As a US therapist, you're licensed in one state — but clients move, travel, and relocate. Seeing a client who is physically in a state where you're not licensed is practicing in that state without a license. There are three legitimate paths around this: interstate compacts, temporary practice permits, and simply verifying client location at each session. For therapists who travel and work remotely, understanding these tools is essential.
Why state licensing matters for nomad therapists
Even if you're abroad, what matters legally is where your client is sitting. A client who moves from New York to Florida while you're traveling through Southeast Asia creates a cross-state licensing issue — not because you moved, but because they did. For the nomad therapist, this is the main ongoing compliance task: tracking client location.
Three tools for cross-state practice
1. Interstate compacts
The US has two major compact agreements that allow telehealth across member states with a single application:
| Compact | Profession | Member states (2026) |
|---|
|---|---|---|
| PSYPACT | Psychologists | 42+ states |
|---|---|---|
| LCSW Compact | Social workers | Growing |
If your profession and states are covered, a compact is the cleanest solution — one credential, multiple states.
2. Temporary practice permits
Many states allow licensed-elsewhere practitioners to see clients temporarily (usually 30–60 days per year). This is useful for clients who travel or relocate briefly. Rules vary widely by state — check your destination state's licensing board.
3. Verifying client location at every session
The simplest compliance step for most nomad therapists is asking where the client is before each session. Some therapists include this in their session opener; others build it into their intake form. If a client is outside your licensed area, pause services until they return or you hold the relevant credential.
Practical steps for the nomad therapist
- Apply for PSYPACT or your relevant compact if you haven't already — it significantly expands where your clients can legally be
- Build a "client location check" into your session start for ongoing clients
- Include a clause in your informed consent about geographic limitations
- When a client plans to travel, discuss it in advance
The bottom line
For US-based nomad therapists, the interstate licensing landscape has improved significantly with PSYPACT and the counseling compact. If you're in a covered profession, the compact is worth pursuing. For everyone else, the practical answer is: know where your clients are, every session, and pause when they're outside your coverage.