I know a lot of people say that phone or email therapy is not effective. Personally I think the effectiveness of therapy is totally an individual thing. For me I struggled a LONG time, probably still struggle with communicating IN session with my T. I am very, very thankful that my T decided to allow me to communicate with her via email. If she had not allowed this I would not be where I am at this point. For me I needed to break the communication impasse and email was an important stepping stone.