Introduction:
India faces a significant mental health treatment gap due to the scarcity of licensed clinical psychologists and the increasing demand for services. Online psychotherapy has emerged as an important mode of service delivery, particularly following the pandemic and recent digital and policy developments. However, research has largely focused on client outcomes, with limited attention to clinicians’ professional experiences, especially within the Indian regulatory and training context.

Aim:
The present study aimed to examine the challenges, felt needs, and professional gaps experienced by clinical psychologists in India providing psychotherapy through online platforms.

Methods:
A two-stage design was employed. First, a systematic review was conducted to identify challenges related to online psychotherapy practice among clinical psychologists in India. Second, a cross-sectional exploratory online survey was conducted with 50 clinical psychologists in India using a semi-structured questionnaire. Descriptive statistics and thematic analysis were used.

Results:
Only nine studies were eligible for final inclusion, published between 2015 and 2025. Findings revealed challenges across technological, clinical, ethical, and regulatory domains, including platform limitations, difficulties in risk management, lack of structured supervision, and ambiguity regarding licensing and regulatory processes. A strong need for clinician-oriented digital tools, training in online psychotherapy and ethics, and clearer regulatory guidance was identified.

Conclusion:
The study highlights critical gaps in the current online psychotherapy ecosystem in India. Findings can inform application developers, training institutions, and regulatory bodies to support ethical, sustainable, and clinician-informed digital mental health practice.