Additionally, we are moving more and more to an environment where mental health care is under government auspices and a majority of therapists serve in Medicaid-driven, fee-for-service settings. even with the best professional ethics, it’s hard to spend too much time with clients on the phone when it is not billable.

I am not aware, at this time, of any insurance companies that will pay for sessions not conducted face-to-face. If that is accurate, then distance therapy is strictly for those few who can afford to pay cash.

BTW Doc, not to be picky, but the expression is “BELT & suspenders,” not “best and suspenders.” I trust that it was your word processor “helping you out.”

Curious to know if it is definitely codified in law or state regulation that distance therapy is considered to be happening in the client’s location, and not that of the therapist. Can anyone point me to a link (particularly in NY)?

A more empowered position might be for us to notice that the bottlenecks can also be seen with us practitioners. We too are slow to fully anticipate the long wait time from licensing boards. And some professional associations are ahead of others in this regard as well. For instance, the Association of State and Provincial Psychology Boards (ASPPB) has a program for us to join to facilitate licensure mobility, but most psychologists are not involved.

A further problem is that we tend to work independently, that is, we operate as individuals rather than collectively. Rather, we tend to work alone. We get a call from a needy client, and we take the law into our hands, claiming it would take too long to do it legally. It might not occur to a physician, therapist or counselor to form a group within their state association to push this licensure issue with their state licensing board. That is precisely what needs to happen before we see substantial change, rather than waiting for the “other guy” to make this happen.

A little more collective effort could go a long way. I hope you join me in rallying the troops to operate legally.