Practical guide on teleconsultation in psychology: OPP legal framework, technical requirements, clinical best practices, ethical considerations, and tools for online psychology consultations in Portugal.

Teleconsultation in Psychology: Complete Guide for Professionals

Teleconsultation in psychology has been establishing itself as an essential modality in the delivery of mental health care in Portugal. What started as an emergency response during the pandemic has transformed into a structured, regulated, and increasingly sought-after practice by both patients and professionals. For psychologists looking to integrate online consultations into their clinical practice — or improve how they already offer them — this guide brings together everything you need to know.

What Is Teleconsultation in Psychology?

Teleconsultation in psychology is the delivery of psychological services remotely, using information and communication technologies. It is not a simplified version of in-person consultation, but rather a clinical modality with its own characteristics, advantages, and challenges.

Teleconsultation Modalities

Teleconsultation can take various forms:

Synchronous video call: The most common form and closest to in-person consultation. The professional and patient interact in real time through video and audio.
Audio-only consultation: Used when video is not possible or when the patient prefers this modality. Less rich in non-verbal information, but effective for many situations.
Asynchronous communication: Secure message exchange between sessions, used as a complement to synchronous consultation for follow-up, sharing materials, or managing mild crises.
Hybrid model: Combination of in-person and online sessions, offering flexibility without losing the depth of the in-person therapeutic relationship.

For Which Situations Is It Suitable?

Scientific research demonstrates that online therapy is effective for a wide range of conditions:

Anxiety disorders (including generalized anxiety disorder and specific phobias)
Major depressive disorder of mild to moderate severity
Post-traumatic stress disorder
Eating disorders (as a complement)
Insomnia and sleep disorders
Stress management and professional burnout
Cognitive-behavioral therapy in general

However, there are situations where teleconsultation may not be the most suitable modality: acute psychiatric crises, imminent suicide risk, formal neuropsychological assessment, or patients with significant cognitive limitations that hinder technological interaction.

Legal Framework in Portugal: OPP Guidelines

The Portuguese Order of Psychologists (OPP) recognizes and regulates the practice of teleconsultation, establishing a set of guidelines that all professionals must follow.

Registration and Qualification Requirements

The psychologist must be registered with the OPP with their status regularized and their professional license in force.
The specialty or area of practice must be compatible with the proposed intervention.
Continuing education must include competencies in teleconsultation and digital literacy applied to clinical practice.

Specific Informed Consent

The OPP requires that informed consent for teleconsultation include additional elements compared to in-person consultation consent:

Detailed description of the platform used and the security measures implemented.
Identification of risks specific to the modality (technical failures, limitations in reading non-verbal cues, privacy issues in the patient's space).
Procedures in case of clinical emergency, including the patient's local emergency contacts.
Policy on session recording, if applicable.
Criteria for referral to in-person consultation.
The patient's responsibility to ensure privacy and adequate technical conditions on their end.

The patient portal allows you to manage digital informed consent securely and traceably, with electronic signature and version control.

Data Protection and GDPR

Teleconsultation involves the processing of health data — a special category under the GDPR. Obligations include:

Processing and storage in the EU: Data must be processed on servers located in the European Economic Area.
Mandatory encryption: Encryption of data in transit (during the session) and at rest (storage).
Data Protection Impact Assessment (DPIA): Mandatory when processing presents high risks to the rights of data subjects.
Data Processing Agreement (DPA): A DPA must exist with all technology providers that process data on behalf of the professional.
Right of access and portability: The patient must be able to access their data and request its portability.

Invoicing and Tax Aspects

Online consultations follow the same tax regime as in-person ones:

Mandatory issuance of invoice-receipt through AT-certified software.
Classification under the economic activity code corresponding to psychology practice.
Possibility of deduction on income tax as a health expense for the patient.
VAT obligations according to the applicable regime (exemption under Article 9 of the CIVA for health acts).

Integrated invoicing and scheduling management automates this process, ensuring tax compliance without additional administrative effort.

Benefits of Teleconsultation for the Psychologist and the Patient

Teleconsultation offers concrete advantages for both parties in the therapeutic relationship.

