International Telemental Health Defined. 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. Practicing Telemental Health Internationally. You can practice international telemental health, but you still need to meet that country's legal licensing requirements.
Is it Legal To Practice Psychotherapy In Other Countries While in The U.S.
First, you won't find the answer to that question by contacting your state licensing board.
Many find it difficult to determine who to ask about delivering telemental health in another country.
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.
So therefore, you are under that country's legal jurisdiction. It is difficult to fully understand the laws of other countries.
Does U.S. Counseling Malpractice Insurance Cover International Practice.
That depends.
Yes: If you are sued in a U.S. jurisdiction by a client located overseas your work is generally covered by your counseling malpractice insurance.
No: If a client sues a counselor for malpractice in a state/ province within and originating from another country, malpractice insurance does not cover the incident.
Still, read the fine print of your counselor insurance policy and contact your carrier to confirm.
Whether you relocate to another country or are essentially working there as a 'tourist', it is wise to understand the laws of that country. Naturally this is also true for non-counseling laws.
It’s also important to understand the sociopolitical climate and justice system of that country.
In some countries, any work in the realm of citizen advocacy could be met with legal charges or intimidation and persecution.
Risk to the counselor is not always apparent. For example, some countries' military recruit child soldiers and child advocacy work is likely suppressed. Some countries are with rampant human rights violations.
In some countries, legal issues of delivering a form of counseling may not be relevant or may not exist since that country does not regulate counseling practice.
Is It Ethical To Practice International Telemental Health
First, the best manner of developing an ethical telemental health counseling practice is to complete quality and useful telemental health training.
Ethical issues of counseling internationally often carry more risk than the legal issues.
Why are they out of the country? Are they vacationing? Relocated indefinitely? Relocated Permanently? Are they a new client?
Assess the clinical risk of that client.
What is your justification for treating a client that is possibly thousands of miles from where you are licensed.
We are mandated to protected our clients from harm and ensure they are receiving the most appropriate care.
In most states, 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.
Balancing the Legal and Ethics of International Telemental Health Psychotherapy
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.
