As the use and availability of virtual conferencing has increased since the beginning of this pandemic, the ability for people to access therapy services from home has increased. But what if a client travels out of state, but still wants to be seen? What if a client moves to a different state for college and wants to continue seeing their therapist who they’ve worked with for years? Unfortunately, most states’ current laws still prevent licensed therapists (LMHC, LICSW and LMFT) from practicing across borders, even when it may be in the best interests of the client. 

The state of emergency declared by Governor Charlie Baker in March 2020, made it clear that it is possible to update our current, out-of-date laws regarding cross-border therapy. The emergency provision allowed for greater public access to Telehealth counseling services as well as provisions for Telehealth supervision.  

One important provision allowed professional counselors to meet with their clients via Telehealth while the client was located out of state (“Licensure Reciprocity”). For example, if a client had to move back home during the pandemic, and the client was in a different state than Massachusetts, a Massachusetts-licensed clinician could still continue to treat their client without losing continuity of care. This reciprocity is significant as professional licensure varies from state to state and there are many barriers that limit a counselor's ability to obtain a license from a state where they did not receive their graduate degree. However the emergency orders have now been lifted, preventing a professional counselor from freely practicing across state lines with one license. If a client moves suddenly, travels home from college, or goes on an extended vacation, it could result in their therapist being unable to treat them. 

Organizations such as the  American Counseling Association  American Counseling Association and the American Association of State Licensing Boards have affirmed that the loss of this provision nationally will ultimately cause more harm than good to consumers. Here in Massachusetts many consumers and professional counselors are feeling the effects of this provisional loss. Here are a few examples to illustrate how this loss directly impacts consumers:

• Active military personnel and their families who need to relocate to different states would lose their existing providers. It is challenging enough for military families to find professional counselors as there are few providers able to accept their insurance.
• Individuals who live on state borders can only see a therapist in the state that they live in even if it would be more convenient or otherwise be a more appropriate therapist in a bordering state. Massachusetts borders Connecticut, New Hampshire, Rhode Island, Vermont and New York.
• College students attending out-of-state colleges are unable to meet with their counselors despite the convenience of Telehealth because while at college they technically “live” out of state. College counseling centers typically only offer short term counseling and in recent years have been inundated by counseling requests that go unmet leaving students to try and find a local therapist which can be daunting to a college student already struggling with their mental health.

It can be devastating for a client to “start over” with a new therapist especially when they have established a trusting and supportive relationship with a professional counselor. It can also be challenging to “find” a new therapist. COVID-19 has created an epic mental health crisis across the United States causing mental health clinics and private practice therapists to stop taking on new clients due to limited availability. Telehealth as well as interstate licensure reciprocity reduces barriers and increases continuity of care for professional counselors and their clients.

Currently there are a handful of U.S states that either have or are in the process of passing bills that will allow mental health counselors to work across state lines however in order for these bills to  take effect 10 U.S states need to pass these bills to form an “interstate compact”. Maryland and Georgia have passed interstate reciprocity bills while Nebraska, Tennessee and North Carolina have bills pending. You may wonder what an interstate compact is so here is an official description:  “An interstate compact is a contract between two or more states creating an agreement on a particular policy issue, adopting a certain standard of cooperating on regional or national matters. Compacts are the most powerful, durable and adaptive tools for ensuring cooperative action among states.” Counseling Compact FAQ

It is time to compel Governor Charlie Baker as well as Senate President Karen Spilka to support bills that will reduce the overwhelming barriers limiting public access to mental health counseling in the Commonwealth of Massachusetts. It is time for Massachusetts to be one of the leading advocates for interstate licensure reciprocity in the United States.

Currently interstate compacts exist for nurses, physicians, psychologists as well as many other healthcare practitioners. The Counseling Compact has a model legislature that would allow “licensed professional counselors to practice in all compact member states either in-person or via Telehealth through a privilege to practice, which is equivalent to a license.” Once again this can ONLY HAPPEN if 10 U.S. states pass bills to join the Counseling Compact.

There are so many individuals in need of mental health counseling unable to receive treatment due to the current and overwhelming demand for services. The current licensure laws just perpetuate the demand. By signing this petition, you will show your support of an INTERSTATE COUNSELING COMPACT between Massachusetts and other surrounding states.

Your signature will send a clear message to our lawmakers that it is time to reduce the barriers to mental health treatment and make counseling services more accessible.

For more information about Massachusetts current Tele-therapy practices rules: https://personcenteredtech.com/teletherapy-practice-rules-by-state/?state=MA

For an outline of the provision proposed by the model legislature of the Counseling Compact: https://counselingcompact.org/wp-content/uploads/2021/01/Counseling-Compact-Section-Summary.pdf

Fact Sheet: States and the Counseling Compact: https://counselingcompact.org/wp-content/uploads/2021/01/Counseling-Compact-Fact-Sheet-For-State-Officials.pdf

Article on North Carolina House support of Counseling Compact (July 26, 2021): https://www.carolinajournal.com/news-article/house-considers-interstate-agreement-for-licensing-mental-health-counselors/?fbclid=IwAR3Ax6YpDjb_4qToTPl8x1pRxWcdciRg2peZVq1sRp1q3tG_a1NwxkZEHDg