Doing International Teletherapy

It’s “Cross-Jurisdictional Practice” month! We just made that up, but if you follow PCT, you’ll know we’ve been immersing in this topic as a support to you in our new phase of COVID-19 pandemic support.

Roy’s Facebook Live (below) is a fun discussion on the considerations of providing mental health care with clients in a different country. He also normalizes “COVID hair”, for which we are all grateful.

Be sure to check out the 90 min CE program Legally Practicing Across Borders: Interstate and International Mental Health Practice, During and Post-COVID (LIVE) event where we will be covering details like:

• Which states or nations will allow me to work with clients within their borders? Will my own state allow me to work outside its borders?
• Can I travel out-of-state and work with clients back home?
• How do I find out if a state normally allows temporary practice from out-of-state, or if they allow it only on an emergency basis?
• What will happen to cross-state practice when COVID-19 ends?
• What risks do I need to manage when working across states — whether I do it legally or illegally?
• What risks do I need to manage when working with clients in nations that don’t regulate my professional practice?

We don’t want to forget to mention that the pandemic- inspired discount of the telemental health programs are ending. If you are looking to up-level your teletherapy offering, it is a great idea to nab this before the end of the month (if you, like me, forget things — you can purchase the program today and take the program in the new month. You’ll feel so much more confident and secure with this program under your belt.)

More Good Stuff

Watch the Facebook Live Here

Summary

In addition to cross-jurisdiction practice for cross-state practice, we get a lot of questions about how to practice teletherapy internationally.  We have been surprised how many folks are interested in this! Ça marches.

(okay, so I don’t speak French, but ‘it works’ for me to talk about practicing teletherapy with those in France.)

How to tell if it’s legal to practice teletherapy where my client is?

• From a high-level viewpoint, it’s just like finding out if it’s legal to practice in another state.
• This is obviously from the perspective of an American practicing clinician- speaking from how we understand licenses. Many countries regulate the field by issuing licenses or certificates, just as each state issues licenses or certifications and regulates accordingly. If you are not licensed in that state you cannot practice there.
• Now you might be surprised to know that not every country operates like this. Not every country licenses or regulates mental health professionals. Some regulate it them another way. Some don’t regulate them at all.

Roy’s Background with Teletherapy
Started practicing in Japan on a volunteer basis in 2007 when he lived there. When he came home to Oregon in 2010, and was working on his Oregon LPC license, it was suggested he connect with his previous clients. He reached out to his previous colleagues and clients in Hokkaido to continue their care.

Legal and Ethical Considerations

• Area-specific community resources
• Rules for practice
• Just like you would if you changed your practice location.
  • How do you report abuse?
  • How do you handle a welfare check?
  • How do you do the ethical duties you need to do in a system that works differently?
• Different countries work differently.
• Potentially, there is a giant list you want to navigate
  • The first this you need to do is find out if it is legal for you to work with clients who are there.
  • Not being licensed in the country might mean various things from not being able to practice, to not being able to be paid by the public health system.
  • Not being regulated at all probably means you can work with clients there, but there are many other risks and considerations that come with being unregulated.

As you can tell there is nuance in this discussion and different circumstances require different judgments.