Telehealth for psychologists: Better Access, privacy and best practice

Telehealth suits psychology better than almost any other discipline. The work is largely conversational, the therapeutic relationship can be built and maintained over video, and access under Medicare’s Better Access initiative is now a permanent, funded option (Australian Psychological Society). The craft is in doing it as well online as you would in the room.

Here’s how telehealth works for psychologists in Australia, and how to run it well.

How telehealth works in psychology practice

For most psychologists, telehealth means a scheduled video session that runs much like an in-room appointment: assessment, formulation, and evidence-based intervention delivered by conversation, with the screen occasionally used to share a worksheet, a formulation diagram, or a between-session task.

It fits a wide range of presentations — anxiety, depression, trauma-focused work, and ongoing therapy where continuity matters more than physical presence. It also removes real barriers: travel time, time off work, rural distance, and the avoidance that can come with a waiting room. What it doesn’t remove is your clinical judgement about suitability, which stays case-by-case.

Better Access and the Medicare picture

Most rebated psychology sessions in Australia sit under the Better Access initiative, which gives eligible people Medicare rebates for a set number of sessions with a registered psychologist each calendar year, on referral under a GP Mental Health Treatment Plan (or a referral from a psychiatrist or paediatrician) (Department of Health, Disability and Ageing).

Telehealth is a permanent part of this. There are specific Better Access telehealth items for video and phone, paired to the equivalent face-to-face items, and the Department publishes dedicated guidance on how they work (Better Access telehealth FAQ). A few points worth holding in mind:

• Video is the default telehealth mode; phone items exist but are more limited.
• Referral and treatment-plan requirements apply the same way they do for in-person sessions.
• Item numbers, rebates and conditions change with MBS updates, so describe the arrangement to clients in general terms and check the current MBS for the exact item and any conditions before you claim.

Telehealth doesn’t change your obligations under Better Access — the referral, the plan and the standard of care are the same. It changes how the session is delivered, not what makes it a valid, rebatable service.

Privacy, security and choosing a platform

Confidentiality is central to psychological practice, and it extends to the tool you use. The APS advises that psychologists take reasonable steps to ensure the technology is secure, with data transferred securely end-to-end using appropriate protocols, and that platforms comply with the Australian Privacy Principles under the Privacy Act (Australian Psychological Society).

In practice that means a purpose-built telehealth platform rather than a consumer video app, and it means paying attention to where data is handled and whether sessions are recorded by default. For the client-facing version of this, our guide on whether telehealth is private and secure is a useful thing to share.

Making video sessions work clinically

Video strips out some of the cues you rely on, so compensate deliberately:

• Protect the frame. Look at the camera when you speak, keep your face well lit, and use a headset so audio stays private on your end.
• Confirm the client’s environment. Ask whether they’re somewhere private and won’t be overheard — this directly affects what they’ll disclose. A client taking the session from a car or a shared house needs a different plan.
• Plan for risk. Confirm the client’s location at the start of each session and keep an emergency contact and local service details on hand. Knowing where the client physically is matters if you ever need to escalate.
• Use the tools you have. Screen sharing for psychoeducation, formulation and homework keeps sessions active and collaborative.
• Watch the alliance. Check in more often than you might in person about how the format is working for the client, and be willing to move to face-to-face where it would serve the work better.

Our broader guide to running a great telehealth consultation covers webside manner and safety-netting in more depth.

When to keep it face-to-face

Telehealth widens access, but it isn’t right for every client or every moment. Reserve or revert to in-person care when:

• Risk is elevated. Acute suicidality, or a client you can’t adequately assess or keep safe remotely, is better seen in person or directed to emergency services.
• There’s no private, safe space. A client who can’t speak freely — because of who they live with, or where they have to take the call — may not be able to do the work by video.
• The assessment demands it. Some structured or cognitive assessments need controlled, standardised conditions that are hard to reproduce on screen.
• Rapport isn’t forming. For some clients, particularly early in therapy, a first in-person session builds an alliance that video can then sustain well.

Making this call explicitly — and documenting it — is part of practising to the same standard online as in the room.

Where MedCall fits

The biggest practical risk to a telehealth session is the client who can’t get connected — and for a first appointment, fifteen minutes lost to a failed app install sets the wrong tone entirely. MedCall is built to remove that friction: it’s made for Australian clinicians, and the client joins a 1:1 video call by tapping a link you text them — no app, no account, no download.

Calls are Australian-hosted and never recorded, and 1:1 video is end-to-end encrypted, which lines up neatly with the privacy expectations the APS sets out. Your bookings, notes and billing stay in the practice software you already use; MedCall just handles the video. It’s a good fit for solo psychologists and group practices alike.

The bottom line

Telehealth is a natural fit for psychology and a permanent part of Better Access — but the fundamentals still decide the outcome. Confirm suitability case-by-case, meet the same referral and treatment-plan requirements as in-person care, choose a secure and private platform, and adapt your technique for the screen. Keep the technology invisible to the client and the therapeutic work stays front and centre. For the current rules, start with the Better Access initiative and the APS guidance on choosing videoconferencing technology.