Remote counseling (Skype/phone), for nomads


If you are a somewhat nomadic entrepreneur like me, you are probably at risk for all kinds of mental health problems. So I’m thinking it might be smart to talk to a therapist on a regular basis, even just as a precautionary measure.

But if you move around a lot, it’s not really feasible to have in-person counseling sessions with some sort of continuity. A lot of developers telecommute, but it seems still unusual for therapists to see their patients over the phone.

How do you nomads out there go about finding a good therapist who is open to do Skype/phone based counseling?

Also: Have any of you had experience with phone counseling? Any issues, or tips for overcoming the distance barrier?


I have had some experience with Skype counselling and have found that it is less stressful than travelling to and from a session. I think it is probably important for a therapist to be able to see you so that they can judge your mood which they can’t do over the phone alone. One psychiatrist told me that they find it hard to work over the phone or on Skype but that particular person is of an older generation. I personally found a good therapist who works over Skype. I am based in the UK so not sure if it would be any use to you (time differences may be prohibitive).


I don’t have experience with this. @JBMarter, do you?


Skype counseling has become increasingly popular and more an more therapists are providing it. As mentioned, the downside is that some of the nuances of in-person communication are lost and also, insurance can’t be legally billed for sessions that do not occur at the office.

At my Chicago based practice, Urban Balance (, we provide counseling via Skype but require that at least the initial appointment be conducted in person. If you are outside Chicago, is a good resource to find a therapist and then ask if they offer Skype sessions.


When looking for a therapist, I highly recommend finding someone who is licensed to practice in their field., both have “video therapy” checkboxes you can use to search for people who do video therapy. I would also strongly recommend AGAINST using Skype for therapy, as skype has been known to collect and record content from their calls. Many therapists in the US who conduct therapy have platforms that are secure, free, and do not require any downloads by the client (like VSee or ReGroupTherapy).

I am not sure about the rules for self-promotion, but I have written a book about how to find the right therapist and get good therapy. I am a licensed clinical psychologist and I also conduct therapy via secure video for people who travel.

You can find more info about me & my practice at


Good news!

Insurance companies began covering telemedicine for psychotherapy and psychiatry January 1, 2016. Aetna plans use the Teladoc platform and many Blue Cross Blue Shield plans use the American Well platform, with insurance plans and employee assistance plans being added all the time. You can call your insurance company to find out if you are covered, or sign up for an account and let the platform do the insurance check for you.

Without insurance, the cost for counseling is around $79 for a 45 minute session. Both of these platforms have mobile apps and browser-based interfaces. Both only hire behavioral health professionals with more than 15 years of clinical experience with licensure. When you log in, you will only see providers licensed in your state. Practice standards and policies are identical to brick and mortar practice, but the sessions are via secure videoconference.

  • Tish Wakefield, LCSW-PA, LICSW-MA, American Well Online Care Group therapist


I kind of want to make an app called “bonfire”. Matches groups of voice chatters randomly around a “bonfire”. Clearly have some moderation capabilities. Maybe have some sort of “talking stick” aspect to make it more chill.


Here you can search for therapists by online therapy/video counseling:

{Disclaimer: I am a professional psychologist/doctor. I volunteer for OSMI. I am not soliciting clients or offering treatment. My participation in this forum is to offer professional input to be considered with the range of responses and support offered by fellow developers.}