Legally Practicing Across Borders: A Detailed Survey of Interstate and International Mental Health Practice

1 CE Credit Hour. Legal-Ethical. Continuing Education Session Replay

Developed by: Roy Huggins, LPC NCC; Liath Dalton
Presented By: Roy Huggins, LPC NCC; Liath Dalton

This course is included as a piece of bonus material in our full
Telemental Health Certificate Program

Course Description

Low stone wall

One of the most common times that clients desire telehealth work is when they travel or move house to a place far from their existing therapist — and not uncommonly, they go to another state or even another country! Additionally, many therapists want to expand their practices across jurisdictions through the use of telehealth services. This is where therapists run into the wall of interjurisdictional practice.

While sometimes such practice simply won’t be possible to do legally, that isn’t always the case. A number of licensing boards have provisions for temporary practice, and differences in regulatory styles across the world can make international practice possible so long as we maintain a healthy habit of managing the risks involved in doing do.

This introductory-level course for counselors, clinical social workers, marriage and family therapists, and clinical and counseling psychologists will discuss if practice in foreign jurisdictions can be legal and how it can be legal, with a survey of specific examples of temporary practice rules under some select US licensing boards and nations outside the United States.

Educational Objectives

  • Describe 3 different schemes of temporary practice provision and how they impact the learner’s ability to work with clients who are present in foreign states
  • Use the Epstein, Becker, Green telehealth survey tool to discover licensure board rules in foreign states
  • Describe 1 method for discovering the circumstances of legal practice with clients present in nations outside North America


  1. How is interjurisdictional practice regulated (or not regulated)?
    • The role of licensing boards in the US
    • When and how foreign licensing board rules come into play
  2. What are some US state boards that allow temporary practice, and how does it work?
    • A process for discovering if temporary practice is available in a given state
    • Some specific state boards without temporary practice allowance, and how we discovered that fact
    • Some specific state boards with temporary practice allowance, and how we discovered that fact
    • What it does and doesn’t mean for temporary practice to be allowed
  3. What are some nations that do not disallow practice from US clinicians, and what are the risks and benefits?
    • The difference between practice being permitted and practice not being forbidden
    • Some risks and benefits of Roy’s telepractice in Japan
    • Some examples of telepractice in European nations
  4. How are professional associations working to make interjurisdictional practice easier?


  • Alabama Code § 34-8A-3(3) (2006 Alabama Code – Section 34-8A-3 – Construction and application of chapter. (n.d.). Retrieved November 1, 2018, from
  • Arizona Revised Statutes 32-2075 (4) ((n.d.). Retrieved November 1, 2018, from
  • Colorado Revised Statute § 12-43-215(9) (2016 Colorado Revised Statutes :: Title 12 – :: Professions and Occupations :: Health Care :: Article 43 – :: Mental Health :: Part 2 – :: General Provisions :: § 12-43-215. Scope of article – exemptions. (n.d.). Retrieved November 1, 2018, from
  • Florida Statutes Title XXXII 490.014 (2.e.2.) ((2019, October 18). Retrieved November 1, 2018, from
1 CE Credit Hour.

Presented/Developed By

Roy Huggins, LPC NCCRoy Huggins, LPC NCC, is a counselor in private practice who also directs Person-Centered Tech. Roy worked as a professional Web developer for 7 years before changing paths, and makes it his mission to grow clinicians’ understanding of the Internet and other electronic communications mediums for the future of our practices and our professions.

Roy is an adjunct instructor at the Portland State University Counseling program where he teaches Ethics, and is a member of the Zur Institute advisory board. He has acted as a subject matter expert on HIPAA, security and clinical use of technology for Counseling licensure boards and both state and national mental health professional organizations. He has co-authored or authored 2 book chapters, and he routinely consults with mental health colleagues on ethical and practical issues surrounding tech in clinical practice. He served for 5 years on the board of the Oregon Mental Health Counselors Association and then the Oregon Counseling Association as the Technology Committee Chair.

He really likes this stuff.

Course Co-Presenters

Liath Dalton is a Ph.D candidate in Religious Studies. She began her academic career at Reed College and continued her graduate work at the University of Cape Town.

Liath is the Deputy Director for Person Centered Tech and runs our HIPAApropriateness review program. Through her combination of experience evaluating products for their utility and security in regards to how they can meet risk management needs and providing guidance to members around what product options will best meet their specific practice needs, Liath has an intimate knowledge of both what the practice tech needs are for mental health professionals and what it takes for a product to meet those needs.

Program Notices

Accuracy, Utility, and Risks Statement: This presentation may not include information on all applicable state or national laws. Misapplication of the materials, or errors in the materials, could result in non-compliance with applicable laws or ethics codes.

Conflicts of Interest: None.

Commercial Support: None.

This course is subject to our cancellation/refund policy and complaint policy.

1 CE Credit Hour.
Low stone wall

1 CE Credit Hour. Legal-Ethical. Continuing Education Session Replay


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