How to Record Telehealth Therapy Sessions

Recording a telehealth therapy session is possible, but it takes a different setup than recording an in-person one. The technical reason: most phones won't record a video call while you're on it. The human reason: you should ask your therapist first, the same way you would in person. The practical answer is to do the session on a laptop or desktop where it's possible, ask your therapist's permission, and then use one of four approaches: your therapist's built-in recording, browser-based recording on the same machine you're using for the call, a separate device, or a tool built for this. Each has tradeoffs. This guide walks through all four.

Why telehealth recording is harder than in-person

If you've ever tried to start a voice memo on your phone while you were on a video call on that same phone, you know what happens. The recording stops the moment the call starts, or the call drops, or both. iOS in particular treats audio as something only one app can use at a time. Most Android phones behave similarly when the call is over a third-party app like Zoom. This is a deliberate platform choice, not a bug, and it's why the obvious move (record on your phone during the call) doesn't work for telehealth the way it does for in-person.

There's a second issue, which is that you usually need to capture two voices, not one. In person, you set a phone on the table and both voices land on the microphone. Over telehealth, your therapist's voice is coming out of a speaker. If you record on a separate device near that speaker, you'll get their voice but the audio quality drops. If you record on the same device that's running the call, you need to capture both your microphone input and the call's audio output at once, which not every recording tool can do.

None of this is insurmountable. It just means the right setup depends on which device you're using and which platform your therapist uses for telehealth. Before we get to the how, the part that comes first.

Ask your therapist first. Every time.

The fact that you can record doesn't mean you should record without saying so. Therapy depends on the assumption that what's said in the room stays in the room. When a recording exists, that assumption shifts. Your therapist deserves to know it's shifting.

Telehealth doesn't change this. If anything, it raises the stakes, because clients sometimes assume that because they're at home on their own laptop, they don't need to ask. Asking is part of the practice. It also matters legally in roughly a quarter of US states and across most of Canada, where two-party consent is the rule (more on the legal piece below).

A full consent script and framing guide lives at Can I Record My Therapy Session?. The short version: tell them what you want to do, why you want to do it, where it'll be stored, and who has access. Most therapists respond well when the request is honest and the purpose is reflection rather than evidence-gathering.

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Your four practical options

Once your therapist has agreed, you have four real ways to actually make the recording. Here they are in order from most-to-least built-in.

Option 1: Use your therapist's platform's built-in recording

Several telehealth platforms have recording baked in. Doxy.me, SimplePractice's telehealth, TheraPlatform, TherapyAppointment, and others all let the therapist hit record on their end with your consent. The recording lives on the platform's HIPAA-compliant storage.

The upside: it's the cleanest legally and technically. Your therapist controls it, the audio is captured at the source, and storage is already compliant. The downside, often surprising to clients: in most of these systems, you don't get a copy. The recording is part of the clinical record, which means your therapist can review it but can't always share it with you, depending on their policy and your jurisdiction's rules on therapy records.

If you want a recording for your own continuity, not just your therapist's, this option may not actually solve your problem. Worth asking before you assume it will.

Option 2: Record in your browser, on the same laptop you're using for the call

This is the option most people don't realize they have. If you take telehealth on a laptop or desktop, whether that's Zoom, Google Meet, Doxy, or SimplePractice's telehealth, you can usually record the same browser tab the call is happening in, with both audio streams captured.

The catch is that the tool you use needs to be allowed to capture system audio, not just your microphone. Most general-purpose screen recorders can do this on macOS and Windows. Some dedicated AI note-takers built for therapy do it as well. The browser-based path also has the practical advantage that your phone stays free for everything else, and you're not balancing two devices through the session.

What recording in the browser usually looks like

1. Join your telehealth session in a browser tab (not the desktop Zoom app, in most cases, since recording tools struggle to capture audio from native apps).
2. Open your recording tool in another tab or window.
3. When it asks which tab or window to capture, select the tab your therapy session is in.
4. Make sure 'Share tab audio' or 'Share system audio' is enabled, otherwise only your voice will be captured.
5. Confirm the recording is running and that both audio levels are moving before the real session begins.

If your therapist's telehealth platform forces you into a downloaded app, you can sometimes still join via browser. Click the meeting link, decline the prompt to open the app, and look for a 'Join from your browser' link. Zoom hides this one a click deep, but it's usually there.

Option 3: Use a second device

If you take telehealth on your phone, this is your most reliable option: take the call on one device, record on another. Phone for the call, iPad for the recording. Or laptop for the call, phone with a voice memo app for the recording. Place the recording device near the speaker, do a test, check the audio level.

It's not elegant. Quality depends on speaker volume, room acoustics, and whether you remember to keep both devices charged. But it works, it's legal where one-party or two-party consent has been met, and it doesn't depend on anyone's software cooperating. A lot of people who've been doing this for years use exactly this setup.

Option 4: A tool built for this

The fourth option is a dedicated tool that handles the technical part on your behalf. Most of the established players in this space are built for therapists (Mentalyc, Supanote, others). They generate session notes for the clinician, not session reflection for you, and they sit on the other side of the room from where this guide is pointed.

