In May 2010, video counselling was added to the counselling services offered through the Employee and Family Assistance Program (EFAP) at Shepell as a pilot project with a full operational launch in September 2011. This retrospective study examined clinical outcomes of video and in-person counselling modalities. A sample of 68 video counselling (VC) cases and 68 in- person (IP) counselling cases were collected from a pool of client clinical files closed in 2012. The study compared the two counselling modalities on: (1) client demographic factors (age, gender), (2) session type (individual vs. conjoint sessions with couples or families), (3) type of presenting issue, (4) average total session hours, (5) client ratings of session helpfulness, (6) client reported goal completion, (7) client session no show rates, (8) client withdrawal rate, and (9) improvement in pre/post client self-assessments of mental health and health. Results indicated that the two modalities had largely similar clinical experience and outcome profiles. However, VC cases were also less likely to cancel their scheduled appointments and less likely to withdraw from counseling than IP cases. In addition, most of the VC cases (69%) lived within a half-hour drive to a local counselor’s office and yet chose to use the video conferencing option for the EFAP service. These findings offer evidence for the appeal and clinical effectiveness of technology-based counseling.