Client centered therapy for telehealth

Client-centered therapy has been transforming lives since Carl Rogers first introduced the concept in the 1940s — and it’s just as relevant today in the world of telehealth.

As therapy increasingly moves online, many clinicians are rediscovering Rogers’ core principles of empathy, unconditional positive regard, and genuineness as powerful tools for building authentic connections through a screen. In this post, we’ll explore how to bring client-centered therapy to life in a virtual setting and maintain the warmth and trust that define this timeless approach.

Summary

• Client-centered therapy translates effectively to telehealth when clinicians intentionally maintain empathy, genuineness, and unconditional positive regard in the virtual setting.

• Teletherapy empowers clients by allowing them to attend sessions from familiar environments and have greater control over their treatment experience. Enrolling in a teletherapy course for therapists can help providers enhance their knowledge.

• Therapists must adjust communication styles online, using tools like open-ended questions, reflective listening, and slightly exaggerated non-verbal cues to convey presence and understanding.

• Secure technology, strong connectivity, and thoughtful setup play key roles in building rapport and ensuring the success of person-centered therapy delivered virtually. Using EHR systems with integrated teletherapy tools, such as TheraPlatform, can help therapists conduct engaging teletherapy sessions and streamline admin tasks.

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Both therapeutic orientations viewed the therapist as an expert who should remain distant and unknowable to the client. Rogers, in contrast, believed that clients should be considered the experts of their own lives and that therapists should convey empathy and a positive perspective.

In these divisive times, we need Rogers' humanistic approach more than ever. Just as Rogers revolutionized psychotherapy, telehealth is transforming the delivery of mental health services.

Gone are the days when clients need to trudge to a physical office to obtain therapy. Now, they can seek therapeutic resources on their phone. But does the person-centered therapy approach translate to telehealth? Let's investigate.

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Foundations of Rogers' humanistic approach

These principles form the bedrock of Rogers' person-centered theory:

The client is the expert

Rogers believed that people were intrinsically motivated to achieve self-actualization, or the realization of their full potential. As such, he thought the client, not the therapist, should lead the therapeutic process.

This flew in the face of both psychoanalysis and behaviorism, which rely on the therapists to guide the process of therapeutic change.

In Rogers' seminal work, On Becoming a Person, he argued for a client-led approach to therapy: "It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried."

Empathic understanding

Utilizing empathic understanding, the therapist seeks to understand the client's inner experience and unique perspective on the world. By actively listening and reflecting on what the client says, the therapist helps the client feel heard and validated.

The focus on the client's subjective understanding of themselves and their world was a significant departure from psychoanalysis, with its emphasis on the unconscious, and behaviorism, which focused on the external rather than the internal environment.

Genuineness

Genuineness, or congruence, refers to the therapist being seen as their genuine self. The therapist seeks to be open and honest, hoping this encourages the client to express their true nature.

Rogers believed that only when a person's ideal and genuine selves aligned (i.e., congruence) could they achieve optimal functioning. Of course, therapists displaying their authentic selves was unheard of at the time.

Psychoanalysts were taught to be a "blank slate" for their patients, and behaviorists did not feel it necessary to reveal their inner selves.

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Unconditional positive regard

The therapist aims to treat the client with unconditional positive regard. This means they are non-judgmental and display support and affirmation.

As a result, the client feels safe, validated, and accepted. In contrast, psychoanalytic and behavioral therapists are taught to remain neutral.

The rise of telehealth

Before the COVID-19 epidemic, a minority of therapists dabbled in teletherapy, but the coronavirus caused telemental health to explode. At the height of the epidemic, almost all therapists incorporated teletherapy into their practice.

Since it ended, approximately 89 percent of psychologists still practice either remotely or in a hybrid model. While the benefits of teletherapy are numerous, one ongoing concern has been whether the quality of the therapeutic relationship can be maintained online.

This is especially relevant for person-centered therapy, which relies heavily upon therapist-client rapport.

Let's explore ways to implement telemental health without sacrificing the effectiveness of Roger's humanistic approach through client-centered therapy techniques.

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How to apply client-centered therapy techniques to telehealth

Therapists should consider the following elements when virtually adapting the principles of client-centered therapy techniques over a secure telehealth platform:

The client is the expert of their teletherapy

Teletherapy, by its very nature, puts treatment in the client's hands. Instead of being intimidated by traveling to the therapist's office, the client can receive therapy when and where they want.

This can be an empowering experience when compared to traditional psychotherapy. Additionally, therapists must take steps to ensure that the client understands they are in control of their therapy process. Here is how:

Practical tips for client centered therapy techniques

• Make sure the client is comfortable with the relevant teletherapy tools. It is hard to feel like an expert in your own treatment if you don't know how to operate the technology.

