  • Message Based Therapy – This type of therapy is generally done email style, where your client has a secure area or room where they leave you messages that you respond to, and the majority of the therapy is conducted that way. For people who need flexibility this can be a great option because you don’t have to be anywhere at a set time or worry about using video. Some clients really prefer this type of therapy.  
  • Multimedia Messages – This can be an extension of message-based therapy. Some therapists exchange video, and audio messages with their clients in addition to doing text-based therapy. For example, you can send a video of yourself doing a tapping sequence to help your client.

    *Please make sure you are using HIPPA compliant communication platforms for all of the above options. 
  • Online Courses – You can create online courses and or resources for your clients to use between sessions. This is really helpful if you find yourself using the same interventions over and over again. It also adds value to your service and provides another option for clients.
  • Online Content– An easy way to systematize how you share information is creating online content. This is similar to creating an online course, but is simpler and easier to share. Examples of online content include: YouTube videos, blog posts, instructional images etc. This gives your clients resources to use to learn new concepts or practice skills between sessions.

When you are thinking about your practice, think out of the box. The above types of practice can be blended and mixed and matched. That is the benefit of the online practice, you don’t just have to do one thing anymore. Check with your specific profession about any rules that may apply to how you can practice.

Things that Make Online Therapy Easier

Let’s make your life and your work as EASY as possible. If the online space is newer for you, that is okay. There are many tools out there to help. 

Take advantage of existing platforms – There are platforms that already exist that you can join in order to learn about new ways of doing therapy. These platforms may not be the best paying, but they provide you with lots of free training, free supervision and clients to help you learn. Most of them only require you to accept a very minimal amount of clients. This a great way to get started when trying something new, especially message-based therapy. 

Software is your friend – Having good software makes things much easier. There are great platforms like SimplePractice that have everything integrated for you, including all consent forms, payments, online scheduling, and video software. This makes life much easier and saves TONS of time.  

Buddy up – Find an online practice friend to share information and learn alongside. Online therapy is a new and evolving field and it involves learning experiences.

Create a lifestyle around it – The personal impacts of working online are not the same as working in an office. Create a lifestyle and a schedule that works for you. Be creative with this. The options are endless. 

Try a session for yourself – If you haven’t had a session with an online therapist, do it. Trying online therapy myself made me a believer in the impact it can have.

Creating an online therapy practice that embraces the dynamic and online world we live in can be fun if you go into it with the right mindset. The world is changing rapidly, don’t be afraid to jump in and go with it.

Author Bio

Kirsten Keach is a licensed marriage and family therapist specializing in relationships. She helps couples and singles develop meaningful, lasting, soulful love relationships. In her free time she is an avid traveler, improv comedy performer and amateur salsa dancer. Learn more about Kirsten here.

Photo from The Lazy Artist Gallery by Pexels


  1. Cindy Baker says:

    Thank you Kirsten for an informative and thought-provoking article! Excellent!

    • You’re so welcome! I look forward to hearing any creative ways that you adapt your practice. Everything is able to be redesigned right now. ~ Kirsten

  2. Heather says:

    Thank you for this blog post!
    I especially benefited from your naming the possibility that recent changes might/can have a longer term impact than simply a short term interruption to my regular, in-office practice, to which I’ve been envisioning returning to in its pre-changes incarnation. I wonder how my energy might shift with a new type of acceptance.
    As both a therapist and a client, I was not excited to move to an exclusively secure video format. However, I have been pleasantly surprised by the embodied sense of safety that can come from clients being in their own space (with their own ‘therapy’ animals), and how the conversation and the interventions can shift. Similarly, seeing conflicted couples in a group therapy video format has also shifted what can happen in session as both partners are able to provide, maintain, and return to their own grounded, embodied safety when not in the physical, energetic presence of their partner.
    As a therapist who had claimed “having not one entrepreneurial bone in my body”, I’ve been shocked by the entrepreneurial energy that has been freed up in me in this season & I’m excited to sit with your suggestions!
    Thank you for opening this conversation!

    • Hey Heather-

      I LOVE how much your entrepreneurial energy has opened-up as a result of working online. I was so hoping that this blog would help inspire therapists to be creative and entrepreneurial with their practices. How the world works in the future is yet to be written. In fact, we are creating it as old structures are breaking down. I am glad that you are finding your way into something new.

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