What Is Blended Therapy & Counseling? 3 Treatment Examples

blended therapy

As society moves ever more readily towards online service, we are finding more novel and creative ways to deliver that service. It used to be a pipe dream that we could actually speak with another person around the world in real-time, let alone send a high-quality picture or video around the world in an instant. Now we can video chat with our friends and family with a clear feed and zero delays.

As our technology moves forward—sometimes by leaps and bounds—we are finding that more and more can be done online. Recently, that includes some aspects of our health care and even our mental health care.

In this article, we explore the world of blended counseling and how practitioners are using blended therapy to support and treat those they help.

What Is Blended Therapy & Counseling?

Traditionally, mental health care has been provided via in-person visits to a doctor or other provider, whether that’s a psychiatrist, a Marriage and Family Therapist, a counselor, or any of dozens of other career paths and specialties.

The stereotypical example involves the patient lying on a couch and discussing their dreams while a serious-looking psychologist takes notes.

Just as recent advances in the therapeutic process have moved away from the “patient on a couch talking about their dreams” model, recent advances in communications technology have changed the landscape as well.

It’s now far easier for people to connect via digital methods, and mental health care providers are finding that a lot of the work they do can be done over video chat or telephone calls.

Blended Counseling: A Definition

Blended therapy, also known as blended care or blended counseling, is a combination of in-person and online components to create a dynamic treatment plan that works for both patient and provider. It’s not necessarily all online, it can be any treatment plan that incorporates some remote activity.

Basically, blended therapy is what happens when a patient or client spends at least some of their time working with the provider via a remote format, whether that’s with their smartphone, tablet, or laptop.

Blended therapy, also known as blended care or blended counseling, is a combination of in-person and online components to create a dynamic treatment plan that works for both patient and provider.

According to researchers, blended therapy can facilitate “longer exposure to therapy in a cost-effective and accessible format.”[1] It enables a lower time commitment for clinicians, less travel time for patients, increased access to content, and lower overall costs.

The evidence is still coming in, but so far it looks like blended therapy works just as well as traditional, face-to-face therapy. A recent study showed that video blended care was highly effective at reducing the symptoms of depression and anxiety from a distance.[2] For some clients, the freedom of being able to choose when, where, and how to complete their “homework” may have contributed to even more positive outcomes.[3]

While it may be important in some cases to unite provider and patient in the same physical location, for many patients, the ease and convenience of blended counseling can more than make up for the loss of face-to-face interaction.

How Does It Look?

Of course, most blended care still involves face-to-face interaction—it’s just via video chat instead of in-person.

Blended care will generally include at least some in-person interaction, whether that’s just to fill out some initial counseling forms, to meet for the initial intake, or for a portion of the regular sessions.

After that, the format of the treatment will take shape based on the provider’s and the client’s unique needs.

Tools for Blended Therapy

Providers may use any or all of the following counseling tools in their working relationship with their client:

  • Emails
  • Messaging on a secure portal
  • Shared online notepad
  • Links to helpful resources online
  • Sharing documents via email, messaging, or online files
  • Telephone calls or online voice calls
  • Pre-recorded video messages, or
  • Video chats

Some providers will opt for video chats for every session, whereas others may prefer a phone call for simple check-ins. Providers might instruct their client to complete online exercises after their session or to take notes in a shared document.

Others may record themselves giving messages or instructions and upload them for their clients to review when they have time.

Quenza Blended Counseling Tools
Quenza Expansions, like the pictured Wheel of Needs, are blended counseling exercises that you can customize and send to clients as part of treatment.

This form of care is new, so there is no real “typical” blended counseling arrangement yet.

Providers and clients can work together to come up with a schedule and treatment plan that works for them, giving both providers and clients more freedom and flexibility than ever before.

9 Practical Tools for Your Blended Care Practice

Luckily, there are many tools and resources available to help providers take advantage of the many benefits blended therapy has to offer. There are countless platforms, software solutions, apps, and tools that can be used to facilitate communication and enhance treatment effectiveness.

Here are a few examples of tools you may be able to use in your own blended care practice:

Therapist Aid

TherapistAid Blended Counseling

Online library of resources
  • Worksheets
  • Interactive tool
  • Guides
  • Videos
  • Articles
  • Other products
Psychology Tools

Psychology Tools Blended Counseling

Online library of resources
  • Resources organized by problem, therapy type, technique, and mechanism
  • Ability to send resources from the website
  • Includes editable/customizable resources and fillable PDF documents
  • Over 280 evidence-based worksheets, handouts, exercises, ebooks, and audio resources
  • Articles, tools, and other resources for the provider to learn and get inspiration

TheraNest Blended Counseling

One-stop-shop for tools and resources
  • Ability to create therapy and mental health progress notes, initial assessment, and treatment plans
  • Store and manage client charts electronically
  • Download or print notes into a PDF file with your own logo
  • Managed billing
  • Scheduling software
  • Client portal for your clients to find everything they need all in one place
  • Manage prescriptions and monitor adherence
  • Analytics and reporting for your practice

Quenza Blended Counseling


E-therapy and coaching platform
  • Ability to design and share custom counseling interventions
  • Care pathway tools for designing treatment plans
  • Automated reminders and notifications
  • Secure, HIPAA-compliant patient data storage and progress tracking
  • Multimedia uploads for video therapy and video coaching
  • User-friendly interface for clients and practitioners
  • Android and Apple mobile apps

