5 Steps for Successful Teletherapy Across State Lines

5 Steps for Successful Teletherapy Across State Lines

Erika Vivyan, PhD

Erika Vivyan

Erika J. Vivyan, PhD (she/her/hers) is a bilingual (Spanish-English) Licensed Psychologist based in Austin, Texas. She specializes in providing therapy for kids, teens, and young adults with anxiety and behavioral disorders. Dr. Vivyan also provides in-depth psychological and psychoeducational assessments for school-aged students.

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5 Steps for Successful Teletherapy Across State Lines

5 Steps for Successful Teletherapy Across State Lines

As the COVID-19 pandemic continues, teletherapy is one of the only ways to continue receiving mental health services...but what happens when therapy must continue across state lines? 

As summer continues, many are taking vacations, moving, or preparing to go away to college. For most mental health providers, teletherapy occurs in the state where the client is currently residing. Here are a few tips to ensure that you can continue your teletherapy sessions from wherever you are:

  1. Share your location.

If you are a client, tell your mental health or medical provider as soon as you know that your location will be changing. Moving across the country? Make sure you tell your therapist first. Taking a trip? Share your itinerary! Planning ahead can mean the difference between missed appointments and continuous mental health care. If you are a mental health provider, it helps if you ask your client where they are located at the start of every telehealth session. Make note of their location in your documentation so that you can be sure to practice ethically both within and outside of your home state.

  1. Check telehealth laws during COVID-19.

Ask your provider if they are comfortable with providing teletherapy across state lines. Many states have allowed for temporary practice across state lines, and the COVID-19 pandemic has increased the number of states allowing for such practice. For a useful listing of information for psychologists, check these sites. For an updated spreadsheet including Licensed Psychologists, Licensed Professional Counselors, Medical Doctors (including Psychiatrists), Licensed Marriage and Family Therapists, and Social Workers, click here.

  1.  Contact the board.

Use phone or email to contact the appropriate licensing board for the provider and the state where the client will be located. Are you a Licensed Psychologist looking to practice in the state of California? Contact the California Board of Psychology. Are you a client hoping to speak with a Licensed Clinical Social worker in Kansas? Reach out to the Kansas Behavioral Sciences Regulatory board. Ask the board if they allow temporary practice across state lines, what paperwork or fees might be required, and if these laws or regulations have changed due to the COVID-19 crisis.

  1. Use flexible licensing laws.

Flexible licensing laws like PSYPACT allow psychologists to practice telepsychology across state lines. Psychologists who are licensed in one of the participating states can practice in other participating states if they apply for the appropriate credentials. Psychologists may obtain a Temporary Authorization to Practice (TAP) or Authority to Practice Interjurisdictional Telepsychology (APIT). The application process is very time-consuming, but the good news is that the Association of State and Provincial Psychology Boards (ASPPB) has been awarded federal funding through the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act, so the application fee for the APIT ($400) will be waived through December 31, 2020. For more information on the rules and fees for these credentials, click here.  

  1. Make the session(s) great!

If you or your clients are scheduling sessions across state lines, be sure to keep in mind the standard telehealth success factors. Ensure that both sides of the call have access to adequate WiFi. Have a backup plan - either a phone call or a time to reschedule - to make sure the session can still happen no matter what. Don’t forget to double-check the time zone so that calendar reminders and start times are all in sync.

As we continue to learn the best ways of providing mental health care across state lines and WiFi connections, these tips will help ensure that clients and providers continue their successful, healing relationships especially during this difficult time. 


© 2020 Erika J. Vivyan, PhD. All rights reserved. Originally published on Austin Anxiety & OCD Specialists and on Dr. Vivyan's website


Erika Vivyan, PhD

Erika Vivyan

Erika J. Vivyan, PhD (she/her/hers) is a bilingual (Spanish-English) Licensed Psychologist based in Austin, Texas. She specializes in providing therapy for kids, teens, and young adults with anxiety and behavioral disorders. Dr. Vivyan also provides in-depth psychological and psychoeducational assessments for school-aged students.

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