Undertone is built for the client side. For telehealth specifically, you scan a QR code with your phone to authenticate, the session records in your browser on the same laptop you're using for the call, and the structured outputs sync back to your iOS app. It solves the iOS limitation by moving recording off the phone and onto the device that's already in the call. It also means you don't need to be juggling two devices or hoping a generic screen recorder cooperates with your platform.

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Comparing the four options at a glance

Which option fits your setup

Built-in platform recording

• Cleanest legally and technically.
• Therapist controls it; storage is already compliant.
• You often can't get a personal copy.
• Recording is usually deleted on a platform-set schedule.

Browser, second device, or a tool built for this

• You control the recording and the copy.
• Works across most telehealth platforms.
• Browser option needs system-audio capture enabled.
• Second-device option trades elegance for reliability.

What to do with the recording afterwards

This is the part most people underestimate. Capturing the session is easy. Doing something useful with the recording is harder, especially when it's seventy minutes long and you have three of them now and the week is full.

The most common pattern: people start recording, accumulate audio files, and then never go back to them. The recording exists. The reflection doesn't happen. That's most of the value lost.

If you're going to listen back yourself, build a small habit around it

• Pick one anchor (the night of the session, or the next morning) and listen for ten minutes, not the full session.
• Skip ahead to the parts that felt charged or unclear. Memory of intensity is a decent index.
• Write down one theme, one question, and one thing to bring back next week.
• After about a month, scan back across what you've written and look for what keeps repeating.

If listening back to a long recording feels like a homework assignment you'll never do (which is often the honest answer), structured outputs help more than raw audio. A short summary you can read in two minutes is more likely to actually get read than seventy minutes of audio is to actually get re-listened to. There's more on this in How to Remember What You Talked About in Therapy.

How a single recorded session moves across the week

1. Right after the call: Session ends. You close the laptop. The recording, or the summary built from it, is now waiting on your terms.
2. A day or two later: You revisit one piece, when you have ten quiet minutes. Not the full hour. Just what felt charged.
3. Mid-week: Something from the session resurfaces in real life. You add a note about it for next week.
4. Before the next session: You walk in with continuity instead of a cold start. The thread didn't drop.

What if your therapist uses a platform with built-in recording?

Worth a specific note, because this comes up a lot. Doxy.me, SimplePractice, TheraPlatform, and a few others all support recording from the therapist side. If you ask, your therapist may say 'we can already record through the platform' and offer that as the answer.

Two questions to ask if they do.

• Can I get a copy I can keep for my own reflection? In some platforms the recording is part of the therapist's clinical record and can't be shared. In others it can be exported. Ask before you assume.
• Where does it live, and how long is it kept? Most platforms keep recordings for a defined window (often 30 to 90 days) before automatic deletion. If you want anything beyond that, you'll need your own copy.

If both answers work for you, this is a clean option. If they don't, fall back to browser-based or second-device recording on your end.

A brief note on legality (US and Canada)

Recording private conversations is governed by state law in the US and by provincial and federal law in Canada. The general framework, summarized by legal resources like the Reporters Committee for Freedom of the Press, is that most US states follow one-party consent (your consent alone is legally sufficient), while about a dozen (including California, Florida, Pennsylvania, Massachusetts, and Washington) require all-party consent. In Canada, federal law allows one-party consent, though provincial privacy laws and professional codes add further requirements when health information is involved.

The state-by-state and province-by-province context lives separately in Recording Therapy Sessions Laws. The short version for this guide: even where one-party consent is legal, ask your therapist anyway. Legal permission and ethical permission aren't the same thing.

What to do if your therapist says no

Sometimes the answer is no. Some therapists have a firm policy against recording (often shaped by training, supervision norms, or experience with how recordings have been misused). Some have specific concerns about your particular situation. Most are willing to talk about it.

If the answer ends up being a firm no, there are still real options for capturing more of what came up. Voice memos right after the session, while the audio is still in your head. A brief structured recap (there's a builder for this in How to Remember What You Talked About in Therapy). Notes during the session itself, if your therapist is comfortable with that. None of these replace a recording, but the gap between 'recording' and 'no record at all' is wide. There's a lot you can do in the middle.

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One last thing

Telehealth made therapy more accessible. It also made the session feel a little more disposable, in a way in-person sessions never did. You close a browser tab and the hour is over. There's no walk back to the car, no transition between the room and the rest of your life, no natural pause to let what came up actually land.

Recording, when your therapist agrees, gives you some of that pause back. Not in the moment, but afterwards, on your own time, in a state you can choose. That's the real thing to optimize for. The setup is just plumbing.

If you want a tool that handles the plumbing for telehealth specifically, that's where Undertone fits. The recording happens in your browser on the laptop you're already using for the call, the structured outputs sync back to your phone, and the raw audio isn't kept around. If it fits, download it. If it doesn't, the four options above are real, and any of them is better than relying on memory alone. There's also more on how to use what you capture in What to Do Between Therapy Sessions.