While typically, the requests have come from patients in psychotherapy who, for personal or professional reasons, have chosen to relocate while in the middle of a course of psychotherapy. Also, patients who live a considerable distance from any city also have proffered these requests. I have steadfastly refused to conduct phone-based psychotherapy. For me, much of what happens in the conduct of psychotherapy is non-verbal. An important part of the clinician's role is to help patients learn to trust others and to put their feelings into words.
Crucial information is lost during phone interactions.
Also, I feel that the phone can be used to create a kind of pseudo-intimacy making it difficult to address conflicts around actual intimacy and trust. One might argue that career counseling does not require the same level of intimacy and trust, so why not conduct it on the phone. However, I am not sure that I concur with this contention. While career counselors vary significantly with respect to background, training and perspective, for me, at times, career counseling, or worklife consultation as I prefer to call it, is simply another form of psychotherapy. Over the years, I have found that career counseling issues seldom exist in isolation.