Online therapy can be as private as in-person — or much less so. Seven questions to ask any practice before your first video session.
Bhatta Psychotherapy6 min read
Share only if you are comfortable — general information, not personal medical advice.
Online therapy can be every bit as private as sitting in a consulting room. It can also be considerably less private. The difference does not come down to whether sessions happen over video — it comes down to which tools a practice uses, and how carefully it handles what you tell it.
The difficulty is that you cannot see any of this from the outside. A polished website tells you nothing about where your records are stored. So the practical answer is to ask — and the questions below are the ones worth asking, along with what a solid answer sounds like.
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Almost every therapy website says its sessions are secure. The word is free to use and means nothing specific. It might refer to a purpose-built clinical platform, or to a general video app that happens to encrypt calls, or to nothing much at all.
Specifics are what you want. A practice that has genuinely thought about privacy can describe what it does in concrete terms. One that has not will keep returning to adjectives.
This is the central question. You are asking whether your file lives in a system built for health information, or somewhere more ordinary — an inbox, a spreadsheet, a folder on someone's laptop.
A good answer names a clinical system, mentions encryption both in transit and at rest, and explains that access is limited to the people involved in your care through their own accounts rather than one shared login.
Intake forms are where the most sensitive information is gathered — history, symptoms, sometimes trauma — and often before you have even met anyone. It is worth knowing whether that lands in a clinical system or in a general-purpose form tool.
A good answer distinguishes the two clearly, and explains where intake information sits once you have submitted it.
Some platforms are built for healthcare and carry the contractual protections that go with it. Others are general meeting tools that were designed for business calls and later used for therapy.
A good answer explains what the practice uses and why, without hand-waving. It is also fair to ask whether links are single-use, and whether anyone else could join a session uninvited.
This one deserves a direct yes or no. Recording and automatic transcription both create a second copy of your session — a copy that then has to be stored, protected, and eventually deleted.
A good answer is unambiguous. If sessions are recorded, you should be told where recordings are kept, who can access them, how long they are retained, and whether you can decline.
AI note-writing assistants have become common, and they are not inherently a problem. What matters is whether anything identifying you reaches such a tool, and what that tool does with it afterwards.
A good answer is precise about which information, if any, leaves the practice — and whether it is used to train anything. Vagueness here is worth noticing.
This question gets asked less often than the others, and it is one of the most revealing. An audit trail records each time your record is opened and by whom, which makes access accountable rather than invisible.
A good answer confirms that such a log exists. Many practices have never considered the question at all, and the response tells you how seriously the systems were set up.
Every practice has limits, and a clinician should be able to state them without hesitating: serious risk of harm, a legal requirement, or care coordination you have specifically agreed to.
Be more cautious about a practice that promises absolute confidentiality than one that explains its limits. Absolute confidentiality is not something any clinician can offer.
Also read: How we protect your information →
Privacy is not only the practice's responsibility. A few things are within your control, and they matter more than people expect — particularly if you live with family:
You are not looking for perfection or technical fluency. You are listening for whether someone has thought about this before you asked. A practice that answers in specifics — naming systems, describing access, being straightforward about limits — is showing you how it operates.
And if a question cannot be answered on the spot, being told so honestly, with an answer to follow, is far better than a confident guess.
