For College Students who need therapy and are OOS

[Anonymous]

How have you handled it? Daughter is many states away and there are no dual-certified therapists that I can find. She does not want to do virtual. She does need it (eating disorder, anxiety, depression). Do you have 2 therapists? Or find another solution?

Why is our country so messed up that therapists cannot help patients out of state?

[Anonymous]

OP, are you saying therapists in the state where she goes to school won’t see her because she isn’t a legal resident of that state? They don’t consider college residency “good enough”?

Does the school have any mental health supports? Most do. Or even if they don’t or they aren’t enough or some other issue, the health services should be able to provide referrals to local services that would work.

Your daughter is nowhere near the only OOS student to need this kind of help.

[Anonymous]

Why won’t she do virtual? It can be far more convenient and you’d have a lot more options. She should give it a try. Also on campus counseling might be an option but appointments could be scarce depending on size of school.

[Anonymous]

Anonymous wrote:How have you handled it? Daughter is many states away and there are no dual-certified therapists that I can find. She does not want to do virtual. She does need it (eating disorder, anxiety, depression). Do you have 2 therapists? Or find another solution?

Why is our country so messed up that therapists cannot help patients out of state?

Are you talking about insurance? Surely, if you pay out of pocket, you can get her a local therapist. Call the dean's office of her school and/ or talk to someone in the wellness office to get some names. You daughter may be able to see someone on the college's staff. Those therapists are usually great.

[Anonymous]

Anonymous wrote:Why won’t she do virtual? It can be far more convenient and you’d have a lot more options. She should give it a try. Also on campus counseling might be an option but appointments could be scarce depending on size of school.

DP: Virtual therapy is difficult for students who live in dorms with limited expectations of privacy. Look into booking music practice rooms or other private spaces on campus if possible

[Anonymous]

OP here- sorry for the confusion. She can get a therapist in her school state and one in this state, but we are struggling to find even one and she doesn't like the idea of switching back and forth depending on which state she is currently residing in. For example, she will be home for a month, then back to school so needs someone else.

I guess my question was, is it normal to have 2 therapists or is there any other solution?

[Anonymous]

I'm a psychologist and work mostly with clients in high school and college. She should prioritize work with a therapist in the state in which she goes to college. A good therapist should be able to provide her with a support plan that covers her for a month when she is home, as well as referrals for crisis support during that time. Additionally, many therapists these days have something called "PSYPACT" licensure, which allows us to see clients in other states even if we are not licensed in that state. So you can ask potential therapists about that. Below is a map of states that have licensure reciprocity with PsyPact. Obviously she'll need to do telehealth with her colllege therapist if she chooses to see them during her breaks.

https://psypact.gov/page/psypactmap

[Anonymous]

Anonymous wrote:OP, are you saying therapists in the state where she goes to school won’t see her because she isn’t a legal resident of that state? They don’t consider college residency “good enough”?

Does the school have any mental health supports? Most do. Or even if they don’t or they aren’t enough or some other issue, the health services should be able to provide referrals to local services that would work.

Your daughter is nowhere near the only OOS student to need this kind of help.

There are licensing issues (that states need to resolve). In most/all states, therapists are only allowed to treat patients in located at the time of each session in a state in which they hold a license. Plenty of therapists are willing to turn a blind eye for college students home on break, but some will not.

[Anonymous]

The problem is my son’s therapist who lives in Maryland is not licensed to give him therapy in Massachusetts.

We tried to find a new one, but he had to start all over. It didn’t seem worth that.

So his therapist did coaching instead of therapy and we paid out-of-pocket. Because you don’t have to be licensed in a state to do coaching you only have to be licensed to do therapy..

But my son was willing to do zoom.

[Anonymous]

Anonymous wrote:I'm a psychologist and work mostly with clients in high school and college. She should prioritize work with a therapist in the state in which she goes to college. A good therapist should be able to provide her with a support plan that covers her for a month when she is home, as well as referrals for crisis support during that time. Additionally, many therapists these days have something called "PSYPACT" licensure, which allows us to see clients in other states even if we are not licensed in that state. So you can ask potential therapists about that. Below is a map of states that have licensure reciprocity with PsyPact. Obviously she'll need to do telehealth with her colllege therapist if she chooses to see them during her breaks.

https://psypact.gov/page/psypactmap

Thank you for this. I will look into it as both states are part of this pact.

[Anonymous]

I was just talking to my child about this who needs therapy. If you can find someone with psypact it may work depending on the state.

Therapy is expensive even with insurance most of the time so if her school has a counseling staff that is probably worth trying for that reason alone but my child just started counseling through their school and I was surprised to learn that the school doesn’t seem to have on staff counseling - or there are very few - counseling is telehealth offered through one of those mental health online companies. This was disappointing to me as I thought my child could benefit from in person and college is actually a time when getting to an in person appt that’s on campus isn’t that logistically difficult.

[Anonymous]

Adding that I’m a little skeptical of the online companies. Maybe you find someone great, maybe you don’t, but the college has essentially outsourced the function and have much less awareness about the therapists their students are seeing.

[Anonymous]

Anonymous wrote:I'm a psychologist and work mostly with clients in high school and college. She should prioritize work with a therapist in the state in which she goes to college. A good therapist should be able to provide her with a support plan that covers her for a month when she is home, as well as referrals for crisis support during that time. Additionally, many therapists these days have something called "PSYPACT" licensure, which allows us to see clients in other states even if we are not licensed in that state. So you can ask potential therapists about that. Below is a map of states that have licensure reciprocity with PsyPact. Obviously she'll need to do telehealth with her colllege therapist if she chooses to see them during her breaks.

https://psypact.gov/page/psypactmap

Hi, can you please provide more info? NP here. DD is a sophomore in PA but we live in VA. Her VA therapist (an MSW if that makes a difference) has been saying that the rules are supposed to change for reciprocity between those two states, but it keeps getting delayed.
Are you saying that it is possible now?
DD is currently just seeing therapist when she is home on break, and it isn’t ideal.

[Anonymous]

Anonymous wrote:How have you handled it? Daughter is many states away and there are no dual-certified therapists that I can find. She does not want to do virtual. She does need it (eating disorder, anxiety, depression). Do you have 2 therapists? Or find another solution?

Why is our country so messed up that therapists cannot help patients out of state?

I don't understand your frustration about our country not being able to help patients out of state. Even if that were allowed, would that mean the therapist would be providing service virtually?

[Anonymous]

A lot of people got accustomed to virtual therapy during the pandemic when some of these cross-state restrictions were loosened. I think it’s good to have the option. My student would probably prefer to keep her long-time therapist with whom she’s established trust for virtual sessions in another state than try to find someone new in the area of her college. Some colleges offer more robust counseling services than others. I’m also skeptical of the national corporate virtual therapy platforms.