Telehealth Options: Full Online or Hybrid Therapy

Quick Answer: Telehealth sessions run over video, with the same Gottman Method structure and materials I use in person — I can screen-share worksheets and exercises directly during the session. You can go fully online, or hybrid, meaning you mix in-person visits (if you're in California) with virtual sessions depending on your schedule. Both formats are effective; what matters most is which one you'll actually be comfortable using.

Full Online vs. Hybrid — What's the Difference?

Full online means every session happens over video, wherever you're located in California or Arizona. This is the only option for Arizona clients right now, and plenty of California clients prefer it too — no commute, no waiting room, just log in from wherever you are.

Hybrid is for California clients who want the option to come into the Encinitas office sometimes and meet virtually other times — say, in-office for laying the foundation, then virtual for regular weekly sessions afterward. You're not locked into one format for the life of the therapy.

How Telehealth Works in California and Arizona

Meeting virtually means you need to be physically located in California or Arizona at the time of your session — that's a licensing requirement for therapists, not a preference. Beyond that, sessions run the same as they would in the office.

Is Telehealth Available for Couples, Not Just Individuals?

Yes, with one condition: if you're doing couples therapy online, both of you need to be in the same physical location for the session. I promise it's not me being difficult — it's genuinely hard to do the kind of attuned, in-the-moment work Gottman-based therapy calls for when I'm splitting attention across two separate screens in two different rooms. Once you're together, the Gottman Method actually works great virtually — I can share assessments and exercises with you directly over Zoom just as I would on paper in the office.

Individual therapy online is just as accessible, and for a lot of people, more so — the barrier of getting into an office disappears, which means sessions fit more easily into a lunch break, the gap before or after work, or a kid's nap time. You'll still want a quiet, private space to talk, but that's usually easier to find than an hour of free time to drive somewhere.

Is Online Therapy Actually Effective?

Here's the honest version: your outcome has a lot more to do with fit than format. People who wanted in-person sessions and only "settled" for online tend to report less satisfaction — not because telehealth doesn't work, but because they didn't want it in the first place. People who choose online, or who are genuinely fine with it, do just as well as anyone meeting in an office.

So my actual advice: pay attention to what you want, and advocate for that. Therapy is just as effective online as in person — I wouldn't let a preference for "eventually doing it in person" keep you from starting sooner online. I've also seen the opposite happen more than once: someone insists on in-person, tries virtual once things are already established, and never goes back to the office.

If you want more on getting the most out of a virtual session, I wrote a short guide here →

FAQ

Can each partner join a couples session from a different location — say, one from home and one from an office?

While we can do this with technology, I have found it is not helpful to couples since talking to one another through Zoom is very different than with each other in real time. I usually ask couples to do their best effort to get to the same place physically and take the call together. This helps the therapy significantly.

What happens if my internet connection drops mid-session? We pick back up where we left off — it happens, and it's not a big deal. Using a computer over WiFi (rather than a phone on cellular data) cuts down on this significantly.

Can I switch between hybrid and full-online later? Yes. This isn't a locked-in decision — plenty of people change format as their schedule or circumstances shift.

Do you use any specific platform for sessions? Sessions run through a HIPAA-compliant video platform with screen-sharing, so I can pull up Gottman Method materials and exercises the same way I would on paper in the office.