I've done a couple of skype sessions with my T. It wasn't even video chat, just text. Actually, I liked it. I would never agree to only online therapy, but I really like the occasional session or two this way. Also, I email my T on a regular basis, and she usually responds with quite long emails, which is very nice and helpful. I'm not a big talker in general, especially when the topic is me , but I can write anything. And since I usually think in writing too (I kind of never truly learned how to just think, I think about complicated stuff when I write, don't know how to do this any other way), so the emails and appts on skype sometimes are the quickest way for me to come up with answers to T's questions.