Why Can We Only See Clients in Maryland?

Why Can We Only See Clients in Maryland?

The most accurate answer is most of our clinicians are licensed in Maryland.  Licensure of therapists, doctors, nurse, etc. is controlled by each state.  While there are national organizations for providers, these are professional organizations (often private companies), not licensing bodies.  States have that control.  The purpose of licensing therapists and other practitioners is to protect the public from inexperienced or predatory people who might try to say they are therapists or social workers or counselors, but may not have had experience or training.  Each State is responsible for protecting people in their individual state.  Every state has different laws and requirements.

Prior to Covid, the use of telehealth was growing slowly and there were no laws governing telehealth – it was like the “Wild West”.  Often therapists would see people who moved to other states or went off to college with the rationale that the person lived in Maryland or just moved from Maryland, but there were no laws or even good guidance. However, with the Covid Pandemic telehealth became essential.  During the pandemic many states allowed clinicians to keep seeing their clients if the client had a prior relationship, even if they moved away. This permission was only in place during the State of Emergency, which has now expired.

During the pandemic, all 50 states created laws around the use of telehealth and who could practice in their states.  All 50 states and Washington DC determined therapy happens where the client is physically in the moment therapy is being provided.  That means that for a therapist licensed in Maryland, the client must be in Maryland.  The clinician can be anywhere in the world and must be licensed in Maryland.  Anyone licensed in Maryland but practicing therapy with a person not physically in Maryland, is practicing without a license.  To do so can open that person up to state and Federal charges.  To practice without a license across state lines could be a federal offence.  

So, if a therapist becomes licensed in say Virginia and Maryland, that therapist can see clients in both states no matter where they are as long as the client is in one of those States. Each state licensing board exists to protect people in their state.  Some groups, like nurses, have broad interstate compacts that allow a nurse to apply to work in states that have adopted that compact.  Counselors and social workers are working to create such compacts.  However, each counselor (or nurse or social worker) still needs to apply in each state and pay a fee yearly.  It would not be worth the trouble and the cost to get licensed in more than a few states you plan to work in regularly.  

This is why your Maryland-licensed therapist (counselors, social workers, or psychologists) can only see clients who are physically in Maryland.