Teletherapy FAQs

How it Works:

Skype support using video is an effective form of online support that allows you to have a live two-way audio-visual individual coaching session from the privacy and convenience of your own home. This way you get an experience that is very close to that of face to face individual therapy session.

Online support sessions have the following advantages:

  • You can have individual therapy sessions from the convenience and privacy of your own home.
  • Greater convenience and flexibility with appointments– no traveling required.
  • Who are online support sessions suitable for? 
  • Individuals who have been or are currently in a relationship with a narcissistic partner.
  • Adult children of narcissistic parents.
  • Individuals who have narcissistic family members, friends or co-workers.

Especially those who:

  • Have difficulty attending regular support sessions due to lack of availability of narcissistic Support groups in their area or are unable to attend due to work or other commitments.
  • Have a disability or illness that prevents you from attending in person.
  • Work away from home, travel or have a busy schedule.
  • Who is online support not suitable for?

Please understand that although you may desire narcissistic abuse teletherapy sessions via Skype, they may not be appropriate for you.

Online support sessions are not appropriate when your situation is an emergency or a crisis situation where you need immediate help. It is not appropriate if you are suicidal and in danger of harming yourself or others. It is not appropriate if you feel you suffer from psychosis (hallucinations, delusions, thought disorganization) or a severe mental health condition.  Online support sessions are also not appropriate if you are under the influence of drugs or alcohol. In any of these cases, I would advise you to contact either your primary care physician or medical professional or walk-in to your local emergency room.

Are Skype support sessions confidential?

All participants will sign a consent form confirming their understanding that communicating via the internet is not 100% secure.

What equipment will I need?

You can connect with your laptop (as long as it has a built-in webcam and audio device, most do) or your mobile device. If you use your mobile device, use a pair of earphones for better sound quality. If you have a desktop computer make sure it has a webcam and use compatible headphones for better sound quality.

How do I get started?

Just send me an email to so we can schedule an appointment date and time. You will then be given payment instructions and receive your intake paperwork.

How long do the individual therapy sessions last?

Individual sessions last for 50 minutes to 1 hour in length. I  incorporate the most effective modalities to promote healing from trauma to help you get unstuck, identify practical coping skills, learn how to apply these tools and heal from these damaging relationships.

Distance Therapy (Telemedicine by Video Conferencing) (also known as Teletherapy, Telemedicine, Internet Therapy, eTherapy, etc.)

What are the limitations of Teletherapy?

Most of the parameters of a psychotherapy meeting remain the same. I will ask you to fill out an additional telemedicine consent form.

The major advantages are that you can use my services without living close by, that you save on travel time to and from my office and that in some ways you have greater privacy.

Innovation and New Choices come with some Risks. That will mean that there may be new or increased risks for you. Here are some areas you should think about:


The most predictable issues would be poor quality of the connection or becoming disconnected altogether. In such instances, the frustration is compounded if you are having an important conversation with your therapist!

The likely remedy would be that we could continue for the rest of the session by telephone. Because of sound quality, we may also elect at some points to have a phone conversation at the same time as the video conversation. By eliminating the audio that comes over the internet, we can improve the quality of the communication.


I have found several services that will provide encrypted video conferencing. I think this is critical for privacy. The video conferencing that I will provide will be HIPAA compliant. Although there are always risks to your confidentiality, not coming to my office in person is probably a net improvement in your privacy. Availability for Emergencies:  Video conferencing is not reliable enough yet to count on being able to “meet” with me in an emergency. This is actually a constraint of ordinary face-to-face meetings too, but the technology of video conferencing may make it seem like I will be able to be more available. We should be agreed that if we anticipate needing to meet on an emergency basis frequently, that this is not a good modality.

If you anticipate needing to call a crisis hotline, you may want to write down those numbers now somewhere where you will be able to find them when you are upset. I do not have these numbers on my recorded message on my answering machine when you call me.

Fee and Insurance:

My fee is $150/ hr. You may try to contact your insurance company to see if they’ll reimburse you. Some will and some won’t. If you would like more information about how to do this, contact me. Insurance reimbursement is likely to grow in the future. All fees remain the same as with face-to-face meetings.

Who can do this?

Current California law explicitly allows for both telephone and online therapy, and further mandates that all telephone and online therapy clients receive and sign a “Teletherapy Informed Consent” agreement prior to treatment. I provide all telephone and online therapy clients with a copy of this agreement, and its parameters are fully discussed with clients prior to initiating therapy.

The issue of providing telephone and online counseling to clients in other US states and in other countries is more complicated. I am licensed to practice in the State of California. In terms of providing counseling to residents of other US states, the key issue is the law of the state in which the client lives. While there are currently no applicable federal or California state laws explicitly regulating or prohibiting teletherapy across state lines, every state in the US has its own specific laws regulating the practice of psychotherapy.

In every US state, those laws limit the practice of psychotherapy to clinicians licensed and/or registered in that specific state. Due to these state legal issues, I only provide teletherapy clients residing in California or internationally.

Telephone and online therapy for international clients

While I do not offer telephone or online counseling to US residents in any state except California, treatment of clients living in countries other than the US is less restricted legally. The great majority of countries do not regulate the practice of counseling and/or psychotherapy. As such, I may legally treat clients in many countries, including the following:

  • Canada
  • United Kingdom
  • Ireland
  • Australia
  • New Zealand
  • South Africa
  • Israel
  • France
  • Germany
  • Belgium
  • Denmark
  • Greece
  • Norway
  • Portugal
  • Spain

Please note, I am usually booked about 2-3 weeks in advance.

To schedule an appointment with me, send me an email to

To reserve your session, click here to make a payment using PayPal.

One thought on “Teletherapy FAQs

  1. Hello Bree, I am a Biblical Counselor and have considered doing sessions by Skype because it was suggested to me. I had been wondering how well that works out for people. I am also a survivor of a Narc/Sociopath relationship which I have been away from for at least 24 years. Lately some have come to me with this issue, so my interest in working with them for healing is in the forefront. I’m still learning about some of the issues they face, so I may want to read your book as well. I am interested in any information or suggestions you might have. I have clinical counseling Masters education, I just chose Biblical counseling instead because I am a minister. Any suggestions would be appreciated! My email is Blessings, Jenine


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