The need for accessible therapy on college campuses cannot be overstated. In Pakistan, where financial dependence on family, cultural collectivism, and mental health stigma exacerbates barriers to in-person therapy, teletherapy emerges as a promising alternative for college students in the face of stress. However, while teletherapy offers convenience and anonymity, our user research reveals significant challenges, particularly privacy breaches. Through interviews with 25 students and 20 therapists, this study identifies solutions to these barriers. Our findings highlight the importance of enhancing the presession experience by integrating a virtual waiting room and remedying intrusions in sessions through privacy focused features. By addressing these user pain points, we propose a prototype design solution that makes teletherapy more effective and culturally relevant for college students in Pakistan.