In spring 2020, Canadians experienced jarring societal changes due to the COVID-19 pandemic, such as physical distancing and quarantine guidelines and the temporary closure of therapy clinics. Within a few weeks, mental health care underwent an unprecedented shift to virtual platforms. While clinicians were grateful to resume services, many were concerned about how the quality of care would be impacted, identifying various practical issues (e.g., lack of familiarity or training with videoconferencing technology and concerns about privacy; Glueckauf et al., 2018; Pierce et al., 2021) and worrying about how well fundamental therapeutic factors would translate to virtual interactions (e.g., the therapeutic relationship, empathy, and effective communication; Gibson et al., 2011; Knott et al., 2020). Study results published in the Canadian Journal of Behavioural Science corroborate some of these concerns about teletherapy-specific weaknesses but also reveal unexpected benefits that continue to shape teletherapy today (Rumeo et al., 2026).
In the literature on therapist perceptions about teletherapy, limited work has represented Canadian clinicians’ perspectives. Carla Rumeo and colleagues developed a survey examining Canadian therapists’ views of teletherapy during the COVID-19 pandemic. Participants rated their attitudes and described their experiences delivering teletherapy, including comparisons of fostering therapeutic factors in virtual versus in-person therapy. Quantitative results indicated that most participants were skeptical about delivering teletherapy and that conveying empathy and emotional attunement felt more difficult online than in person. In contrast, flexibility emerged as a key strength of teletherapy. Qualitative analysis of written responses (Robinson, 2022) revealed themes related to practical and therapeutic advantages (e.g., convenience and efficiency) and disadvantages (e.g., inadequate technological infrastructure). The most frequent themes were distractions (e.g., pets, children, and partners, as well as the absence of a dedicated therapeutic space) and access to additional information about clients due to an increased willingness to share aspects of their home during virtual sessions.
As teletherapy remains common post-pandemic, it is vital to address inherent limitations of this platform while leveraging its strengths. To reduce distractions, clinicians should encourage clients to disable notifications and attend sessions from private locations where interruptions are unlikely (Burgoyne & Cohn, 2020). Clinicians can also use the additional contextual information available in virtual sessions to better understand clients’ living circumstances and interpersonal dynamics between the client and others in the household. For clients who are initially reluctant to share, therapists can invite them to show an item in their home that holds personal significance and discuss its meaning.
Two additional themes—the loss of reflective time while commuting to and from therapy and the potential for technological disruptions to foster authentic connection—offer further implications for practice. Drawing on these findings, clinicians should recommend that clients establish pre- and post-session rituals to support reflection and emotional processing before resuming their daily activities. When technical issues arise, clinicians are encouraged to respond with humor, light-heartedness, or acknowledging shared frustration, which may strengthen the therapeutic relationship.
As virtual therapy services become embedded within the mental health care system, clinicians must further expand our understanding of how we experience teletherapy and continue to draw on research to enhance the quality of care.