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Can I Provide Telemental Health in Other Countries


You can practice international telemental health, but you still need to meet that country’s legal licensing requirements.

International Telemental Health Defined

First, the best manner of developing an ethical telemental health counseling practice is to complete quality and useful telemental health training.

Essentially, when you are delivering electronic forms of therapy to a patient in another country you are delivering overseas telemental health.

Sometimes the client is an existing client who is traveling, reports they will be staying in that country for an indefinite period of time, or they have relocated.

A counselor may be contacted by someone living in another country and  they want counseling in the United States. 

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Is it Legal To Practice Psychotherapy In Other Countries While in The U.S.

  1. First, you won’t find the answer to that question by contacting your state licensing board.
  2. Many find it difficult to determine who to ask about delivering telemental health in another country.
  3. As you may have discovered, the state where you are licensed can’t answer these questions. Your board will usually refer you to the other  jurisdiction for answers.
    • Why? A state cannot impose their laws upon another state or country.
  4. So therefore, you are under that country’s legal jurisdiction. Is it possible to understand and access the civil and criminal processes of that country?

Residing in a Another Country and International Telemental Health in Your Home State

U.S. counselor license holders out of the country may deliver telemental health to a client located in the counselors home state at the time the counseling services are provided.

However, inappropriate delivery of international telemental health from overseas can result in ethical and legal consequences. This is true especially if treatment becomes catastrophic.

For example, a counselor is located in Italy. The client is an adolescent and the parents are also located in the U.S. state where the counselor is licensed. If the adolescent client suicides, the home state would be the jurisdiction that investigates a board complaint even though the counselor is in another country.

Is It Ethical To Practice International Telemental Health

Now that you understand the legal, let’s understand the ethical issues of counseling internationally because they are of even greater concern. 

These are very personal decisions and each counselor must determine what is best for them. Is:

  1. Why are they out of the country? Are they vacationing? Relocated indefinitely? Relocated Permanently? Are they a new client?
  2. Assess the clinical risk of that client.
  3. What is your justification for treating a client that is possibly thousands of miles from where you are licensed.
  4. We are mandated to protected our clients from harm and ensure they are receiving the most appropriate care. 

Is It Legal and Ethical To Practice Telemental Health Internationally

Openly ask yourself, ‘why do I need to practice counseling internationally’. Particularly when it is a client who has relocated or travels frequently overseas. 

Ask yourself, do you want to counsel internationally because you want to accommodate the client? Whereas clients are entitled to decisions about their care, counselors are responsible for ensuring clients receive the best treatment. 

First determine if non-resident counselors can legally practice in the country. Then determine where they will receive the best and most comprehensive treatment. 

If the client has relocated, they will have likely considered their need for psychotherapy in a country that may not provide or regulate it. 

Are you more interested in the client receiving counseling services than are they?

Answering these questions will help you make the correct legal and ethical decisions about international telemental health practice. 

You deserve a former licensing board president on your side.

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