Allison O’Konski, LPC, NCC, is a Licensed Professional Counselor and National Certified Counselor at Harmony’s Wheeling clinic. She provides therapy for adults in person and through telehealth, integrating approaches like CBT, mindfulness, attachment work, and solution-focused counseling. In this conversation, she shares how virtual care expands access, what a typical session looks like, and why telehealth often helps people feel safe enough to open up.
Getting started with virtual care
Are you primarily in person or virtual? What drew you to telehealth?
Allison: I work a hybrid schedule. I’m in our Wheeling office a few days a week, and I work from home the other days. I was in graduate school during the height of the pandemic, so I saw that shift to telehealth up close. It felt a little different at first, but once you get comfortable, it’s the same process. As we coped with stay-at-home orders, we learned that virtual relationships can be just as meaningful and that online conversations can be effective. When I joined Harmony, I was excited to offer both options.
What benefits stand out for you and your clients?
The flexibility of telehealth helps everyone. I can schedule appointments after the workday and offer last-minute cancellation spots, and clients can join on a lunch break or at a time that fits their life. With virtual sessions, clients don’t have to worry about where to park, what to wear, or who can babysit their kids. It makes things simpler. It also lets clinicians practice what we preach about self-care. There is more space to reset between sessions or after a cancellation, which helps me show up authentically.
What a virtual session looks like
How is a telehealth visit different from coming into the office?
Telehealth creates opportunities to meet wherever it works best. Instead of checking in at the front desk, you receive a secure link or a call and join from a phone, tablet, or laptop. Video helps it feel personal, but audio works when needed. Clients choose a space that feels right. They can meet in a bedroom for privacy, sit on their private, enclosed porch, or take a call from a parked car if home isn’t private. Clients also have the option to move around or multitask, which can be great for managing ADHD. One of my clients walks on the treadmill or folds laundry while we talk.
Privacy, safety, and setting expectations
What concerns do people have, and how do you address them?
Some worry telehealth won’t feel as personal. I share that many long-standing telehealth clients feel just as comfortable and connected to their therapist as in-person clients. If someone lives near a clinic, they can switch back and forth. Knowing there are options eases nerves.
Distraction is another concern. Headphones help, and the video window is narrow, so people don’t need to worry about what their house looks like in the background. That makes it easier to focus on the conversation and not be distracted by clutter.
Technology concerns come up too. If a connection keeps dropping, that can disrupt therapy, and in those cases in-person may be better. As for any security concerns, our platform is HIPAA compliant. We send a private link for each session, and confidentiality boundaries are clear.
How do you set the stage with new clients?
During the first session, I explain what therapy looks like and my approach. I show clients my setup, including the second laptop I use for notes, so if I look down, they know I’m still with them. I also remind clients they control their environment. If someone else might be nearby, tell me, especially if it impacts what they can discuss that day. They can use headphones to limit what’s heard and send me a private message through the chat feature to let me know what’s going on. I want to make sure it is safe for them to be open.
Access across distances and different lifestyles
How does telehealth help people in rural areas or with limited time?
West Virginia’s offices are spread out, and not everyone lives near a clinic. Telehealth removes the transportation barrier. I’m based in Wheeling, and I see clients from Charleston, Morgantown, and across the state. If internet is spotty, we might start with video to build rapport and then continue by phone when that’s more stable.
Telehealth also supports timeliness and convenience. With ADHD or OCD, for example, routines or time blindness can make it hard to leave the house on schedule. With telehealth, you click the link and start, without all the prep and travel time.
When telehealth is a great fit
Are there concerns that respond especially well to virtual care?
Depression is a broad example. For some, getting out of bed can be hard, and telehealth lowers that barrier. I have clients who wake up when the link arrives, and that helps them conserve energy. Any form of anxiety can benefit, like social anxiety, health anxiety, even anxiety about parking or navigating a new place. Telehealth removes many stressors.
PTSD is another. If someone feels safer in a familiar space, being at home gives peace of mind and a sense of control. Physical health needs can also be met more easily. If someone needs dim lights for headaches, easy restroom access, or just needs to lie down with a pet nearby, they can do that and still have a full session. Virtual care offers more opportunities than people expect.
Simple ways to make telehealth work
What tips help people get the most from virtual sessions?
Keep it simple. Use headphones, choose a comfortable space, and tell me what’s happening in your environment. If something makes it hard to be open, say so.
We can adapt together. The more we collaborate, the more effective sessions are.
If you are nervous to start
What would you say to someone unsure about a first telehealth appointment?
Therapy is the same process whether it is in person or virtual—the same interventions and psychoeducation. You meet with a qualified clinician and get to build a therapeutic relationship, which makes the biggest impact in therapy. You are not losing anything by meeting online. If you live near a clinic, you can try telehealth and switch or start in person and move online. You do not have to pick one forever.
Telehealth can even be an advantage because feeling safe is essential for change and healing. When you control your space, comfort and vulnerability can come faster. You are already in a place that feels familiar, and I am joining you there. This is real therapy with a real person in a real space.
If you give it a chance, you may find it works better than you expected.
A final word of encouragement
You deserve care that meets you where you are. If telehealth removes a barrier and helps you feel safer or more comfortable, that is a good place to begin. You do not have to do this alone. Support is out there.
Reach out to Harmony today to get started
If you’re ready to start your mental health journey, Harmony offers compassionate, evidence-based care. For new clients, please click here to schedule an appointment. For existing clients, please click here and find your office location to contact your office directly.