I am at the opposite coast here in the US from my T so phone sessions are what we do. I'm back east once a year and I have a double session when I see him.

It isn't ideal--
I miss the coziness of his office, going for walks, get coffee together, the occasional pat on the back, sharing/swapping books, seeing his reaction etc. All those things are missing. We don't skype because of the time difference. I'm often still in pj's when I call!

One way i'm dealing with it is that I've found a T out here to deal with specific issues. He's sort of my back up if anything happens to my long term T.