For the Professional

Greater geographic reach: Ability to see patients anywhere in the country or Portuguese nationals abroad.
Schedule management efficiency: Elimination of dead time between in-person consultations. Ability to fit online sessions into time slots that would be impractical at the office.
Reduced operational costs: Less dependence on physical space. Possibility of partially operating without a dedicated office.
Therapeutic continuity: Maintaining follow-up during holidays, travel, or temporary mobility situations.
Lower no-show rate: Studies indicate that the no-show rate is lower for online sessions, likely due to the elimination of logistical barriers.

For the Patient

Accessibility: Access to quality care regardless of geographic location.
Convenience: No travel, parking, or waiting room time.
Comfort of familiar environment: Some patients feel more at ease at home, which can facilitate therapeutic openness.
Easier access for specific populations: People with reduced mobility, social phobias, agoraphobia, or conditions that make travel difficult.
Schedule flexibility: Ability to schedule sessions at times compatible with professional and family commitments.

Technical Setup: What You Need

The quality of teleconsultation depends significantly on technical infrastructure. Adequate investment in this area is fundamental for a professional experience.

Recommended Hardware

Component	Minimum	Recommended
Computer	Processor from the last 5 years, 8 GB RAM	Recent processor, 16 GB RAM
Webcam	HD 720p	Full HD 1080p (external)
Microphone	Built-in laptop mic	Headset with noise cancellation or USB condenser microphone
Lighting	Front-facing desk lamp	Ring light or LED panel with adjustable color temperature
Monitor	Laptop screen	External monitor of at least 24 inches

Internet Connection

Minimum speed: 10 Mbps download / 5 Mbps upload
Recommended: 25 Mbps download / 10 Mbps upload
Preference for Ethernet cable: More stable than Wi-Fi; reduces dropouts and latency
Contingency plan: Mobile hotspot as backup; agree with the patient beforehand on the protocol in case of failure

Physical Space

Private room with closed door and "in session" signage
Neutral and professional background (plain wall, organized bookshelf)
Adequate sound insulation (avoid spaces with echo or outside noise)
Controlled front-facing lighting; avoid windows or light sources behind you
Comfortable temperature and quiet ventilation

Software and Platform

The choice of video call platform is one of the most important decisions. The essential criteria are:

End-to-end encryption: Session data should not be accessible to third parties.
GDPR compliance: Servers in the EU, DPA available, no use of data for advertising purposes.
No recording by default: Recording should be an explicit option, never automatic.
Virtual waiting room: To manage the patient's entry in a controlled manner.
Easy access: Ideally without the patient needing to install software.
Integration with clinical tools: Notes, scheduling, invoicing.

Mena.ai offers integrated video calls specifically designed for psychotherapy sessions, with end-to-end encryption, clinical-quality video, and full integration with schedule management, clinical notes, and invoicing.

Best Practices for Teleconsultation in Psychology

The effectiveness of teleconsultation depends as much on clinical competence as on technical and relational execution.

Session Preparation

Test the technology 10 minutes before: Camera, microphone, internet connection, lighting.
Send automatic reminders: A reminder with the session link 24 hours before and another 30 minutes before significantly reduces no-shows.
Prepare the space: Check background, lighting, and privacy.
Have a Plan B defined: Clear protocol for technical failures (phone call, rescheduling).
Review notes from the previous session: Clinical preparation is equally important.

During the Session

Eye contact with the camera: Look at the camera (not the screen) when speaking. This small adjustment simulates eye contact and strengthens the therapeutic connection.
Enhanced verbal feedback: Compensate for the partial loss of non-verbal cues with more explicit verbal feedback.
Pause management: Digital latency can create overlaps. Leave more space between your interventions.
Therapeutic silences: They can feel more uncomfortable online. When using silence intentionally, validate it verbally.
Visual framing: Keep your face and upper body visible. Avoid sudden movements or going out of frame.
Attention to the patient's environment: Observe cues from the patient's context that may be clinically relevant.

After the Session

Immediate clinical notes: Document while the session is fresh. AI-assisted clinical notes can automatically generate a structured draft that only needs review and approval.
Complete closure: Ensure the video call is fully ended before speaking with others or starting another activity.
Technical incident log: If there were failures, document them and their impact on the session.

Ethical Considerations in Teleconsultation

Teleconsultation raises specific ethical questions that the psychologist should consider proactively.

