Quote:
Originally Posted by Depletion
About a year ago I decided to separate from my husband. I was unemployed at this time so I decided to stay with family in another state. I asked my therapist about the rules regarding her seeing me while I was in another state. I asked her this both out of interest in attending a graduate program while living elsewhere and because I wanted to leave my husband. She said it would be no problem for me to do this and continue seeing her. Based on the information she gave me I decided that I felt able leave my husband and stay with family in another state temporarily.
Unfortunately things did not go entirely according to plan as it turned out that I had a condition that was causing me chronic pain in one of my feet, and this made working very difficult. The pain got really bad at one point and spread to my hips and low back. There were periods of time where I had to spend most of the day in bed. The dr. Wanted to exhaust all conservative options before deciding on surgery. I spent my days just trying to do pt and care for myself. It was very difficult. My therapist knew about all of this as it even impacted our ability to have sessions at times.
I am now going to have surgery (no date yet as I'm getting a second opinion) but will likely be in the next two to three months.
My husband and I are still legally married but leading mostly separate lives. We are good friends and I am seeing a dr. In the state we both used to live in as he works at a university with a good medical school and I have access to the best care there. I have also house sat and taken care of our cat when he travels. I am still a legal resident of this state and my name is still on our lease. We have filled no legal paperwork and have arrived at monetary decisions through discussions.
Yesterday my therapist informed me that her continuing to see me while I'm living out of state is illegal and she is no longer comfortable with our arrangement eventhough it has been like this for over a year now. I was extremely upset by this as it was not at all how I understood the situation. It seems very unfair for her to see me for so long and then suddenly change her mind. I don't know what to do. This is a therapy relationship of over 5 years. I feel I have made a lot of progress with her and that we were negotiating some later stage issues in therapy including my coming to see her more as a person and in a less idealized way. This hasn't been an easy process for me and I am still fighting this issue quite a bit often in the form of dissatisfaction with her. But this has all seemed rather necessary and part of the process. I'm also quite depressed due to my medical issues, not working, and not living where I would prefer. I'm afraid to lose her and I'm not exactly sure if I want to look for another therapist at this point. I've not always had the best experiences with therapists and was hoping this one would be the last for quite some time.
I appreciate any support, insight or advice that can be offered.
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here in the USA -
therapists are certified / licensed by state.
Each state has a board of clinical social workers where certified / licensed treatment providers are registered.
each state board keeps track of each treatment provider in the state that they are registered in.
in order for a mental health professional to treat someone in another state the treatment provider must be registered with the other state.
example -
my therapist is registered in NY state and Vermont therefore he is able to treat clients in NY state and in vermont state.
that means when I am in NY I can see my therapist by what ever means he has available (telehealth, online, texts, in person whatever he has available.)
before 2018 he was only registered in NY therefore he was only able to provide services in New York State.
it would have been illegal for him to practice mental health in vermont because at that time he was not registered or had vermonts credentials for treating clients in vermont.
if he had tried to practice mental health services in vermont while not certified or licensed in vermont he could have not only lost his credentials but also been arrested for fraud/ pretending to be a treatment provider in vermont.
if you watch the news you will see all kinds of articles about doctors, therapists, psychiatrists that have been arrested for not being a doctor, therapist, or psychiatrist in the state they were trying to perform.
this is probably what your therapist is talking about. she may not be licensed or certified to practice mental health therapy in the state you reside in now. in order to continue treating you she may need to contact your new states board of clinical social workers to find out how to get that states degree's, licenses and certifications.
think of it like if you were seeing a medical doctor, you would want that medical doctor to have all the professional degrees saying they are a doctor. you wouldnt go outside on the street and trust the first stranger that says Im a doctor.
thats how the state boards are in the USA. treatment providers have to provide proof to the state boards in each state that they are who they say they are, have the knowledge and degrees they say they do and pass a test in order to work in each state.
my therapist has provided both New York and Vermont proof of who he is, that he has all the required college degrees and education and passed the state board testing process to be able to be a therapist in both New York and Vermont.
each state is different and has a set of criteria that has to happen before its legal for a therapist to treat clients in other states.
there is also a situation with insurance. insurance in one state will not pay for treatment in another state unless its an emergency situation.
example -
medicaid and medicare (state issued insurance plans) carries the disclaimer in their member handbook that they do not pay for out of state services unless its an emergency (a pregnant person goes into labor in another state, a broken bone while visiting another state and so on)
check with your therapist to see if they are licensed or certified to treat clients in your new state, if not shes right she most likely had a deadline time frame of when your temporary move changed to permanent and can no longer treat you while you live outside her credentialed area.
check with your insurance company, (all americans must have health insurance by law wither through work aka private insurance or state insurance options) they will be able to tell you what locations they pay for now.