What is Virtual Counseling? An Expert’s Perspective
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“Virtual counseling has seen massive growth in the last few years. Prior to Covid-19, counseling services were mostly provided direct, face-to-face, in person. But technology now allows us to provide the same level of service remotely.”
Beverly Smith, PhD, CEO and Executive Director of the American Mental Health Counselors Association (AMHCA)
Virtual counseling is a form of mental health counseling provided through digital platforms like video calls, phone calls, or messaging. Think of it as telehealth for counseling. Popularized during the Covid-19 pandemic, it’s here to stay.
Today, virtual counseling can provide a wide range of services, including individual therapy, couples and family therapy, group therapy, and specialized therapy. Unlike traditional medicine, many complex conditions in behavioral and mental health can be treated successfully without the patient and counselor ever being in the same room.
Virtual counseling holds immense promise in addressing America’s mental health needs. However, regulatory challenges remain. Additionally, for practicing counselors, some adaptation and flexibility may be needed to transfer their counseling skills into the virtual setting.
To learn more about the role of the virtual counselor and where it’s going, read on.
Meet the Expert: Beverly Smith, PhD, LPC, NCC, CCMHC, ACS, BCC, HS-BCP, BC-TMH
Dr. Beverly Smith is CEO and executive director of the American Mental Health Counselors Association (AMHCA). She has professional counseling experience in various settings, including private practice, public education, corrections, community counseling, and higher education.
Dr. Smith is also the owner and principal therapist of BSmith Consulting Group, LLC. She is a two-time graduate of Tuskegee University (BS-biology, MEd-counseling & higher education) and has earned counseling degrees from Troy University (EdS) and Amridge University (PhD). Additionally, Dr. Smith has a certificate in administration and leadership from Kennesaw State University.
The Benefits of Virtual Counseling
“Virtual counseling has seen massive growth in the last few years,” Dr. Smith says. “Prior to Covid-19, counseling services were mostly provided direct face to face, in person. But technology now allows us to provide the same level of service remotely.”
The tech enabling virtual counseling existed before the Covid-19 pandemic, but the urgency of the public health emergency—and the public mental health emergency that went with it and its quarantines—pushed it into practice. Delivering and receiving mental health services remotely turned out to be a much more comfortable experience and an easier transition than most expected. Being able to receive counseling from the comfort of one’s own home turned out to be a huge benefit.
“Virtual counseling allows patients and clients to still be somewhat within the comfort zone of their home or established safe space while gradually moving closer to therapeutic progress,” Dr. Smith says.
Virtual counseling also removes several barriers to care. Clients don’t need to drive to a physical office. They don’t have to set aside as much time in their schedule. And the whole process of seeing a counselor for the first time may feel less monumental: it’s just turning on your phone and answering a call.
“It’s convenient,” Dr. Smith says. “The user-friendly platform makes it not only easy to access services but also reduces a certain amount of anxiety or apprehension one might have around a new process.”
Challenges in Virtual Counseling
Virtual counseling does have its drawbacks, the most obvious of which is it still takes place through a screen. That means virtual counseling literally lacks a dimension.
“As we know in counseling, the verbal and nonverbal can be equally important and informative,” Dr. Smith says. “If you’re face-to-face with someone, you can see body language and really key in on the nonverbal aspect. You can do the same virtually, but you have to be a little more attentive.”
It’s a drawback that can be partially mitigated. Counselors can still see their clients from the waist up. The counselor might also ask to adjust the camera or adjust the conversation, looking for particular verbal and nonverbal cues.
The difference between virtual and traditional counseling is narrowing. But they’re not the same, and they don’t need to be: these are different tools for different contexts. Tomorrow’s counselor will be adept at both.
“Traditionally, we’ve held onto the thought that face-to-face counseling is better than virtual counseling,” Dr. Smith says. “I’m not sure that the research demonstrates that definitively. I think it comes down to the individual, what they’re looking for, and what they’re comfortable with.”
Advocacy Issue: The Counseling Compact
The more pressing concerns related to virtual counseling are regulatory. Jurisdictional limits around licensing mean a counselor can only provide counseling in the state in which they’re licensed. Also, different states may have slightly different requirements for counselors (i.e., educational, experiential, or exam-based) that make it hard to get licensed in more than one state. All this undercuts the ability of virtual counseling to expand access to care.
The solution is the Interstate Counseling Compact, an agreement that allows licensed professional counselors to practice in member states without needing additional licenses. The Compact increases counselor mobility, standardizes licensure requirements, addresses workforce shortages, and boosts access to mental health services.
To be fully enacted, it must be adopted by a minimum number of states. So far, several states have adopted the Compact, and more are considering it. This requires careful coordination between several state governments and professional organizations, but the counseling community is working hard to see it done.
“We’ve come an extremely long way in standing up the Counseling Compact and moving towards full-fledged implementation,” Dr. Smith says.
The Future of the Virtual Counselor
All counselors may, at some point, be virtual counselors, too. Dr. Smith recommends new counselors get comfortable with any virtual platform they use. They’ll need to consult with colleagues and make sure it’s a vetted platform that’s HIPAA compliant. They’ll need to practice with the platform and have backup plans for what to do if the tech fails on a call. Dr. Smith also stresses the importance of communicating the details around virtual counseling to patients and getting feedback from them throughout the process.
“There needs to be informed consent so that the patient can make an informed decision about the services they’re receiving,” Dr. Smith says. “That should be a standard of practice whether it’s virtual counseling or traditional, face-to-face therapy, whether it includes some kind of advanced technology or not.”
Familiarity with and curiosity about technology will serve tomorrow’s counselors well. Virtual counseling is here to stay, and more tech is coming to support it. Meditation apps and calming games can be useful outlets for patients, and AI is gaining traction for its potential in the counseling space—though Dr. Smith remains optimistically cautious.
“I think we’re off to a great start with integrating technology into counseling,” Dr. Smith says. “With artificial intelligence, I foresee more guidelines as we move forward: do’s and don’ts for how we ethically engage with our patients and clients in utilizing AI.”
Further integrations with augmented and virtual reality could bring the missing dimension back to virtual counseling, though those might still be a little far out. Still, it’s important for new counselors to stay open to new ideas that serve the patient. The future’s bright—and it may be closer than we think.
“Before Covid-19, we didn’t think we were ready for virtual counseling,” Dr. Smith says. “Look at the progress we’ve made.”
Matt Zbrog
WriterMatt Zbrog is a writer and researcher from Southern California. Since 2020, he’s written extensively about how counselors and other behavioral health professionals are working to address the nation’s mental health and substance use crises, with a particular focus on community-driven and interdisciplinary approaches. His articles have included detailed interviews with leaders and subject matter experts from the American Counseling Association (ACA), the American Mental Health Counselor Association (AMHCA), the American School Counselor Association (ASCA), and the Substance Abuse and Mental Health Services Administration (SAMHSA).