Telehealth: 3 MISTAKES To Avoid And How to Fix Them

Because of the pandemic, many people are much more comfortable with telehealth.

The problem is most therapists lack the technical know-how when it comes to providing telehealth counseling that looks good, sounds great, and is free from technical interruptions. 

Telehealth can’t replace in-person sessions, but we can try to recreate them so your clients can have a positive telehealth experience and will want to keep scheduling with you! 

So, if you want to provide the best telehealth experience for your clients, here are three mistakes you want to avoid and how to fix them. 

And, if you read till the end, you’ll find a bonus tip to level up your telehealth sessions. 

Mistake #1. Avoid Poor Video Angles. 

Whenever you meet with a client in-person you’re probably sitting on chairs and couches that keep you at eye level

The same should apply to video telehealth.  You want to have your camera at eye level. 

Too low and your client will be staring up at your nose creating this “I’m above you” affect. 

Poor Camera Angles: 

Also, If the camera is too high, then you have a security camera look which isn’t good either. 

Here’s a trick that videographers and photographers use:  it’s called the rule of thirds

Here is how to “frame” a shot using the rule of thirds principle. 

The subject’s eyes should be on the top line of this grid

This produces a natural looking feel to the picture. 

Rule of Thirds

Now, how do you respond when there’s a poorly framed image? 

You subconsciously feel something about this picture doesn’t feel right.  It might even make you feel uncomfortable.  

Poorly Framed

So, if you can keep your camera at eye-level and place it in the middle, upper 3rd of your frame (like this image) your client will have a better telehealth experience. 

A quick bonus tipIf you’re using a computer camera that’s on the top of your computer, Have your video application as close to the camera as you can

That way when you look at your client, your eyes are pointed towards the camera so it looks like you’re providing eye contact.  

But you might say, “Well, that’s a good idea Brent, but I have a laptop and I sit at my kitchen table.” 

Good point.  Just get some of those big thick counseling and medical books you have and stack them up to raise your laptop up to eye level. 

Or buy one of these laptop lifters

If you don’t do this, your client will not experience positive eye contact with you and it will make them feel like you don’t care. 

Even though you ARE looking at them through the video, they are not seeing your eyes on the other end. 

So keep your video application window up towards your camera so you can make better eye contact. 

When it comes to video remember these two things:

1) Keep your face & eyes on the top third of your screen

2) Put your telehealth application towards the top of your screen to make good eye contact. 

Mistake #2. Avoid Dim Lighting. 

Lighting is so important! 

Imagine if a client was to walk into your office and you had the room almost completely dark, that would really throw them off. 

So here are two crucial things you need to avoid when it comes to lighting: 

1. Don’t have your telehealth appointments in a poorly lit room. 

2. Don’t have a major light source behind you.

Okay, let’s take the first one: Don’t have your appointments in a dark room. 

Why?  Your client should be able to clearly see you. 

It’s important for clients to see your eyes and body language. 

The first thing you need to do, if possible, is to sit in front of a window or in a room where there’s a lot of natural light.  

If you’re in a darker room bring a lamp over to your desk.

Just get light closer to your face. Don’t let the only thing lighting your face be your computer screen.

One of my clients has a window in her office but it doesn’t provide enough light so she bought a desk light something like this, to provide a little more light so her telehealth clients could clearly see her. 

The second lighting mistake to avoid, and I see this ALL the time, is when someone has a major light source (like a window or lamp) behind them instead of in front of them

This creates what I call, the “Witness protection” video effect. 

For example, I’m going to turn off my main light source, that’s hitting me in the face, and see what happens. 

I go dark and you can’t see my face. You just see a silhouette. Don’t do this to your clients. 

Don’t have your main light source behind you, but in front of you. 

Always have the stronger light source coming at you and hitting your face, NOT from behind. 

Before we go on, if this post has been helpful, could you share it? 

I’m also providing a free telehealth checklist for you to DOWNLOAD, print out, and keep by your computer to make sure you’re ready to provide an amazing telehealth experience for your client. 

Mistake #3. Avoid Bad Audio.  

If I were to qualify the components of what makes quality video it would be this: 25% video resolution, 25% lighting, and 50% would be audio

People can tolerate bad video quality, but they will absolutely not tolerate bad audio. 

This is why you need to prioritize audio in your telehealth sessions. 

Even if you have a terrible video quality, or no video at all, you need to have clear audio. 

