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Distance Counseling and Appropriate Practitioners

answered 02:57 PM EST, Wed September 14, 2011
Is there any reason why I shouldn’t get more affordable online counseling from a therapist who practices outside of the US? After all, as long as he speaks English, if I’m not in his office, does it matter if I’m 5 miles away or 5000?

Art Matthews Says...

The quick answer is yes, it matters... but maybe not to everyone.


Let's say you go online and work with a counselor in another country that speaks your language. How well they understand you as a person depends to a great extent on how well they know and understand your culture and experience. For example, there are many turns of the phrase that are specific to a country or even a region of a country that when used can create misunderstanding for someone not aware of its meaning. Cultural attitudes, values and behaviors can be misinterpreted as well. Western psychotherapy is based on the independence of the client and the client's right to choose; however, several Latin and Asian cultures are more geared towards the superiority of the family or society over the individual. Some clients are seeking a growth experience and others are seeking parental or authoritative advice. In some countries, hearing voices and seeing images that others don't experience is considered a range of normal or being gifted and in many Western countries is considered psychopathology. If the therapist isn't well versed in how cultural difference can affect the therapeutic relationship, harm can come to the client.


And speaking of those situations, how does a client hold a therapist accountable for the harm they've caused when the therapist is not in the same state, country or hemisphere? Local, national and international laws have not caught up to technology as far as distance counseling is concerned. Standards of certification and licensure exist for a reason. State boards of counseling and national certification agencies were created to help protect the citizenry from unqualified, untrained, inexperienced and downright unethical practitioners. When a person chooses to work with someone outside of their own country who claims to be a therapist, they may have no idea how to check that person's credentials or right to work as a psychotherapist. They may also be choosing to deny themselves the ability to seek restitution if they are harmed or scammed out of money.


If you work with a local therapist via distance, you can easily find out through your local board of counseling or psychology whether they are licensed, whether they have any complaints, the outcomes of those complaints and if there are any restrictions on their license. You also have a way of bringing attention to the state board or national association if that therapist engages in malpractice or abuse. The therapist can be held accountable criminally and civilly in a court of law. Some states, like New York, will even extradite therapists from other states who work with a New York State resident when they are not licensed in New York. However, Interpol will not arrest and send foreign therapists to the US to stand trial.


The world of distance counseling is similar to the Wild West of the 1800's in America. Lots of interest and promise of wealth for some therapists with little regulation. The best thing to remember as a healthcare consumer is the old warning "Caveat emptor": "Let the buyer beware." Is it worth saving a little money to use a therapist outside your country if you risk getting poor service from an unqualified or unscrupulous practitioner? Does the cheap service pay off when you have to spend more time with that therapist versus a local one who charges more but helps you grow faster?


Let me end by asking you this: Would you risk getting eye surgery from a clinic offering Lasix surgery to correct your eyes for only $100? Why trust your mental health to a therapist outside your country just because they're cheaper? Aren't your mind and spirit worth as much as your eyes?

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Page last updated Sep 15, 2011

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