Should You Offer Remote or In Person Therapy? Which is Better?

During those early stages of starting a practice, it’s not uncommon to try to avoid any unnecessary costs. After all, starting any business can be expensive, and most of us are not sitting on a large sum of money that we can live on as we try to grow.

I want to also encourage you to read my past from a few weeks ago about running a practice without quitting your day job, as it’s relevant to this.

Easily, one of the largest expenses that you may someday need to take on is rent on an in-person office. Rent for a nice looking, well managed in person office can be anywhere from $500 a month to $1500 a month or more depending on your setup, how large your space is, and where you’re located.

That can be a lot!

It is that expense that pushes some people towards the idea of offering remote therapy through some type of HIPAA TeleHealth Service. Why pay for office space when you can perform therapy virtually?

Doing it in this way can have many advantages, but you should also be aware that it has some drawbacks as well, some of which can be fairly serious. We’ll talk about these below, as well as some ideas and solutions that you may want to consider.

Advantages of Offering Only Remote Therapy

If you’re a new therapist on an ultra-tight budget that cannot afford any office space, and you’d like to consider virtual therapy, it can have advantages. These include:

  • Very Little Cost – Other than the cost of the video conferencing service you use, it costs much less to be a virtual therapist than an in-person one. You can work out of your home, or anywhere secure with internet access, allowing you to reduce expenses considerably.
  • Opens Up to the Whole State – I live in Arizona, and I am also licensed in California. No one from San Francisco is driving 14 hours for therapy twice a week. But remotely, I can see clients in any state I’m licensed. That means the potential client pool is significantly larger and with far fewer location based limitations.
  • Easier – It is much, much easier to be able to wake up, put on a shirt, make sure your PJ pants are not visible on camera, and provide therapy in a dedicated room in your house than it is to drive every day to an office. No one likes commuting anymore. Remote work is far more relaxing.
  • No Landlords, No Masters – If you’ve tried to buy a home or rent an apartment in the past few years, you know how long the process is or how difficult it can be. You could even be stuck renting from someone that is less than pleasant, or get a room next to some guy that sleeps at work and snores uncomfortably loud. You don’t know. At home, you have no landlords, and the only noisy neighbors are kids on sick days that barge in looking for a snack.
  • Better for the Immunocompromised – If you or your clients are immunocompromised, remote therapy is safer in today’s virus rich world.

There are some clear reasons that many therapists – including myself – prefer virtual therapy when appropriate.

But there’s a problem – it also has drawbacks, and many of the drawbacks can really affect the success of your business.

Disadvantages of Being a Remote Therapist

Being a full-time remote therapist may sound like a great way to reduce your costs, but it has some very significant drawbacks. These include:

  • Many People Do Not Want Remote Therapy – This is the greatest challenge facing therapists that do not have an office. Full time remote therapists tend to have a much more difficult time converting calls into clients. Many, many people still prefer in-person therapy, or at least the option of having it. They want to work with someone local that they can see in a setting outside of their home. Building a business can thus be much harder if you do not have an in-person office.
  • Not Everyone Benefits From Remote Therapy – Not all clients or psychosocial situations are conducive to the use of technology for therapy. So while remote may open some doors in who you can see, it also has limitations on who would be a good candidate.
  • Marketing is More Challenging – Someday, I’ll have a very long and detailed post about how search engine optimization works and how to market yourself online, but for now you’ll just have to trust me on this: it is much, much more difficult to market yourself statewide than it is to market yourself in a small local area, especially on a budget. Having a physical location makes both digital and offline marketing easier.
  • HIPAA and Internet Connections – How familiar are you with HIPAA law as it relates to the TeleHealth platforms you can use? What about fixing an internet connection that isn’t working well? Remote therapists still have many questions they’ll need to answer, and not everyone is prepared for those needs.
  • Clients Want to Pay Less – Similar to the difficulties of converting clients when you only have remote therapy, some clients also believe they should be paying less. After all, they know you don’t have an office, so they believe that they shouldn’t be paying as much for therapy, expecting you to pass the cost savings on to them.
  • You Still Need an Office Address – Even if you offer full-time remote therapy, (telehealth/telepsych), you will need a professional address for your insurance contracts, superbills or receipts.  You may not want your clients knowing where you actually live. This is an added overhead cost. As is HIPAA compliant video platforms (vs. regular zoom), decent cameras/mics/monitors, etc. Being remote is not free.

Overall, being a remote therapist does have many advantages, but it’s drawbacks are not minor. These are all significant issues that need to be considered before making this decision.

Alternatives to Full Time Remote Therapy

Quickly, let’s differentiate one thing – even if you have an office, you can DEFINITELY offer remote therapy as a secondary option. This is known as a hybrid practice, and combines the best of both worlds – a physical location for those local patients, and remote for everyone else. Most therapists go this route these days.

Similarly, just because there are significant drawbacks doesn’t mean you need an office. You can absolutely operate remotely if that’s what is right for you.

With that in mind, if you’re not ready to or unable to pay for a full time office, consider the following:

  • On Demand Rooms and Part Time Rentals – Some office spaces allow people to rent rooms needed or part time. This can dramatically decrease monthly costs, though they may cost more on a daily basis.
  • Hospital Rooms – Similarly, some hospitals allow you to do this as well, and if you have any connections to doctor’s offices, you can ask them if they’ll rent space for private therapy for a fee. Many are willing to do that if they know you will not use it too often.
  • Other Therapists – Therapists have this tendency to see other therapists as competition. It’s why I started PsychFusion in the first place – to help therapists get guidance from another therapist! But, if you know therapists in your area that are already renting space, see if they’re willing to rent part of their space out to you as well. They may have room, and be happy to offset some of their own costs by subletting to you on their off hours.

These are only a few of the options available, but they’re worth considering. Your local area may have even more options. I have a property myself in Arizona where I allow therapists to rent their own space and operate, and I know there are others like me all over the US.

There IS a right or wrong answer when it comes to offering remote therapy over in-person, and vice versa. But that right or wrong answer is uniquely personal to you. Want help figuring out how to launch your practice? Reach out to PsychFusion, today!

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