Online therapy and licences, explained

Therapists must follow the rules of the place where they are authorised to work. Those rules are about professional standing - a licence or a registration - rather than the fact that a session happens by video or phone.

That means a therapist who lists online sessions may still be able to work only with people who are located in the state, nation or territory where they are licensed or registered. The technology lets you meet across distance. The legal and professional rules set where a therapist may offer care.

Regulation is handled differently in each country, and within the United States it often varies by state. That affects whether a therapist can work with you if you are in another place.

• United States - Each state has its own licencing board and rules about who may offer services to people located in that state. A therapist who is licensed in one state may need permission, a compact, or a separate licence to work with clients in a different state.
• United Kingdom - Different professions are registered with different bodies. Some registers cover particular professions across the UK, while professional associations hold voluntary registers for others. Which register applies depends on the therapist's profession and where you are located.
• Australia - Many professionals are registered nationally, but there are also state and territory rules and requirements about practice and telehealth arrangements. The relevant register or regulator will depend on the therapist's profession and location.

These examples are only general. The particular rules that apply to a therapist depend on their profession and the register or board that governs them.

It is reasonable to ask a few clear questions so you know whether an online session is lawful and appropriate where you live. Short, direct questions work best.

• Ask whether they are licensed or registered where you live to work with clients located in your state, region or country.
• Ask where they are based for professional purposes and where they hold their registration or licence.
• Ask whether they have any restrictions on offering services across borders, and whether they keep records or follow practice rules that affect cross-border work.

A therapist can give you the name of the register or board they belong to and, on request, the registration number or other identifier. You can then follow up with the relevant body if you wish.

If you want to be sure, the next step is to contact the regulator or register that covers professionals where you live. The bodies that keep registers differ by country and, in the US, by state. You can usually find contact details and an online verification tool on the regulator's website.

When you contact them, you can ask whether a named therapist is authorised to work with clients located in your area, and whether there are any restrictions on cross-border or online work. Keep your questions factual and simple.

Before you start, it helps to confirm a few practical things so there are no surprises.

• Check and save the therapist's registration details, if they provide them.
• Make sure you and the therapist are clear about where you are during each session. A therapist may need to know your location on every session day for legal or safety reasons.
• Ask about an agreed plan for emergencies and what the therapist expects you to do if you need urgent help where you live.
• If you use our site, the pages /locations/ and /therapists/ can help you narrow choices by area and by the approaches therapists say they use. A therapist listing may note that they list Narrative Therapy among their approaches, for example, but that phrase only describes what the therapist has written about themselves.

If you are feeling acutely distressed, that matters and should be treated with care. If you think you are in danger or in a crisis right now, please contact your local emergency service or a crisis line where you live. Each country and region has different numbers and services, so use the ones appropriate to your location.

This page is not a substitute for urgent help. A clinician who is actually talking to you is the person who can say what is needed in the moment.

Rules about where a therapist may work are about professional standing and public protection. They are not about whether video or phone work is possible. Clear communication helps you and the therapist choose what is appropriate.

This is not advice or diagnosis. A clinician who is actually talking to you is the person who can say what applies to your situation. If you are unsure, ask the therapist for the name of the register or board they use and contact that body if you need confirmation.