Doxyme Blended Counseling

Telemedicine platform
  • Online videoconferencing platform
  • Free to use
  • No download required; accessible from any browser-enabled device
  • Includes a free Business Associate Agreement (BAA) with sign-up

Theralink Blended Counseling

Telemedicine platform
  • Videoconferencing
  • HIPAA compliant
  • Includes a BAA
  • Scheduling, appointment reminders, and client self-scheduling
  • Accept client payment
  • Group or family sessions
  • Secure messaging
  • Secure session/client notes
  • Share files securely
  • Custom waiting room
  • Accessible from any browser-enabled device
Simple Practice

Simple Practice Blended Counseling

Practice management software
  • HIPAA-compliant video appointments, including screen-sharing
  • Client portal for secure communication
  • Scheduling and reminders
  • Intake forms and documentation all in one place
  • Billing and payment processing
  • Insurance claim filing
  • Mobile app
  • Library of free resources

VSee Blended Counseling

Telemedicine platform
  • HIPAA-compliant video conferencing
  • Secure messaging
  • File-sharing between provider and client
  • Share and collect intake documents, consent forms, etc.
  • Online payments
  • Self-scheduling
  • Virtual waiting room

Acuity Blended Counseling

Scheduling tool
  • Customized scheduling page
  • Real-time availability updates
  • Client self-scheduling
  • Automated reminders
  • Collect intake forms at the time of booking

Blended Treatment: 3 Practical Examples

It seems that blended care can be a really effective alternative to traditional therapy, but you might be wondering how it actually looks in practice. It’s a new concept that’s being tested as we speak, so there is no set treatment regimen or strict guidelines to adhere to.

However, there are some practical examples you can sample to get inspiration for creating your own blended care treatment plans.

1:1 Ratio

For instance, a study on blended Cognitive Behavioral Therapy (CBT) treatment for individuals with depression discovered that this protocol was an effective one:

  1. Treatment starts with an in-person session in order to establish a functional and friendly therapeutic relationship and engage patients in therapy.
  2. Half of the future sessions are in-person and half are online.
  3. In-person sessions are centered on adapting the treatment content to the client’s individual needs, while online sessions are focused on offering background information, recording mood ratings, and providing homework exercises.
  4. The treatment plan is structured beforehand, ensuring delivery of the full CBT protocol.
  5. Online sessions include an optional, open-ended session evaluation at the end.
  6. Email reminders are used to encourage adherence.
  7. Online therapist feedback is provided after each session in order to monitor and motivate patients in between sessions.[4]

This is on the stricter side of treatment plans, but it may be your best option if you provide care in a structured format like CBT.

Purely Digital

Another option is to go fully online and work through an online therapy website. Clinical psychologist Nina Barlevy does that with Better Help; she says she:

  • Generally uses a secure messaging platform to work with her clients.
  • Occasionally schedules live video and phone sessions with clients who wish to use them.[5]

This option provides maximum flexibility for both client and provider, although at the potential cost of building a more connected and close therapeutic relationship.

On a Needs-Basis

A third option, one that is becoming more popular in a world that is increasingly concerned about spreading germs, is to:

  1. Start with one in-person office visit to establish a relationship, fill out forms, and build a foundation for treatment.
  2. Schedule all future sessions for an online format, whether that’s video chat, phone calls, or both.
  3. Occasionally meet in-person when absolutely necessary.

There are tons of different possibilities for your practice in this new, digital world. If none of these examples work well for you, the good news is that you can create your own unique formula to offer your clients—one that suits your dynamic needs.

Final Thoughts

As blended care continues to increase in popularity, it’s absolutely essential to start considering your changing needs. Take some time to research the many different telecounseling tools and resources that can help you deliver your services to those who need them, and you will be ahead of the curve.

We hope you’ve enjoyed exploring the world of blended therapy in this article. To turn your knowledge into tangible mental health gains for your clients, don’t forget to try Quenza’s blended counseling tools yourself with your one-month, $1 trial. Our software will give you all the functions and tools you need to deliver high-caliber therapy online today, helping you enhance the mental health of those you work with.


  1. ^ Fitzpatrick, M., Nedeljkovic, M., Abbott, J., Kyrios, M., & Moulding, R. (2018). “Blended” therapy: The development and pilot evaluation of an internet-facilitated cognitive behavioral intervention to supplement face-to-face therapy for hoarding disorder. Internet Interventions, 21(12), 16.
  2. ^ Lungu, A., Jun, J. J., Azarmanesh, O., Leykin, Y., & Chen, C. E. (2020). Blended care-cognitive behavioral therapy for depression and anxiety in real-world settings: Pragmatic retrospective study. Journal of Medical Internet Research, 22(7), e18723.
  3. ^ Wilhelmsen et al. (2013). Motivation to persist with internet-based cognitive behavioural treatment using blended care: A qualitative study. BMC Psychiatry, 13, 296.
  4. ^ Kooistra et al. (2016). Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care. Internet Interventions, 4, 61.
  5. ^ Novotney, A. (2017). A growing wave of online therapy. Monitor on Psychology, 48(2), 48. Retrieved from https://www.apa.org/monitor/2017/02/online-therapy

About the author

Courtney is currently working as a healthcare workforce researcher for the state of California and is a regular contributor to the Quenza blog. She has a passion for taking research findings and translating them into concise, actionable packages of information that anyone can understand and implement.

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