These days it's fairly easy and inexpensive to set up a telehealth-based mental health practice. All you need is a private space at your home, a secure internet connection and some basic hardware, and you're open for business.

It's not quite that simple, of course. You still need to comply with business paperwork requirements (federal, state, local), arrange for insurance, and set up your accounting and billing systems, if you don't already have them in place.

Getting clients can be a challenge, especially at the beginning.

Also, some colleagues have reported that their home-based telehealth practice is not quite what they expected.


Here are 5 common mis-assumptions about telehealth practice:


1. If you build it they will come

FACT: In order to get clients, they need to know about you. Unlike a brick-and-mortar street-side business, people won't randomly walk by your website and see your sign.

Thus, you need to develop a marketing plan to reach the types of people who need, want, and are willing to pay for your services. Carrying out the plan requires time and sustained effort.

2. An online practice requires only online marketing

FACT: While your service delivery is online, people will be more apt to trust you and hire you if they meet you in person, or if they are referred by someone who knows you personally.

Online marketing is important. Devote some time to building your online presence via blogging, social media, podcasting, etc. Keep in mind, however, that people's attention span online is just a few seconds.

Thus, it's also important to market yourself offline, such as networking at community events and giving talks to local community groups. In person, you have a much better chance of connecting with prospective clients and referral sources.

3. Working online from home is much easier than working in person with clients in an office

FACT: In some ways, it is easier and more convenient. No need to get yourself out the door and travel to a physical office. You can probably get away without showering every day, and you just need to look business-like from the waist up.

However, you also have to deal with Zoom fatigue. Working with clients through a screen interface is more taxing than in person. You are more aware of needing to control your fidgeting, to maintain eye gaze at an uncomfortably close distance, and to disregard your own image on the screen. It also takes more effort to pay attention to your client's body language and other cues.

Contributing further to Zoom fatigue is the lack of a natural break between clients as in an office setting, when you would normally get up out of your chair, and walk one person out and welcome the next person in.

Sitting at your screen, there is no natural incentive to get up between appointments. Thus, it's important to include such activity as part of your self-care. Intentionally moving between appointments is not only good for your body, it also helps clear your head so that you can be more alert and attuned to your next client.


4. A telehealth practice allows for more flexibility in my schedule

FACT: Yes, it is possible to schedule clients around gym time, chores, errands, and other activities. That is also the case if you see clients in person. As your own boss, you can take time off whenever you choose.

But it is more convenient, when you're working from home, to do things like laundry or shopping between client appointments. The downside is that it's tempting to use these activities as an excuse to put off (sometimes indefinitely) important administrative and practice development tasks. As a result, you could miss out on business opportunities.

Unless you have strong self-discipline, it's probably best to save chores for non-work time, or to hire someone to do them for you.


5. A telehealth-only practice allows for more time with my family

FACT: While you are in close physical proximity to your children or other family members at home, it doesn't necessarily mean that you are always available to them.

For example, between client appointments, if you get up to briefly walk around or to go to the bathroom, other family members may assume you are free and want to talk to you or ask you to do something for them. Or your toddler may be loudly complaining about not wanting to take a nap. After responding to them, it can sometimes be difficult to quickly switch back to your professional role with the next client and not be distracted by thoughts of family issues.

Also, it may seem like an advantage to have no commute time between work and home, thus leaving more time for evening activities with your family. However, people who do commute to work often use that time to unwind on their way home, so that by the time they arrive they feel more relaxed and less distracted.

If you find yourself feeling irritable or inattentive at the end of your work day, take a few minutes alone to unwind, whether it's deep breathing, meditation, a brief walk up the street, or whatever helps you to feel calm.


In summary...

A telehealth-only practice is easy and inexpensive to set up. Plus, it offers some flexibility and convenience. But there are also some potential downsides that you didn't anticipate.

Simply being aware of them is the first step to gaining control over your time and your career.