• Let the client take the lead in developing their treatment plan. Have them write down their goals and submit them through your practice management software or Google Docs.

• Use open-ended questions to ensure that clients feel their responses are not being guided toward a certain answer.

• Use reflective listening to show that you are hearing the client as they intended.

Therapist self-check question: Am I offering too much guidance or advice?

Empathic understanding online

One of the criticisms of telemental health is that it is more difficult to express empathy and other feelings online.

In person, therapists can use nonverbal cues to help convey to the client that they understand their world. In a virtual setting, expressing sentiment through body language may be limited. The following suggestions may help:

Practical empathetic understanding tips for client-centered therapy

• Encourage the client to express themselves. This shows them that you want to hear and understand what they have to say. The therapist can use verbal communication, such as saying "tell me more", or non-verbal means, such as a head nod. Just because you are performing a virtual session doesn't mean that all non-verbal cues are ineffective. The client can still see your head and shoulders. Use them to your advantage.

• Employ a warm and inviting tone. People associate empathy with a kind, comforting voice. If you talk like a robot, people will think you don't care.

• Ensure you have a strong wifi connection and use a reliable teleconferencing platform. A clear connection is necessary for the client to see what emotions you are expressing with your face and to hear the tone of your voice. Also, it is hard to establish empathy if you lose your connection in the middle of a session.

• Utilize clarification and paraphrasing. Clarifying what a client says shows them that you want to understand what they are saying. For example, "Did you mean to say…?" Paraphrasing, on the other hand, shows them that you are hearing them accurately.

Therapist self-check question(s): What is the client trying to express? Do I understand their point of view?

Virtual genuineness

The client will only feel comfortable being their genuine self if they can trust their therapist. Establishing trust online may seem like a difficult task. Here are some things you can do:

Practical virtual genuineness tips for client centered therapy

• Present an inviting visual background. It should be clean, uncluttered, and free from distraction. A few personal items can help the client feel that they know you better.

• Make eye contact, lean forward, and don't cross your arms. These are body language cues that express interest and openness. Pro tip: To maintain eye contact, look directly at the camera lens rather than at the person on the screen.

• Slightly exaggerate your facial expressions. It can be more challenging to detect visual cues online. A slight overemphasis on your body language can make a big difference.

• Be authentic but don't overshare. Being genuine does not mean you sacrifice professional boundaries.

Therapist self-check question: Am I exhibiting my authentic self?

Expressing unconditional positive regard online

One advantage of a physical office is that clients learn to associate it with caring and positivity. Creating a similar judgment-free space in the metaverse is more challenging. Here are several suggestions:

Practical therapist tips

• Use affirmations. Affirmations touch upon a client's positive characteristics and behavior. For example, you might say, "I believe that you handled that situation as well as possible". Just make sure it comes from an honest place. You don't want to jeopardize any feelings of genuineness.

• Avoid judgment words. Certain words are loaded with judgment. When you use "should", "supposed to", and "ought", you are implying that there is a right way to do things.

• Be aware of voice inflections. We express numerous opinions through our voice. When you disagree with someone, it is common for your voice to change slightly. Keep your voice as even as possible.

• Accept and validate. You may not agree with everything your client is saying, but you can accept that it is their experience and validate their feelings. The aforementioned head nod is an effective way to display encouragement, validation, and positivity in a virtual environment.

Therapist self-check question(s): Have I accepted their feelings and behavior? Am I expressing my internal judgment?

The relevance of person-centered therapy for telemental health

Person-centered therapy has never been more essential. In the current turbulent and negative environment, a dose of judgment-free positivity benefits everyone. Additionally, the primary tenets of Rogers' theory, including positive regard and genuineness, have been linked to beneficial client outcomes. The advent of teletherapy certainly presents a few challenges, but it is clear that, with a bit of tweaking, person-centered therapy can be delivered effectively in a virtual setting.

Choosing the best HIPAA-compliant platform

Telehealth use has skyrocketed since the pandemic, with teletherapy emerging as a trusted, convenient, and secure alternative to in-person care for both children and adults. Therapists and clients report high satisfaction, and teletherapy now accounts for 13–17% of U.S. healthcare visits.

To protect privacy, providers must use HIPAA-compliant video platforms. The top platforms not only secure sessions with encryption but also support scheduling, billing, documentation, and client portals to streamline practice management.

The best teletherapy platforms go beyond video conferencing. By combining compliance, reliability, stable video, resources, games and practice management tools, they help therapists deliver care that’s safe, effective, and adaptable to modern client needs.

