[nickbarnwell]

Teletherapy outcomes have yet to be thoroughly researched, but anecdotally most clinicians report a strong preference for face-to-face sessions. Part of the discomfort stems from legal concerns – how do you handle a patient who reports intense suicidal ideation with a plan being one of the big ones – but also the limitations of teleconferencing. Neither the typical therapist nor their patient is like to have access to a fancy $$$ teleconferencing setup; both are likely stuck using whatever $0.50 on the BOM selfie camera Apple chose for their latest iDevice. Seeing only the face, and a 720p at that, denies the clinician a lot of valuable information about the client's internal state, their physiological responses, and their body language. Not to mention connection issues. Imagine being someone who's kept a secret about their sexuality or childhood abuse and finally developed enough trust and worked up the courage to discuss it to your therapist only to be met with a "Connection lost…" or frozen image of their face.

Additionally, licensure for mental health professionals is handled on a state-by-state basis, making CoL arbitrage difficult.