Telehealth or In-Person? What Teletherapists Need to Know About Surprising Preferences


September 20, 2023 | Reading Time: 4 Minutes

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Teletherapists are at the crossroads of rapidly evolving healthcare models and patient or client preferences. A recent study, “Choosing Or Losing In Behavioral Health: A Study Of Patients’ Experiences Selecting Telehealth Versus In-Person Care,” has recently shed light on whether clients and patients prefer telehealth only or in-person care (Sousa, 2023). Notably, the research highlights that approximately one-third of patients receiving therapy or medication visits reported that their clinicians, which include teletherapists, did not offer both modalities. Some patients could benefit from hybrid models, whereby the teletherapist offers telehealth augmented by in-person meetings at routine intervals. Such hybrid models can help solidify therapeutic bonds, meet client and patient preferences, and offer welcomed variety for some clinicians who work from home.

Moreover, 32% of patients queried claimed they did not typically receive their preferred modality, and 45% believed their clinicians did not consider their preferences. These findings underscore the urgent need for teletherapists to revisit and potentially recalibrate their approach to modality selection. It also suggests that teletherapists and those working in person may need to inquire about their clients’ and patients’ preferences more often.

Strategies for Teletherapists Seeking to Offer Scheduled In-Person Meetings

Teletherapists today have various options for developing hybrid practices, and some might be surprisingly beneficial for both parties. The remainder of this article offers several approaches to developing such services.

Travel-Based Solutions

1. Mobile Office Strategy. Creating a temporary mobile office with secure technology could be another avenue for teletherapists.

Considerations. Appropriate boundaries between personal and public meeting areas, zoning laws, accessibility, local licensure, and sanitation are important.

2. Renting an Office. Teletherapists might choose their favorite mountain village, beach town, or lakeside retreat as a meeting spot for in-person consultations. Depending on your type of practice, scheduling regular in-person meetings at predictable intervals may benefit both you and the people you serve. Think about the visiting doctor traveling to rural areas on horseback in yesteryear. Teletherapists using this model typically schedule in-person visits at a destination located a reasonable distance from some of their clients every three to six months. Locations can vary to include several areas throughout the year. Teletherapists can consider renting a colleague’s office for a day to offer in-person consultations at a distant location.

Considerations. Privacy, HIPAA compliance for document transfers and other technology uses, a written office lease, local licensure, and malpractice insurance are essential.

3. Use of Coworking Spaces. Renting a private, behavioral healthcare-designed room in coworking spaces is an option for teletherapists.

Considerations. Soundproofing and HIPAA-compliant network security.

Additional Thoughts for Teletherapists

Tax Benefits of Traveling for Work

You might eagerly anticipate routine travel to your preferred destination(s) while enjoying potential tax deductions. You may also find that offering such flexibility can strengthen your rapport and increase satisfaction with your services. Speak to your accountant to determine if this option will be financially feasible.

How to Find Suitable Locations

Local digital newspapers or professional association listings can be excellent resources for teletherapists seeking suitable office spaces. Hotel rooms are not likely to be considered acceptable for therapy sessions by your licensing boards. However, a local church or school might accommodate you with an office at an affordable price.

That church or school might also serve as a referral source. Being sensitive to privacy issues is crucial when working in small towns and rural areas. 

Developing Distant Referral Sources

Incorporating periodic local visits can serve as a potent avenue for generating referrals, further enhancing a telehealth provider’s practice. A temporary physical presence enables meaningful connections with local healthcare ecosystems, fostering trust and extending the provider’s network. To optimize the impact of such visits, providers can proactively reach out to local organizations and healthcare facilities in advance. Churches, medical clinics, and other community centers often serve as information hubs and can be excellent platforms for introducing one’s specialty services. 


Reaching out to local school districts, dentists, hospitals, clinics, and physicians can provide invaluable insights into the community’s needs and mental healthcare gaps. Conversing directly with these professionals—or even their office managers, who often have a pulse on patient needs—can shed light on what types of mental health or substance use services are most in demand. Whether it’s stress management for patients undergoing long-term medical treatments or counseling services for families with chronic illnesses, these insights can help tailor your offerings to meet the most urgent community needs. Office managers, in particular, can act as crucial conduits of information, offering perspectives on logistical concerns, patient demographics, and even suggestions for collaborative efforts that would be mutually beneficial. Thus, a simple phone call to local healthcare providers can go a long way in making your temporary in-person visits more targeted and effective.


Contacting local mental health professionals can also serve as a strategic avenue to refine your service offerings and establish a collaborative network. By initiating conversations with local behavioral health practitioners already working in the area, you can better understand existing service gaps or areas of unmet need. This allows you to position your specialty services as complementary rather than a direct competitor. Furthermore, such interactions can often pave the way for cross-referrals and collaborative case management, enhancing the level of care for patients in the community. Given that local providers may have well-established practices, your telehealth services could offer valuable supplementary support, such as providing coverage for patient overflow or specialized services not readily available. They may even offer you the office space you need.

Developing Your Informational Materials

Before the visit, prepare a page on your website or section of your LinkedIn profile, as well as brochures or informational cards that succinctly highlight your expertise. Address any community needs you have identified, the services offered, and how interested parties can schedule appointments. These materials can be distributed through these local venues or directly to other healthcare providers, who may be more inclined to refer patients to your telehealth service when needed. Always ensure compliance with HIPAA or other relevant regulations when sharing and distributing such information.

Local Associations and Geographical Concerns

Local hospitals, clinics, or professional associations may view teletherapists outside their area as competition, requiring diplomatic and sensitive engagement.


Being attuned to client preferences regarding visit modalities is not just a logistical concern for teletherapists but also an ethical imperative. The research indicates that a patient-centered approach can significantly elevate telehealth service quality and satisfaction.

However, there is an equal imperative for clinicians to care for themselves. If that means that in-person service does not appeal to the therapist for whatever reason, their needs come first. Choosing to be a counselor or psychotherapist means putting many preferences aside, but the issue of practitioner self-care is paramount.


Sousa, J., Smith, A., Richard, J., Rabinowitz, M., Raja, P., Mehrotra, A., Busch, A. B., Huskamp, H. A., & Uscher-Pines, L. (2023). Choosing Or Losing In Behavioral Health: A Study Of Patients’ Experiences Selecting Telehealth Versus In-Person Care. Health affairs (Project Hope), 42(9), 1275–1282.

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S. Rose
S. Rose
2 months ago

We can not always bend like pretzels to appeal to clients preferences.

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