None of this is ideal, of course. No doubt it would be better if my clients and I were able to meet in my office week after week, me inviting them in from my waiting room at the beginning of each session and ushering them out through the exit door at the end. But for people who live in remote locations where qualified professional help is scarce or entirely unavailable, connecting with a therapist by Skype is often the best option. Over the last few years, I’ve worked with an American expat living in Japan, a Ukrainian émigré in Israel, and the scion of a wealthy family in Egypt. I’ve held Skype sessions with people located in remote corners of the United States, England, Australia, and other countries. They had few options for getting the help they needed.

Consider the situation of the American expat in Japan. Given where he lived, he wasn’t able to find a therapist able to understand not only his language, but his cultural values and attitudes as well. Immersed in a foreign culture, expats often struggle to adapt; they may feel anxious, alienated, and depressed. People forced to move when a spouse is transferred to a foreign country, with no job and only the expat community for support, may have an especially hard time. They often search in vain for a local therapist to help, particularly in countries where psychotherapy is undeveloped as a profession.

My colleague Anastasia Gire—a Russian émigré married to a Frenchman and currently living in Madrid—specializes in addressing the particular psychological needs of expats. Fluent in Russian, English, French, and Italian, she works by Skype with a diverse group of clients whose jobs (or their spouses’) carry them far away from their home countries. If you were a Russian speaker married to a Spaniard whose company transferred him to Dubai, what are your chances of finding a compatible in-person therapist?

For some people who choose a distance therapist, convenience is often an issue. Ever since Freud invented talk therapy more than a century ago, driving or taking public transport to your therapist’s office has been a time-consuming part of the experience. You must fight traffic or brave the subway to get there. In order to make sure you don’t arrive late, you need to allow time for unexpected delays. After the session is over, you waste more time traveling home or getting back to work.

With the advent of Skype therapy, clients don’t have to allot more that 45 or 50 minutes for their sessions. I’ve worked with a number of busy professionals living in New York, Zurich, and London where there is no shortage of qualified therapists. All of these clients came to me after following my blog, After Psychotherapy, but convenience probably factored into their decisions, too. Many of them also travel as part of their job; in the pre-Internet days, this would have meant lots of missed sessions. Now they take me along on their business trips.