Confidentiality and Privacy

The professional is responsible for the security of their side of the communication, but should guide the patient on how to ensure privacy on their end.
Openly discuss with the patient the limits of confidentiality in the online format.
Avoid sessions in shared spaces (coworking, cafes) — both the professional and the patient.

Professional Competence

Teleconsultation requires specific competencies that go beyond in-person clinical competence.
Invest in continuing education on best practices for remote intervention.
Recognize the limits of the modality and know when to refer for in-person consultation.

Therapeutic Relationship Boundaries

The home context can blur professional boundaries. Maintain the formal framework.
Set clear rules about contact between sessions (messages, emergency calls).
The fact that technology is always available does not mean the psychologist should be.

Remote Crisis Management

Always keep updated the emergency contact and geographic location of the patient.
Know the local emergency resources: 112, SNS 24, SOS Voz Amiga (213 544 545).
Define a crisis protocol for online sessions in advance.
Regularly assess whether teleconsultation continues to be the suitable modality for each patient.

Access Equity

Consider the patient's digital literacy and technological conditions.
Offer technical test sessions before the first consultation.
Consider maintaining the in-person option for those who do not adapt to the online format.
Do not assume that all patients have access to stable internet or a private space.

Platforms and Tools for Teleconsultation

Choosing the right tools has a direct impact on the quality of the service provided.

What to Look for in a Platform

Security and compliance: End-to-end encryption, GDPR, servers in the EU.
Clinical integration: Connection with clinical notes, scheduling, and invoicing to avoid tool fragmentation.
Patient experience: Simple interface, no need for an account or software installation.
Reliability: Consistent video and audio quality, with low latency.
Technical support: Assistance available in case of problems.

What to Avoid

General-purpose video call platforms without GDPR compliance for health data.
Free tools that monetize user data.
Solutions without end-to-end encryption.
Platforms that store data outside the EU without adequate safeguards.
Multiplication of disconnected tools (one for video, another for scheduling, another for notes) that increases the risk of failures and errors.

An integrated platform like Mena.ai combines secure video calls, scheduling and invoicing, clinical notes with AI assistance, and a patient portal in a single environment, specifically designed for the practice of psychology.

Frequently Asked Questions

Is teleconsultation in psychology recognized by the OPP?

Yes. The Portuguese Order of Psychologists recognizes teleconsultation as a legitimate and regulated practice. The professional must be registered with a valid professional license, use platforms that ensure confidentiality and security, and obtain specific informed consent for the online modality. Teleconsultation must meet the same ethical and deontological standards as in-person consultation.

Can I issue an invoice and receipt for teleconsultation sessions?

Yes. Teleconsultation sessions follow exactly the same tax regime as in-person consultations. You must issue an invoice-receipt through AT-certified software. For patients, the consultations are deductible on income tax as health expenses, provided they are classified under the correct activity code. Integrated invoicing management automates this entire process.

Is it possible to conduct psychological assessment via teleconsultation?

It depends on the type of assessment. Clinical interviews and some self-report questionnaires can be administered online effectively. However, formal neuropsychological assessment, tests requiring the manipulation of physical materials, or assessments that depend heavily on behavioral observation in a controlled context are generally more suitable for the in-person format. The decision should be made on a case-by-case basis, prioritizing the validity of results.

How to handle a crisis during a teleconsultation session?

Preparation is key. Before starting online follow-up, collect the patient's emergency contact and their usual location during sessions. Know the local emergency resources (112, SNS 24, SOS Voz Amiga). During a crisis, maintain open communication, assess the level of risk, and if necessary contact emergency services providing the patient's location. Always document the episode and reassess whether teleconsultation continues to be the suitable modality.

Conclusion

Teleconsultation in psychology is an established reality that has significantly expanded the reach and flexibility of clinical practice. With the appropriate legal framework, the necessary technical preparation, and the adoption of ethical and clinical best practices, it is possible to offer a service of quality equivalent to in-person consultations — and, in some respects, superior.

The success of teleconsultation depends on three pillars: clinical competence adapted to the online format, reliable and secure technological infrastructure, and integrated tools that simplify administrative management. A platform like Mena.ai was designed to cover these three pillars, allowing psychologists to focus on what truly matters: the therapeutic relationship and the patient's well-being.

Teleconsultation does not replace in-person consultation — it complements it. And for many patients, it is the difference between accessing mental health care or going without it.