Marketing is also another aspect of owning a practice that can be conducted through secure through a HIPAA-compliant platform as you can communicate with existing clients via chat, email and more.

Why therapists choose TheraPlatform as their teletherapy platform

Whether for solo practice or larger clinics, therapists choose TheraPlatform for its blend of usability, flexibility, and robust telehealth tools.

Here are top reasons why therapists choose TheraPlatform for teletherapy:

• Efficiency and convenience: Everything down to payments, scheduling, documentation, and insurance claims is managed in one integrated platform, saving time and reducing friction.
• Security and compliance: TheraPlatform is fully HIPAA and PIPEDA compliant, with encrypted video sessions, secure data storage, and 24/7 monitoring for peace of mind.
• Engagement tools: Built-in interactive features like whiteboards, games, media sharing, screen annotation, and therapy-specific “apps” enhance client engagement especially useful in pediatric and speech therapy.
• Client-centered functionality: The secure client portal empowers clients to book sessions, complete forms, submit documents, and make payments, reducing admin work for the therapist.
• Customization and flexibility: Therapists can create and customize templates for notes, treatment plans, and intake forms allowing them to tailor workflows to their practice style.
• All-in-one practice management: Combines telehealth, EHR, billing, insurance, scheduling, and documentation, eliminating the need for multiple tools or software.
• Therapy-specific design: Unlike generic telehealth platforms, TheraPlatform is purpose-built for mental health, speech therapy, OT, PT, and more with features tailored to each specialty.
• Professional credibility: Recording features, branded portals, and compliance tools help therapists present a more professional, trustworthy experience to clients.
• Positive user experience: Therapists appreciate having everything in one place and often report a smoother workflow, fewer tech issues, and faster onboarding.

What therapists are saying about TheraPlatform

Therapists praise TheraPlatform for its ease of use, seamless scheduling, and built-in billing tools like superbills. They value the platform’s features including intuitive charting, customizable notes, and interactive telehealth tools as well as the responsive support team, which listens to feedback and implements updates.

Many highlight that the platform offers the best of all worlds, combining excellent video conferencing with resource sharing and an engaging, client-centered teletherapy experience.

"There's seriously no better platform out there! Easy to use … syncs to your personal schedule, provides superbills …"- Jacqueline S. (Source)

“It is not just the platform, it is the team behind TheraPlatform, always willing to help and receptive to feedback to bring updates requests to live,” Orly, Smarty Therapy PC (Source)

"The video conferencing is excellent and the ability to share resources and the interactive screen make Telehealth a rich experience."- Kathy J. (Source)

"TheraPlatform has been the best of all worlds! … intuitive charting, in-system billing, customizable notes …"-Kendrah B. (Source)

Streamline your practice with One EHR

• Scheduling
• Flexible notes
• Template library
• Billing & payments

• Insurance claims
• Client portal
• Telehealth
• E-fax

Learn More

Resources

Theraplatform is an all-in-one EHR, practice management and teletherapy solution with AI-powered note taking features that allows you to focus more on patient care. With a 30-day free trial, you have the opportunity to experience Theraplatform for yourself with no credit card required. Cancel anytime. They also support different industries including mental and behavioral health therapists in group practices and solo practices.

More resources

• Top-to-bottom approach to launching teletherapy on-demand video academy
• Teletherapy worksheets
• Teletherapy blog

References

Braillon, A., & Taiebi, F. (2020). Practicing "Reflective listening" is a mandatory prerequisite for empathy. Patient education and counseling, 103(9), 1866–1867. https://doi.org/10.1016/j.pec.2020.03.024

Farber, B. A., Suzuki, J. Y., & Lynch, D. A. (2018). Positive regard and psychotherapy outcome: A meta-analytic review. Psychotherapy, 55(4), 411–423. https://doi.org/10.1037/pst0000171

Kolden, G. G., Wang, C.-C., Austin, S. B., Chang, Y., & Klein, M. H. (2018). Congruence/genuineness: A meta-analysis. Psychotherapy, 55(4), 424–433. https://doi.org/10.1037/pst0000162

Page, C., Stamm, K., & Assefa, M. (2024, September 1). Telehealth and hybrid practice are here to stay. Monitor on Psychology, 55(6). https://www.apa.org/monitor/2024/09/telehealth-hybrid-practice

Rogers CR. On Becoming a Person, A Therapist's View of Psychotherapy. Houghton Mifflin; 1961. https://www.academia.edu/20184763/Rogers_Carl_1961_On_Becoming_a_Person