super.ego

Psychologist
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Mar 11, 2017
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Hi, all!

I was wondering if anyone is familiar with the potential jurisdictional/legal issues that'd need to be negotiated in conducting video-therapy internationally? I've never conducted video therapy before, let alone internationally, but I'm currently in a situation with a client where doing so might be indicated.

It seems that there are some free HIPAA compliant video chat platforms, such as Doxy.me. Any advice would be much appreciated!
 

MCParent

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Writing as someone whose (small) PP is entirely Telehealth:
If this is your first foray into Telehealth, probably doing it internationally is not a good idea. There is a lot more to setting it up than just getting the software and scheduling the patient. Everything to consider from setting up emergency protocols with patients to getting the lighting in your office and the camera angle right.
Re: Legality, you have to check the Telehealth laws in your state and then the laws for the practice of psychology (or whatever psychology falls under there) in the other county (and whatever province/state the patient is in). The laws for the practice of therapy in different countries vary enormously so it's not really possible to say much without knowing what the other county is. E.g., In a few countries you just need a bachelor's degree to be a psychologist and nearly everyone does psychodynamic therapy. Also other things matter, e.g., is patient on a US military base.
 

cara susanna

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Even across state lines it's tricky. Can't even imagine international.
 

PSYDR

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The relevant law is based upon where the person is physically based. Legally, you need to be licensed in that country to provide services to that person.

HIPPA is a US law, and would not apply in other countries.

If the patient committed sued, the venue for the lawsuit would be that country.
 

Sanman

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Agreed with all of the above advice. I am looking into starting a tele-health side practice and the laws vary by state and country and they are often murky at best. If they are international, are they travelling or is there a time difference? If there was an emergency (such as active SI) are you familiar with the protocols in that country and do you have the number to contact authorities in the local jurisdiction? Is this a person going on vacation for a few weeks or a more permanent move? If they sue you for some reason, are you even covered by your malpractice when participating in this activity?
 

MamaPhD

Psychologist, Academic Medical Center
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My only experience of international teletherapy is when someone attempted to transfer a case to me when they suddenly found themselves in way over their head. The patient lived in my state; the therapist was on the other side of the Atlantic. I chose not to get involved.

Be careful because for a number of reasons you don’t want to be the therapist in that situation. I have only provided therapy via videoconferencing in the state where I am licensed. I agree with others who advise you to do the same.