U.S. flag

An official website of the United States government

Woman sitting on chair using tablet with a doctor on the screen. Three bubbles appear in front of her with three heads. One has a jumble of lines on it, the other has puzzle pieces, and the last one has an umbrella blocking rain.

Telehealth for behavioral health care

Individual teletherapy

More than one third of Americans live in areas that do not have enough behavioral health providers to meet patient need. Telebehavioral and telemental health can help address this widespread issue.

Individual, one-on-one therapy, is the most common form of behavioral and mental health treatment. Telehealth is an effective way to deliver individual therapy. Medicare covers many telebehavioral and telemental health services including audio-only services. Most private insurers and Medicaid plans also cover telebehavioral health care.

Benefits of individual telebehavioral health therapy

  • Privacy for the patient.
  • Reduced stigma associated with being seen by others at a clinic or office.
  • Convenience, including reduced travel and disruption to daily activities like work and childcare.
  • Improved accessibility for patients who may have difficulty leaving home, including patients with disabilities, older adults, and parents of children with autism spectrum disorder.

Ways to provide individual telebehavioral and telemental health care

  • Virtual talk therapy: Telehealth talk therapy is used to address emotional and psychological issues. Providers typically conduct online counseling with a patient through video, phone calls, or online apps.

  • Telepsychiatry: Telepsychiatry can offer a range of services including online counseling and psychiatric evaluation and diagnosis. Unlike talk therapy, the provider may also prescribe and manage medications.

  • Online apps: Apps can be useful for tracking and monitoring mood, though they may require users to first enter information about their symptoms. App offerings vary and may include built-in features like text therapy, talk therapy, or chatbots. They may also offer resources, quizzes, access to online communities, guided meditations, or suggestions for activities. Apps can help users better understand moods and emotions and reframe negative thoughts.

  • Chatbots: Mental health chatbots use software programmed to mimic human conversation. They are designed to provide real-time encouragement, advice, and tips for emotionally challenging situations. Chatbots offer 24/7 support, which is helpful during weekends or evenings when more traditional forms of therapy are not always available. Typically a patient or the chatbot itself initiates the conversation.

  • Text therapy: Text therapy offers the convenience and relative anonymity of text messaging. Unlike chatbots, text therapy offers the assurance and support of a real person at the other end. Some text therapy lines offer 24/7 support in real time, while others provide responses from licensed professionals asynchronously or during different times of the day. There may be some wait time to get advice.

Did you know?

Texts or chatbots can be useful for patients who want frequent contact or faster access to care between visits. They are ideal for answering simple questions or sharing resources. They are usually not appropriate for crisis situations, or for addressing complex issues. Most insurance companies do not typically reimburse costs associated with text therapy and chatbots.

Considerations when providing individual telebehavioral and telemental health therapy

  • Build trust: Telebehavioral health requires establishing a good relationship with the patient so they feel comfortable and safe sharing their feelings. It is important to discuss any concerns and fears and reassure them that their information will continue to be private and secure.
  • Confirm privacy: Reassure the patient that the session is private, no one else is in the room with you, and the door is closed. Remind the patient to make sure they are in a room where they will not be disturbed or overheard.
  • Select your settings and technology: Choose the telehealth video platform that best suits your needs for encryption and privacy, user controls, and more. Have the patient test their technology before the session starts.
  • Be engaging: It is important to make sure the patient knows that you are listening and engaged. Always make sure you are looking into the camera and making eye contact.


Athol Memorial Hospital

The Athol Memorial Hospital telemental health program serves local high school students. Based out of rural Massachusetts, the program provides important behavioral health and primary care in an area where the school nurse is sometimes the students’ only form of health care. Challenges such as broadband access and lack of privacy are common so text-messaging and email communication supplement virtual video visits. Read more about the Athol Memorial Hospital telemental health program.