How Does Online Therapy Work?

When I first heard of online therapy, my first thought was “What? Why? That sounds terrible.” But, here I am 2 years into providing online counseling to teens and young adults in different areas of Tennessee (yes, I started voluntarily, a year before the pandemic started). It can bring up so many questions for people, though.
What exactly is online therapy? Will you like it? How does it work? And how do you even get started with that sort of thing? All good questions. I’ve wondered a lot of these things myself, both as therapist and as client (because I have a therapist, too, as I believe all therapists should).
Before we get to how it works, maybe we should cover what it is…and what it isn’t. Here we go.
What online therapy is…
- Real-time, looking at each other’s faces, talking about what you want to talk about.
- It’s still confidential. I have a program that uses HIPAA-approved security to protect your privacy, and I use a password-protected wifi system. I won’t be sitting at the coffee shop using their free wifi. I’m always in a confidential space, my office or home office.
- It’s natural feeling. Usually, a few minutes into the first time we meet, it doesn’t feel weird. I mean, therapy is “weird” sometimes, but video doesn’t typically cause a crazy amount of awkwardness. It’s just people talking at the end of the day.
- It is still effective. The vast majority of my clients say that online therapy is still really helpful, and I suppose the best evidence of that is the fact that they keep coming back.
What online therapy isn’t…
- It’s not impersonal. I’m just as much in tune with people in online sessions as I am when we’re sitting in the same room. The feelings are there and the very real, close therapeutic relationship that usually develops between therapist and client is still there.
- It isn’t just texting or emailing. Sometimes yes, we need to text about scheduling, email for an excuse note or quick update, or something like that. Overall, though, we do most of our work together face-to-face online.
How does online therapy work?
It really works a lot like in-office therapy works. The types of therapy I do all translate pretty much seamlessly to online. There is always a focus from me on the counseling relationship. Without that, it’s kind of difficult to talk about some of the really tough things we talk about in therapy sometimes. I’m always focused on making sure that I understand you in the way you want to be understood, and that’s something that absolutely stays the same online.

I believe the best way to deal with things so that life will be better for a long time is to get to the root of a problem, and figure out what’s causing trouble. Again, that’s absolutely possible to do online. Even for the really specific techniques like Brainspotting (which is actually really cool), online therapy works absolutely fine. Actually, all of the Brainspotting education events and practicums are online right now, and I love using it both online and in the office. The other techniques I use – like some Jungian principles – that help to get to the not-so-obvious underlying issues causing current problems also work just fine online.
I also use cognitive behavioral therapy (CBT), which looks at ways we feel, think, and do things and putting those together in a way that work for us the best. That is usually helpful in dealing with certain things or focusing on really particular issues, but there are definitely parts of CBT that are useful overall. CBT is another type of therapy that easily translates to online.
Will you like online therapy?
Some of that really depends on you. Some people prefer online to in-office, and vice versa. Others really don’t care which, and several of my people go back and forth between coming to the office and meeting online, based on what they may have going on that week.
A good thing about online therapy is that if you’re uncomfortable or unable to leave home, you don’t have to. I work with lots of folx who deal with anxiety and trauma. Those things can make it all but impossible to leave home at times, which are times when it could be argued that people would benefit the most from therapy. So, now that’s an option from home.
You also have therapists across the entire state available to you, and you can move anywhere within the state (like if you were move from Franklin to Memphis, Chattanooga, Knoxville, Sewanee – I’m thinking college towns).
I definitely understand if you believe that talking to someone online wouldn’t work or wouldn’t be the same. I was a true skeptic of it at first. And for some people it’s actually not the same. I think it’s great to give it a shot, but if you know that you absolutely hate talking to people online, facetime, etc, it may not be your thing. You probably have some friends who see a therapist online, since virtually every therapist is offering online therapy now – ask them how they like it.
How do you get started with online therapy?
What’s it like to get started with online therapy? I can imagine something like in some of those futuristic movies where you email and have a digital “person” who returns your email, and you never get any written communication, much less actually hear someone’s voice.

But it’s different with getting started with therapy (at least the way I do it). You can call me, text me, email me, or fill out the contact form on my website. You’ll almost always hear back from me within 24 hours, most likely the same day, even if I’m not able to see new clients at that time.
If you’re interested in getting started, we will typically go ahead and talk at that time, or we’ll set up a time to talk for about 15 minutes, I’ll answer any questions you have, and we can make sure that we feel like it will be a good fit for us to work together – because that is a really important part of therapy. After that it’s just scheduling a time to start. And that’s it. It’s all personalized, not digitized or computerized.
Begin Online Therapy in Tennessee
Throughout this pandemic and beyond, Edge and I still want to be able to offer therapy to as many people as possible, even if you’re not able to come to the office. Online therapy can help teens and young adults feel more confident, figure out who they are, and overcome the challenges they’re dealing with – including adjusting to a pandemic and all the extra challenges that brings.
We specialize in working with teens and young women, and are LGBTQ+ affirming and welcome everyone as they are.
To start in Tennessee, follow these simple steps:
- Contact Cody and Edge to schedule a free 15-minute consultation for you or your teen.
- Meet with Cody and Edge for an initial counseling session
- Begin online therapy and help your teen cope with their anxiety, stress, and worry during this COVID-19 pandemic.
Counseling services offered by Cody Higgs and his therapy assistant dog Edge:
In addition to online and in-office therapy, Edge and I offer a variety of counseling services in Franklin or online throughout the state of Tennessee. More specifically, we offer teen therapy, young adult counseling, and walk + talk therapy. I specialize in working with folx experiencing anxiety, as well as depression, trauma, and generally feeling lost or trying to figure out who they are. I. also provide group therapy for teen girls and a young adult women’s group in the Nashville area. To get to know Edge and me further, please contact my counseling office.
