Telemental health services, particularly counseling and therapy through videoconferencing, have rapidly expanded since the onset of the COVID pandemic in 2020. Increasingly, clients are being served by mental health professionals (MHPs) located in different cities and different states. Although MHPs have historically been licensed to practice on a state-by-state basis, interstate compacts among certain states now allow MHPs to be licensed and practice in multiple states, including through videoconferencing. Examples of such compacts include Counseling Compact, PSYPACT, and Social Work Licensure Compact. In this post, let’s explore what clients need to know when considering work with mental health professionals from another state.
Licensing Requirements
Not all services related to mental health and counseling require licensure. For instance, parent coaching, life coaching, life skills training, and case management services typically fall outside regulatory frameworks. Across the United States, states do require licensure and, or accreditation for particular types of mental health services including psychotherapy, psychiatric diagnosis, family therapy, clinical social work, and sexuality therapy. Furthermore, practitioners are generally required to have licensure to access insurance reimbursements Medicare, Medicaid, and private insurers. When seeking services, it’s important to know whether the type of services that you are seeking require licensure (Barsky, 2023). If they do, then make sure your practitioner is properly licensed and, if appropriate, that their services are covered by your health insurer.
Location Matters
For legal purposes, the location of services is determined by where the client is located, not the practitioner. Thus, if you live in Idaho and your therapist lives in Arkansas, make sure your therapist is licensed (or legally authorized) to practice in Idaho. Ask the therapist for their professional license and issuing regulatory board. You may go to the licensing body’s website to verify that the therapist has a current license, and to check whether the therapist has had any claims, investigations, or regulatory actions against them.
Professional Competence
Having a license does not ensure that an MHP has the knowledge and skills required to provide you with safe, effective, and ethical services. Before engaging in services—and as part of the intake and informed consent processes—find out what types of training, skills, and experience the MHP has. Make sure that their scope of practice and areas of competence fit with the nature of the mental health concerns that you have, for instance, anxiety, depression, family conflict, or addiction (American Counseling Association, 2014; American Psychological Association, 2017; National Association of Social Workers, 2021).
If your concerns relate to ethnocultural, regional, or socioeconomic factors, ask questions to determine the level of competence that the MHP has in relation to working with people from your social identity groups and geographic area. An MHP from an urban area, for instance, may or may not have the knowledge and skills required to serve a client in a rural area, particularly when the client’s concerns relate to local factors. An MHP’s knowledge and awareness of cultural and contextual factors can influence therapeutic outcomes.
Local Resources
When working with MHPs from other states, you might consider a combination of telehealth and local services to best meet your needs. Your telehealth provider may be able to provide you with counseling services; however, you may need to access local services and resources for mental health emergencies (such as suicidal thoughts), educational programs, housing assistance, food insecurity, or other basic needs.
Backup Plans
Access to inter-state counseling and tele-therapy depends on access to technology, for instance, having a high-speed internet connection and a computer, tablet, or cell phone. If electricity, cell phone services, or other technology are interrupted, you may lose access to mental health services. Ask your MHP what to do in the event of a technological failure, including how to reconnect with them if you are disconnected mid-session. In addition, inquire about how to access local services in emergency situations. Your MHP may also ask for an emergency contact (e.g., a close friend or family member) in situations when they are unable to contact you directly.
Conclusion
There are many potential advantages to accessing services through videoconferencing or other technology—whether within your state or from another state. You may save time and money since you can access services from your home, place of employment, or other convenient location. You may be able to access specialized services from a type of provider that is not available locally. You may also appreciate the confidentiality that is afforded by accessing services from a private location rather than having to go to an office or institution where people may know that you are accessing a particular type of mental health service. Still, it’s important to make sure that you are being served by a professional with the appropriate credentials, knowledge, skills, policies, and practices to ensure that you receive the care you need and deserve. A well-informed client is an empowered client.