If you were going to make one investment it should be in making your audio sound better.  

My first quick tip is always wear headphones.  No matter what, wear headphones. 

Headphones will eliminate any feedback loops created by your computer microphone picking up audio coming from computer speakers. 

AND, using headphones will eliminate the risk of someone else overhearing your telehealth session.

So at a minimum, always wear headphones. 

You can use the ones that came with your cell phone, use bluetooth headphones, or even high-end noise canceling headphones. 

Always wear headphones. It will make a massive difference in your telehealth sessions. 

Now, if you’d like to go a bit further in providing a better audio experience would be to use an external microphone that you can get close to your mouth. 

You’ll see a lot of podcasters and radio folks use these mics. 

The good news is that great microphones are really affordable

So, for example, you can start with headphones that have a microphone attached to them.

Now, you might look like a call support agent, but you’ll have a much clearer sound coming from one of these mics because it’s closer to the audio source which is your mouth. 


This MPOW is a cheap one and it starts to hurt my ears after wearing it for a while but it gets the job done. 

If you plan to do a lot of telehealth sessions, buy a better quality headset microphone.  

If you have bluetooth headphones or AirPods, go ahead and use those. 

You should be able to connect them to your computer and use them as a microphone source as well. 

The other thing you can do if your headphones don’t have a built-in microphone is purchase a USB microphone anywhere from $99-$200 and you will improve your audio 10x.  

I’d recommend these two mics that you can easily plug into your computer’s USB port:  The Audio Technica – ATR2100x-USB and the Rode NT-USB Mini Condenser Microphone

They sound amazing, are inexpensive for the quality you get, and will level up your client’s telehealth experience. 

Before I get to my BONUS tip: I want to let you know that I’m providing a FREE Telehealth checklist for you to DOWNLOAD

It’s a sheet you can reference right before you have a telehealth session to make sure your video, lighting, and audio is ready to go. 

BONUS: You Need a consistent Internet Connection.

To level up your Telehealth sessions and to minimize any distractions, especially with video telehealth, you need a solid internet connection. 

Having a solid internet connection is like having your office space open with the lights on and the door unlocked so you can have a session with your client.

If you don’t have a consistent internet connection, it’s like your office is closed. 

So your internet connection doesn’t have to be fast, it has to be consistent.

That is, you need, at a minimum, 2MB’s of consistent upload speeds and at least 2MB’s of consistent download speeds.

Telehealth Internet Speeds

So here are a few things you can do to make sure your connection to the internet is optimized for video telehealth:

  1. Check your internet speed connection with
    It’s free to use and will give you a quick look at your connection speed.
  2. Plug directly into your internet router. 
    If you can plug directly into your router this is the best option.
    All you need is an ethernet cable, and possibly an adapter depending on your computer.
    I need a USB-C to Ethernet adapter for my MacBook Pro. 

Most likely, there are other devices wirelessly streaming Netflix, music, YouTube, or whatever at the same time which will slow down your internet speeds.  It’s kind of like an interstate highway.

If there’s a lot of devices on your wireless router streaming content, then your wireless connection speeds will be slow because there’s so much traffic on it.

 BUT, if you plug into your router, it’s kind of like you’re in the express or car-pool lane.

There will still be congestion, but you’ll have the advantage of having your own “private” lane with more consistent speeds than the wireless connection b/c there’s so much traffic on it.

If internet speed is a problem, just kindly ask not to stream videos while you’re holding telehealth appointments.

If you can’t connect directly into your router then get as close as you can to your router with a wireless connection.

The closer you are to your wireless router, the stronger the connection and faster internet speed.

If you’re still experiencing a bad connection, just turn off your camera and have your telehealth session with just the audio.

You can turn your camera on later if the quality improves.

If you’re planning on making telehealth a regular part of your practice either in an office or a home, consider upgrading your internet speeds. It’s a small expense compared to the revenue you’ll make by having strong internet speeds. 

Again, having a strong internet connection is like having your physical office doors unlocked, with the “open” sign on.  You’ll need to have it in order to facilitate telehealth appointments. 

Remember to download myTelehealth Checklist” so you’ll be ready to look good, sound great, and minimize any interruptions so you can provide the best telehealth care for your clients. 

If you’re stressed about all your goals to improve your practice, read my blog How to Set Private Practice Goals and Actually Meet Them.  

And If you want to scale your business get my FREE three-part video series that shows you how to market and grow your private practice. 

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