Online counseling can go by many names: telehealth, e-therapy, cyber counseling and it is nothing new. Whether by video chat, crisis chat and/or text, telephone, or in person, the counseling profession has had a history of being adaptable to suit client needs. During the emergence of the Coronavirus, in person or traditional one-on-one therapy sessions have become difficult due to social distancing. Despite these important precautions, options for therapy can, will and should remain.

What does the online counseling process look like?

In many ways, it is virtually the same. All confidentiality, HIPAA compliance, and client rights and privileges stay intact, even on a virtual or online platform. Simply put, therapy remains unchanged despite the medium. It is up to the therapist to create some new methods to fit the online environment. This could include different exercises to make use of the virtual platform is more of a tool, as opposed to a limitation. A licensed therapist will work with the client’s individual needs to develop an appropriate treatment plan, conduct therapy sessions with a client, and provide supplemental material such as worksheets, learning materials, or referrals while in the virtual meeting room.

What is the process of signing up for online counseling?

Again, very similar to walking into an office and filling out intake paperwork. Through docu-sign, a client can fill out all the necessary paperwork, discuss a time to meet with a therapist, and safely submit sensitive materials in a private setting.

Does it cost more?

No. Most major insurance carriers have allowed counselors to conduct services in this manner to promote social distancing and client welfare. Additionally, payment can be done virtually through a PCI compliant payment gateway.

What about children?

Although working with a child through online counseling can provide some challenges, there are many opportunities for growth and development! Children are more tech-savvy than ever, and an online counselor may appeal to many children and adolescents.

How should I prepare for my first online session?

Due to the sensitive nature of much of the subject matter during therapy, a private place is essential. An individual should find a private place with good lighting, few distractions, and a high-speed Internet connection. While this may seem great in theory, it is not always realistic particularly with children being at home from school, and busy families with busy lives. It is the therapist’s job to work with you around these challenges and provide the best care possible.

Who is my therapist?

Although many online counseling companies use bachelor level crisis counselors to conduct text and phone chats, our counselors are licensed mental health professionals through the state of Nebraska, all with graduate-level degrees. Additionally, we have a physical location in which we can work. This provides us with an advantage for administering counseling services as we have access to numerous resources and the ability to make referrals within the community.

Will it always be this way?

If there is one constant in life, it is that everything will change. This statement is now more apparent than ever and as we attempt to roll with the punches, we must adapt. If an individual is utilizing online counseling services, they can switch to in-person when social distancing is no longer a concern. Moreover, individuals who are seeing our therapists at our physical location, have already begun to make the switch from traditional therapy to e-therapy for numerous reasons, and many are enjoying the switch.

Is this effective?

As with any therapy, a person will typically get out of it what they are willing to put into it. In a review of studies published in the World Journal of Psychiatry, patients receiving mental health treatment through videoconferencing reported: “high levels of satisfaction” (Chakrabarti, 2015).

During this time of change, hardship, and loss, it is now more important than ever to take care of ourselves, our families and our communities. Simply put, we are at our best as people when we can think about others. To achieve this, we must be able to take care of ourselves first. Online counseling allows us the ability to do this despite the current preventative strategies of social distancing.

Therapy is not a luxury item, but rather a way to try and cope with these intense and overwhelming challenges. Ultimately, these challenges will pass, but inevitably, others will arise. When this occurs, we must be able to withstand and tolerate the distress ahead of us and we must be able to reconcile the past behind us. Counseling can help provide tools for growth, coping, and positive change. Whether in person or online, let us begin the journey with you to pick up the pieces during this global crisis.

SAGE Counseling Omaha

For approved clients, we are able to utilize telehealth services through our HIPAA compliant virtual software. For more details, please contact us or email us at

Loren Dexter, PLMHP, PLADC, CCTP


SAGE Counseling Omaha


Chakrabarti S., Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World Journal of Psychiatry. 2015, (3), 286-304. doi:10.5498/wjp.v5.i3.286