I think phone and skype will help a lot. I live 4 hours from one of my therapists. I talk to her on the phone. In some ways it's not as good as regular face to face therapy, but in some ways it is actually better. I like not having to drive anywhere. I think it is good for me to rely on verbal and written communication rather than counting on her to "pick up" on signals that I am anxious or angry. I think it has helped my communication skills.